WorldWideScience

Sample records for breathing improving health

  1. "What We Breathe Impacts Our Health : Improving Understanding of the Link between Air Pollution and Health"

    NARCIS (Netherlands)

    West, J Jason; Cohen, Aaron; Dentener, Frank; Brunekreef, Bert; Zhu, Tong; Armstrong, Ben; Bell, Michelle L; Brauer, Michael; Carmichael, Gregory; Costa, Dan L; Dockery, Douglas W; Kleeman, Michael; Krzyzanowski, Michal; Künzli, Nino; Liousse, Catherine; Lung, Shih-Chun Candice; Martin, Randall V; Pöschl, Ulrich; Pope, C Arden; Roberts, James M; Russell, Armistead G; Wiedinmyer, Christine

    2016-01-01

    Air pollution contributes to the premature deaths of millions of people each year around the world, and air quality problems are growing in many developing nations. While past policy efforts have succeeded in reducing particulate matter and trace gases in North America and Europe, adverse health eff

  2. The role of telemedicine and mobile health in the monitoring of sleep-breathing disorders: improving patient outcomes

    Directory of Open Access Journals (Sweden)

    Villanueva JA

    2017-02-01

    Full Text Available Jair A Villanueva,1,* Monique C Suarez,2,* Onintza Garmendia,2,3 Vera Lugo,2 Concepción Ruiz,2 Josep M Montserrat,2–5 1Unit of Biophysics and Bioengineering, Faculty of Medicine, University of Barcelona, 2Sleep Unit, Respiratory Medicine Department, Hospital Clinic, Barcelona, 3Center for Biomedical Research in Respiratory Diseases (CIBERES, Madrid, 4Faculty of Medicine, University of Barcelona, 5August Pi i Sunyer Biomedical Research Institute (IDIBAPS, Barcelona, Spain *These authors contributed equally to this work Abstract: Although the concepts are broad, telemedicine and mobile health (mHealth can be defined as a methodology to provide health care remotely and improve health services and outcomes using telecommunication tools. The widespread adoption of these technologies and current health care challenges, such as the aging population and increasing costs, has encouraged interest in the development of new strategies involving telemedicine. Overall, there is a lack of evidence rigorously assessing the impact of telemedicine and mHealth. Therefore, proper randomized controlled trials, with cost-effectiveness and impact on quality-of-life analysis, are urgently needed. They should also focus on specific populations and their comorbidities, since customizing telemedicine approaches is paramount to ensure success. Obstructive sleep apnea is a highly prevalent chronic condition and the most common of sleep-breathing disorders, and telemedicine and mHealth could play a pivotal role in the different phases of its management. In the future, using new devices capable of signal acquisition and analysis will refine obstructive sleep apnea diagnosis; even smartphones’ built-in sensors could offer improved comfort and the possibility of home sleep monitoring. Continuous positive airway pressure titration could be performed with wireless devices, whose parameters can be changed remotely from sleep centers. Finally, the follow-up phase could be

  3. Sudarshan kriya yoga: Breathing for health

    Directory of Open Access Journals (Sweden)

    Sameer A Zope

    2013-01-01

    Full Text Available Breathing techniques are regularly recommended for relaxation, stress management, control of psychophysiological states, and to improve organ function. Yogic breathing, defined as a manipulation of breath movement, has been shown to positively affect immune function, autonomic nervous system imbalances, and psychological or stress-related disorders. The aim of this study was to assess and provide a comprehensive review of the physiological mechanisms, the mind-body connection, and the benefits of Sudarshan Kriya Yoga (SKY in a wide range of clinical conditions. Various online databases searched were Medline, Psychinfo, EMBASE, and Google Scholar. All the results were carefully screened and articles on SKY were selected. The references from these articles were checked to find any other potentially relevant articles. SKY, a unique yogic breathing practice, involves several types of cyclical breathing patterns, ranging from slow and calming to rapid and stimulating. There is mounting evidence to suggest that SKY can be a beneficial, low-risk, low-cost adjunct to the treatment of stress, anxiety, post-traumatic stress disorder, depression, stress-related medical illnesses, substance abuse, and rehabilitation of criminal offenders.

  4. Take a Breath (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-03-26

    Breathing is a natural bodily function that most take for granted. But for people with chronic obstructive pulmonary disease, or COPD, inhaling and exhaling is a daily struggle. In this podcast, Dr. Anne Wheaton discusses health problems associated with COPD.  Created: 3/26/2015 by MMWR.   Date Released: 3/26/2015.

  5. Take a Deep Breath (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2016-11-24

    Nearly 16 million Americans have been diagnosed with COPD; however, many may not be aware they have the condition. This podcast discusses the importance of seeing a health care provider if you have trouble breathing.  Created: 11/24/2016 by MMWR.   Date Released: 11/24/2016.

  6. Smart sensor systems for human health breath monitoring applications.

    Science.gov (United States)

    Hunter, G W; Xu, J C; Biaggi-Labiosa, A M; Laskowski, D; Dutta, P K; Mondal, S P; Ward, B J; Makel, D B; Liu, C C; Chang, C W; Dweik, R A

    2011-09-01

    Breath analysis techniques offer a potential revolution in health care diagnostics, especially if these techniques can be brought into standard use in the clinic and at home. The advent of microsensors combined with smart sensor system technology enables a new generation of sensor systems with significantly enhanced capabilities and minimal size, weight and power consumption. This paper discusses the microsensor/smart sensor system approach and provides a summary of efforts to migrate this technology into human health breath monitoring applications. First, the basic capability of this approach to measure exhaled breath associated with exercise physiology is demonstrated. Building from this foundation, the development of a system for a portable asthma home health care system is described. A solid-state nitric oxide (NO) sensor for asthma monitoring has been identified, and efforts are underway to miniaturize this NO sensor technology and integrate it into a smart sensor system. It is concluded that base platform microsensor technology combined with smart sensor systems can address the needs of a range of breath monitoring applications and enable new capabilities for healthcare.

  7. Health, social and economical consequences of sleep-disordered breathing

    DEFF Research Database (Denmark)

    Jennum, Poul; Kjellberg, Jakob

    2011-01-01

    The objective direct and indirect costs of sleep-disordered breathing (snoring, sleep apnoea (SA) and obesity hypoventilation syndrome (OHS)) and the treatment are incompletely described.......The objective direct and indirect costs of sleep-disordered breathing (snoring, sleep apnoea (SA) and obesity hypoventilation syndrome (OHS)) and the treatment are incompletely described....

  8. Mouth breathing: adverse effects on facial growth, health, academics, and behavior.

    Science.gov (United States)

    Jefferson, Yosh

    2010-01-01

    The vast majority of health care professionals are unaware of the negative impact of upper airway obstruction (mouth breathing) on normal facial growth and physiologic health. Children whose mouth breathing is untreated may develop long, narrow faces, narrow mouths, high palatal vaults, dental malocclusion, gummy smiles, and many other unattractive facial features, such as skeletal Class II or Class III facial profiles. These children do not sleep well at night due to obstructed airways; this lack of sleep can adversely affect their growth and academic performance. Many of these children are misdiagnosed with attention deficit disorder (ADD) and hyperactivity. It is important for the entire health care community (including general and pediatric dentists) to screen and diagnose for mouth breathing in adults and in children as young as 5 years of age. If mouth breathing is treated early, its negative effect on facial and dental development and the medical and social problems associated with it can be reduced or averted.

  9. The use of counting beads to improve the classification of fast breathing in low-resource settings: a multi-country review.

    Science.gov (United States)

    Noordam, Aaltje Camielle; Barberá Laínez, Yolanda; Sadruddin, Salim; van Heck, Pabla Maria; Chono, Alex Opio; Acaye, Geoffrey Larry; Lara, Victor; Nanyonjo, Agnes; Ocan, Charles; Källander, Karin

    2015-07-01

    To decrease child mortality due to common but life-threatening illnesses, community health workers (CHWs) are trained to assess, classify and treat sick children. For pneumonia, CHWs are trained to count the respiratory rate of a child with cough and/or difficulty breathing, and determine whether the child has fast breathing or not based on how the child's breath count relates to age-specific respiratory rate cut-off points. International organizations training CHWs to classify fast breathing realized that many of them faced challenges counting and determining how the respiratory rate relates to age-specific cut-off points. Counting beads were designed to overcome these challenges. This article presents findings from different studies on the utility of these beads, in conjunction with a timer, as a tool to improve classification of fast breathing. Studies conducted by the International Rescue Committee and Save the Children among illiterate CHWs assessed the effectiveness of counting beads to improve both counting and classifying respiratory rate against age-specific cut-off points. These studies found that the use of counting beads enabled and improved the assessment and classification of fast breathing. However, a Malaria Consortium study found that the use of counting beads decreased the accuracy of counting breaths among literate CHWs. Qualitative findings from these studies and two additional studies by UNICEF suggest that the design of the beads is crucial: beads should move comfortably, and a separate bead string, with colour coding, is required for the age groups with different cut-off thresholds-eliminating more complicated calculations. Further research, using standardized protocols and gold standard comparisons, is needed to understand the accuracy of beads in comparison to other tools used for classifying pneumonia, which CHWs benefit most from each different tool (i.e. disaggregating data by levels of literacy and numeracy) and what the impact is on

  10. Free-breathing motion-corrected late-gadolinium-enhancement imaging improves image quality in children

    Energy Technology Data Exchange (ETDEWEB)

    Olivieri, Laura; O' Brien, Kendall J. [Children' s National Health System, Division of Cardiology, Washington, DC (United States); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (United States); Cross, Russell [Children' s National Health System, Division of Cardiology, Washington, DC (United States); Xue, Hui; Kellman, Peter; Hansen, Michael S. [National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (United States)

    2016-06-15

    -enhancement imaging with motion-corrected averaging is feasible in children, robust at high heart rates and with variable R-R intervals, and can be performed without breath-holding with higher image quality ratings than standard breath-held techniques. Use of free-breathing single-shot motion-corrected technique does not compromise LGE image quality in children who can hold their breath, and it can significantly improve image quality in children who cannot hold their breath or who have significant arrhythmia. (orig.)

  11. Controlled-frequency breath swimming improves swimming performance and running economy.

    Science.gov (United States)

    Lavin, K M; Guenette, J A; Smoliga, J M; Zavorsky, G S

    2015-02-01

    Respiratory muscle fatigue can negatively impact athletic performance, but swimming has beneficial effects on the respiratory system and may reduce susceptibility to fatigue. Limiting breath frequency during swimming further stresses the respiratory system through hypercapnia and mechanical loading and may lead to appreciable improvements in respiratory muscle strength. This study assessed the effects of controlled-frequency breath (CFB) swimming on pulmonary function. Eighteen subjects (10 men), average (standard deviation) age 25 (6) years, body mass index 24.4 (3.7) kg/m(2), underwent baseline testing to assess pulmonary function, running economy, aerobic capacity, and swimming performance. Subjects were then randomized to either CFB or stroke-matched (SM) condition. Subjects completed 12 training sessions, in which CFB subjects took two breaths per length and SM subjects took seven. Post-training, maximum expiratory pressure improved by 11% (15) for all 18 subjects (P inspiratory pressure was unchanged. Running economy improved by 6 (9)% in CFB following training (P swimmers.

  12. Breathing exercises improve post-operative pulmonary function and quality of life in patients with lung cancer: A meta-analysis.

    Science.gov (United States)

    Liu, Wei; Pan, Ying-Li; Gao, Cai-Xiang; Shang, Zuo; Ning, Li-Juan; Liu, Xing

    2013-04-01

    Previous research has shown that breathing exercises may improve the prognosis and health status in patients with lung cancer by enhancing pulmonary function and quality of life (QOL). However, individually published results are inconclusive. The aim of the present meta-analysis was to evaluate the clinical value of breathing exercises on post-operative pulmonary function and QOL in patients with lung cancer. A literature search of Pubmed, Embase, the Web of Science and CBM databases was conducted from their inception through to October 2012. Crude standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to assess the effect of breathing exercises. A total of eight clinical studies were ultimately included with 398 lung cancer patients. When all the eligible studies were pooled into the meta-analysis, there was a significant difference between the pre-intervention and post-intervention results of breathing exercises on post-operative pulmonary function; forced expiratory volume in 1 sec (FEV1): SMD, 3.37; 95% CI, 1.97-4.77; Pintervention with breathing exercises; there were significant differences between the pre-intervention and post-intervention results on the ability of self-care in daily life (SMD, -1.00; 95% CI, -1.467 to -0.52; P<0.001), social activities (SMD, -0.94; 95% CI, -1.73 to -0.15; P=0.02), symptoms of depression (SMD, -0.91; 95% CI, -1.25 to -0.57; P<0.001) and symptoms of anxiety (SMD, -0.91; 95% CI, -1.20 to -0.63; P<0.001). Results from the present meta-analysis suggest that breathing exercises may significantly improve post-operative pulmonary function and QOL in patients with lung cancer.

  13. Chemical Analysis of Whale Breath Volatiles: A Case Study for Non-Invasive Field Health Diagnostics of Marine Mammals

    Directory of Open Access Journals (Sweden)

    Raquel Cumeras

    2014-09-01

    Full Text Available We explored the feasibility of collecting exhaled breath from a moribund gray whale (Eschrichtius robustus for potential non-invasive health monitoring of marine mammals. Biogenic volatile organic compound (VOC profiling is a relatively new field of research, in which the chemical composition of breath is used to non-invasively assess the health and physiological processes on-going within an animal or human. In this study, two telescopic sampling poles were designed and tested with the primary aim of collecting whale breath exhalations (WBEs. Once the WBEs were successfully collected, they were immediately transferred onto a stable matrix sorbent through a custom manifold system. A total of two large volume WBEs were successfully captured and pre-concentrated onto two Tenax®-TA traps (one exhalation per trap. The samples were then returned to the laboratory where they were analyzed using solid phase micro extraction (SPME and gas chromatography/mass spectrometry (GC/MS. A total of 70 chemicals were identified (58 positively identified in the whale breath samples. These chemicals were also matched against a database of VOCs found in humans, and 44% of chemicals found in the whale breath are also released by healthy humans. The exhaled gray whale breath showed a rich diversity of chemicals, indicating the analysis of whale breath exhalations is a promising new field of research.

  14. Clinical and polygraphic improvement of breathing abnormalities after valproate in a case of Pitt-Hopkins syndrome.

    Science.gov (United States)

    Maini, Ilenia; Cantalupo, Gaetano; Turco, Emanuela Claudia; De Paolis, Fernando; Magnani, Cinzia; Parrino, Liborio; Terzano, Mario Giovanni; Pisani, Francesco

    2012-12-01

    Pitt-Hopkins syndrome is a rare genetic form of severe psychomotor delay, caused by mutations in transcription cell factor-4 gene and characterized by distinctive dysmorphic features and abnormal breathing pattern. The current report describes the polygraphic features of the syndrome's typical breathing pattern in a patient both in wakefulness and in sleep. The control of these breathing alterations is important to prevent the neurological sequelae linked to chronic cerebral hypoxemia in early ages. No data are available on effective treatment options for breathing abnormalities of Pitt-Hopkins syndrome. The authors polygraphically documented a reduction of apneic and hypopneic phenomena, with a significant improvement in saturation values, after the introduction of sodium valproate.

  15. What Causes Bad Breath?

    Science.gov (United States)

    ... A Week of Healthy Breakfasts Shyness What Causes Bad Breath? KidsHealth > For Teens > What Causes Bad Breath? A A A en español ¿Qué es lo que provoca el mal aliento? Bad breath, or halitosis , can be a major problem, ...

  16. Engineering-aided treatment of chest deformities to improve the process of breathing.

    Science.gov (United States)

    Gzik-Zroska, Bożena; Wolański, Wojciech; Gzik, Marek

    2013-09-01

    In this paper, the application of new visualization technologies in correction of funnel chest is presented. Often, such defects cause problems with breathing, and therefore, to improve the cardiorespiratory efficiency, a correction is required. The virtual model of chest was formulated to determine the strains and stresses after correction of deformation with using the stabilizing plate. From biomechanical point of view, the knowledge of the load-affecting stabilizer is necessary to select optimal parameters of the plate. The force-affecting plate that was used in the correction of chest deformation by Nuss method was determined on the basis of finite element model of funnel chest. The main aim of this work was to select the optimal thickness of plate. Calculations were conducted for three alternative constraints.

  17. Health and efficiency in trimix versus air breathing in compressed air workers.

    Science.gov (United States)

    Van Rees Vellinga, T P; Verhoeven, A C; Van Dijk, F J H; Sterk, W

    2006-01-01

    The Western Scheldt Tunneling Project in the Netherlands provided a unique opportunity to evaluate the effects of trimix usage on the health of compressed air workers and the efficiency of the project. Data analysis addressed 318 exposures to compressed air at 3.9-4.4 bar gauge and 52 exposures to trimix (25% oxygen, 25% helium, and 50% nitrogen) at 4.6-4.8 bar gauge. Results revealed three incidents of decompression sickness all of which involved the use of compressed air. During exposure to compressed air, the effects of nitrogen narcosis were manifested in operational errors and increased fatigue among the workers. When using trimix, less effort was required for breathing, and mandatory decompression times for stays of a specific duration and maximum depth were considerably shorter. We conclude that it might be rational--for both medical and operational reasons--to use breathing gases with lower nitrogen fractions (e.g., trimix) for deep-caisson work at pressures exceeding 3 bar gauge, although definitive studies are needed.

  18. Spontaneous breathing during high-frequency oscillatory ventilation improves regional lung characteristics in experimental lung injury

    NARCIS (Netherlands)

    van Heerde, M.; Roubik, K.; Kopelent, V.; Kneyber, M. C. J.; Markhorst, D. G.

    2010-01-01

    Background Maintenance of spontaneous breathing is advocated in mechanical ventilation. This study evaluates the effect of spontaneous breathing on regional lung characteristics during high-frequency oscillatory (HFO) ventilation in an animal model of mild lung injury. Methods Lung injury was induce

  19. Propofol Breath Monitoring as a Potential Tool to Improve the Prediction of Intraoperative Plasma Concentrations

    NARCIS (Netherlands)

    Colin, Pieter; Eleveld, Douglas J; van den Berg, Johannes P; Vereecke, Hugo E M; Struys, Michel M R F; Schelling, Gustav; Apfel, Christian C; Hornuss, Cyrill

    2015-01-01

    INTRODUCTION: Monitoring of drug concentrations in breathing gas is routinely being used to individualize drug dosing for the inhalation anesthetics. For intravenous anesthetics however, no decisive evidence in favor of breath concentration monitoring has been presented up until now. At the same tim

  20. Sleep board review questions: sleep disordered breathing that improves in REM

    Directory of Open Access Journals (Sweden)

    Budhiraja R

    2012-08-01

    Full Text Available No abstract available. Article truncated at end of question. Which of the following breathing disorders is usually less severe in rapid eye movement (REM sleep compared to non-rapid eye movement (NREM sleep?1.Sleep-related hypoxemia in COPD2.Obstructive Sleep Apnea3.Cheyne Stokes Breathing4.Hypoxemia in Pulmonary Hypertension

  1. 42 CFR 84.81 - Compressed breathing gas and liquefied breathing gas containers; minimum requirements.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Compressed breathing gas and liquefied breathing... APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Self-Contained Breathing Apparatus § 84.81 Compressed breathing gas and liquefied breathing gas containers; minimum requirements. (a) Compressed breathing gas...

  2. Strengthening public health research for improved health

    Directory of Open Access Journals (Sweden)

    Enrique Gea-Izquierdo

    2012-08-01

    Full Text Available Research in public health is a range that includes from fundamental research to research in clinical practice, including novel advances, evaluation of results and their spreading. Actually, public health research is considered multidisciplinary incorporating numerous factors in its development. Establishing as a mainstay the scientific method, deepens in basic research, clinical epidemiological research and health services. The premise of quality and relevance is reflected in international scientific research, and in the daily work and good biomedical practices that should be included in the research as a common task. Therefore, the research must take a proactive stance of inquiry, integrating a concern planned and ongoing development of knowledge. This requires improve international coordination, seeking a balance between basic and applied research as well as science and technology. Thus research cannot be considered without innovation, weighing up the people and society needs. Acting on knowledge of scientific production processes requires greater procedures thoroughness and the effective expression of the results. It is noted as essential to establish explicit principles in review and evaluation of the adjustments of actions, always within the standards of scientific conduct and fairness of the research process. In the biomedical scientific lines it have to be consider general assessments that occur related to the impact and quality of health research, mostly leading efforts to areas that require further attention. However, other subject areas that may be deficient or with lower incidence in the population should not be overlook. Health research as a source of new applications and development provides knowledge, improving well-being. However, it is understandable without considering the needs and social demands. Therefore, in public health research and to improve the health of the population, we must refine and optimize the prevention and

  3. Effectiveness of a new toothbrush design versus a conventional tongue scraper in improving breath odor and reducing tongue microbiota

    Directory of Open Access Journals (Sweden)

    Luciana Assirati Casemiro

    2008-08-01

    Full Text Available For centuries, specific instruments or regular toothbrushes have routinely been used to remove tongue biofilm and improve breath odor. Toothbrushes with a tongue scraper on the back of their head have recently been introduced to the market. The present study compared the effectiveness of a manual toothbrush with this new design, i.e., possessing a tongue scraper, and a commercial tongue scraper in improving breath odor and reducing the aerobic and anaerobic microbiota of tongue surface. The evaluations occurred at 4 moments, when the participants (n=30 had their halitosis quantified with a halimeter and scored according to a 4-point scoring system corresponding to different levels of intensity. Saliva was collected for counts of aerobic and anaerobic microorganisms. Data were analyzed statistically by Friedman's test (p<0.05. When differences were detected, the Wilcoxon test adjusted for Bonferroni correction was used for multiple comparisons (group to group. The results confirmed the importance of mechanical cleaning of the tongue, since this procedure provided an improvement in halitosis and reduction of aerobe and anaerobe counts. Regarding the evaluated methods, the toothbrush's tongue scraper and conventional tongue scraper had a similar performance in terms of breath improvement and reduction of tongue microbiota, and may be indicated as effective methods for tongue cleaning.

  4. News from the Breath Analysis Summit 2011.

    Science.gov (United States)

    Corradi, Massimo; Mutti, Antonio

    2012-06-01

    analysis is now used to diagnose and monitor asthma, check for transplant organ rejection, detect lung cancer and test for Helicobacter pyloriinfection-and the list is growing. A major milestone in the scientific study of breath was marked in the 1970s when Linus Pauling demonstrated that there is more to exhaled breath than the classic gases of nitrogen, oxygen, carbon dioxide and water vapour-a lot more. Based on the gas-liquid partition chromatography analysis, Pauling reported the presence of 250 substances in exhaled breath. We now have the technology to test for any and all of these components. The field of breath analysis has made considerable advances in the 21st century and the utility of breath analysis in health care is advancing quickly. The science is rapidly expanding, the technology is improving and several new applications have been developed or are under commercial development. Breath analysis may rely on both direct (on line) and indirect (off line) reading methods: in the on-line method, breath analysis is immediately available, whereas the use of indirect methods generally involves collecting and trapping the breath sample and subsequently transferring it to an analytical instrument for analysis. Various kinds of breath samples have been used in biological monitoring, including mixed expired air and end expired air: end exhaled air represents the alveolar air concentration and mixed exhaled air represents the gas mixture coming from the dead space of the bronchial tree and the alveolar gas-exchange space. Exhaled breath analysis is an area where the modern day advances in technology and engineering meet the ever expanding need in medicine for more sensitive, specific and non-invasive tests which makes this area a major front in the interface between medicine and engineering. A major breakthrough over the past decade has been the increase in breath-based tests approved by the US Food and Drug Administration (FDA). Devices measuring common breath gases

  5. SU-E-J-236: Audiovisual Biofeedback Improves Breath-Hold Lung Tumor Position Reproducibility Measured with 4D MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, D; Pollock, S; Keall, P [Radiation Physics Laboratory, Sydney Medical School, The University of Sydney, NSW (Australia); Greer, P [School of Mathematical and Physical Sciences, The University of Newcastle, Newcastle, NSW (Australia); Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW (Australia); Lapuz, C; Ludbrook, J [Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, NSW (Australia); Kim, T [Radiation Physics Laboratory, Sydney Medical School, The University of Sydney, NSW (Australia); Department of Radiation Oncology, University of Virginia Health System, Charlottesville, VA (United States)

    2015-06-15

    Purpose: Audiovisual biofeedback breath-hold (AVBH) was employed to reproduce tumor position on inhale and exhale breath-holds for 4D tumor information. We hypothesize that lung tumor position will be more consistent using AVBH compared with conventional breath-hold (CBH). Methods: Lung tumor positions were determined for seven lung cancer patients (age: 25 – 74) during to two separate 3T MRI sessions. A breathhold training session was performed prior to the MRI sessions to allow patients to become comfortable with AVBH and their exhale and inhale target positions. CBH and AVBH 4D image datasets were obtained in the first MRI session (pre-treatment) and the second MRI session (midtreatment) within six weeks of the first session. Audio-instruction (MRI: Siemens Skyra) in CBH and verbal-instruction (radiographer) in AVBH were used. A radiation oncologist contoured the lung tumor using Eclipse (Varian Medical Systems); tumor position was quantified as the centroid of the contoured tumor after rigid registration based on vertebral anatomy across two MRI sessions. CBH and AVBH were compared in terms of the reproducibility assessed via (1) the difference between the two exhale positions for the two sessions and the two inhale positions for the sessions. (2) The difference in amplitude (exhale to inhale) between the two sessions. Results: Compared to CBH, AVBH improved the reproducibility of two exhale (or inhale) lung tumor positions relative to each other by 33%, from 6.4±5.3 mm to 4.3±3.0 mm (p=0.005). Compared to CBH, AVBH improved the reproducibility of exhale and inhale amplitude by 66%, from 5.6±5.9 mm to 1.9±1.4 mm (p=0.005). Conclusions: This study demonstrated that audiovisual biofeedback can be utilized for improving the reproducibility of breath-hold lung tumor position. These results are advantageous towards achieving more accurate emerging radiation treatment planning methods, in addition to imaging and treatment modalities utilizing breath

  6. The Health Improvement Network (THIN)

    Science.gov (United States)

    The Health Improvement Network is a collaboration between Cegedim Strategic Data EPIC, an expert in the provision of UK primary care patient data that is used for medical research, and In Practice Systems (InPS), who continue to develop and supply the widely-used Vision general practice computer system.

  7. Minimizing Shortness of Breath

    Science.gov (United States)

    ... is also placed on proper use of the abdominal muscles to better control episodes of shortness of breath, ... Treatment & Programs Health Insights Doctors & Departments Research & Science Education & Training Make a Donation Make an Appointment Contact ...

  8. Breathing difficulty - lying down

    Science.gov (United States)

    ... short of breath. Considerations This is a common complaint in people with some types of heart or ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  9. Breathing Problems

    Science.gov (United States)

    ... getting enough air. Sometimes you can have mild breathing problems because of a stuffy nose or intense ... panic attacks Allergies If you often have trouble breathing, it is important to find out the cause.

  10. Wawared Peru: reducing health inequities and improving maternal health by improving information systems in health

    OpenAIRE

    2015-01-01

    In developing countries, there are no high quality data to support decision-making and governance due to inadequateinformation collection and transmission processes. Our project WawaRed-Peru: “Reducing health inequities andimproving maternal health by improving health information systems” aims to improve maternal health processes andindicators through the implementation of interoperability standards for maternal health information systems in order fordecision makers to have timely, high quali...

  11. Improvement of plastic optical fiber microphone based on moisture pattern sensing in devoiced breath

    Science.gov (United States)

    Taki, Tomohito; Honma, Satoshi; Morisawa, Masayuki; Muto, Shinzo

    2008-03-01

    Conversation is the most practical and common form in communication. However, people with a verbal handicap feel a difficulty to produce words due to variations in vocal chords. This research leads to develop a new devoiced microphone system based on distinguishes between the moisture patterns for each devoiced breaths, using a plastic optical fiber (POF) moisture sensor. In the experiment, five POF-type moisture sensors with fast response were fabricated by coating swell polymer with a slightly larger refractive index than that of fiber core and were set in front of mouth. When these sensors are exposed into humid air produced by devoiced breath, refractive index in cladding layer decreases by swelling and then the POF sensor heads change to guided type. Based on the above operation principle, the output light intensities from the five sensors set in front of mouth change each other. Using above mentioned output light intensity patterns, discernment of devoiced vowels in Japanese (a,i,u,e,o) was tried by means of DynamicProgramming-Matching (DP-matching) method. As the result, distinction rate over 90% was obtained to Japanese devoiced vowels. Therefore, using this system and a voice synthesizer, development of new microphone for the person with a functional disorder in the vocal chords seems to be possible.

  12. Improved pre-concentration and detection methods for volatile sulphur breath constituents.

    Science.gov (United States)

    Mochalski, Paweł; Wzorek, Beata; Sliwka, Ireneusz; Amann, Anton

    2009-07-01

    Suitability of different types of pre-concentration (solid phase microextraction and sorbent trapping) and detection (flame photometric detector (FPD) and mass selective detector (MSD)) for gas chromatographic determination of sulphur-containing compounds (H2S, MeSH, EtSH, DMS, COS and CS2) in breath-gas was assessed in this study. Several factors like influence of humidity, influence of oxygen, or stability of target compounds in extraction vessels (SPME vials and sorbent tubes) were investigated. Despite poor stability of VSCs in SPME vials and matrix effects (unfavorable influence of humidity), SPME was found to be a fast and reliable enrichment method, which coupled with mass selective detector provided satisfactory LODs of target compounds at the ppt level (from 0.15 ppb for CS2 to 2.3 ppb for H2S). Application of sorbent trapping with two-bed sorbent tubes containing Tenax TA and Carboxen 1000 gave excellent LODs (0.03-0.3 ppb for 200 ml sample and MSD). Stability of investigated VSCs in sorbents was found to be very poor (30-40% losses after 2 h). FPD showed satisfactory sensitivity only when it was coupled with sorbent trapping. Breath samples were collected into Tedlar bags in a CO2-controlled manner. Humidity was removed during sampling (permeation dryer--Nafion) to avoid unfavorable water dependent effects during analysis.

  13. Long-Term Improvements in Sleep and Respiratory Parameters in Preschool Children Following Treatment of Sleep Disordered Breathing

    Science.gov (United States)

    Walter, Lisa M.; Biggs, Sarah N.; Nisbet, Lauren C.; Weichard, Aidan J.; Hollis, Samantha L.; Davey, Margot J.; Anderson, Vicki; Nixon, Gillian M.; Horne, Rosemary S.C.

    2015-01-01

    Study Objectives: Sleep disordered breathing (SDB) in preschool-aged children is common, but long-term outcomes have not been investigated. We aimed to compare sleep and respiratory parameters in preschool children to examine the effects of treatment or non-treatment after 3 years. Methods: Children (3–5 years) diagnosed with SDB (n = 45) and non-snoring controls (n = 30) returned for repeat overnight polysomnography (39% of original cohort), 3 years following baseline polysomnography. Children with SDB were grouped according to whether they had received treatment or not. SDB resolution was defined as an obstructive apnea hypopnea index (OAHI) ≤ 1 event/h, no snoring detected on polysomnography and habitual snoring not indicated by parents on questionnaire. Results: Fifty-one percent (n = 23) of the children with SDB were treated. Overall, SDB resolved in 49% (n = 22), either spontaneously (n = 8) or with treatment (n = 14). SDB remained unresolved in 39% (n = 9) of those treated and 64% (n = 14) of the children who were untreated. Two of the non-snoring controls developed SDB at follow-up. The treated group had significantly lower OAHI (p Anderson V, Nixon GM, Horne RS. Long-term improvements in sleep and respiratory parameters in preschool children following treatment of sleep disordered breathing. J Clin Sleep Med 2015;11(10):1143–1151. PMID:26094933

  14. Immediate and Sustained Improvement in Behavior and Life Quality by Adenotonsillectomy in Children With Sleep-Disordered Breathing

    Science.gov (United States)

    Jeon, Yung Jin; Song, Jae-Jin; Ahn, Jae-Cheul; Kong, Il Gyu; Kim, Jae-Won; Park, Gyeong-Hun; Won, Tae-Bin

    2016-01-01

    Objectives To investigate longitudinal changes in behavior and quality-of-life (QoL) in children with sleep disordered breathing (SDB) after adenotonsillectomy (AT). Methods This study prospectively enrolled 148 children who underwent AT for SDB. Caregivers filled out Korean attention deficit hyperactivity disorder (ADHD) rating scale (K-ARS) and Korean version of the obstructive sleep apnea-18 (KOSA-18) at preoperative 1 day, postoperative 1 month, and postoperative 6 months. Longitudinal changes in K-ARS and KOSA-18 were evaluated and compared among subgroups. Results Both K-ARS and KOSA-18 scores improved immediately at postoperative 1 month and were maintained at postoperative 6 months. The mean preoperative K-ARS scores of the non-ADHD, ADHD-trait, and overt-ADHD groups showed uniformly immediate and sustained improvements. Also, the mean preoperative KOSA-18 scores of the small, moderate, and large impact groups were significantly improved both at postoperative 1 month and 6 months. The changes in behavior and QoL showed no significant differences with regard to the aforementioned factors. Conclusion After AT, we may expect immediate and sustained improvements in behavior and QoL in children with SDB regardless of preoperative symptom severity. Moreover, by performing AT, improvements in behavior and QoL are expected regardless of sex, age, allergic trait, or concurrent coblation-assisted turbinoplasty. These findings may help our colleague physicians counselling pediatric SDB patients and their caregivers. PMID:27090276

  15. Our Breaths We Take: Outdoor Air Quality, Health, and Climate Change Consequences of Household Heating and Cooking with Solid Fuels

    Science.gov (United States)

    Chafe, Zoe Anna

    Worldwide, nearly 3 billion people--40% of the global population--burn wood, coal, and other solid fuels every day to cook their food; this number is even larger when including those who heat their homes with solid fuels as well. Exposure to pollution from heating and cooking fires causes about 3 million deaths each year, making it one of the biggest environmental health problems the world faces. The harm from this smoke is not restricted to those who breathe it, however: it contains gases and particles that contribute to global climate change as well. Chapter 2 shows that household cooking with solid fuels caused an estimated 12% of population-weighted ambient PM2.5 worldwide in 2010. Exposure to this air pollution caused the loss of 370,000 lives and 9.9 million disability-adjusted life years (DALYs) globally in the same year. In Chapter 3 I demonstrate that household heating with solid fuels caused an estimated 21% of population-weighted ambient PM2.5 in 2010 in Central Europe, 13% in Eastern Europe, 12% in Western Europe, and 8% in North America. Exposure to this air pollution results caused approximately 60,000 premature deaths in Europe, and nearly 10,000 deaths in North America, as well as an estimated 1.0 million disability-adjusted life years (DALYs) in Europe and 160,000 DALYs in North America. Chapter 4 addresses drivers of household wood combustion pollution in the San Francisco Bay Area, where the sector is the largest source of PM 2.5 and regulators recently introduced amendments to wood burning rules for the airshed. Fireplaces are the source of the vast majority (84%) of PM 2.5 from residential wood combustion in the San Francisco Bay Area, despite their use primarily as an aesthetic or recreational combustion activity. By evaluating hypothetical fuel and combustion device changeouts, I find that replacing fireplaces with gas would yield significant health and economic benefits. Specifically, retrofitting frequently used fireplaces (300,000 units

  16. 42 CFR 84.79 - Breathing gas; minimum requirements.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing gas; minimum requirements. 84.79 Section...-Contained Breathing Apparatus § 84.79 Breathing gas; minimum requirements. (a) Breathing gas used to supply... respiratory tract irritating compounds. (c) Compressed, gaseous breathing air shall meet the...

  17. 42 CFR 84.72 - Breathing tubes; minimum requirements.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing tubes; minimum requirements. 84.72...-Contained Breathing Apparatus § 84.72 Breathing tubes; minimum requirements. Flexible breathing tubes used in conjunction with breathing apparatus shall be designed and constructed to prevent: (a)...

  18. 42 CFR 84.85 - Breathing bags; minimum requirements.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing bags; minimum requirements. 84.85 Section...-Contained Breathing Apparatus § 84.85 Breathing bags; minimum requirements. (a) Breathing bags shall have.... (b) Breathing bags shall be constructed of materials which are flexible and resistant to...

  19. The efficiency of active cycle of breathing techniques regarding the improvement the quality of life in cystic fibrosis patients

    Directory of Open Access Journals (Sweden)

    Bogdan Almăjan-Guţă

    2008-12-01

    Full Text Available Background: Physiotherapy is well known as one of the most important part of CF patient’s management. The right choice ofappropriate therapy schema will improve the life’s quality of the patients. The purpose of the study was to prove the efficiencyof Active cycle of breathing techniques at children with cystic fibrosis. The study was performed between September 2006-september 2007 and the lot of study consisted of 20 children (11 girls and 9 boys with an age range between 6 and 18 years(average 14,8 years from the records of the Cystic Fibrosis National Centre Timisoara. The results showed an improvement inall measured values: general well-being, coughing, physical signs, X-ray signs and CT, bacteriological exam, nutritional status,functional respiratory tests. The statistical briefing of data shows the fact that there are significant statistical difference (p<0,05, before and after treatment in all ventilator index. The conclusion of this study was that the chosen technique (ACTBproved to be very efficient, in improving of respiratory symptoms and ventilator parameters

  20. Breathe In, Breathe Out

    Centers for Disease Control (CDC) Podcasts

    2007-11-01

    This podcast promotes healthy lifestyle messages through original music.  Created: 11/1/2007 by National Diabetes Education Program (NDEP), a joint program of the Centers for Disease Control and Prevention and the National Institutes of Health.   Date Released: 11/30/2007.

  1. Improving African health research capacity

    DEFF Research Database (Denmark)

    Lazarus, Jeff; Wallace, Samantha A; Liljestrand, Jerker

    2010-01-01

    The issue of strengthening local research capacity in Africa is again high on the health and development agenda. The latest initiative comes from the Wellcome Trust. But when it comes to capacity development, one of the chief obstacles that health sectors in the region must confront is the migrat...

  2. Improving Mental Health in Schools

    Science.gov (United States)

    Rossen, Eric; Cowan, Katherine C.

    2015-01-01

    Students do not leave their mental health at the front door when they come to school. From wellness to serious illness, a student's mental health status is integral to how they think, feel, interact, behave, and learn. Decades of research and experience have laid a solid foundation and framework for effectively providing mental health…

  3. Improving Health and Quality of Life

    Science.gov (United States)

    ... Fatigue Syndrome (CFS) Share Compartir Improving Health and Quality of Life On this Page Cognitive Behavioral Therapy (CBT) Support ... and improve their ability to function and their quality of life. Doctors may refer some of their CFS patients ...

  4. BostonBreathes: Improving pediatric asthma care with a home-based interactive website for patient education, monitoring, and clinical teamwork

    OpenAIRE

    2006-01-01

    The BostonBreathes (BB) system is an interactive website enabling physician-physician and physician-patient communication, monitoring (peak-flow, medication use, symptoms) of asthma patients in the home, and patient and family asthma education. The system helps primary care physicians to function in team relationships with asthma specialists and nurses. Patients and families can interact with their health professionals online as members of the care team. BB uniquely combines patient education...

  5. INCENTIVE SPIROMETRY AND BREATHING EXERCISES WERE NOT ABLE TO IMPROVE RESTRICTIVE PULMONARY CHARACTERISTICS INDUCED BY WATER IMMERSION IN HEALTHY SUBJECTS

    Directory of Open Access Journals (Sweden)

    Aline A. Vepo,

    2016-04-01

    Full Text Available pulmonary volumes and capacities which could be at least in part similar to that happen in healthy individuals during water immersion. Objectives: To investigate if respiratory effects of water immersion are partially due to enhanced return venous from legs and arms and if physiotherapeutic techniques incentive spirometry (IS and breathing exercises (BE are able to improve pulmonary volumes and capacities in healthy subjects during water immersion. Design: Randomised, within-participant experimental study. Participants: 18 healthy subjects. Intervention: Stage 1 was realized to investigate the cardiorespiratory effects of water immersion with and without a cuff-induced venous compression. Stage 2 was conducted to explain the effects of physiotherapeutic techniques IS and BE during water immersion. Main outcome measures: The pulmonary function (forced vital capacity - FVC, forced expiratory volume the first second - FEV1, ratio of FEV/FVC, peak expiratory flow rate - PEFR and forced expiratory flow of 25-75% FVC - FEF25-75% was evaluated. Results: Water immersion decreased FVC and FEV1 after 10 minutes of immersion. After a total compression of arms and legs the reduction on FVC and FEV1 was not observed, even with only partial compression of legs (P>0.05. Conclusions: Water immersion promotes pulmonary restrictive characteristics due to increased venous return mainly from legs. The application IS and BE did not normalize the spirometric values.

  6. Suction/inspiration against resistance or standardized Mueller maneuver: a new breathing technique to improve contrast density within the pulmonary artery: a pilot CT study

    Energy Technology Data Exchange (ETDEWEB)

    Gutzeit, Andreas [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Hospital St. Anna, Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Lucerne (Switzerland); Kantonsspital Winterthur, Department of Radiology, Winterthur (Switzerland); Froehlich, Johannes M.; Weymarn, Constantin von; Goyen, Matthias [Hirslanden Hospital St. Anna, Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Lucerne (Switzerland); Waelti, Stephan [Cantonal Hospital St. Gallen, Department of Radiology and Nuclear Medicine, St. Gallen (Switzerland); Roos, Justus E. [Duke University Medical Center, Department of Radiology, Durham, NC (United States); Meissnitzer, Matthias; Hergan, Klaus [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Czell, David [Cantonal Hospital Winterthur, Department of Neurology, Winterthur (Switzerland); Reischauer, Carolin [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Hospital St. Anna, Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Lucerne (Switzerland)

    2015-11-15

    Our aim was to prospectively investigate whether the recently introduced suction/inspiration against resistance breathing method leads to higher computed tomography (CT) contrast density in the pulmonary artery compared to standard breathing. The present study was approved by the Medical Ethics committee and all subjects gave written informed consent. Fifteen patients, each without suspicious lung emboli, were randomly assigned to four different groups with different breathing maneuvers (suction against resistance, Valsalva, inspiration, expiration) during routine CT. Contrast enhancement in the central and peripheral sections of the pulmonary artery were measured and compared with one another. Peripheral enhancement during suction yielded increased mean densities of 138.14 Hounsfield units (HU) (p = 0.001), compared to Valsalva and a mean density of 67.97 HU superior to inspiration (p = 0.075). Finally, suction in comparison to expiration resulted in a mean increase of 30.51 HU (p = 0.42). Central parts of pulmonary arteries presented significantly increased enhancement values (95.74 HU) for suction versus the Valsalva technique (p = 0.020), while all other mean densities were in favour of suction (versus inspiration: p = 0.201; versus expiration: p = 0.790) without reaching significance. Suction/Inspiration against resistance is a promising technique to improve contrast density within pulmonary vessels, especially in the peripheral parts, in comparison to other breathing maneuvers. (orig.)

  7. Improving health promotion using quality improvement techniques in Australian Indigenous primary health care

    Directory of Open Access Journals (Sweden)

    Nikki ePercival

    2016-03-01

    Full Text Available While some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centres. Our study objectives were to: (a describe the scope and quality of health promotion activities; (b describe the status of health centre system support for health promotion activities; and (c introduce a CQI intervention and examine the impact on health promotion activities and health centres systems over two years. Baseline assessments showed sub-optimal health centre systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health centre systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence based health promotion by engaging front line health practitioners in decision making processes about the design/redesign of health centre systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff and members of the local community to address organisational and policy level barriers.

  8. Breathing Easier.

    Science.gov (United States)

    Smolkin, Rachel

    2003-01-01

    Describes use of Environmental Protection Agency's Tools for Schools tool kit to improve indoor air quality aimed specifically at eliminating asthma triggers such as dust mites and mold. Includes several examples of school district efforts to reduce or eliminate student health problems associated with poor indoor air quality. (PKP)

  9. Breathing In

    Science.gov (United States)

    Mahoney, Daniel P.

    2008-01-01

    Healthful indoor air quality (IAQ) in education facilities can improve the learning environment for students, enhance teacher job satisfaction, and reduce staff complaints. A proactive indoor air quality program helps identify and eliminate conditions that could lead to IAQ complaints, building-related illnesses, and workers' compensation claims.…

  10. Yoga for health

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000876.htm Yoga for health To use the sharing features on this page, ... postures, breathing exercises, and meditation to improve overall health. Yoga was developed as a spiritual practice thousands of ...

  11. Learn More Breathe Better

    Centers for Disease Control (CDC) Podcasts

    2011-11-16

    Chronic obstructive pulmonary disease (COPD) is a serious lung disease that makes breathing very difficult and can affect your quality of life. Learn the causes of COPD and what you can do to prevent it.  Created: 11/16/2011 by National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health (NCCDPHP, DACH).   Date Released: 11/16/2011.

  12. Reducing Health Disparities and Improving Health Equity in Saint Lucia.

    Science.gov (United States)

    Holden, Kisha; Charles, Lisa; King, Stephen; McGregor, Brian; Satcher, David; Belton, Allyson

    2015-12-22

    St. Lucia is an island nation in the Eastern Caribbean, with a population of 179,000 people, where chronic health conditions, such as hypertension and diabetes, are significant. The purpose of this pilot study is to create a model for community health education, tracking, and monitoring of these health conditions, research training, and policy interventions in St. Lucia, which may apply to other Caribbean populations, including those in the U.S. This paper reports on phase one of the study, which utilized a mixed method analytic approach. Adult clients at risk for, or diagnosed with, diabetes (n = 157), and health care providers/clinic administrators (n = 42), were recruited from five healthcare facilities in St. Lucia to assess their views on health status, health services, and improving health equity. Preliminary content analyses indicated that patients and providers acknowledge the relatively high prevalence of diabetes and other chronic illnesses, recognize the impact that socioeconomic status has on health outcomes, and desire improved access to healthcare and improvements to healthcare infrastructures. These findings could inform strategies, such as community education and workforce development, which may help improve health outcomes among St. Lucians with chronic health conditions, and inform similar efforts among other selected populations.

  13. Reducing Health Disparities and Improving Health Equity in Saint Lucia

    Directory of Open Access Journals (Sweden)

    Kisha Holden

    2015-12-01

    Full Text Available St. Lucia is an island nation in the Eastern Caribbean, with a population of 179,000 people, where chronic health conditions, such as hypertension and diabetes, are significant. The purpose of this pilot study is to create a model for community health education, tracking, and monitoring of these health conditions, research training, and policy interventions in St. Lucia, which may apply to other Caribbean populations, including those in the U.S. This paper reports on phase one of the study, which utilized a mixed method analytic approach. Adult clients at risk for, or diagnosed with, diabetes (n = 157, and health care providers/clinic administrators (n = 42, were recruited from five healthcare facilities in St. Lucia to assess their views on health status, health services, and improving health equity. Preliminary content analyses indicated that patients and providers acknowledge the relatively high prevalence of diabetes and other chronic illnesses, recognize the impact that socioeconomic status has on health outcomes, and desire improved access to healthcare and improvements to healthcare infrastructures. These findings could inform strategies, such as community education and workforce development, which may help improve health outcomes among St. Lucians with chronic health conditions, and inform similar efforts among other selected populations.

  14. Reducing Health Disparities and Improving Health Equity in Saint Lucia

    Science.gov (United States)

    Holden, Kisha; Charles, Lisa; King, Stephen; McGregor, Brian; Satcher, David; Belton, Allyson

    2015-01-01

    St. Lucia is an island nation in the Eastern Caribbean, with a population of 179,000 people, where chronic health conditions, such as hypertension and diabetes, are significant. The purpose of this pilot study is to create a model for community health education, tracking, and monitoring of these health conditions, research training, and policy interventions in St. Lucia, which may apply to other Caribbean populations, including those in the U.S. This paper reports on phase one of the study, which utilized a mixed method analytic approach. Adult clients at risk for, or diagnosed with, diabetes (n = 157), and health care providers/clinic administrators (n = 42), were recruited from five healthcare facilities in St. Lucia to assess their views on health status, health services, and improving health equity. Preliminary content analyses indicated that patients and providers acknowledge the relatively high prevalence of diabetes and other chronic illnesses, recognize the impact that socioeconomic status has on health outcomes, and desire improved access to healthcare and improvements to healthcare infrastructures. These findings could inform strategies, such as community education and workforce development, which may help improve health outcomes among St. Lucians with chronic health conditions, and inform similar efforts among other selected populations. PMID:26703647

  15. Improving the oral health of older people

    DEFF Research Database (Denmark)

    Petersen, Poul Erik; Yamamoto, Tatsuo

    2005-01-01

    changing burden of chronic diseases in old age. Chronic disease and most oral diseases share common risk factors. Globally, poor oral health amongst older people has been particularly evident in high levels of tooth loss, dental caries experience, and the prevalence rates of periodontal disease, xerostomia...... and oral precancer/cancer. The negative impact of poor oral conditions on the quality of life of older adults is an important public health issue, which must be addressed by policy-makers. The means for strengthening oral health programme implementation are available; the major challenge is therefore...... to translate knowledge into action programmes for the oral health of older people. The World Health Organization recommends that countries adopt certain strategies for improving the oral health of the elderly. National health authorities should develop policies and measurable goals and targets for oral health...

  16. 42 CFR 84.115 - Breathing tubes; minimum requirements.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing tubes; minimum requirements. 84.115 Section 84.115 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... § 84.115 Breathing tubes; minimum requirements. Flexible breathing tubes used in conjunction with...

  17. FMWC Radar for Breath Detection

    DEFF Research Database (Denmark)

    Suhr, Lau Frejstrup; Tafur Monroy, Idelfonso; Vegas Olmos, Juan José

    We report on the experimental demonstration of an FMCW radar operating in the 25.7 - 26.6 GHz range with a repetition rate of 500 sweeps per second. The radar is able to track the breathing rate of an adult human from a distance of 1 meter. The experiments have utilized a 50 second recording window...... to accurately track the breathing rate. The radar utilizes a saw tooth modulation format and a low latency receiver. A breath tracking radar is useful both in medical scenarios, diagnosing disorders such as sleep apnea, and for home use where the user can monitor its health. Breathing is a central part of every...... radar chip which, through the use of a simple modulation scheme, is able to measure the breathing rate of an adult human from a distance. A high frequency output makes sure that the radar cannot penetrate solid obstacles which is a wanted feature in private homes where people therefore cannot measure...

  18. Sampling considerations for health care improvement.

    Science.gov (United States)

    Perla, Rocco J; Provost, Lloyd P; Murray, Sandra K

    2014-01-01

    Sampling in improvement work can pose challenges. How is it different from the sampling strategies many use with research, clinical trials, or regulatory programs? What should improvement teams consider when determining a useful approach to sampling and a useful sample size? The aim of this article is to introduce some of the concepts related to sampling for improvement. We give specific guidance related to determining a useful sample size to a wider health care audience so that it can be applied to improvement projects in hospitals and health systems.

  19. A one-day "Helping Babies Breathe" course improves simulated performance but not clinical management of neonates

    DEFF Research Database (Denmark)

    Ersdal, H L; Vossius, C; Bayo, E

    2013-01-01

    "Helping Babies Breathe" (HBB) is a simulation-based one-day course developed to help reduce neonatal mortality globally. The study objectives were to (1) determine the effect on practical skills and management strategies among providers using simulations seven months after HBB training, and (2...

  20. 42 CFR 84.91 - Breathing resistance test; exhalation.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing resistance test; exhalation. 84.91...-Contained Breathing Apparatus § 84.91 Breathing resistance test; exhalation. (a) Resistance to exhalation...-circuit apparatus with a breathing machine as described in § 84.88, and the exhalation resistance...

  1. 42 CFR 84.88 - Breathing bag test.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing bag test. 84.88 Section 84.88 Public... RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Self-Contained Breathing Apparatus § 84.88 Breathing bag test. (a) Breathing bags will be tested in an air atmosphere saturated...

  2. Low Back Pain? Relax, Breathe and Try Yoga

    Science.gov (United States)

    ... Videos & Tools Español You Are Here: Home → Latest Health News → Article URL of this page: https://medlineplus.gov/news/fullstory_163537.html Low Back Pain? Relax, Breathe and Try Yoga Review of 12 studies found small improvements in ...

  3. The impact of sleep-disordered breathing on body mass index (BMI: the sleep heart health study (SHHS

    Directory of Open Access Journals (Sweden)

    Robbins JA

    2011-12-01

    Full Text Available Introduction: It is well known that obesity is a risk factor for sleep-disordered breathing (SDB. However, whether SDB predicts increase in BMI is not well defined. Data from the Sleep Heart Health Study (SHHS were analyzed to determine whether SDB predicts longitudinal increase in BMI, adjusted for confounding factors.Methods: A full-montage unattended home polysomnogram (PSG and body anthropometric measurements were obtained approximately five years apart in 3001 participants. Apnea-hypopnea index (AHI was categorized using clinical thresholds: < 5 (normal, ≥ 5 to <15 (mild sleep apnea, and ³ 15 (moderate to severe sleep apnea. Linear regression was used to examine the association between the three AHI groups and increased BMI. The model included age, gender, race, baseline BMI, and change in AHI as covariates.Results: Mean (SD age was 62.2 years (10.14, 55.2% were female and 76.1% were Caucasian. Five-year increase in BMI was modest with a mean (SD change of 0.53 (2.62 kg/m2 (p=0.071. A multivariate regression model showed that subjects with a baseline AHI between 5-15 had a mean increase in BMI of 0.22 kg/m2 (p=0.055 and those with baseline AHI ≥ 15 had a BMI increase of 0.51 kg/m2 (p<0.001 compared to those with baseline AHI of <5.Conclusion: Our findings suggest that there is a positive association between severity of SDB and subsequent increased BMI over approximately 5 years. This observation may help explain why persons with SDB have difficulty losing weight.

  4. WHEN DOES IMPROVING HEALTH RAISE GDP?

    Science.gov (United States)

    Ashraf, Quamrul H; Lester, Ashley; Weil, David N

    2009-04-01

    We assess quantitatively the effect of exogenous health improvements on output per capita. Our simulation model allows for a direct effect of health on worker productivity, as well as indirect effects that run through schooling, the size and age-structure of the population, capital accumulation, and crowding of fixed natural resources. The model is parameterized using a combination of microeconomic estimates, data on demographics, disease burdens, and natural resource income in developing countries, and standard components of quantitative macroeconomic theory. We consider both changes in general health, proxied by improvements in life expectancy, and changes in the prevalence of two particular diseases: malaria and tuberculosis. We find that the effects of health improvements on income per capita are substantially lower than those that are often quoted by policy-makers, and may not emerge at all for three decades or more after the initial improvement in health. The results suggest that proponents of efforts to improve health in developing countries should rely on humanitarian rather than economic arguments.

  5. BostonBreathes: improving pediatric asthma care with a home-based interactive website for patient education, monitoring, and clinical teamwork.

    Science.gov (United States)

    Wiecha, John M; Adams, William G

    2006-01-01

    The BostonBreathes (BB) system is an interactive website enabling physician-physician and physician-patient communication, monitoring (peak-flow, medication use, symptoms) of asthma patients in the home, and patient and family asthma education. The system helps primary care physicians to function in team relationships with asthma specialists and nurses. Patients and families can interact with their health professionals online as members of the care team. BB uniquely combines patient education, monitoring, and clinical teamwork functions into one integrated web environment.

  6. BostonBreathes: an RCT to improve pediatric asthma care with a home-based interactive website for patient education, monitoring, and clinical teamwork.

    Science.gov (United States)

    Wiecha, John M; Adams, William G

    2007-10-11

    The BostonBreathes (BB) system is an interactive website enabling physician-physician and physician-patient communication, monitoring (peak-flow, medication use, symptoms) of asthma patients in the home, and patient and family asthma education. The system helps primary care physicians to function in team relationships with asthma specialists and nurses. Patients and families can interact with their health professionals online as members of the care team. BB uniquely combines patient education, monitoring, and clinical teamwork functions into one integrated web environment.

  7. Climate services to improve public health.

    Science.gov (United States)

    Jancloes, Michel; Thomson, Madeleine; Costa, María Mánez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary

    2014-04-25

    A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4-6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers.

  8. Can life coaching improve health outcomes?

    DEFF Research Database (Denmark)

    Ammentorp, Jette

    26. Ammentorp J, Uhrenfeldt L, Angel F, Ehrensvärd, Carlsen E, Kofoed P-E. Can life coaching improve health outcomes? – A systematic review of intervention studies. Poster presented at the International Conference on Communication in Healthcare, Montreal Canada, 30 Sept 2013.......26. Ammentorp J, Uhrenfeldt L, Angel F, Ehrensvärd, Carlsen E, Kofoed P-E. Can life coaching improve health outcomes? – A systematic review of intervention studies. Poster presented at the International Conference on Communication in Healthcare, Montreal Canada, 30 Sept 2013....

  9. Breath alcohol test

    Science.gov (United States)

    Alcohol test - breath ... There are various brands of breath alcohol tests. Each one uses a different method to test the level of alcohol in the breath. The machine may be electronic or manual. One ...

  10. Rapid shallow breathing

    Science.gov (United States)

    Tachypnea; Breathing - rapid and shallow; Fast shallow breathing; Respiratory rate - rapid and shallow ... Shallow, rapid breathing has many possible medical causes, including: Asthma Blood clot in an artery in the lung Choking Chronic obstructive ...

  11. Breathing difficulties - first aid

    Science.gov (United States)

    Difficulty breathing - first aid; Dyspnea - first aid; Shortness of breath - first aid ... Breathing difficulty is almost always a medical emergency. An exception is feeling slightly winded from normal activity, ...

  12. Point-of-care continuous 13C-methacetin breath test improves decision making in acute liver disease: Results of a pilot clinical trial

    Institute of Scientific and Technical Information of China (English)

    Gadi Lalazar; Tomer Adar; Yaron Ilan

    2009-01-01

    AIM: To assess the role of the 13C-methacetin breath test (MBT) in patients with acute liver disease. METHODS: Fifteen patients with severe acute liver disease from diverse etiologies were followed-up with 13C-MBT during the acute phase of their illnesses (range 3-116 d after treatment). Patients fasted for 8 h and ingested 75 mg of methacetin prior to the MBT. We compared results from standard clinical assessment, serum liver enzymes, synthetic function, and breath test scores. RESULTS: Thirteen patients recovered and two patients died. In patients that recovered, MBT parameters improved in parallel with improvements in lab results. Evidence of consistent improvement began on day 3 for MBT parameters and between days 7 and 9 for blood tests. Later convergence to normality occurred at an average of 9 d for MBT parameters and from 13 to 28 d for blood tests. In both patients that died, MBT parameters remained low despite fluctuating laboratory values. CONCLUSION: The 13C-MBT provides a rapid, noninvasive assessment of liver function in acute severe liver disease of diverse etiologies. The results of this pilot clinical trial suggest that the MBT may offer greater sensitivity than standard clinical tests for managing patients with severe acute liver disease.

  13. Improving educational preparation for transcultural health care.

    Science.gov (United States)

    Le Var, R M

    1998-10-01

    There is increasing evidence that the health care needs of people from black and ethnic minority groups in England are not being met. A growing number of initiatives are being undertaken to remedy the situation. Many of them are focused on health care delivery at local and national levels. However, unless the preparation of health care professionals in the area of multi-cultural health care is appropriate and effective, a great deal of corrective action will continue to have to be taken. Despite 1997 having been the European Year Against Racism, it is still necessary to consider what educational preparation should be like. The article draws on identified inadequacies in health care provision as well as examples of initiatives taken to improve care provision. The author identifies deficiencies in educational preparation and proposes a range of actions to be taken. The article is focused on nursing, midwifery and health visiting education in England, but is deemed to be relevant to all health care professionals not only in Europe but other continents, as they become increasingly international and multi-ethnic.

  14. Improved inhaled air quality at reduced ventilation rate by control of airflow interaction at the breathing zone with lobed jets

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Spilak, Michal

    2014-01-01

    Inhaled air quality at a reduced supply of clean air was studied by controlling the airflow interaction at the breathing zone of a person using lobed jets as part of personalized ventilation (PV). Experiments were performed in a full-scale test room at 23°C (73.4°F) with a breathing thermal manikin......) equivalent diameter. The nozzles were positioned frontally at the face within the boundary layer and centered to the mouth. The enhancement of inhaled air quality by changing the initial velocity (0.2-0.6 m/s, 0.66-1.97 fps) and the distance from the mouth (0.02-0.06 m, 0.07-0.20 ft) was studied. The control...... over the interaction between the inserted jets and the free convection flow was efficient. Over 80% clean PV air was measured in inhalation. The worst performing nozzle was the four-leafed clover: its best performance yielded 23% clean air inhalation, at the shortest distance and the highest velocity...

  15. Using surface imaging and visual coaching to improve the reproducibility and stability of deep-inspiration breath hold for left-breast-cancer radiotherapy

    Science.gov (United States)

    Cerviño, Laura I.; Gupta, Sonia; Rose, Mary A.; Yashar, Catheryn; Jiang, Steve B.

    2009-11-01

    Late cardiac complications may arise after left-breast radiation therapy. Deep-inspiration breath hold (DIBH) allows reduction of the irradiated heart volume at the same time as it reduces tumor bed motion and increases lung sparing. In the present study, we have evaluated the improvement in reproducibility and stability of the DIBH for left-breast-cancer treatment when visual coaching is provided with the aid of 3D video surface imaging and video goggles. Five left-breast-cancer patients and fifteen healthy volunteers were asked to perform a series of DIBHs without and with visual coaching. Reproducibility and stability of DIBH were measured for each individual with and without visual coaching. The average reproducibility and stability changed from 2.1 mm and 1.5 mm, respectively, without visual feedback to 0.5 mm and 0.7 mm with visual feedback, showing a significant statistical difference (p 2 mm) in reproducibility and stability were observed in 35% and 15% of the subjects, respectively. The average chest wall excursion of the DIBH with respect to the free breathing preceding the DIBH was found to be 11.3 mm. The reproducibility and stability of the DIBH improve significantly from the visual coaching provided to the patient, especially in those patients with poor reproducibility and stability.

  16. Improving mental health outcomes: achieving equity through quality improvement

    Science.gov (United States)

    Poots, Alan J.; Green, Stuart A.; Honeybourne, Emmi; Green, John; Woodcock, Thomas; Barnes, Ruth; Bell, Derek

    2014-01-01

    Objective To investigate equity of patient outcomes in a psychological therapy service, following increased access achieved by a quality improvement (QI) initiative. Design Retrospective service evaluation of health outcomes; data analysed by ANOVA, chi-squared and Statistical Process Control. Setting A psychological therapy service in Westminster, London, UK. Participants People living in the Borough of Westminster, London, attending the service (from either healthcare professional or self-referral) between February 2009 and May 2012. Intervention(s) Social marketing interventions were used to increase referrals, including the promotion of the service through local media and through existing social networks. Main Outcome Measure(s) (i) Severity of depression on entry using Patient Health Questionnaire-9 (PHQ9). (ii) Changes to severity of depression following treatment (ΔPHQ9). (iii) Changes in attainment of a meaningful improvement in condition assessed by a key performance indicator. Results Patients from areas of high deprivation entered the service with more severe depression (M = 15.47, SD = 6.75), compared with patients from areas of low (M = 13.20, SD = 6.75) and medium (M = 14.44, SD = 6.64) deprivation. Patients in low, medium and high deprivation areas attained similar changes in depression score (ΔPHQ9: M = −6.60, SD = 6.41). Similar proportions of patients achieved the key performance indicator across initiative phase and deprivation categories. Conclusions QI methods improved access to mental health services; this paper finds no evidence for differences in clinical outcomes in patients, regardless of level of deprivation, interpreted as no evidence of inequity in the service with respect to this outcome. PMID:24521701

  17. Health care quality improvement publication trends.

    Science.gov (United States)

    Sun, Gordon H; MacEachern, Mark P; Perla, Rocco J; Gaines, Jean M; Davis, Matthew M; Shrank, William H

    2014-01-01

    To analyze the extent of academic interest in quality improvement (QI) initiatives in medical practice, annual publication trends for the most well-known QI methodologies being used in health care settings were analyzed. A total of 10 key medical- and business-oriented library databases were examined: PubMed, Ovid MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, Scopus, the Cochrane Central Register of Controlled Trials, ABI/INFORM, and Business Source Complete. A total of 13 057 articles were identified that discuss at least 1 of 10 well-known QI concepts used in health care contexts, 8645 (66.2%) of which were classified as original research. "Total quality management" was the only methodology to demonstrate a significant decline in publication over time. "Continuous quality improvement" was the most common topic of study across all publication years, whereas articles discussing Lean methodology demonstrated the largest growth in publication volume over the past 2 decades. Health care QI publication volume increased substantially beginning in 1991.

  18. Health innovation for patient safety improvement

    Directory of Open Access Journals (Sweden)

    Renukha Sellappans

    2013-01-01

    Full Text Available Medication error has been identified as a major factor affecting patient safety. Many innovative efforts such as Computerised Physician Order Entry (CPOE, a Pharmacy Information System, automated dispensing machines and Point of Administration Systems have been carried out with the aim of improving medication safety. However, areas remain that require urgent attention. One main area will be the lack of continuity of care due to the breakdown of communication between multiple healthcare providers. Solutions may include consideration of “health smart cards” that carry vital patient medical information in the form of a “credit card” or use of the Malaysian identification card. However, costs and technical aspects associated with the implementation of this health smart card will be a significant barrier. Security and confidentiality, on the other hand, are expected to be of primary concern to patients. Challenges associated with the implementation of a health smart card might include physician buy-in for use in his or her everyday practice. Training and technical support should also be available to ensure the smooth implementation of this system. Despite these challenges, implementation of a health smart card moves us closer to seamless care in our country, thereby increasing the productivity and quality of healthcare.

  19. MELATONIN: POTENTIAL UTILITY FOR IMPROVING PUBLIC HEALTH

    Directory of Open Access Journals (Sweden)

    Russel J REITER; Fatih GULTEKIN; Luis J FLORES; Ma Pilar TERRON; Dun-Xian TAN

    2006-04-01

    Full Text Available This review summarizes the beneficial actions of melatonin in various experimental conditions/diseases and identifies where the use of melatonin may be helpful in improving public health. The nightly use of melatonin supplements by humans often improves their sleep and helps correct the circadian dyssynchronization associated with “jet lag”. Additionally, melatonin has been found effective in curtailing the growth of a variety of experimental cancers. Mechanistically, this is achieved by melatonin’s ability to limit fatty acid uptake, especially linoleic acid, by tumor cells. Fatty acids are growth factors for many tumors. Additionally, melatonin inhibits the elevated telomerase activity of tumor cells thus making them more fragile and vulnerable to chemotherapies. Melatonin also may inhibit angiogenesis in tumors by suppressing endothelin-1 production and the indole interferes with the stimulatory action of steroids on hormone-responsive tumors. As an ubiquitously-acting antioxidant, melatonin reduces cardiac damage during ischemia/reperfusion (I/R injury (heart attack and during I/R to the brain (stroke. Melatonin also limits the toxicity of amyloid  peptide and of neurofibrillary tangles, two of the cardinal signs of Alzheimer’s disease. Collectively, these data suggest supplementation with melatonin, whose endogenous levels decrease with age, may improve the quality of life in the aged and, as a consequence, be beneficial for public health generally. [TAF Prev Med Bull 2006; 5(2.000: 131-158

  20. Judgment sampling: a health care improvement perspective.

    Science.gov (United States)

    Perla, Rocco J; Provost, Lloyd P

    2012-01-01

    Sampling plays a major role in quality improvement work. Random sampling (assumed by most traditional statistical methods) is the exception in improvement situations. In most cases, some type of "judgment sample" is used to collect data from a system. Unfortunately, judgment sampling is not well understood. Judgment sampling relies upon those with process and subject matter knowledge to select useful samples for learning about process performance and the impact of changes over time. It many cases, where the goal is to learn about or improve a specific process or system, judgment samples are not merely the most convenient and economical approach, they are technically and conceptually the most appropriate approach. This is because improvement work is done in the real world in complex situations involving specific areas of concern and focus; in these situations, the assumptions of classical measurement theory neither can be met nor should an attempt be made to meet them. The purpose of this article is to describe judgment sampling and its importance in quality improvement work and studies with a focus on health care settings.

  1. Reviewing Health Manpower Development. A Method of Improving National Health Systems. Public Health Papers No. 83.

    Science.gov (United States)

    Fulop, Tamas; Roemer, Milton I.

    This guide is intended to assist countries contemplating a comprehensive, action-oriented review of health labor force development to improve their national health systems. Various aspects of the health system infrastructure are examined (major components, organizational structure, coordinating mechanisms, sources of information, and…

  2. Technologies for Clinical Diagnosis Using Expired Human Breath Analysis

    Directory of Open Access Journals (Sweden)

    Thalakkotur Lazar Mathew

    2015-02-01

    Full Text Available This review elucidates the technologies in the field of exhaled breath analysis. Exhaled breath gas analysis offers an inexpensive, noninvasive and rapid method for detecting a large number of compounds under various conditions for health and disease states. There are various techniques to analyze some exhaled breath gases, including spectrometry, gas chromatography and spectroscopy. This review places emphasis on some of the critical biomarkers present in exhaled human breath, and its related effects. Additionally, various medical monitoring techniques used for breath analysis have been discussed. It also includes the current scenario of breath analysis with nanotechnology-oriented techniques

  3. Social networks in improvement of health care.

    Science.gov (United States)

    Masic, Izet; Sivic, Suad; Toromanovic, Selim; Borojevic, Tea; Pandza, Haris

    2012-01-01

    , etc., which gives a special emphasis on public health aspects of information, especially in the field of medicine and health care. The authors of this paper discuss the role and practical importance of social networks in improving the health and solving of health problems without the physical entrance into the health care system. Social networks have their advantages and disadvantages, benefits and costs, especially when it comes to information which within the network set unprofessional people from unreliable sources, without an adequate selection. The ethical aspect of the norms in this segment is still not adequately regulated, so any sanctions for the unauthorized and malicious use of social networks in private and other purposes in order to obtain personal gain at the expense of individuals or groups (sick or healthy, owners of certain businesses and companies, health organizations and pharmaceutical manufacturers, etc.), for which there is still no global or European codes and standards of conduct. Cyber crime is now one of the mostly present types of crime in modern times, as evidenced by numerous scandals that are happening both globally and locally.

  4. Submarines, Spacecraft, and Exhaled Breath

    Science.gov (United States)

    The International Association of Breath Research (IABR) meetings are an eclectic gathering of researchers in the medical, environmental and instrumentation fields; our focus is on human health as assessed by the measurement and interpretation of trace chemicals in human exhaled b...

  5. Air pollution and public health: emerging hazards and improved understanding of risk.

    Science.gov (United States)

    Kelly, Frank J; Fussell, Julia C

    2015-08-01

    Despite past improvements in air quality, very large parts of the population in urban areas breathe air that does not meet European standards let alone the health-based World Health Organisation Air Quality Guidelines. Over the last 10 years, there has been a substantial increase in findings that particulate matter (PM) air pollution is not only exerting a greater impact on established health endpoints, but is also associated with a broader number of disease outcomes. Data strongly suggest that effects have no threshold within the studied range of ambient concentrations, can occur at levels close to PM2.5 background concentrations and that they follow a mostly linear concentration-response function. Having firmly established this significant public health problem, there has been an enormous effort to identify what it is in ambient PM that affects health and to understand the underlying biological basis of toxicity by identifying mechanistic pathways-information that in turn will inform policy makers how best to legislate for cleaner air. Another intervention in moving towards a healthier environment depends upon the achieving the right public attitude and behaviour by the use of optimal air pollution monitoring, forecasting and reporting that exploits increasingly sophisticated information systems. Improving air quality is a considerable but not an intractable challenge. Translating the correct scientific evidence into bold, realistic and effective policies undisputedly has the potential to reduce air pollution so that it no longer poses a damaging and costly toll on public health.

  6. 42 CFR 84.90 - Breathing resistance test; inhalation.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing resistance test; inhalation. 84.90...-Contained Breathing Apparatus § 84.90 Breathing resistance test; inhalation. (a) Resistance to inhalation airflow will be measured in the facepiece or mouthpiece while the apparatus is operated by a...

  7. 42 CFR 84.122 - Breathing resistance test; minimum requirements.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing resistance test; minimum requirements. 84... Masks § 84.122 Breathing resistance test; minimum requirements. (a) Resistance to airflow will be measured in the facepiece or mouthpiece of a gas mask mounted on a breathing machine both before and...

  8. 42 CFR 84.172 - Breathing tubes; minimum requirements.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing tubes; minimum requirements. 84.172... Air-Purifying Particulate Respirators § 84.172 Breathing tubes; minimum requirements. Flexible breathing tubes used in conjunction with respirators shall be designed and constructed to prevent:...

  9. 42 CFR 84.203 - Breathing resistance test; minimum requirements.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing resistance test; minimum requirements. 84.203 Section 84.203 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Chemical Cartridge Respirators § 84.203 Breathing resistance test; minimum requirements. (a) Resistance...

  10. Breathing guidance in radiation oncology and radiology: A systematic review of patient and healthy volunteer studies

    Energy Technology Data Exchange (ETDEWEB)

    Pollock, Sean, E-mail: sean.pollock@sydney.edu.au; Keall, Paul [Radiation Physics Laboratory, University of Sydney, Sydney 2050 (Australia); Keall, Robyn [Central School of Medicine, University of Sydney, Sydney 2050, Australia and Hammond Care, Palliative Care and Supportive Care Service, Greenwich 2065 (Australia)

    2015-09-15

    Purpose: The advent of image-guided radiation therapy has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion irregularities is the use of breathing guidance systems during imaging and treatment. These systems aim to facilitate regular respiratory motion which in turn improves image quality and radiation treatment accuracy. A review of such research has yet to be performed; it was therefore their aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: From August 1–14, 2014, the following online databases were searched: Medline, Embase, PubMed, and Web of Science. Results of these searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with preferred reporting items for systematic reviews and meta-analyses. Reference lists of included articles, and repeat authors of included articles, were hand-searched. Results: The systematic search yielded a total of 480 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. These 27 articles detailed the intervention of breathing guidance strategies in controlled studies assessing its impact on such outcomes as breathing regularity, image quality, target coverage, and treatment margins, recruiting either healthy adult volunteers or patients with thoracic or abdominal lesions. In 21/27 studies, significant (p < 0.05) improvements from the use of breathing guidance were observed. Conclusions: There is a trend toward the number of breathing guidance studies increasing with time, indicating a growing clinical interest. The results found here indicate that further clinical studies are warranted that quantify the

  11. Preinduction incentive spirometry versus deep breathing to improve apnea tolerance during induction of anesthesia in patients of abdominal sepsis: A randomized trial

    Directory of Open Access Journals (Sweden)

    M Tripathi

    2013-01-01

    Full Text Available Background: Abdominal sepsis is associated with varied degree of hypoxemia and atelactasis in the lung and can enhance the onset of desaturation of arterial blood during apnea. Aims : This study looked at methods to improve safety margin of apnea during induction of anesthesia in these high-risk patients. Settings and Design: It was a randomized, single blind study on adult patients presenting for emergency laparotomy due to peritonitis in a university teaching hospital setting. Materials and Methods: In group 1 (IS (n = 32, three sessions of incentive spirometry (IS were performed within one hour before induction of anesthesia. In group 2 (DB (n = 34, patients were subjected to deep breathing sessions in a similar manner. All patients received preoxygenation (100% by mask for 3 min, followed by rapid-sequence induction of anesthesia using fentanyl, thiopental, and suxamethonium and endotracheal intubation. Patients were subjected to a period of apnea by keeping the end of the endotracheal tube open to air till they developed 95% hemoglobin saturation (SpO 2 by pulse oxymetry. Positive pressure ventilation was resumed at the end. We observed for hemodynamic changes, apnea time, and SpO 2 (100% recovery time on resuming ventilation. Arterial blood gas samples were taken before intervention, after IS or DB, after preoxygenation, and at the end of apnea. Statistical analysis used: One-way analysis of variance (ANOVA, X 2 test, Kaplan-Meier graph, and log-rank tests were applied to compare the two study groups. Results: Oxygenation level in group 1 (265 ± 76.7 mmHg patients was significantly (P < 0.001 higher than in group 2 (221 ± 61.8 mmHgat the end of preoxygenation. The apnea time (median: lower bound - upper bound Confidence Interval apnea time (272:240-279 s in group 1 (IS patients was significantly higher P < 0.05 than in group 2 (180:163-209 s patients. Saturation recovery time (35:34-46 s in group 1 (IS patients was also quicker than in

  12. Improving Coordination of Addiction Health Services Organizations with Mental Health and Public Health Services.

    Science.gov (United States)

    Guerrero, Erick G; Andrews, Christina; Harris, Lesley; Padwa, Howard; Kong, Yinfei; M S W, Karissa Fenwick

    2016-01-01

    In this mixed-method study, we examined coordination of mental health and public health services in addiction health services (AHS) in low-income racial and ethnic minority communities in 2011 and 2013. Data from surveys and semistructured interviews were used to evaluate the extent to which environmental and organizational characteristics influenced the likelihood of high coordination with mental health and public health providers among outpatient AHS programs. Coordination was defined and measured as the frequency of interorganizational contact among AHS programs and mental health and public health providers. The analytic sample consisted of 112 programs at time 1 (T1) and 122 programs at time 2 (T2), with 61 programs included in both periods of data collection. Forty-three percent of AHS programs reported high frequency of coordination with mental health providers at T1 compared to 66% at T2. Thirty-one percent of programs reported high frequency of coordination with public health services at T1 compared with 54% at T2. Programs with culturally responsive resources and community linkages were more likely to report high coordination with both services. Qualitative analysis highlighted the role of leadership in leveraging funding and developing creative solutions to deliver coordinated care. Overall, our findings suggest that AHS program funding, leadership, and cultural competence may be important drivers of program capacity to improve coordination with health service providers to serve minorities in an era of health care reform.

  13. Improving physical health international students enrolled in a technical college in Baikal region

    Directory of Open Access Journals (Sweden)

    Kolokoltsev M.M.

    2014-01-01

    Full Text Available Purpose : to improve the physical health of foreign students enrolled in a technical college Baikal region using an extended motor mode. Material : in the experiment participated 57 students attending the training of South-East Asia, 74 - from Central Asia and 455 - Slavs, natives of the Irkutsk region. Results : it was found poor fitness and low functional performance among foreign students. For this purpose they had used advanced motoring. It included, besides training curriculum additional group activities in the form of sports, participating in sports events and guided independent study physical education. Conclusion : the end of follow foreign students involved in the extended motor mode, significantly outperform their peers engaged on normal functional parameters (heart rate, a test with 20 squats, the recovery time after exercise, dynamometry hands, breath tests, adaptive capacity as well as motor qualities.

  14. First Breath prenatal smoking cessation pilot study: preliminary findings.

    Science.gov (United States)

    Jehn, Lisette; Lokker, Nicole; Matitz, Debra; Christiansen, Bruce

    2003-01-01

    Despite the many dangers associated with smoking during pregnancy, it remains a salient public health problem for Wisconsin women. The First Breath pilot program was developed in an attempt to reduce rates of smoking during pregnancy among low-income women. Preliminary results suggest that the First Breath counseling-based approach is effective, with a quit rate of 43.8% among First Breath enrollees at 1 month postpartum. Women receiving First Breath cessation counseling also had higher quit rates at every measurement period versus women in a comparison group who were receiving whatever cessation care was available in their county in the absence of First Breath. The First Breath pilot study has demonstrated success in helping pregnant women quit smoking and in creating a model for integration of cessation services into prenatal health care service provision. It is through this success that First Breath is expanding beyond the pilot study stage to a statewide program in 2003.

  15. Evaluation of sleep related breathing problems and sleep disturbances among health related employees at Fayoum University Hospitals

    Directory of Open Access Journals (Sweden)

    Radwa Ahmed Elhefny

    2016-07-01

    Conclusion: Our findings indicate that the daytime somnolence is common among health care workers followed by nocturnal sleep problems. Urbanization and large scale of industrialization can explain the incidence of sleep problems among rural living.

  16. Improved abdominal MRI in non-breath-holding children using a radial k-space sampling technique

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Hyuk; Choi, Young Hun; Cheon, Jung Eun; Lee, So Mi; Cho, Hyun Hae; Kim, Woo Sun; Kim, In One [Seoul National University Children' s Hospital, Department of Radiology, Seoul (Korea, Republic of); Shin, Su Mi [SMG-SNU Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of)

    2015-06-15

    Radial k-space sampling techniques have been shown to reduce motion artifacts in adult abdominal MRI. To compare a T2-weighted radial k-space sampling MRI pulse sequence (BLADE) with standard respiratory-triggered T2-weighted turbo spin echo (TSE) in pediatric abdominal imaging. Axial BLADE and respiratory-triggered turbo spin echo sequences were performed without fat suppression in 32 abdominal MR examinations in children. We retrospectively assessed overall image quality, the presence of respiratory, peristaltic and radial artifact, and lesion conspicuity. We evaluated signal uniformity of each sequence. BLADE showed improved overall image quality (3.35 ± 0.85 vs. 2.59 ± 0.59, P < 0.001), reduced respiratory motion artifact (0.51 ± 0.56 vs. 1.89 ± 0.68, P < 0.001), and improved lesion conspicuity (3.54 ± 0.88 vs. 2.92 ± 0.77, P = 0.006) compared to respiratory triggering turbo spin-echo (TSE) sequences. The bowel motion artifact scores were similar for both sequences (1.65 ± 0.77 vs. 1.79 ± 0.74, P = 0.691). BLADE introduced a radial artifact that was not observed on the respiratory triggering-TSE images (1.10 ± 0.85 vs. 0, P < 0.001). BLADE was associated with diminished signal variation compared with respiratory triggering-TSE in the liver, spleen and air (P < 0.001). The radial k-space sampling technique improved the quality and reduced respiratory motion artifacts in young children compared with conventional respiratory-triggered turbo spin-echo sequences. (orig.)

  17. Controlled Frequency Breathing Reduces Inspiratory Muscle Fatigue.

    Science.gov (United States)

    Burtch, Alex R; Ogle, Ben T; Sims, Patrick A; Harms, Craig A; Symons, Thorburn B; Folz, Rodney J; Zavorsky, Gerald S

    2016-08-16

    Controlled frequency breathing (CFB) is a common swim training modality involving holding one's breath for about 7 to 10 strokes before taking another breath. We sought to examine the effects of CFB training on reducing respiratory muscle fatigue. Competitive college swimmers were randomly divided into either the CFB group that breathed every 7 to 10 strokes, or a control group that breathed every 3-4 strokes. Twenty swimmers completed the study. The training intervention included 5-6 weeks (16 sessions) of 12x50-m repetitions with breathing 8-10 breaths per 50m (control group), or 2-3 breaths per 50-m (CFB group). Inspiratory muscle fatigue was defined as the decrease in maximal inspiratory mouth-pressure (MIP) between rest and 46s after a 200 yard free-style swimming race [115s (SD 7)]. Aerobic capacity, pulmonary diffusing capacity, and running economy were also measured pre and post-training. Pooled results demonstrated a 12% decrease in MIP at 46s post-race [-15 (SD 14) cm H2O, Effect size = -0.48, p training, only the CFB group prevented a decline in MIP values pre to 46 s post-race [-2 (13) cm H2O, p > 0.05]. However, swimming performance, aerobic capacity, pulmonary diffusing capacity, and running economy did not improve (p > 0.05) post-training in either group. In conclusion, CFB training appears to prevent inspiratory muscle fatigue yet no difference was found in performance outcomes.

  18. Decolonisation: a critical step for improving Aboriginal health.

    Science.gov (United States)

    Sherwood, Juanita; Edwards, Tahnia

    2006-09-01

    Aboriginal health continues to be in crisis in Australia although expenditure has increased in service provision, strategic planning, research and policy development over the last thirty years. This paper recommends that a shift must occur to make Aboriginal health improvement a reality. This shift requires the decolonising of Aboriginal health so that the experts in Aboriginal health, namely Aboriginal people, can voice and action initiatives that address their health issues. This shift is from the current western dominant approach that continues to manage Aboriginal health in its linear spectrum of illness and disease. Aboriginal people view health differently; their contexts for health issues are also diverse requiring a more holistic and informed response.

  19. Improved general physical fitness of young swimmers by applying in the training process of endogenous hypoxic breathing techniques

    Directory of Open Access Journals (Sweden)

    Furman Y.M.

    2014-06-01

    Full Text Available Purpose : to examine the effect of general physical preparedness of young swimmers in the body artificially created state hypercapnic normobaric hypoxia. Material : the study involved 21 swimmer aged 13-14 years with sports qualifications at third and second sports categories. Results : the original method of working with young swimmers. Studies were conducted for 16 weeks a year preparatory period macrocycle. The average value of the index on the results of general endurance races 800m improved by 2.80 %. 8.24 % increased speed- strength endurance and 18.77 % increased dynamic strength endurance. During the period of formative experiment performance speed, agility, static endurance, flexibility and explosive strength athletes first experimental group was not significantly changed. Conclusions : it was found that the use of the proposed technique provides statistically significant increase in overall endurance, speed strength endurance and dynamic strength endurance.

  20. Improving primary health care through technological innovation.

    NARCIS (Netherlands)

    Groenewegen, P.P.; Hutten, J.B.F.

    1989-01-01

    As a result of policy changes and developments on the demand side, the importance of technology in primary health care will grow fast. An approach to the implementation of new technologies in primary health care is presented in this article. First we describe the main problems in Dutch primary healt

  1. Improving a free air breathing proton exchange membrane fuel cell through the Maximum Efficiency Point Tracking method

    Science.gov (United States)

    Higuita Cano, Mauricio; Mousli, Mohamed Islam Aniss; Kelouwani, Sousso; Agbossou, Kodjo; Hammoudi, Mhamed; Dubé, Yves

    2017-03-01

    This work investigates the design and validation of a fuel cell management system (FCMS) which can perform when the fuel cell is at water freezing temperature. This FCMS is based on a new tracking technique with intelligent prediction, which combined the Maximum Efficiency Point Tracking with variable perturbation-current step and the fuzzy logic technique (MEPT-FL). Unlike conventional fuel cell control systems, our proposed FCMS considers the cold-weather conditions, the reduction of fuel cell set-point oscillations. In addition, the FCMS is built to respond quickly and effectively to the variations of electric load. A temperature controller stage is designed in conjunction with the MEPT-FL in order to operate the FC at low-temperature values whilst tracking at the same time the maximum efficiency point. The simulation results have as well experimental validation suggest that propose approach is effective and can achieve an average efficiency improvement up to 8%. The MEPT-FL is validated using a Proton Exchange Membrane Fuel Cell (PEMFC) of 500 W.

  2. Markers of Sleep Disordered Breathing and Diabetes Mellitus in a Multiethnic Sample of US Adults: Results from the National Health and Nutrition Examination Survey (2005–2008)

    Science.gov (United States)

    Sabanayagam, Charumathi; Teppala, Srinivas; Shankar, Anoop

    2012-01-01

    We examined gender and ethnic differences in the association between sleep disordered breathing (SDB) and diabetes among 6,522 participants aged ≥20 years from the National Health and Nutrition Examination Survey 2005–08. SDB severity was defined based on an additive summary score including sleep duration, snoring, snorting, and daytime sleepiness. We found that the summary SDB score was significantly associated with diabetes after adjusting for potential confounders in the whole population. Compared to those without any sleep disturbance, the multivariable odds ratio (OR) (95% confidence interval (CI)) of diabetes among those with ≥3 sleep disturbances was 2.04 (1.46–2.87). In sex-specific analyses, this association was significant only in women (OR (95% CI) = 3.68 (2.01–6.72)) but not in men (1.10 (0.59–2.04)), P-interaction = 0.01. However, there were no ethnic differences in this association, P-interaction = 0.7. In a nationally representative sample of US adults, SDB was independently associated with diabetes only in women, but not in men. PMID:22518133

  3. Markers of Sleep Disordered Breathing and Diabetes Mellitus in a Multiethnic Sample of US Adults: Results from the National Health and Nutrition Examination Survey (2005–2008

    Directory of Open Access Journals (Sweden)

    Charumathi Sabanayagam

    2012-01-01

    Full Text Available We examined gender and ethnic differences in the association between sleep disordered breathing (SDB and diabetes among 6,522 participants aged ≥20 years from the National Health and Nutrition Examination Survey 2005–08. SDB severity was defined based on an additive summary score including sleep duration, snoring, snorting, and daytime sleepiness. We found that the summary SDB score was significantly associated with diabetes after adjusting for potential confounders in the whole population. Compared to those without any sleep disturbance, the multivariable odds ratio (OR (95% confidence interval (CI of diabetes among those with ≥3 sleep disturbances was 2.04 (1.46–2.87. In sex-specific analyses, this association was significant only in women (OR (95% CI = 3.68 (2.01–6.72 but not in men (1.10 (0.59–2.04, P-interaction =0.01. However, there were no ethnic differences in this association, P-interaction =0.7. In a nationally representative sample of US adults, SDB was independently associated with diabetes only in women, but not in men.

  4. Design and Evaluation of a Breath Analysis System for Occupational Exposure Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Soldat, Kelvin L.; Thrall, Karla D.

    2001-06-01

    Exposure assessment is an integral part of industrial hygiene and occupational health. To ensure the health and safety of workers, integrated industrial hygiene methodologies often include biological monitoring strategies. Exhaled breath is an ideal matrix for measuring volatile biomarkers, particularly since the non-invasive collection of breath may improve volunteer participation. A real-time, field-portable system was developed to analyze undiluted exhaled air from experimental animals and humans. The system combines (1) an ion-trap mass spectrometer capable of atmospheric sampling; (2) a breath interface for continual analysis of the exhaled breath stream; (3) chemical dosimeters that are analyzed in the field/workplace; and (4) physiologically based pharmacokinetic (PBPK) models to estimate total exposure and internal target tissue dosimetry. The intent of this development was to provide new instrumentation to evaluate volatile chemical exposures as part of a daily monitoring pro gram. For example, the system was designed to monitor a worker every time they enter and leave a work environment - a vast improvement over current 8-hr integrated monitoring strategies. To evaluate the system in actual work environments, field tests were conducted using volunteers providing exhaled breath samples before and after each specific job task. In these field studies, several volunteers had post-task breath levels higher than pre-task levels. Compared to the breath analysis findings, chemical dosimeters underpredicted exposures, particularly for longer sampling intervals where the volume of air sampled may have diluted exposures. The results of these field studies illustrate the utility of monitoring workers for exposures at numerous times throughout the day, particularly when job-specific tasks may indicate a potential for exposure.

  5. How could health information be improved? Recommended actions from the Victorian Consultation on Health Literacy.

    Science.gov (United States)

    Hill, Sophie J; Sofra, Tanya A

    2017-03-07

    Objective Health literacy is on the policy agenda. Accessible, high-quality health information is a major component of health literacy. Health information materials include print, electronic or other media-based information enabling people to understand health and make health-related decisions. The aim of the present study was to present the findings and recommended actions as they relate to health information of the Victorian Consultation on Health Literacy.Methods Notes and submissions from the 2014 Victorian Consultation workshops and submissions were analysed thematically and a report prepared with input from an advisory committee.Results Health information needs to improve and recommendations are grouped into two overarching themes. First, the quality of information needs to be increased and this can be done by developing a principle-based framework to inform updating guidance for information production, formulating standards to raise quality and improving the systems for delivering information to people. Second, there needs to be a focus on users of health information. Recommendation actions were for information that promoted active participation in health encounters, resources to encourage critical users of health information and increased availability of information tailored to population diversity.Conclusion A framework to improve health information would underpin the efforts to meet literacy needs in a more consistent way, improving standards and ultimately increasing the participation by consumers and carers in health decision making and self-management.What is known about the topic? Health information is a critical component of the concept of health literacy. Poorer health literacy is associated with poorer health outcomes across a range of measures. Improving access to and the use of quality sources of health information is an important strategy for meeting the health literacy needs of the population. In recent years, health services and governments

  6. Working with women to improve child and community eye health

    Directory of Open Access Journals (Sweden)

    Gopa Kothari

    2009-06-01

    Full Text Available In the slums and rural areas of India, visual impairment, blindness, and childhood blindness are usually more prevalent.In order to improve the eye health of children and the community in these areas, it is important to understand the influence women and mothers have over children’s eye health and the eye health of the community as a whole.

  7. Diffusion of a quality improvement programme among allied health professionals.

    NARCIS (Netherlands)

    Sluijs, E.M.; Dekker, J.

    1999-01-01

    Objective: To assess the diffusion of a quality improvement (QI) programme among allied health professions in The Netherlands. Design: Descriptive study, based on a questionnaire distributed to allied health professionals; response rate, 63%. Settings and participants: All subsectors in health care

  8. Evaluation of two communication strategies to improve udder health management

    NARCIS (Netherlands)

    Jansen, J.; Renes, R.J.; Lam, T.J.G.M.

    2010-01-01

    Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers’ udder health management, tools such as

  9. From breathing to respiration.

    Science.gov (United States)

    Fitting, Jean-William

    2015-01-01

    The purpose of breathing remained an enigma for a long time. The Hippocratic school described breathing patterns but did not associate breathing with the lungs. Empedocles and Plato postulated that breathing was linked to the passage of air through pores of the skin. This was refuted by Aristotle who believed that the role of breathing was to cool the heart. In Alexandria, breakthroughs were accomplished in the anatomy and physiology of the respiratory system. Later, Galen proposed an accurate description of the respiratory muscles and the mechanics of breathing. However, his heart-lung model was hampered by the traditional view of two non-communicating vascular systems - veins and arteries. After a period of stagnation in the Middle Ages, knowledge progressed with the discovery of pulmonary circulation. The comprehension of the purpose of breathing progressed by steps thanks to Boyle and Mayow among others, and culminated with the contribution of Priestley and the discovery of oxygen by Lavoisier. Only then was breathing recognized as fulfilling the purpose of respiration, or gas exchange. A century later, a controversy emerged concerning the active or passive transfer of oxygen from alveoli to the blood. August and Marie Krogh settled the dispute, showing that passive diffusion was sufficient to meet the oxygen needs.

  10. Metrics for assessing improvements in primary health care.

    Science.gov (United States)

    Stange, Kurt C; Etz, Rebecca S; Gullett, Heidi; Sweeney, Sarah A; Miller, William L; Jaén, Carlos Roberto; Crabtree, Benjamin F; Nutting, Paul A; Glasgow, Russell E

    2014-01-01

    Metrics focus attention on what is important. Balanced metrics of primary health care inform purpose and aspiration as well as performance. Purpose in primary health care is about improving the health of people and populations in their community contexts. It is informed by metrics that include long-term, meaning- and relationship-focused perspectives. Aspirational uses of metrics inspire evolving insights and iterative improvement, using a collaborative, developmental perspective. Performance metrics assess the complex interactions among primary care tenets of accessibility, a whole-person focus, integration and coordination of care, and ongoing relationships with individuals, families, and communities; primary health care principles of inclusion and equity, a focus on people's needs, multilevel integration of health, collaborative policy dialogue, and stakeholder participation; basic and goal-directed health care, prioritization, development, and multilevel health outcomes. Environments that support reflection, development, and collaborative action are necessary for metrics to advance health and minimize unintended consequences.

  11. Adopting feminist strategies to improve women's health.

    Science.gov (United States)

    James, T

    The new public health movement offers community nurses a context in which to address the continuing inequalities faced by women in society. This paper explores the use of feminism as a tool for this. It considers some of the constraints on feminist nursing practice and offers some ways forward.

  12. Can life coaching improve health outcomes?

    DEFF Research Database (Denmark)

    Ammentorp, Jette; Uhrenfeldt, Lisbeth; Angel, Flemming;

    2013-01-01

    for an overview of the evidence regarding coaching interventions used in patient care, the effect of the interventions, and the quality of the studies published. However, in order to provide a clear definition of the coaching interventions selected for this review, we have found it necessary to distinguish...... between health coaching and life coaching. In this review, we will only focus on the latter method and on that basis assess the health related outcomes of life coaching. METHODS Intervention studies using quantitative or qualitative methods to evaluate the outcome of the life coach interventions were...... suggest that the description and categorisation of the coaching methods are described more comprehensively, and that research into this area is supplemented by a more qualitative approach....

  13. Improvements in well-being and vagal tone following a yogic breathing-based life skills workshop in young adults: Two open-trial pilot studies

    Directory of Open Access Journals (Sweden)

    Michael R Goldstein

    2016-01-01

    Conclusions: These findings suggest that a life skills workshop integrating yogic breathing techniques may provide self-empowering tools for enhancing well-being in young adults. Future research is indicated to further explore these effects, particularly in regards to vagal tone and other aspects of stress physiology.

  14. Optimal Blood Suppression inversion time based on breathing rates and heart rates to improve renal artery visibility in spatial labeling with multiple inversion pulses: A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Pei, Yi Gang; Li, Fang; Long, Xue Ying; Liu, Hui; Wang, Xiao Yi; Liu, Jin Kang; Li, Wen Zheng [Dept. of Radiology, Xiangya Hospital, Central South University, Changsha (China); Shen, Hao [GE Healthcare, Waukesha (United States)

    2016-02-15

    To determine whether an optimal blood suppression inversion time (BSP TI) can boost arterial visibility and whether the optimal BSP TI is related to breathing rate (BR) and heart rate (HR) for hypertension subjects in spatial labeling with multiple inversion pulses (SLEEK). This prospective study included 10 volunteers and 93 consecutive hypertension patients who had undergone SLEEK at 1.5T MRI system. Firstly, suitable BSP TIs for displaying clearly renal artery were determined in 10 volunteers. Secondly, non-contrast enhanced magnetic resonance angiography with the suitable BSP TIs were performed on those hypertension patients. Then, renal artery was evaluated and an optimal BSP TI to increase arterial visibility was determined for each patient. Patients' BRs and HRs were recorded and their relationships with the optimal BSP TI were analyzed. The optimal BSP TI was negatively correlated with BR (r1 = -0.536, P1 < 0.001; and r2 = -0.535, P2 < 0.001) and HR (r1 = -0.432, P1 = 0.001; and r2 = -0.419, P2 = 0.001) for 2 readers (κ = 0.93). For improving renal arterial visibility, BSP TI = 800 ms could be applied as the optimal BSP TI when the 95% confidence interval were 17-19/min (BR1) and 74-82 bpm (HR1) for reader#1 and 17-19/min (BR2) and 74-83 bpm (HR2) for reader#2; BSP TI = 1100 ms while 14-15/min (BR1, 2) and 71-76 bpm (HR1, 2) for both readers; and BSP TI = 1400 ms when 13-16/min (BR1) and 63-68 bpm (HR1) for reader#1 and 14-15/min (BR2) and 64-70 bpm (HR2) for reader#2. In SLEEK, BSP TI is affected by patients' BRs and HRs. Adopting the optimal BSP TI based on BR and HR can improve the renal arterial visibility and consequently the working efficiency.

  15. Improving physical health monitoring for patients with chronic mental health problems who receive antipsychotic medications.

    Science.gov (United States)

    Abdallah, Nihad; Conn, Rory; Latif Marini, Abdel

    2016-01-01

    Physical health monitoring is an integral part of caring for patients with mental health problems. It is proven that serious physical health problems are more common among patients with severe mental health illness (SMI), this monitoring can be challenging and there is a need for improvement. The project aimed at improving the physical health monitoring among patients with SMI who are receiving antipsychotic medications. The improvement process focused on ensuring there is a good communication with general practitioners (GPs) as well as patient's education and education of care home staff. GP letters requesting physical health monitoring were updated; care home staff and patients were given more information about the value of regular physical health monitoring. There was an improvement in patients' engagement with the monitoring and the monitoring done by GPs was more adherent to local and national guidelines and was communicated with the mental health service.

  16. Improving physical health monitoring for patients with chronic mental health problems who receive antipsychotic medications

    Science.gov (United States)

    Abdallah, Nihad; Conn, Rory; Latif Marini, Abdel

    2016-01-01

    Physical health monitoring is an integral part of caring for patients with mental health problems. It is proven that serious physical health problems are more common among patients with severe mental health illness (SMI), this monitoring can be challenging and there is a need for improvement. The project aimed at improving the physical health monitoring among patients with SMI who are receiving antipsychotic medications. The improvement process focused on ensuring there is a good communication with general practitioners (GPs) as well as patient's education and education of care home staff. GP letters requesting physical health monitoring were updated; care home staff and patients were given more information about the value of regular physical health monitoring. There was an improvement in patients' engagement with the monitoring and the monitoring done by GPs was more adherent to local and national guidelines and was communicated with the mental health service. PMID:27559474

  17. Systematic review of the effectiveness of breathing retraining in asthma management.

    Science.gov (United States)

    Burgess, John; Ekanayake, Buddhini; Lowe, Adrian; Dunt, David; Thien, Francis; Dharmage, Shyamali C

    2011-12-01

    In asthma management, complementary and alternative medicine is enjoying a growing popularity worldwide. This review synthesizes the literature on complementary and alternative medicine techniques that utilize breathing retraining as their primary component and compares evidence from controlled trials with before-and-after trials. Medline, PubMed, Cumulative Index to Nursing and Allied Health Literature and the Cochrane Library electronic databases were searched. Reference lists of all publications were manually checked to identify studies not found through electronic searching. The selection criteria were met by 41 articles. Most randomized controlled trials (RCTs) of the Buteyko breathing technique demonstrated a significant decrease in β(2)-agonist use while several found improvement in quality of life or decrease in inhaled corticosteroid use. Although few in number, RCTs of respiratory muscle training found a significant reduction in bronchodilator medication use. Where meta-analyses could be done, they provided evidence of benefit from yoga, Buteyko breathing technique and physiotherapist-led breathing training in improving asthma-related quality of life. However, considerable heterogeneity was noted in some RCTs of yoga. It is reasonable for clinicians to offer qualified support to patients with asthma undertaking these breathing retraining techniques.

  18. Workforce strategies to improve children's oral health.

    Science.gov (United States)

    Goodwin, Kristine

    2014-12-01

    (1) Tooth decay is the most common chronic disease for children. (2) As millions receive dental coverage under the Affordable Care Act, the demand for dental services is expected to strain the current workforce's ability to meet their needs. (3) States have adopted various workforce approaches to improve access to dental care for underserved populations.

  19. [e-Health interventions and improvement in treatment adherence].

    Science.gov (United States)

    Sieben, Angelien; Bredie, S J H Bas; van Laarhoven, C J H M Kees; Schoonhoven, Lisette; Burger, David M; van Onzenoort, Hein A W

    2014-01-01

    Poor adherence to medication is one of the most important determinants in the treatment of patients with chronic disorders. e-Health-based interventions may be able to improve treatment adherence. This article gives an overview of the available e-Health interventions and the extent to which they can improve adherence. We searched in the PubMed, Cinahl, PsycInfo, and Embase databases for e-Health interventions that aimed at improving adherence to treatment. Of the 16 included studies, 15 used a website and one used an app. Ten studies showed a significant improvement in treatment adherence by using the intervention. e-Health interventions were generally complex. Simple interventions were the most successful in improving treatment adherence.

  20. Suicide Prevention Strategies for Improving Population Health.

    Science.gov (United States)

    Wilcox, Holly C; Wyman, Peter A

    2016-04-01

    Suicide is a public health problem that accounts for more than 1 million deaths annually worldwide. This article addresses evidence-based and promising youth suicide prevention approaches at the primary, secondary, and tertiary levels. Coordinated, developmentally timed, evidence-based suicide prevention approaches at all intervention levels are likely to reduce youth suicide. For most youth who die by suicide, there are opportunities for intervention before imminent risk develops. Current research in suicide prevention points to the value of investing in "upstream" universal interventions that build skills and resilience as well as policies that enable access to care and protection from lethal means.

  1. Breathing exercises to improve pulmonary ventilation were observed slow resistance pulmonary function%呼吸操训练提高慢阻肺患者肺通气功能的观察

    Institute of Scientific and Technical Information of China (English)

    杨玉平; 周向东

    2013-01-01

    目的:探讨慢性阻塞性肺病患者(COPD)进行呼吸操训练对肺通气功能的影响。方法:选取2011年1月至2012年6月我院住院的COPD患者120例,采用自身对照的方法,对入院患者进行初始评估及肺通气功能检测,并练习呼吸操,告知其锻炼的具体要求,随访观察患者锻炼呼吸操3个月后的肺通气功能各项指标及气短症状的改善情况。所有数据均使用t检验方法进行比较。结果:患者经呼吸操锻炼后,肺通气功能检测指标(VC、FVC、FEV1、FEV1/FVC%)以及气短症状均有所改善,差别具有显著性(p<0.05)。结论:COPD患者进行呼吸操锻炼有助于改善肺通气功能、缓解气短症状。%Objective:To investigate the breathing exercises to improve in patients with chronic obstructive pulmonary disease (COPD) effect of pulmonary ventilation function. Methods:From 2011 January to 2012 June in COPD 120 cases in our hospital, using self control ed method, initial assessment of patients, the church breath exercise method, tel the specific requirements for their training, improve the exercise of patients were observed after 3 months of pulmonary ventilation function and shortness of breath, were compared with t test al data. Results:After breathing exercises, index (VC, FVC, FEV1, FEV1/FVC%) of pulmonary function in patients with dyspnea symptoms were significantly improved , there was significant difference (p<0.05). Conclusions:Respiratory exercises can improve the pulmonary ventilation function of the patients with COPD symptoms, al eviate the effect of shortness of breath.

  2. The role of health insurance in improving health services use by Thais and ethnic minority migrants.

    Science.gov (United States)

    Hu, Jian

    2010-01-01

    In Thailand, a universal coverage health care scheme for Thai citizens and a foreign worker health insurance program for registered foreign workers have been implemented since 2001. This study uses the 2000-2004 panel data of the Kanchanaburi Demographic Surveillance System to explore the role of health insurance in influencing the use of health care for Thai, Thai ethnic minority, and ethnic minority migrants from 2000 to 2004. The results show that health insurance plays a major role in improving the use of health care for ethnic groups, especially for Thai ethnic minorities. However, a gap still existed in 2004 between health insurance and health care use by ethnic minority migrants and by Thais. The results suggest that improving health insurance status for ethnic minority migrants should be encouraged to reduce the ethnic gap in the use of health care.

  3. Lessons from San Francisco: health impact assessments have advanced political conditions for improving population health.

    Science.gov (United States)

    Bhatia, Rajiv; Corburn, Jason

    2011-12-01

    Health impact assessment is a structured decision support tool used to systematically characterize the anticipated health effects, both adverse and beneficial, of societal decisions. In San Francisco, the use of health impact assessments has not only produced evidence to inform health policy decision making but has also contributed to the political conditions needed to achieve optimal population health. Health impact assessments have helped increase public awareness of the determinants of health, routine monitoring of these determinants, cooperation among institutions, health-protective laws and regulations, and organizational networks for health advocacy and accountability. Drawing on more than a decade of local experience, we identify the direct and indirect effects of the assessments on the politics of governance as well as on health. We demonstrate that health impact assessment is both an analytic tool and a process that helps build the social institutions that can improve health.

  4. Improving Global Health Education: Development of a Global Health Competency Model

    Science.gov (United States)

    Ablah, Elizabeth; Biberman, Dorothy A.; Weist, Elizabeth M.; Buekens, Pierre; Bentley, Margaret E.; Burke, Donald; Finnegan, John R.; Flahault, Antoine; Frenk, Julio; Gotsch, Audrey R.; Klag, Michael J.; Lopez, Mario Henry Rodriguez; Nasca, Philip; Shortell, Stephen; Spencer, Harrison C.

    2014-01-01

    Although global health is a recommended content area for the future of education in public health, no standardized global health competency model existed for master-level public health students. Without such a competency model, academic institutions are challenged to ensure that students are able to demonstrate the knowledge, skills, and attitudes (KSAs) needed for successful performance in today's global health workforce. The Association of Schools of Public Health (ASPH) sought to address this need by facilitating the development of a global health competency model through a multistage modified-Delphi process. Practitioners and academic global health experts provided leadership and guidance throughout the competency development process. The resulting product, the Global Health Competency Model 1.1, includes seven domains and 36 competencies. The Global Health Competency Model 1.1 provides a platform for engaging educators, students, and global health employers in discussion of the KSAs needed to improve human health on a global scale. PMID:24445206

  5. Meeting the challenge: using policy to improve children's health.

    Science.gov (United States)

    Brush, Charles Adam; Kelly, Maggie M; Green, Denise; Gaffney, Marcus; Kattwinkel, John; French, Molly

    2005-11-01

    We reflect on the proceedings of a symposium at a conference of the Centers for Disease Control and Prevention National Center on Birth Defects and Developmental Disabilities. We present examples of bridging the gap between science and policy to achieve improvements in children's health through case studies in early hearing detection and intervention, folic acid fortification to prevent birth defects, sleep positioning recommendations to reduce infant mortality, and workplace lactation support programs. We discuss case studies that present different policy strategies (public health law and voluntary practices) for improving public health. These case studies demonstrate both the power of policy as a tool for improving children's health and the challenges of communicating public health research to policy decisionmakers.

  6. Improving Sanitation and Health in Rural Alaska

    Science.gov (United States)

    Bubenheim, David L.

    2013-01-01

    In rural Alaskan communities personal health is threatened by energy costs and limited access to clean water, wastewater management, and adequate nutrition. Fuel-­-based energy systems are significant factors in determining local accessibility to clean water, sanitation and food. Increasing fuel costs induce a scarcity of access and impact residents' health. The University of Alaska Fairbanks (UAF) School of Natural Resources and Agricultural Sciences (SNRAS), NASA's Ames Research Center, and USDA Agricultural Research Service (ARS) have joined forces to develop high-efficiency, low­-energy consuming techniques for water treatment and food production in rural circumpolar communities. Methods intended for exploration of space and establishment of settlements on the Moon or Mars will ultimately benefit Earth's communities in the circumpolar north. The initial phase of collaboration is completed. Researchers from NASA Ames Research Center and SNRAS, funded by the USDA­-ARS, tested a simple, reliable, low-energy sewage treatment system to recycle wastewater for use in food production and other reuse options in communities. The system extracted up to 70% of the water from sewage and rejected up to 92% of ions in the sewage with no carryover of toxic effects. Biological testing showed that plant growth using recovered water in the nutrient solution was equivalent to that using high-purity distilled water. With successful demonstration that the low energy consuming wastewater treatment system can provide safe water for communities and food production, the team is ready to move forward to a full-scale production testbed. The SNRAS/NASA team (including Alaska students) will design a prototype to match water processing rates and food production to meet rural community sanitation needs and nutritional preferences. This system would be operated in Fairbanks at the University of Alaska through SNRAS. Long­-term performance will be validated and operational needs of the

  7. Improving Mental Health Care for Young Adults in Badakshan Province of Afghanistan Using eHealth.

    Science.gov (United States)

    Khoja, Shariq; Khan, Maria Arif; Husyin, Nida; Scott, Richard; Yousafzai, Abdul Wahab; Durrani, Hammad; Mohbatali, Fatima; Khan, Dodo

    2015-01-01

    Decades of war, social problems and poverty, have led large number of Afghan youth aged between 18-25 years suffering from mental health problems. Other important contributing factors include extreme poverty, insecurity, and violence and gender disparities, contributing to worsening mental and emotional health conditions in the country. The reported project is designed to strengthen the health system for improving mental health services in the province of Badakshan by improving awareness in the community and empowering frontline health workers. The project uses technological innovations, in combination with traditional approaches, to reduce stigma, enhance capacity of health providers and improve access to the specialist. The project also focuses on skills development of health providers, and empowering them to provide quality mental health services through access to interactive protocols, Management Information system and telemedicine.

  8. Take a Deep Breath

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Everyone involved in Beijing’s Olympic Games held their breath last week, not because of the city’s famously polluted air , but in anticipation of the results of an experiment that could help to clean it up.

  9. Improving Performance through Knowledge Translation in the Veterans Health Administration

    Science.gov (United States)

    Francis, Joseph; Perlin, Jonathan B.

    2006-01-01

    The Veterans Health Administration (VA) provides a case study for linking performance measurement, information technology, and aligned research efforts to facilitate quality improvement in a large, complex health system. Dialogue between clinical researchers and VA leaders occurs through structured activities (e.g., the Quality Enhancement…

  10. Fasting Diet: Can It Improve My Heart Health?

    Science.gov (United States)

    ... but it seems that regularly fasting — severely restricting food and drink for one to two days a week — can potentially improve your heart health. It's difficult to tell what effect fasting has on your heart health because many people who routinely fast often do so for religious reasons. These people ...

  11. Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health.

    Science.gov (United States)

    Aguilar-Gaxiola, Sergio; Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton Mickey; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B; Strelnick, A Hal; Wallerstein, Nina

    2014-04-01

    The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health.

  12. Improving prenatal health: setting the agenda for increased male involvement.

    Science.gov (United States)

    Guadagno, Marie; Mackert, Michael; Rochlen, Aaron

    2013-11-01

    The U.S. infant mortality rate is among the highest in the developed world, with recent vital statistics reports estimating 6.14 infant deaths per 1,000 live births. Traditional health education and promotion to improve maternal, infant, and child health in the United States has focused only on women, leaving men out of important health messages that may affect pregnancy outcomes as well as family well-being. Recently, public health scholars have suggested that men be included in prenatal health education in an effort to improve birth outcomes and reduce infant mortality. Incorporating men in prenatal health promotion and education has been found to improve overall birth preparedness, reduce the risk of maternal-infant HIV transmission, and reduce perinatal mortality in less-developed nations. Although these results are positive, research on paternal impact in pregnancy outcomes in the United States to date is lacking. This article proposes a U.S.-specific research agenda to understand the current role of men in pregnancy health, as well as actual involvement, barriers, and the influence men can have in prenatal health. A discussion of culture, individual motivations, health care providers, and social marketing is also considered.

  13. Physical Activity: A Tool for Improving Health (Part 2-Mental Health Benefits)

    Science.gov (United States)

    Gallaway, Patrick J.; Hongu, Nobuko

    2016-01-01

    By promoting physical activities and incorporating them into their community-based programs, Extension professionals are improving the health of individuals, particularly those with limited resources. This article is the second in a three-part series describing the benefits of physical activity for human health: (1) biological health benefits of…

  14. Physical Activity: A Tool for Improving Health (Part 1--Biological Health Benefits)

    Science.gov (United States)

    Gallaway, Patrick J.; Hongu, Nobuko

    2015-01-01

    Extension educators have been promoting and incorporating physical activities into their community-based programs and improving the health of individuals, particularly those with limited resources. This article is the first of a three-part series describing the benefits of physical activity for human health: 1) biological health benefits of…

  15. Using eHealth to improve health literacy among the patient population.

    Science.gov (United States)

    Landry, Kathryn E

    2015-01-01

    There is no denying the global influence of eHealth, in its various forms, on the health care system in the 21st Century. Health care professionals are often familiar with technological tools used to enhance health outcomes by assisting clinicians in meeting the needs of the patient population. In an age of social media, web-based information, and material available literally in an instant, it is crucial for nurses to use and proactively share their knowledge regarding accessing and finding credible sources of online health information with the patient population. By improving health literacy among consumers, self-sufficiency and competence can be developed and promoted to improve health outcomes, placing the patient in a participatory starring role of managing and improving his or her overall well-being.

  16. For debate: a new wave in public health improvement.

    Science.gov (United States)

    Davies, Sally C; Winpenny, Eleanor; Ball, Sarah; Fowler, Tom; Rubin, Jennifer; Nolte, Ellen

    2014-11-22

    The rising burden of chronic disease poses a challenge for all public health systems and requires innovative approaches to effectively improve population health. Persisting inequalities in health are of particular concern. Disadvantage because of education, income, or social position is associated with a larger burden of disease and, in particular, multimorbidity. Although much has been achieved to enhance population health, challenges remain, and approaches need to be revisited. In this paper, we join the debate about how a new wave of public health improvement might look. We start from the premise that population health improvement is conditional on a health-promoting societal context. It is characterised by a culture in which healthy behaviours are the norm, and in which the institutional, social, and physical environment support this mindset. Achievement of this ambition will require a positive, holistic, eclectic, and collaborative effort, involving a broad range of stakeholders. We emphasise three mechanisms: maximisation of the value of health and incentives for healthy behaviour; promotion of healthy choices as default; and minimisation of factors that create a culture and environment which promote unhealthy behaviour. We give examples of how these mechanisms might be achieved.

  17. Improving health literacy in community populations: a review of progress.

    Science.gov (United States)

    Nutbeam, Don; McGill, Bronwyn; Premkumar, Pav

    2017-03-28

    Governments around the world have adopted national policies and programs to improve health literacy. This paper examines progress in the development of evidence to support these policies from interventions to improve health literacy among community populations. Our review found only a limited number of studies (n=7) that met the criteria for inclusion, with many more influenced by the concept of health literacy but not using it in the design and evaluation. Those included were diverse in setting, population and intended outcomes. All included educational strategies to develop functional health literacy, and a majority designed to improve interactive or critical health literacy skills. Several papers were excluded because they described a protocol for an intervention, but not results, indicating that our review may be early in a cycle of activity in community intervention research. The review methodology may not have captured all relevant studies, but it provides a clear message that the academic interest and attractive rhetoric surrounding health literacy needs to be tested more systematically through intervention experimentation in a wide range of populations using valid and reliable measurement tools. The distinctive influence of the concept of health literacy on the purpose and methodologies of health education and communication is not reflected in many reported interventions at present. Evidence to support the implementation of national policies and programs, and the intervention tools required by community practitioners are not emerging as quickly as needed. This should be addressed as a matter of priority by research funding agencies.

  18. Why economic analysis of health system improvement interventions matters

    Directory of Open Access Journals (Sweden)

    Edward Ivor Broughton

    2016-10-01

    Full Text Available There is little evidence to direct health systems toward providing efficient interventions to address medical errors, defined as an unintended act of omission or commission or one not executed as intended that may or may not cause harm to the patient but does not achieve its intended outcome. We believe that lack of guidance on what is the most efficient way to reduce adverse events and improve the quality of health care limits the scale-up of health system improvement interventions. Challenges to economic evaluation of these interventions include defining and implementing improvement interventions in different settings with high fidelity, capturing all of the positive and negative effects of the intervention, using process measures of effectiveness rather than health outcomes, and determining the full cost of the intervention and all economic consequences its effects. However, health system improvement interventions should be treated similarly to individual medical interventions and undergo rigorous economic evaluation to provide actionable evidence to guide policy-makers in decisions of resources allocation for improvement activities among other competing demands for health care resources.

  19. Why Economic Analysis of Health System Improvement Interventions Matters

    Science.gov (United States)

    Broughton, Edward Ivor; Marquez, Lani

    2016-01-01

    There is little evidence to direct health systems toward providing efficient interventions to address medical errors, defined as an unintended act of omission or commission or one not executed as intended that may or may not cause harm to the patient but does not achieve its intended outcome. We believe that lack of guidance on what is the most efficient way to reduce medical errors and improve the quality of health-care limits the scale-up of health system improvement interventions. Challenges to economic evaluation of these interventions include defining and implementing improvement interventions in different settings with high fidelity, capturing all of the positive and negative effects of the intervention, using process measures of effectiveness rather than health outcomes, and determining the full cost of the intervention and all economic consequences of its effects. However, health system improvement interventions should be treated similarly to individual medical interventions and undergo rigorous economic evaluation to provide actionable evidence to guide policy-makers in decisions of resource allocation for improvement activities among other competing demands for health-care resources.

  20. Family physicians improve patient health care quality and outcomes.

    Science.gov (United States)

    Bowman, Marjorie A; Neale, Anne Victoria

    2013-01-01

    This issue exemplifies family physicians' ability to provide great care and to continuously improve. For example, beyond other specialty care, the care provided by family physicians is associated with improved melanoma diagnosis and outcomes and improved preventive services for those with a history of breast cancer. Electronic health records are providing new avenues to both assess outcomes and influence care. However, to truly reward quality care, simplistic and readily measurable items such as laboratory results or assessment of the provision of preventive services must be adjusted for risk. Health insurance influences classic preventive care services more than personal health behaviors. The care provided at federally qualified health centers throughout the nation is highly appreciated by the people they serve and is not plagued by the types of disparities in other settings.

  1. Improving health and safety through greater cooperation: A labor perspective

    Energy Technology Data Exchange (ETDEWEB)

    Main, J.A.

    1996-12-31

    There has been considerable effort in the coal mining industry to improve the future of mining operations and the health and safety conditions through improved labor and management relations. The United Mine Workers of America has been a major part of that effort.

  2. Improving the financial viability of primary care health centers.

    Science.gov (United States)

    Finkler, S A; Knickman, J R; Hanson, K L

    1994-01-01

    This article presents findings from a national demonstration program to improve the long-term financial viability of small not-for-profit primary care health centers. The program initiatives and their implementation are described in some detail. A standard pre/post study design was used to measure the impact of the initiatives on general outcome measures, financial ratios, and the utilization of management techniques. Overall, demonstration centers showed improvement over the study period. Notable short-term improvements included significant growth in the volume of patient visits and increased profit. Observed changes also revealed an increased use of sophisticated management techniques, expected to positively affect longer-term financial health. The findings suggest that improving the financial viability of health centers need not be expensive.

  3. An integrated model for continuous quality improvement and productivity improvement in health services organizations.

    Science.gov (United States)

    Rakich, J S; Darr, K; Longest, B B

    1993-01-01

    The health services paradigm with respect to quality has shifted to that of conformance to requirements (the absence of defects) and fitness for use (meeting customer expectations and needs). This article presents an integrated model of continuous quality improvement (CQI) (often referred to as total quality management) and productivity improvement for health services organizations. It incorporates input-output theory and focuses on the CQI challenge--"How can we be certain that we do the right things right the first time, every time?" The twin pillars of CQI are presented. Achievement of both will result in productivity improvement and enhancement of the health services organization's competitive position.

  4. Improving public health system performance through multiorganizational partnerships.

    Science.gov (United States)

    Mays, Glen P; Scutchfield, F Douglas

    2010-11-01

    Public health activities in the United States are delivered through multiple public and private organizations that vary widely in their resources, missions, and operations. Without strong coordination mechanisms, these delivery arrangements may perpetuate large gaps, inequities, and inefficiencies in public health activities. We examined evidence and uncertainties concerning the use of partnerships to improve the performance of the public health system, with a special focus on partnerships between public health agencies and health care organizations. We found that the types of partnerships likely to have the largest and most direct effects on population health are among the most difficult, and therefore least prevalent, forms of collaboration. High opportunity costs and weak and diffuse participation incentives hinder partnerships that focus on expanding effective prevention programs and policies. Targeted policy actions and leadership strategies are required to illuminate and enhance partnership incentives.

  5. A Qualitative Study Exploring Facilitators for Improved Health Behaviors and Health Behavior Programs: Mental Health Service Users’ Perspectives

    Directory of Open Access Journals (Sweden)

    Candida Graham

    2014-01-01

    Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.

  6. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program

    Directory of Open Access Journals (Sweden)

    Markiewicz Milissa

    2012-02-01

    Full Text Available Abstract Background In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. Methods We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1 elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2 examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Results Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Conclusions Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public

  7. Improving shift workers' health and tolerance to shiftwork: recent advances.

    Science.gov (United States)

    Kogi, K

    1996-02-01

    Recent developments in research in relation to health and tolerance to shiftwork offer useful guidance for improving conditions of shiftwork. These developments were discussed by the papers of this special issue, presented at the Mini-symposium on improving shift workers' health and tolerance to shiftwork in the 24th International Congress on Occupational Health in Nice, France, in 1993. While there is evidence that shiftwork is regarded as a risk factor with respect to the health of shift workers, many shift workers are engaged in shift systems for years while coping with associated burdens in their working life. In order to improve shift workers' health and tolerance, recent research points to the importance of multifaceted measures addressing both the effects of disruptions in circadian rhythms, and the actual interferences with daily routines at work and in family and social life. Increasing attention is paid to changed working hours and shift systems, including more flexible shiftwork systems, as well as to supporting effective coping activities and occupational health services. As shown by the new ILO Convention on night work, a consensus is being built internationally that multifaceted actions are necessary for improving shiftworking conditions and that such actions should be based on participatory planning and implementation.

  8. [Comprehensive reform to improve health system performance in Mexico].

    Science.gov (United States)

    Frenk, Julio; González-Pier, Eduardo; Gómez-Dantés, Octavio; Lezana, Miguel Angel; Knaul, Felicia Marie

    2007-01-01

    Despite having achieved an average life expectancy of 75 years, much the same as that of more developed countries, Mexico entered the 21st century with a health system mared by its failure to offer financial protection in health to more than half of its citizens; this was both a result and a cause of the social inequalities that have marked the development process in Mexico. Several structural limitations have hampered performance and limited the progress of the health system. Conscious that the lack of financial protection was the major bottleneck, Mexico has embarked on a structural reform to improve health system performance by establishing the System of Social Protection in Health (SSPH), which has introduced new financial rules and incentives. The main innovation of the reform has been the Seguro Popular (Popular Health Insurance), the insurance-based component of the SSPH, aimed at funding health care for all those families, most of them poor, who had been previously excluded from social health insurance. The reform has allowed for a substantial increase in public investment in health while realigning incentives towards better technical and interpersonal quality. This paper describes the main features and initial results of the Mexican reform effort, and derives lessons for other countries considering health-system transformations under similarly challenging circumstances.

  9. Comprehensive reform to improve health system performance in Mexico.

    Science.gov (United States)

    Frenk, Julio; González-Pier, Eduardo; Gómez-Dantés, Octavio; Lezana, Miguel A; Knaul, Felicia Marie

    2006-10-28

    Despite having achieved an average life expectancy of 75 years, much the same as that of more developed countries, Mexico entered the 21st century with a health system marred by its failure to offer financial protection in health to more than half of its citizens; this was both a result and a cause of the social inequalities that have marked the development process in Mexico. Several structural limitations have hampered performance and limited the progress of the health system. Conscious that the lack of financial protection was the major bottleneck, Mexico has embarked on a structural reform to improve health system performance by establishing the System of Social Protection in Health (SSPH), which has introduced new financial rules and incentives. The main innovation of the reform has been the Seguro Popular (Popular Health Insurance), the insurance-based component of the SSPH, aimed at funding health care for all those families, most of them poor, who had been previously excluded from social health insurance. The reform has allowed for a substantial increase in public investment in health while realigning incentives towards better technical and interpersonal quality. This paper describes the main features and initial results of the Mexican reform effort, and derives lessons for other countries considering health-system transformations under similarly challenging circumstances.

  10. Towards Automatic Improvement of Patient Queries in Health Retrieval Systems

    Directory of Open Access Journals (Sweden)

    Nesrine KSENTINI

    2016-07-01

    Full Text Available With the adoption of health information technology for clinical health, e-health is becoming usual practice today. Users of this technology find it difficult to seek information relevant to their needs due to the increasing amount of the clinical and medical data on the web, and the lack of knowledge of medical jargon. In this regards, a method is described to improve user's needs by automatically adding new related terms to their queries which appear in the same context of the original query in order to improve final search results. This method is based on the assessment of semantic relationships defined by a proposed statistical method between a set of terms or keywords. Experiments were performed on CLEF-eHealth-2015 database and the obtained results show the effectiveness of our proposed method.

  11. Measuring and improving patient safety through health information technology: The Health IT Safety Framework.

    Science.gov (United States)

    Singh, Hardeep; Sittig, Dean F

    2016-04-01

    Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety

  12. Sports-related lung injury during breath-hold diving

    Directory of Open Access Journals (Sweden)

    Tanja Mijacika

    2016-12-01

    Full Text Available The number of people practising recreational breath-hold diving is constantly growing, thereby increasing the need for knowledge of the acute and chronic effects such a sport could have on the health of participants. Breath-hold diving is potentially dangerous, mainly because of associated extreme environmental factors such as increased hydrostatic pressure, hypoxia, hypercapnia, hypothermia and strenuous exercise. In this article we focus on the effects of breath-hold diving on pulmonary function. Respiratory symptoms have been reported in almost 25% of breath-hold divers after repetitive diving sessions. Acutely, repetitive breath-hold diving may result in increased transpulmonary capillary pressure, leading to noncardiogenic oedema and/or alveolar haemorrhage. Furthermore, during a breath-hold dive, the chest and lungs are compressed by the increasing pressure of water. Rapid changes in lung air volume during descent or ascent can result in a lung injury known as pulmonary barotrauma. Factors that may influence individual susceptibility to breath-hold diving-induced lung injury range from underlying pulmonary or cardiac dysfunction to genetic predisposition. According to the available data, breath-holding does not result in chronic lung injury. However, studies of large populations of breath-hold divers are necessary to firmly exclude long-term lung damage.

  13. Sports-related lung injury during breath-hold diving.

    Science.gov (United States)

    Mijacika, Tanja; Dujic, Zeljko

    2016-12-01

    The number of people practising recreational breath-hold diving is constantly growing, thereby increasing the need for knowledge of the acute and chronic effects such a sport could have on the health of participants. Breath-hold diving is potentially dangerous, mainly because of associated extreme environmental factors such as increased hydrostatic pressure, hypoxia, hypercapnia, hypothermia and strenuous exercise.In this article we focus on the effects of breath-hold diving on pulmonary function. Respiratory symptoms have been reported in almost 25% of breath-hold divers after repetitive diving sessions. Acutely, repetitive breath-hold diving may result in increased transpulmonary capillary pressure, leading to noncardiogenic oedema and/or alveolar haemorrhage. Furthermore, during a breath-hold dive, the chest and lungs are compressed by the increasing pressure of water. Rapid changes in lung air volume during descent or ascent can result in a lung injury known as pulmonary barotrauma. Factors that may influence individual susceptibility to breath-hold diving-induced lung injury range from underlying pulmonary or cardiac dysfunction to genetic predisposition.According to the available data, breath-holding does not result in chronic lung injury. However, studies of large populations of breath-hold divers are necessary to firmly exclude long-term lung damage.

  14. How can developing countries harness biotechnology to improve health?

    Science.gov (United States)

    Daar, Abdallah S; Berndtson, Kathryn; Persad, Deepa L; Singer, Peter A

    2007-01-01

    Background The benefits of genomics and biotechnology are concentrated primarily in the industrialized world, while their potential to combat neglected diseases in the developing world has been largely untapped. Without building developing world biotechnology capacity to address local health needs, this disparity will only intensify. To assess the potential of genomics to address health needs in the developing world, the McLaughlin-Rotman Centre for Global Health, along with local partners, organized five courses on Genomics and Public Health Policy in the developing world. The overall objective of the courses was to collectively explore how to best harness genomics to improve health in each region. This article presents and analyzes the recommendations from all five courses. Discussion In this paper we analyze recommendations from 232 developing world experts from 58 countries who sought to answer how best to harness biotechnology to improve health in their regions. We divide their recommendations into four categories: science; finance; ethics, society and culture; and politics. Summary The Courses' recommendations can be summarized across the four categories listed above: Science - Collaborate through national, regional, and international networks - Survey and build capacity based on proven models through education, training, and needs assessments Finance - Develop regulatory and intellectual property frameworks for commercialization of biotechnology - Enhance funding and affordability of biotechnology - Improve the academic-industry interface and the role of small and medium enterprise Ethics, Society, Culture - Develop public engagement strategies to inform and educate the public about developments in genomics and biotechnology - Develop capacity to address ethical, social and cultural issues - Improve accessibility and equity Politics - Strengthen understanding, leadership and support at the political level for biotechnology - Develop policies outlining

  15. How can developing countries harness biotechnology to improve health?

    Directory of Open Access Journals (Sweden)

    Persad Deepa L

    2007-12-01

    Full Text Available Abstract Background The benefits of genomics and biotechnology are concentrated primarily in the industrialized world, while their potential to combat neglected diseases in the developing world has been largely untapped. Without building developing world biotechnology capacity to address local health needs, this disparity will only intensify. To assess the potential of genomics to address health needs in the developing world, the McLaughlin-Rotman Centre for Global Health, along with local partners, organized five courses on Genomics and Public Health Policy in the developing world. The overall objective of the courses was to collectively explore how to best harness genomics to improve health in each region. This article presents and analyzes the recommendations from all five courses. Discussion In this paper we analyze recommendations from 232 developing world experts from 58 countries who sought to answer how best to harness biotechnology to improve health in their regions. We divide their recommendations into four categories: science; finance; ethics, society and culture; and politics. Summary The Courses' recommendations can be summarized across the four categories listed above: Science - Collaborate through national, regional, and international networks - Survey and build capacity based on proven models through education, training, and needs assessments Finance - Develop regulatory and intellectual property frameworks for commercialization of biotechnology - Enhance funding and affordability of biotechnology - Improve the academic-industry interface and the role of small and medium enterprise Ethics, Society, Culture - Develop public engagement strategies to inform and educate the public about developments in genomics and biotechnology - Develop capacity to address ethical, social and cultural issues - Improve accessibility and equity Politics - Strengthen understanding, leadership and support at the political level for biotechnology

  16. World Health Organization global policy for improvement of oral health--World Health Assembly 2007

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2008-01-01

    The World Health Organization (WHO) Global Oral Health Programme has worked hard over the past five years to increase the awareness of oral health worldwide as an important component of general health and quality of life. Meanwhile, oral disease is still a major public health problem in high income...

  17. Improving Oral Health Status of Children in Tabuk, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Ziad D. Baghdadi

    2014-02-01

    Full Text Available This comprehensive community health intervention aimed to improve the oral health and reduce the incidence of dental caries in Tabuk schoolchildren. The program supports the public health pyramid that provides a framework to improve health and included creating and evaluating a school oral health surveillance system, applying fluoride varnish and dental sealants on high- and medium-caries risk children, and providing treatment for existing diseases. In a pilot phase, 48 children (26 males 22 females; mean age 6.42; dmft 9.33, Decayed, Missing, or Filled Primary and Permanent Teeth (DMFT 3.27 received the dental services, both treatment and prevention. Three hundred seventy-eight composite resin or resin-modified light-cured glass ionomer restorations were placed. One-hundred and eighteen teeth received pulp therapy (pulpotomy or pulpectomy, ten of which received stainless steel crowns. A total of 72 teeth were extracted due to caries. To understand the effects of dental disease on children, as perceived by parents, an oral health-related quality of life survey was completed and analyzed. Results found an underestimation of the role the teeth play, particularly primary teeth, in the general health and wellbeing of the child. The program’s main evaluation effort focused on the process and outcome objectives, including the number of children received care, number of teeth received restorations and sealants, and number of children received fluoride varnish, etc. Analyzing the effect of the program on oral hygiene revealed an improvement in oral health, as a direct result of oral health educational sessions and one-to-one counseling. There is an urgent need to expand the program to include all primary schools.

  18. The business case for health-care quality improvement.

    Science.gov (United States)

    Swensen, Stephen J; Dilling, James A; Mc Carty, Patrick M; Bolton, Jeffrey W; Harper, Charles M

    2013-03-01

    The business case for health-care quality improvement is presented. We contend that investment in process improvement is aligned with patients' interests, the organization's reputation, and the engagement of their workforce. Four groups benefit directly from quality improvement: patients, providers, insurers, and employers. There is ample opportunity, even in today's predominantly pay-for-volume (that is, evolving toward value-based purchasing) insurance system, for providers to deliver care that is in the best interest of the patient while improving their financial performance.

  19. Breathing exercises for dysfunctional breathing/hyperventilation syndrome in adults

    OpenAIRE

    2013-01-01

    Copyright © 2013 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd. Background: Dysfunctional breathing/hyperventilation syndrome (DB/HVS) is a respiratory disorder, psychologically or physiologically based, involving breathing too deeply and/or too rapidly (hyperventilation) or erratic breathing interspersed with breath-holding or sighing (DB). DB/HVS can result in significant patient morbidity and an array of symptoms including breathlessness, chest tightness, dizziness, tre...

  20. Sustainable Development Goals for Monitoring Action to Improve Global Health.

    Science.gov (United States)

    Cesario, Sandra K

    2016-01-01

    Women and children compose the largest segment of the more than 1 billion people worldwide who are unable to access needed health care services. To address this and other global health issues, the United Nations brought together world leaders to address growing health inequities, first by establishing the Millennium Development Goals in 2000 and more recently establishing Sustainable Development Goals, which are an intergovernmental set of 17 goals consisting of 169 targets with 304 indicators to measure compliance; they were designed to be applicable to all countries. Goal number 3, "Good Health and Well-Being: Ensure Heathy Lives and Promote Well-Being for All at All Ages," includes targets to improve the health of women and newborns.

  1. Who plans for health improvement? SEA, HIA and the separation of spatial planning and health planning

    Energy Technology Data Exchange (ETDEWEB)

    Bond, Alan, E-mail: alan.bond@uea.ac.uk [InteREAM (Interdisciplinary Research in Environmental Assessment and Management), School of Environmental Sciences, University of East Anglia, Norwich, NR4 7TJ (United Kingdom); Cave, Ben, E-mail: ben.cave@bcahealth.co.uk [Ben Cave Associates Ltd., Leeds (United Kingdom); Ballantyne, Rob, E-mail: robdballantyne@gmail.com [Planning and Health Consultant, Oxfordshire (United Kingdom)

    2013-09-15

    This study examines whether there is active planning for health improvement in the English spatial planning system and how this varies across two regions using a combination of telephone surveys and focus group interviews in 2005 and 2010. The spatial planning profession was found to be ill-equipped to consider the health and well-being implications of its actions, whilst health professionals are rarely engaged and have limited understanding and aspirations when it comes to influencing spatial planning. Strategic Environmental Assessment was not considered to be successful in integrating health into spatial plans, given it was the responsibility of planners lacking the capacity to do so. For their part, health professionals have insufficient knowledge and understanding of planning and how to engage with it to be able to plan for health gains rather than simply respond to health impacts. HIA practice is patchy and generally undertaken by health professionals outside the statutory planning framework. Thus, whilst appropriate assessment tools exist, they currently lack a coherent context within which they can function effectively and the implementation of the Kiev protocol requiring the engagement of health professionals in SEA is not to likely improve the consideration of health in planning while there continues to be separation of functions between professions and lack of understanding of the other profession. -- Highlights: ► Health professionals have limited aspirations for health improvement through the planning system. ► Spatial planners are ill-equipped to understand the health and well-being implications of their activities. ► SEA and HIA currently do not embed health consideration in planning decisions. ► The separation of health and planning functions is problematic for the effective conduct of SEA and/or HIA.

  2. Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care.

    Science.gov (United States)

    Fisher, Elisa; Hasselberg, Michael; Conwell, Yeates; Weiss, Linda; Padrón, Norma A; Tiernan, Erin; Karuza, Jurgis; Donath, Jeremy; Pagán, José A

    2017-01-20

    Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO(®) (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health)-a remote learning and mentoring program-is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016. The curriculum consisted of case presentations and didactic lessons on best practices related to geriatric mental health care. Twenty-six interviews with program participants were conducted to explore changes in geriatric mental health care knowledge and treatment practices. Health insurance claims data were analyzed to assess changes in health care utilization and costs before and after program implementation. Findings from interviews suggest that the program led to improvements in clinician geriatric mental health care knowledge and treatment practices. Claims data analysis suggests that emergency room costs decreased for patients with mental health diagnoses. Patients without a mental health diagnosis had more outpatient visits and higher prescription and outpatient costs. Telementoring programs such as Project ECHO GEMH may effectively build the capacity of frontline clinicians to deliver high-quality, evidence-based care to older adults with mental health conditions and may contribute to the transformation of health care delivery systems from volume to value.

  3. Iron supplementation reduces the frequency and severity of breath-holding attacks in non-anaemic children

    Directory of Open Access Journals (Sweden)

    Anthony Zehetner

    2011-11-01

    Full Text Available Iron supplementation reduces the frequency and severity of breath-holding attacks (BHAs, particularly in children with iron deficiency. The issue of iron supplementation is less clear for Westernized children with BHAs who present to an outpatient community clinic and are not iron-deficient. This is the first reported case series of iron-replete children with frequent and disabling breath-holding attacks who have responded to a course of oral iron supplementation. This intervention is safe, improves quality of life for both child and carer, and is significantly cost-effective in terms of health resource utilization.

  4. Taking Her Breath Away: The Rise of COPD in Women

    Science.gov (United States)

    ... Disparities Taking Her Breath Away: The Rise of COPD in Women Disparities in Lung Health Series More ... the U.S. live with chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. Millions more ...

  5. Assessing health centre systems for guiding improvement in diabetes care

    Directory of Open Access Journals (Sweden)

    Robinson Gary

    2005-08-01

    Full Text Available Abstract Background Aboriginal people in Australia experience the highest prevalence of diabetes in the country, an excess of preventable complications and early death. There is increasing evidence demonstrating the importance of healthcare systems for improvement of chronic illness care. The aims of this study were to assess the status of systems for chronic illness care in Aboriginal community health centres, and to explore whether more developed systems were associated with better quality of diabetes care. Methods This cross-sectional study was conducted in 12 Aboriginal community health centres in the Northern Territory of Australia. Assessment of Chronic Illness Care scale was adapted to measure system development in health centres, and administered by interview with health centre staff and managers. Based on a random sample of 295 clinical records from attending clients with diagnosed type 2 diabetes, processes of diabetes care were measured by rating of health service delivery against best-practice guidelines. Intermediate outcomes included the control of HbA1c, blood pressure, and total cholesterol. Results Health centre systems were in the low to mid-range of development and had distinct areas of strength and weakness. Four of the six system components were independently associated with quality of diabetes care: an increase of 1 unit of score for organisational influence, community linkages, and clinical information systems, respectively, was associated with 4.3%, 3.8%, and 4.5% improvement in adherence to process standards; likewise, organisational influence, delivery system design and clinical information systems were related to control of HbA1c, blood pressure, and total cholesterol. Conclusion The state of development of health centre systems is reflected in quality of care outcome measures for patients. The health centre systems assessment tool should be useful in assessing and guiding development of systems for improvement of

  6. Submarines, spacecraft and exhaled breath.

    Science.gov (United States)

    Pleil, Joachim D; Hansel, Armin

    2012-03-01

    Foreword The International Association of Breath Research (IABR) meetings are an eclectic gathering of researchers in the medical, environmental and instrumentation fields; our focus is on human health as assessed by the measurement and interpretation of trace chemicals in human exhaled breath. What may have escaped our notice is a complementary field of research that explores the creation and maintenance of artificial atmospheres practised by the submarine air monitoring and air purification (SAMAP) community. SAMAP is comprised of manufacturers, researchers and medical professionals dealing with the engineering and instrumentation to support human life in submarines and spacecraft (including shuttlecraft and manned rockets, high-altitude aircraft, and the International Space Station (ISS)). Here, the immediate concerns are short-term survival and long-term health in fairly confined environments where one cannot simply 'open the window' for fresh air. As such, one of the main concerns is air monitoring and the main sources of contamination are CO(2) and other constituents of human exhaled breath. Since the inaugural meeting in 1994 in Adelaide, Australia, SAMAP meetings have been held every two or three years alternating between the North American and European continents. The meetings are organized by Dr Wally Mazurek (a member of IABR) of the Defense Systems Technology Organization (DSTO) of Australia, and individual meetings are co-hosted by the navies of the countries in which they are held. An overriding focus at SAMAP is life support (oxygen availability and carbon dioxide removal). Certainly, other air constituents are also important; for example, the closed environment of a submarine or the ISS can build up contaminants from consumer products, cooking, refrigeration, accidental fires, propulsion and atmosphere maintenance. However, the most immediate concern is sustaining human metabolism: removing exhaled CO(2) and replacing metabolized O(2). Another

  7. The Air We Breathe

    Science.gov (United States)

    Davila, Dina

    2010-01-01

    Topics discussed include NASA mission to pioneer the future in space exploration, scientific discovery and aeronautics research; the role of Earth's atmosphere, atmospheric gases, layers of the Earth's atmosphere, ozone layer, air pollution, effects of air pollution on people, the Greenhouse Effect, and breathing on the International Space Station.

  8. The Breath of Chemistry

    DEFF Research Database (Denmark)

    Josephsen, Jens

    The present preliminary text is a short thematic presentation in biological inorganic chemistry meant to illustrate general and inorganic (especially coordination) chemistry in biochemistry. The emphasis is on molecular models to explain features of the complicated mechanisms essential to breathing...

  9. Breathing Like a Fish

    Science.gov (United States)

    Katsioloudis, Petros J.

    2010-01-01

    Being able to dive and breathe underwater has been a challenge for thousands of years. In 1980, Fuji Systems of Tokyo developed a series of prototype gills for divers as a way of demonstrating just how good its membranes are. Even though gill technology has not yet reached the point where recipients can efficiently use implants to dive underwater,…

  10. Optimal technique for deep breathing exercises after cardiac surgery.

    Science.gov (United States)

    Westerdahl, E

    2015-06-01

    Cardiac surgery patients often develop a restrictive pulmonary impairment and gas exchange abnormalities in the early postoperative period. Chest physiotherapy is routinely prescribed in order to reduce or prevent these complications. Besides early mobilization, positioning and shoulder girdle exercises, various breathing exercises have been implemented as a major component of postoperative care. A variety of deep breathing maneuvres are recommended to the spontaneously breathing patient to reduce atelectasis and to improve lung function in the early postoperative period. Different breathing exercises are recommended in different parts of the world, and there is no consensus about the most effective breathing technique after cardiac surgery. Arbitrary instructions are given, and recommendations on performance and duration vary between hospitals. Deep breathing exercises are a major part of this therapy, but scientific evidence for the efficacy has been lacking until recently, and there is a lack of trials describing how postoperative breathing exercises actually should be performed. The purpose of this review is to provide a brief overview of postoperative breathing exercises for patients undergoing cardiac surgery via sternotomy, and to discuss and suggest an optimal technique for the performance of deep breathing exercises.

  11. Program home visit Costa Rica's health system: guidelines for improvement

    Directory of Open Access Journals (Sweden)

    Katherine Solís Cordero

    2015-07-01

    Full Text Available Introduction. Home visit is the main strategy of primary care by bringing health services to the homes and workplaces of people, which allows knowing the needs of the population firsthand. Thus, home visit by the ATAP represents the first contact of the individual, family and community with the health system, with significant benefits both individually and collectively. This research responds to the need to identify the elements that the home visiting program needs to improve modify or replace in order to maximize the provision of this service.Method. It is a qualitative, observational analytic study. Data were collected through documentary research, key informant interviews and focus group. The analysis was performed from the grounded theory.Results. The main results showed the existence of elements at the level of the health system, home visiting program and the figure of the ATAP that should be reviewed, modified or replaced to the home visit, thus it has bigger and better results for the population and the health system.Conclusion. The Home Visiting Program is strength of the Costa Rican health system to address health inequities. However, it is imperative to make decisions and implementation of actions that promote the improvement and increased results of the home visit at a family and community level.

  12. Lung cancer biomarkers in exhaled breath.

    Science.gov (United States)

    Amann, Anton; Corradi, Massimo; Mazzone, Peter; Mutti, Antonio

    2011-03-01

    Lung cancer is the leading cause of cancer-related mortality worldwide. Methods for early detection of lung cancer, such as computerized tomography scanning technology, often discover a large number of small lung nodules, posing a new problem to radiologists and chest physicians. The vast majority of these nodules will be benign, but there is currently no easy way to determine which nodules represent very early lung cancer. Adjuvant testing with PET imaging and nonsurgical biopsies has a low yield for these small indeterminate nodules, carries potential morbidity and is costly. Indeed, purely morphological criteria seem to be insufficient for distinguishing lung cancer from benign nodules at early stages with sufficient confidence, therefore false positives undergoing surgical resection frequently occur. A molecular approach to the diagnosis of lung cancer through the analysis of exhaled breath could greatly improve the specificity of imaging procedures. A biomarker-driven approach to signs or symptoms possibly due to lung cancer would represent a complementary tool aimed at ruling out (with known error probability) rather than diagnosing lung cancer. Volatile and nonvolatile components of the breath are being studied as biomarkers of lung cancer. Breath testing is noninvasive and potentially inexpensive. There is promise that an accurate lung cancer breath biomarker, capable of being applied clinically, will be developed in the near future. In this article, we summarize some of the rationale for breath biomarker development, review the published literature in this field and provide thoughts regarding future directions.

  13. Medication effects on sleep and breathing.

    Science.gov (United States)

    Seda, Gilbert; Tsai, Sheila; Lee-Chiong, Teofilo

    2014-09-01

    Sleep respiration is regulated by circadian, endocrine, mechanical and chemical factors, and characterized by diminished ventilatory drive and changes in Pao2 and Paco2 thresholds. Hypoxemia and hypercapnia are more pronounced during rapid eye movement. Breathing is influenced by sleep stage and airway muscle tone. Patient factors include medical comorbidities and body habitus. Medications partially improve obstructive sleep apnea and stabilize periodic breathing at altitude. Potential adverse consequences of medications include precipitation or worsening of disorders. Risk factors for adverse medication effects include aging, medical disorders, and use of multiple medications that affect respiration.

  14. International research needs for improving sleep and health of workers.

    Science.gov (United States)

    Kogi, Kazutaka

    2005-01-01

    Research needs in identifying preventive measures dealing with working time arrangements and associated sleep problems are reviewed. These needs are based on the recognition of a range of risk factors for health involving disturbed circadian rhythms leading to various levels of sleep deficits. The review takes account of recent joint change approaches that address both working time arrangements and various relevant intervening factors. As examples of such approaches, voluntary industry-based guidelines for improving shift work are examined. Also reviewed is evidence indicating the effects of improved working time arrangements and sleep hygiene on the tolerance of workers working irregular shifts. Trends in action-oriented risk assessment are further discussed as the effects on health and sleep of these workers may be modified by complex aspects related to working situations, family and social conditions, personal characteristics and social support. Generally relevant are not only the relationships between sleep-affecting factors and health, but also advances in taking the various support measures. The effective use of participatory steps is found important in dealing with working time arrangements and associated health and sleep problems together. It is thus considered important to study (a) the efficacy of joint change approaches addressing complex sleep and health factors, (b) effective procedures for action-oriented health risk assessment in various work life situations, and (c) the relevance of innovative participatory steps to improving health and tolerance of workers. Future research topics mentioned by the participants of the international symposium on night and shift work held in Santos in 2003 are presented, and international efforts to promote research into these aspects in field conditions are discussed. Interactive research involving local people appears crucial.

  15. Improving intra-fractional target position accuracy using a 3D surface surrogate for left breast irradiation using the respiratory-gated deep-inspiration breath-hold technique.

    Directory of Open Access Journals (Sweden)

    Yi Rong

    Full Text Available PURPOSE: To evaluate the use of 3D optical surface imaging as a surrogate for respiratory gated deep-inspiration breath-hold (DIBH for left breast irradiation. MATERIAL AND METHODS: Patients with left-sided breast cancer treated with lumpectomy or mastectomy were selected as candidates for DIBH treatment for their external beam radiation therapy. Treatment plans were created on both free breathing (FB and DIBH computed tomography (CT simulation scans to determine dosimetric benefits from DIBH. The Real-time Position Management (RPM system was used to acquire patient's breathing trace during DIBH CT acquisition and treatment delivery. The reference 3D surface models from FB and DIBH CT scans were generated and transferred to the "AlignRT" system for patient positioning and real-time treatment monitoring. MV Cine images were acquired during treatment for each beam as quality assurance for intra-fractional position verification. The chest wall excursions measured on these images were used to define the actual target position during treatment, and to investigate the accuracy and reproducibility of RPM and AlignRT. RESULTS: Reduction in heart dose can be achieved using DIBH for left breast/chest wall radiation. RPM was shown to have inferior correlation with the actual target position, as determined by the MV Cine imaging. Therefore, RPM alone may not be an adequate surrogate in defining the breath-hold level. Alternatively, the AlignRT surface imaging demonstrated a superior correlation with the actual target positioning during DIBH. Both the vertical and magnitude real-time deltas (RTDs reported by AlignRT can be used as the gating parameter, with a recommended threshold of ±3 mm and 5 mm, respectively. CONCLUSION: The RPM system alone may not be sufficient for the required level of accuracy in left-sided breast/CW DIBH treatments. The 3D surface imaging can be used to ensure patient setup and monitor inter- and intra- fractional motions

  16. Translating evidence into population health improvement: strategies and barriers.

    Science.gov (United States)

    Woolf, Steven H; Purnell, Jason Q; Simon, Sarah M; Zimmerman, Emily B; Camberos, Gabriela J; Haley, Amber; Fields, Robert P

    2015-03-18

    Among the challenges facing research translation-the effort to move evidence into policy and practice-is that key questions chosen by investigators and funders may not always align with the information priorities of decision makers, nor are the findings always presented in a form that is useful for or relevant to the decisions at hand. This disconnect is a problem particularly for population health, where the change agents who can make the biggest difference in improving health behaviors and social and environmental conditions are generally nonscientists outside of the health professions. To persuade an audience that does not read scientific journals, strong science may not be enough to elicit change. Achieving influence in population health often requires four ingredients for success: research that is responsive to user needs, an understanding of the decision-making environment, effective stakeholder engagement, and strategic communication. This article reviews the principles and provides examples from a national and local initiative.

  17. Probiotics: can they be used to improve oral health?

    Science.gov (United States)

    Gungor, O E; Kirzioglu, Z; Kivanc, M

    2015-01-01

    The role of probiotic bacteria in improving human health has been an attractive subject for researchers since the beginning of the 20(th) century. They have been used to control gastro-intestinal infections, to promote immunity and to prevent various diseases (allergies, urogenital infections, etc.). However, the use of beneficial bacteria in the field of dentistry has only recently gained interest. Investigation of the effects of probiotic bacteria on oral health has become an important research subject. These studies are still in the early stages, however results show that probiotic bacteria are effective against tooth caries, periodontal disease, oral mucosal lesions and oral malodour. This review provides information on the effects of probiotics--well-known for their effects on general health, and therefore more widely used in healthcare--on oral and dental health, in order to promote their use/prescription by physicians and patients.

  18. Animal-Assisted Therapy for Improving Human Health

    Directory of Open Access Journals (Sweden)

    Sibel Cevizci

    2009-06-01

    Full Text Available ABSTRACT Animal Assisted Therapy (AAT or Pet Therapy is an adjunctive therapy by taking advantage of human and animal interaction, activate the physiological and psychological mechanisms, initiate positive changes improving health in metabolism. In recent years, this interaction are in use to treat psychological and psychiatric disorders such as stress, depression, loneliness, pervasive developmental disorders affect negatively to human health. Furthermore, AAT has been increasingly used to improve quality of life, hypertension, cardiovascular diseases, chronic illnesses such as cancer and AIDS. The aim of this paper is to identify AAT by reviewing human and animal interaction, evaluate how AAT has a scientific background from past to now. Also, we aim to give some information about the risks, institutional applications, some factors referring AAT’s mechanism of action and chronic diseases, psychological and physical improvements provided with animal assisted therapies. The therapy results will be evaluated more advisable providing AAT is being applied with public health specialist, veterinarian, physician, psychologist, psychiatrist and veterinary public health experts who are monitor applications. Especially, the psychosomatic effects result from physical, emotional and play mechanism of action of HDT can be used for improving quality of life in individuals with chronic diseases. In Turkey, there is no any investigation which have been performed in this scientific field. It is quitely important to evaluate the benefits of this therapy accurately and to select various methods proper to diseases. Consequently, it is obvious that AAT will be considered by the healthcare services as a supportive therapy process for improving human health in Turkey and needs further studies. [TAF Prev Med Bull 2009; 8(3.000: 263-272

  19. Telemedicine can improve the health of youths in detention.

    Science.gov (United States)

    Fox, Karen C; Whitt, Anna Lyn

    2008-01-01

    Young people in correctional care facilities often have physical or psychological disorders that contribute to their behavioural problems. In the US, the need for medical services in youth facilities far exceeds current resources, especially for paediatric mental health and specialty services. There is obvious potential for telemedicine to improve access to care and thus the level of health care for juvenile detainees. A few studies have indicated that in specific instances telemedicine has improved access to care, referrals, contact between providers, and has also reduced unnecessary referrals. The question remains, however, whether this improved access and timeliness to care has any effect on the major goals of the incarceration: treatment, education and rehabilitation. Further investigation of this linkage is needed.

  20. Policy Statement--Using personal health records to improve the quality of health care for children.

    Science.gov (United States)

    2009-07-01

    A personal health record (PHR) is a repository of information from multiple contributors (eg, patient, family, guardians, physicians, and other health care professionals) regarding the health of an individual. The development of electronic PHRs presents new opportunities and challenges to the practice of pediatrics. This policy statement provides recommendations for actions that pediatricians can take to support the development and use of PHRs for children. Pediatric health care professionals must become actively involved in developing and adopting PHRs and PHR systems. The American Academy of Pediatrics supports development of: educational programs for families and clinicians on effective and efficient use of PHRs; incentives to facilitate PHR use and maintenance; and child- and adolescent-friendly standards for PHR content, portability, security, and privacy. Properly designed PHR systems for pediatric care can empower patients. PHRs can improve access to health information, improve coordination of preventive health and health maintenance activities, and support emergency and disaster management activities. PHRs provide support for the medical home for all children, including those with special health care needs and those in foster care. PHRs can also provide information to serve as the basis for pediatric quality improvement efforts. For PHRs to be adopted sufficiently to realize these benefits, we must determine how best to support their development and adoption. Privacy and security issues, especially with regard to children and adolescents, must be addressed.

  1. Big data in global health: improving health in low- and middle-income countries.

    Science.gov (United States)

    Wyber, Rosemary; Vaillancourt, Samuel; Perry, William; Mannava, Priya; Folaranmi, Temitope; Celi, Leo Anthony

    2015-03-01

    Over the last decade, a massive increase in data collection and analysis has occurred in many fields. In the health sector, however, there has been relatively little progress in data analysis and application despite a rapid rise in data production. Given adequate governance, improvements in the quality, quantity, storage and analysis of health data could lead to substantial improvements in many health outcomes. In low- and middle-income countries in particular, the creation of an information feedback mechanism can move health-care delivery towards results-based practice and improve the effective use of scarce resources. We review the evolving definition of big data and the possible advantages of - and problems in - using such data to improve health-care delivery in low- and middle-income countries. The collection of big data as mobile-phone based services improve may mean that development phases required elsewhere can be skipped. However, poor infrastructure may prevent interoperability and the safe use of patient data. An appropriate governance framework must be developed and enforced to protect individuals and ensure that health-care delivery is tailored to the characteristics and values of the target communities.

  2. StaR Child Health: improving global standards for child health research.

    Science.gov (United States)

    Offringa, Martin; Needham, Allison C; Chan, Winnie W Y

    2013-11-01

    Standards for Research (StaR) in Child Health, founded in 2009, addresses the current scarcity of and deficiencies in pediatric clinical trials. StaR Child Health brings together leading international experts devoted to developing practical, evidence-based standards to enrich the reliability and relevance of pediatric clinical research. Through a systematic "knowledge to action" plan, StaR Child Health creates opportunities to improve the evidence base for child health across the world. To date, six standards have been published and four more are under development. It is now time to use these standards. Improving the design, conduct and reporting of pediatric clinical trials will ultimately advance the quality of health care provided to children across the globe.

  3. The effectiveness of M-health technologies for improving health and health services: a systematic review protocol

    Directory of Open Access Journals (Sweden)

    Patel Vikram

    2010-10-01

    Full Text Available Abstract Background The application of mobile computing and communication technology is rapidly expanding in the fields of health care and public health. This systematic review will summarise the evidence for the effectiveness of mobile technology interventions for improving health and health service outcomes (M-health around the world. Findings To be included in the review interventions must aim to improve or promote health or health service use and quality, employing any mobile computing and communication technology. This includes: (1 interventions designed to improve diagnosis, investigation, treatment, monitoring and management of disease; (2 interventions to deliver treatment or disease management programmes to patients, health promotion interventions, and interventions designed to improve treatment compliance; and (3 interventions to improve health care processes e.g. appointment attendance, result notification, vaccination reminders. A comprehensive, electronic search strategy will be used to identify controlled studies, published since 1990, and indexed in MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, the Cochrane Library, or the UK NHS Health Technology Assessment database. The search strategy will include terms (and synonyms for the following mobile electronic devices (MEDs and a range of compatible media: mobile phone; personal digital assistant (PDA; handheld computer (e.g. tablet PC; PDA phone (e.g. BlackBerry, Palm Pilot; Smartphone; enterprise digital assistant; portable media player (i.e. MP3 or MP4 player; handheld video game console. No terms for health or health service outcomes will be included, to ensure that all applications of mobile technology in public health and health services are identified. Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies. Data on objective and self-reported outcomes and study quality will

  4. Improving health services in developing countries with new types of public and allied health personnel.

    Science.gov (United States)

    Blayney, K D; Trulove, J W

    1982-10-01

    Allied health manpower in developing countries should be able to serve the specific needs of these countries in solving malnutrition, diarrheal disease, and other health problems. Disease patterns tend to evolve in stages with each stage requiring a special type of health manpower: 1) the 1st stage where infectious diseases are linked to poverty, malnutrition, and poor personal hygiene for which personnel trained to improve health through providing safe water supplies, improving sanitation, and immunizing the population are needed; 2) in the 2nd stages, diseases such as cancer, arthritis, and cardiac diseases exist, requiring extensive technology such as is available in the US; and 3) the 3rd stage relates to an awareness of health hazards (caused by the environment, by the lifestyle dysfunctions of the society, and an emphasis on health promotion) and implies a responsibility for one's own health by the individual; this is a difficult stage to apply to developing countries since the ability to bring about change assumes literacy on the part of the population which is not always the case. Since most developing countries need to cause change in the 1st stage, more public health personnel such as sanitarians and generalist workers are needed. Training of these personnel should include on-the-job education; traditionally trained US allied health professionals are not always equipped to deal with health problems in developing countries. Health educators should look to the lessons learned by the US in the allied health movement: 1) the system of control that national membership organizations have over schooling and the job environment has contributed to an increased cost of health care delivery, unnecessary prolonged curricula, overspecialization, extreme protectionism for membership, and inappropriate fractionalization of health care delivery; 2) the emphasis on prolonged curricula sometimes causes the student to lose sight of the supposed direct relationship between

  5. LEGAL BASES FOR DISCLOSING CONFIDENTIAL PATIENT INFORMATION FOR PUBLIC HEALTH: DISTINGUISHING BETWEEN HEALTH PROTECTION AND HEALTH IMPROVEMENT.

    Science.gov (United States)

    Taylor, Mark J

    2015-01-01

    The disclosure of confidential patient data without an individual's explicit consent should be for purposes that persons have reason to both expect and accept. We do not currently have the required level of clarity or consistency in understanding regarding the disclosure of confidential patient information for public health purposes to support effective public dialogue. The Health Service (Control of Patient Information) Regulations 2002 establish a legal basis in England and Wales for data to be disclosed for public health purposes without patient consent. Under the Regulations, there is more than one potential route towards lawful processing: Data may be processed for public health purposes under both Regulations 3 and 5. The alternatives have different safeguards and conditions attached, and their respective applicability to processing for purposes of public health improvement is currently unclear and subject to review. Beyond the need for clarity regarding the safeguards applicable to processing for particular public health purposes, there are reasons to prefer recognition that Regulation 5 is the most appropriate legal basis for disclosure when the purpose is public health improvement rather than public health protection. Where health improvement, rather than protection, is the aim, there is no justification for discarding the additional safeguards associated with processing under Regulation 5.

  6. Nature-Based Strategies for Improving Urban Health and Safety.

    Science.gov (United States)

    Kondo, Michelle C; South, Eugenia C; Branas, Charles C

    2015-10-01

    Place-based programs are being noticed as key opportunities to prevent disease and promote public health and safety for populations at-large. As one key type of place-based intervention, nature-based and green space strategies can play an especially large role in improving health and safety for dwellers in urban environments such as US legacy cities that lack nature and greenery. In this paper, we describe the current understanding of place-based influences on public health and safety. We focus on nonchemical environmental factors, many of which are related to urban abandonment and blight. We then review findings from studies of nature-based interventions regarding impacts on health, perceptions of safety, and crime. Based on our findings, we suggest that further research in this area will require (1) refined measures of green space, nature, and health and safety for cities, (2) interdisciplinary science and cross-sector policy collaboration, (3) observational studies as well as randomized controlled experiments and natural experiments using appropriate spatial counterfactuals and mixed methods, and (4) return-on-investment calculations of potential economic, social, and health costs and benefits of urban greening initiatives.

  7. Debate on the methods to improve health care.

    Science.gov (United States)

    Cairns, J

    1995-01-01

    In Zambia, free health care is not sustainable, so the community must participate actively in the operation of health services. A well-operated district hospital and health centers within the community must cooperate. A successful cost-effective health system depends on effective leadership of the health care team; use of appropriate technology; delegation of much responsibility to paramedical, nursing, and ancillary staff; and use of the district hospital and its district for postgraduate teaching programs for district health specialists. The health care team consists of medical officers, who are generalists; nurses and midwives; administrators; and an engineer to maintain equipment. Examples of appropriate or intermediate technology include Perkin's traction for most fractures, dynamic skin traction for fracture/dislocations of the elbow in adults or olecranon traction, split skin grafting, musculo-cutaneous or axial flaps, suturing of tendons, spinal anesthesia, draw-over anesthesia, and IV ketamine. In some African countries, including Zambia, medical assistants are trained to deal with some types of general anesthesia. Nurses can be trained to become children's nurses, organizing preventive clinics and being responsible for diagnosis and treatment of all conditions except the most serious. Both medical assistants and nurses can become ophthalmic assistants. Dental therapists can handle many activities usually handled by dentists (e.g., fillings and extractions). Operating nurses can be trained to perform some surgery. In many countries, the training ability of the good district hospital is not used to its potential. The district hospital can form important links by teaching medical students at university centers and the districts. Improvement of health problems in developing countries depends on persons willing to work with the poor and to sacrifice material gain.

  8. Breath Figures Formation

    OpenAIRE

    Guadarrama-Cetina, J.; González-Viñas, W

    2013-01-01

    We present experimental observations of Breath Figures (BF) which are formed by the dew of water when it condenses on a cold surface. The experiments were done in specific conditions and configurations of temperature, surfaces and mixes in controlled concentration of miscibles and immiscibles substances like the salt saturated solution, alcohol and silicon oil (C_6H_18O_2Si). The hydrophobic surfaces used on those observations are thin glasses coated with ITO (Indium Tin Oxide), 3M ECG-1700 w...

  9. Physical improvement and its impact on the health of students

    Directory of Open Access Journals (Sweden)

    Konova L.A.

    2013-05-01

    Full Text Available The directions of physical improvement in personal and individual approach and its impact on the health of students. The definitions of the concept of physical perfection and its main components: strength, speed, endurance, agility, flexibility. Special attention is paid to the importance of physical perfection as part of positive self-identity. Outlines the theory of the acquisition of physical improvement in the availability of a clear human motivation. It is noted that physical perfection is in need of motivation on the part of the student, the proper selection of a complex exercise and may be based only on a personal and individual approach based on the physical abilities of each student. Show the direction of their own physical fitness improvement during the self-study. It is shown that promoting the harmonious development of all-round, avoiding harmful habits, improve mental and physical performance and confidence in their own ability to significantly change the person's self esteem.

  10. Taking a deep breath

    Directory of Open Access Journals (Sweden)

    Carlos Renato Zacharias

    2012-12-01

    Full Text Available While 2012 is going away, IJHDR prepares the celebration of its 5th anniversary! This is thus a time for reflection, to ponder on the good and bad experiences, to (rethink the next steps to improve our service to readers, authors and the scientific community at large. Along these hard, but rewarding first five years, IJHDR reached many readers and was supported by many authors all over the world, it achieved recognition by important scientific databases and societies. This success is the result of the joint work of the Editorial Board members and with GIRI, our hosting scientific society. IJHDR provided the homeopathic community an open, free, multimedia and electronic venue to share high-quality information. Focused on research articles, and open to the entire field of High Dilution research, including homeopathy and hormesis, IJHDR came to occupy a special place within the scientific map. Nevertheless, the goals achieved are not enough, but further improvement is needed for IJHDR keep on growing. Our aim for the next years is to maintain the original editorial vision and mission, while increasing even more the quality of publication. IJHDR will start 2013 by revising its Board of Consultants. Five years ago, when IJHDR was an unknown journal that still had to prove its quality, friends, idealists, and invited experts kindly contributed with their expertise to make peer review a mandatory step in the evaluation of articles. However, not only IJHDR grew, but also the editorial work did! The time arrives to include new experts in our Board of Consultant,, not only to share in the work, but to have cover a broader scope of knowledge, as HD research is a cross-disciplinary and emergent field. Also the structure of the articles will be revised. Improvement in the layout will be discussed to stimulate the use of multimedia resources like video and audio files, simulations, supplementary materials, links, and color images. Special attention will

  11. A fully integrated standalone portable cavity ringdown breath acetone analyzer

    Science.gov (United States)

    Sun, Meixiu; Jiang, Chenyu; Gong, Zhiyong; Zhao, Xiaomeng; Chen, Zhuying; Wang, Zhennan; Kang, Meiling; Li, Yingxin; Wang, Chuji

    2015-09-01

    Breath analysis is a promising new technique for nonintrusive disease diagnosis and metabolic status monitoring. One challenging issue in using a breath biomarker for potential particular disease screening is to find a quantitative relationship between the concentration of the breath biomarker and clinical diagnostic parameters of the specific disease. In order to address this issue, we need a new instrument that is capable of conducting real-time, online breath analysis with high data throughput, so that a large scale of clinical test (more subjects) can be achieved in a short period of time. In this work, we report a fully integrated, standalone, portable analyzer based on the cavity ringdown spectroscopy technique for near-real time, online breath acetone measurements. The performance of the portable analyzer in measurements of breath acetone was interrogated and validated by using the certificated gas chromatography-mass spectrometry. The results show that this new analyzer is useful for reliable online (online introduction of a breath sample without pre-treatment) breath acetone analysis with high sensitivity (57 ppb) and high data throughput (one data per second). Subsequently, the validated breath analyzer was employed for acetone measurements in 119 human subjects under various situations. The instrument design, packaging, specifications, and future improvements were also described. From an optical ringdown cavity operated by the lab-set electronics reported previously to this fully integrated standalone new instrument, we have enabled a new scientific tool suited for large scales of breath acetone analysis and created an instrument platform that can even be adopted for study of other breath biomarkers by using different lasers and ringdown mirrors covering corresponding spectral fingerprints.

  12. Improving the physical health of long-term psychiatric inpatients

    DEFF Research Database (Denmark)

    Hjorth, Peter; Davidsen, Annette S; Kilian, Reinhold

    2014-01-01

    circumference was a proxy of unhealthy body fat in view of the increased risk of cardiovascular diseases and type 2 diabetes. Results: Waist circumference was 108 cm for men and 108 cm for women. Controlled for cluster randomization, sex, age, and body fat, the intervention group showed a small......, but not significant, reduction in waist circumference, while participants in the control group showed a significant increase in waist circumference. Conclusions: The intervention had a positive effect on the physical health of the patients measured by a reduction in the increase of waist circumference. © The Royal...... programme to improve physical health is effective. Methods: An extension of the European Network for Promoting the Health of Residents in Psychiatric and Social Care Institutions (HELPS) project further developed as a 12-month controlled cluster-randomized intervention study in the Danish centre. Waist...

  13. Design of foods with bioactive lipids for improved health.

    Science.gov (United States)

    Chen, Bingcan; McClements, David Julian; Decker, Eric Andrew

    2013-01-01

    Numerous studies have found an association between the consumption of certain bioactive lipids and improved human health, e.g., the prevention, delay, or treatment of chronic and acute diseases, such as cancer, cardiovascular disease (CVD), osteoporosis, and immune disorders. In this review, we discuss food-based sources and potential beneficial attributes of major dietary bioactive lipids: polyunsaturated fatty acids; carotenoids; phytosterols and phytostanols; and fat-soluble vitamins. We summarize the various challenges associated with incorporating these bioactive lipids into foods and beverages, such as poor water solubility, high melting point, and low chemical stability. Finally, we propose several techniques that have been used to solve the challenges and integrate dietary bioactive lipids into foods for improved health.

  14. Does participation in health information exchange improve hospital efficiency?

    Science.gov (United States)

    Walker, Daniel M

    2017-02-24

    The federal government allocated nearly $30 billion to spur the development of information technology infrastructure capable of supporting the exchange of interoperable clinical data, leading to growth in hospital participation in health information exchange (HIE) networks. HIEs have the potential to improve care coordination across healthcare providers, leading ultimately to increased productivity of health services for hospitals. However, the impact of HIE participation on hospital efficiency remains unclear. This dynamic prompts the question asked by this study: does HIE participation improve hospital efficiency. This study estimates the effect of HIE participation on efficiency using a national sample of 1017 hospitals from 2009 to 2012. Using a two-stage analytic design, efficiency indices were determined using the Malmquist algorithm and then regressed on a set of hospital characteristics. Results suggest that any participation in HIE can improve both technical efficiency change and total factor productivity (TFP). A second model examining total years of HIE participation shows a benefit of one and three years of participation on TFP. These results suggest that hospital investment in HIE participation may be a useful strategy to improve hospital operational performance, and that policy should continue to support increased participation and use of HIE. More research is needed to identify the exact mechanisms through which HIE participation can improve hospital efficiency.

  15. Towards improving perinatal maternal mental health in Vietnam

    OpenAIRE

    Niemi, Maria

    2012-01-01

    Major depression is increasing world-wide, and is the third leading cause of the global disease burden. In Vietnam, perinatal depression is underdiagnosed and under-treated, leading to severe consequences for the pregnant mother, her child and surroundings. AIMS: The overall aim was to improve knowledge about perinatal depression to contribute to evidence based development of prevention and treatment strategies in Vietnam. The specific aims were: To generate a report of the mental health prio...

  16. Is walking to school associated with improved metabolic health?

    OpenAIRE

    Pizarro Andreia Nogueira; Ribeiro José Carlos; Marques Elisa Amélia; Mota Jorge; Santos Maria Paula

    2013-01-01

    Abstract Background Active commuting to/from school is an important source of physical activity that has been declining over the past years. Although it is an affordable and simple way of increasing physical activity levels it is still unclear whether it has enough potential to improve health. Therefore, the aim of this cross sectional study was to examine the relationship between active commuting to/from school and metabolic risk factors in 10 to 12 year old children. Methods Participants we...

  17. Health education improves effectively therapy of inpatients with hypertension

    Institute of Scientific and Technical Information of China (English)

    Xiang Gu; Chunzhi Shi; Yibai Feng; Xianggui Wang; Hongbin Nie; Yongming Zhou; Yeqiang Liu; Xiangdong Xu

    2006-01-01

    Objective: Low rate of medication usage and blood pressure (BP) control, bad lifestyle, poor cognition to hypertension, have been obstacles in prevention from hypertensive disease and complication in Chinese cohort. Health education appears to be an impendent measure to improve this situation. To study the effect of health education on the rate of medication usage and BP control, the lifestyle, and the incidence of complication among patients with hypertension. Methods: 284 hypertensive inpatients were divided randomly into two groups: the control group was intervened with routine medication; the education group was intervened with routine medication in combination with intensive health education according to the investigation on the risk factors of cardiocerebrovascular diseases and cognitive levels of hypertensivedisease. During 12.16 ± 1.95 months of following up,the status of lifestyle, the rate of medication usage and BP control, and incidence of complications between two groups were analyzed. Results: In education group, the rate of smoking, alcohol intake, lower-salt ingesting, exercise, medication usage and BP control were improved after intervention and significantly different from those before intervention (P < 0.01). After intervention,the incidence of complications in education group and control group was 10.9% and 30.5% respectively (P < 0.01 ). Conclusion:Intensive health education is an important measure in preventing from hypertension.

  18. Can health care teams improve primary care practice?

    Science.gov (United States)

    Grumbach, Kevin; Bodenheimer, Thomas

    2004-03-10

    In health care settings, individuals from different disciplines come together to care for patients. Although these groups of health care personnel are generally called teams, they need to earn true team status by demonstrating teamwork. Developing health care teams requires attention to 2 central questions: who is on the team and how do team members work together? This article chiefly focuses on the second question. Cohesive health care teams have 5 key characteristics: clear goals with measurable outcomes, clinical and administrative systems, division of labor, training of all team members, and effective communication. Two organizations are described that demonstrate these components: a private primary care practice in Bangor, Me, and Kaiser Permanente's Georgia region primary care sites. Research on patient care teams suggests that teams with greater cohesiveness are associated with better clinical outcome measures and higher patient satisfaction. In addition, medical settings in which physicians and nonphysician professionals work together as teams can demonstrate improved patient outcomes. A number of barriers to team formation exist, chiefly related to the challenges of human relationships and personalities. Taking small steps toward team development may improve the work environment in primary care practices.

  19. Diagnosing and improving functioning in interdisciplinary health care teams.

    Science.gov (United States)

    Blackmore, Gail; Persaud, D David

    2012-01-01

    Interdisciplinary teams play a key role in the delivery of health care. Team functioning can positively or negatively impact the effective and efficient delivery of health care services as well as the personal well-being of group members. Additionally, teams must be able and willing to work together to achieve team goals within a climate that reflects commitment to team goals, accountability, respect, and trust. Not surprisingly, dysfunctional team functioning can limit the success of interdisciplinary health care teams. The first step in improving dysfunctional team function is to conduct an analysis based on criteria necessary for team success, and this article provides meaningful criteria for doing such an analysis. These are the following: a common team goal, the ability and willingness to work together to achieve team goals, decision making, communication, and team member relationships. High-functioning interdisciplinary teams must exhibit features of good team function in all key domains. If a team functions well in some domains and needs to improve in others, targeted strategies are described that can be used to improve team functioning.

  20. Integrating health promotion with quality improvement in a Swedish hospital.

    Science.gov (United States)

    Astnell, Sandra; von Thiele Schwarz, Ulrica; Hasson, Henna; Augustsson, Hanna; Stenfors-Hayes, Terese

    2016-09-01

    Integration of workplace employee health promotion (HP) and occupational health and safety (OHS) work into organizational quality improvement systems is suggested as a way to strengthen HP and OHS activities in an organization. The aim of this article was to study what consequences integration of HP, OHS and a quality improvement system called kaizen has on the frequency and type of HP and OHS activities. A quasi-experimental study design was used where an integration of the three systems for HP, OHS respectively kaizen, was performed at six intervention units at a Swedish hospital. The remaining six units served as controls. Document analysis of all employees' written improvement suggestions (kaizen notes) during 2013 was conducted. The findings show that the intervention group had more suggestions concerning HP and OHS (n = 114) when compared with the control group (n = 78) and a greater variety of HP and OHS suggestions. In addition, only the intervention group had included HP aspects. In both groups, most kaizen notes with health consideration had a preventive focus rather than rehabilitative. The intervention, i.e. the integration of HP, OHS and kaizen work, had a favourable effect on HP and OHS work when compared with the controls. The results of the study support that this system can work in practice at hospitals.

  1. Population health improvement: a community health business model that engages partners in all sectors.

    Science.gov (United States)

    Kindig, David A; Isham, George

    2014-01-01

    Because population health improvement requires action on multiple determinants--including medical care, health behaviors, and the social and physical environments--no single entity can be held accountable for achieving improved outcomes. Medical organizations, government, schools, businesses, and community organizations all need to make substantial changes in how they approach health and how they allocate resources. To this end, we suggest the development of multisectoral community health business partnership models. Such collaborative efforts are needed by sectors and actors not accustomed to working together. Healthcare executives can play important leadership roles in fostering or supporting such partnerships in local and national arenas where they have influence. In this article, we develop the following components of this argument: defining a community health business model; defining population health and the Triple Aim concept; reaching beyond core mission to help create the model; discussing the shift for care delivery beyond healthcare organizations to other community sectors; examining who should lead in developing the community business model; discussing where the resources for a community business model might come from; identifying that better evidence is needed to inform where to make cost-effective investments; and proposing some next steps. The approach we have outlined is a departure from much current policy and management practice. But new models are needed as a road map to drive action--not just thinking--to address the enormous challenge of improving population health. While we applaud continuing calls to improve health and reduce disparities, progress will require more robust incentives, strategies, and action than have been in practice to date. Our hope is that ideas presented here will help to catalyze a collective, multisectoral response to this critical social and economic challenge.

  2. Reducing Food Loss And Waste While Improving The Public's Health.

    Science.gov (United States)

    Neff, Roni A; Kanter, Rebecca; Vandevijvere, Stefanie

    2015-11-01

    An estimated 30 percent of the global food supply is lost or wasted, as is about 40 percent of the US food supply. There are valuable synergies between efforts to reduce food loss and waste and those promoting public health. To demonstrate the potential impact of building upon these synergies, we present an analysis of policies and interventions addressing food loss and waste, food security, food safety, and nutrition. We characterize as opportunities the policies and interventions that promote synergistic relationships between goals in the fields of food loss and waste and of public health. We characterize as challenges the policies and interventions that may reduce food loss and waste but compromise public health, or improve public health but increase food loss and waste. Some interventions are both opportunities and challenges. With deliberate planning and action, challenges can often be addressed and turned into opportunities. In other cases, it may be necessary to strike a balance between potential benefit in one area and risk of harm in the other. To help policy makers make the best use of the opportunities while tackling the challenges, it is essential to consider public health in efforts to reduce food loss and waste.

  3. Four centuries on from Bacon: progress in building health research systems to improve health systems?

    Science.gov (United States)

    Hanney, Stephen R; González-Block, Miguel A

    2014-09-23

    In 1627, Francis Bacon's New Atlantis described a utopian society in which an embryonic research system contributed to meeting the needs of the society. In this editorial, we use some of the aspirations described in New Atlantis to provide a context within which to consider recent progress in building health research systems to improve health systems and population health. In particular, we reflect on efforts to build research capacity, link research to policy, identify the wider impacts made by the science, and generally build fully functioning research systems to address the needs identified. In 2014, Health Research Policy and Systems has continued to publish one-off papers and article collections covering a range of these issues in both high income countries and low- and middle-income countries. Analysis of these contributions, in the context of some earlier ones, is brought together to identify achievements, challenges and possible ways forward. We show how 2014 is likely to be a pivotal year in the development of ways to assess the impact of health research on policies, practice, health systems, population health, and economic benefits.We demonstrate how the increasing focus on health research systems will contribute to realising the hopes expressed in the World Health Report, 2013, namely that all nations would take a systematic approach to evaluating the outputs and applications resulting from their research investment.

  4. Improving health services for African migrants in China: A health diplomacy perspective.

    Science.gov (United States)

    McLaughlin, Megan M; Lee, Margaret C; Hall, Brian J; Bulterys, Marc; Ling, Li; Tucker, Joseph D

    2014-01-01

    Global health has become an increasingly prominent component of foreign policy in the last decade. The term health diplomacy has been used to describe this growing interface between foreign policy and global health, and it encompasses both the concept of using health to further foreign policy objectives as well as the idea that diplomatic tools can be helpful for attaining public health goals. The Chinese presence in Africa has grown in the last 15 years, generating increased interest in Sino-African relations. While much has been written in recent years about the Chinese presence in Africa, the growing numbers of Africans in China have attracted considerably less attention. Many are small-scale traders and might be expected to face many of the health challenges common among foreign migrants, but their health needs have been largely unrecognised. In this paper, we consider how a health diplomacy approach could be applied to African migrants in China, and the potential advantages and limitations of this strategy. We identify areas of overlap between public health, trade and foreign policy goals that can be emphasised to generate support for improved services for African migrants in China and to engage partners from a diversity of sectors.

  5. Ineffective breathing pattern related to malnutrition.

    Science.gov (United States)

    Openbrier, D R; Covey, M

    1987-03-01

    This article has highlighted the problem of malnutrition in the stable COPD patient and the critically ill, hypercatabolic patient, and has reviewed resultant mechanisms which influence the alteration of breathing pattern. These complex patients present a challenge for the nurse. Table 1 briefly summarizes the manifestations of malnutrition, goals, interventions and expected outcomes of the nursing diagnosis, ineffective breathing pattern related to malnutrition. The goal of the interventions is to modify the cause (malnutrition) of the nursing diagnosis (altered breathing pattern). The success of the interventions will lead to the achievement of expected outcome As expected outcomes are achieved, relief of signs and symptoms related to the nursing diagnosis will occur. The nurse caring for the patient with actual or potential malnutrition must be knowledgeable about the physiology of malnutrition and effect on breathing pattern. It is essential that the nurse assess and provide appropriate nutritional support and evaluate progress toward expected outcomes. In the event that expected outcomes are not achieved, reassessment with modification of interventions is necessary. Nurses play a key role in the total health care delivery to these complex patients. Further study will strengthen the research base of nursing interventions.

  6. Health and education: service providers in partnership to improve mental health

    Directory of Open Access Journals (Sweden)

    Eapen Valsamma

    2012-09-01

    Full Text Available Abstract Background Children and adolescents from complex or disadvantaged backgrounds and multiple needs often are reluctant to seek help and this is particularly relevant in the context of mental health difficulties. Further, the complexity of the health system can be overwhelming to the family who are likely to be chaotic and less able to seek help. The current project piloted an integrated service delivery model involving a child psychiatry service and the department of education to promote access to mental health assessment and intervention to young people attending special education schools in Sydney, Australia. Findings and conclusion The project allowed improved access to mental health services for a group of young people who would otherwise not have sought help through traditional referral pathways. Our findings support strategies to promote the social milieu of schools as a way of achieving better mental health and learning outcomes.

  7. Improving Perinatal Mental Health Care for Women Veterans: Description of a Quality Improvement Program.

    Science.gov (United States)

    Katon, Jodie G; Lewis, Lacey; Hercinovic, Selma; McNab, Amanda; Fortney, John; Rose, Susan M

    2017-02-06

    Purpose We describe results from a quality improvement project undertaken to address perinatal mental healthcare for women veterans. Description This quality improvement project was conducted in a single VA healthcare system between 2012 and 2015 and included screening for depressive symptoms with the Edinburgh Postnatal Depression Scale (EPDS) three times during the perinatal period, a dedicated maternity care coordinator (MCC), an on-site clinical social worker, and an on-site obstetrician/gynecologist (Ob/gyn). Information on prior mental health diagnosis was collected by the MCC or Ob/gyn. The prevalence of perinatal depressive symptoms and receipt of mental healthcare among those with such symptoms are reported by presence of a pre-pregnancy mental health diagnosis. Assessment Of the 199 women who used VA maternity benefits between 2012 and 2015, 56% (n = 111) had at least one pre-pregnancy mental health diagnosis. Compared to those without a pre-pregnancy mental health diagnosis, those with such a diagnosis were more likely to be screened for perinatal depressive symptoms at least once (61.5% vs. 46.8%, p = 0.04). Prevalence of depressive symptoms was 46.7% among those with a pre-pregnancy mental health diagnosis and 19.2% among those without. Among those with a pre-pregnancy mental health diagnosis and depressive symptoms (n = 35), 88% received outpatient mental healthcare and 77% met with the clinical social worker. Among those without a pre-pregnancy mental health diagnosis and depressive symptoms (n = 8), none received outpatient mental healthcare, but 77.8% met with the clinical social worker. Conclusion Improving perinatal mental healthcare for women veterans requires a multidisciplinary approach, including on-site integrated mental healthcare.

  8. Improved health or improved decision making? The ethical goals of EBM.

    Science.gov (United States)

    Gupta, Mona

    2011-10-01

    Evidence-based medicine (EBM) is frequently portrayed as a value-free approach to knowing what kinds of treatment 'really work.' Since practitioners should help patients to improve their health, and EBM tells us which interventions will work, then it follows that we must practice EBM, offering only those interventions supported by evidence. The primary goal of EBM, then, is an ethical one - to improve health. More recently, EBM's authors have also committed themselves to 'shared decision making' in which evidence plays a role in the clinical encounter, but where patients, motivated by their own values, should have final decision-making authority. Envisioned this way, strengthening the informed consent process, rather than improved health per se, is viewed as the goal of EBM. In this paper, I will explore this shift in EBM's ethics from the goal of improved health towards the goal of strengthened informed consent. Drawing upon data from a qualitative enquiry of scholars involved in the development of EBM, I will argue that EBM is now committed to both of these ethical goals. Where they conflict, the aim of the intervention will determine which goal practitioners should pursue. Having increased the ethical complexity of EBM, we are left with the question of whether EBM would still be judged a success if it did not lead to much in the way of improvements in health, but primarily strengthened informed consent. This paper will conclude by arguing that this more nuanced version of EBM's ethics accurately reflects the dynamics of real clinical practice but undermines the original, perceived need for EBM.

  9. Improving Quality of Emergency Care Through Integration of Mental Health.

    Science.gov (United States)

    Okafor, Martha; Wrenn, Glenda; Ede, Victor; Wilson, Nana; Custer, William; Risby, Emile; Claeys, Michael; Shelp, Frank E; Atallah, Hany; Mattox, Gail; Satcher, David

    2016-04-01

    The goal of this study was to better integrate emergency medical and psychiatric care at a large urban public hospital, identify impact on quality improvement metrics, and reduce healthcare cost. A psychiatric fast track service was implemented as a quality improvement initiative. Data on disposition from the emergency department from January 2011 to May 2012 for patients impacted by the pilot were analyzed. 4329 patients from January 2011 to August 2011 (pre-intervention) were compared with 4867 patients from September 2011 to May 2012 (intervention). There was a trend of decline on overall quality metrics of time to triage and time from disposition to discharge. The trend analysis of the psychiatric length of stay and use of restraints showed significant reductions. Integrated emergency care models are evidence-based approach to ensuring that patients with mental health needs receive proper and efficient treatment. Results suggest that this may also improve overall emergency department's throughput.

  10. Electronic Nose Functionality for Breath Gas Analysis during Parabolic Flight

    Science.gov (United States)

    Dolch, Michael E.; Hummel, Thomas; Fetter, Viktor; Helwig, Andreas; Lenic, Joachim; Moukhamedieva, Lana; Tsarkow, Dimitrij; Chouker, Alexander; Schelling, Gustav

    2017-02-01

    The presence of humans in space represents a constant threat for their health and safety. Environmental factors such as living in a closed confinement, as well as exposure to microgravity and radiation, are associated with significant changes in bone metabolism, muscular atrophy, and altered immune response, which has impacts on human performance and possibly results in severe illness. Thus, maintaining and monitoring of crew health status has the highest priority to ensure whole mission success. With manned deep space missions to moon or mars appearing at the horizon where short-term repatriation back to earth is impossible the availability of appropriate diagnostic platforms for crew health status is urgently needed. In response to this need, the present experiment evaluated the functionality and practicability of a metal oxide based sensor system (eNose) together with a newly developed breath gas collecting device under the condition of altering acceleration. Parabolic flights were performed with an Airbus A300 ZeroG at Bordeaux, France. Ambient air and exhaled breath of five healthy volunteers was analyzed during steady state flight and parabolic flight maneuvres. All volunteers completed the study, the breath gas collecting device valves worked appropriately, and breathing through the collecting device was easy and did not induce discomfort. During breath gas measurements, significant changes in metal oxide sensors, mainly sensitive to aromatic and sulphur containing compounds, were observed with alternating conditions of acceleration. Similarly, metal oxide sensors showed significant changes in all sensors during ambient air measurements. The eNose as well as the newly developed breath gas collecting device, showed appropriate functionality and practicability during alternating conditions of acceleration which is a prerequisite for the intended use of the eNose aboard the International Space Station (ISS) for breath gas analysis and crew health status

  11. [Continuous nursing education to improve the quality of health care].

    Science.gov (United States)

    Fumić, Nera; Marinović, Marin; Brajan, Dolores

    2014-10-01

    Health care and today's medical and technical achievements and approved standards of treatment provide comprehensive quality, safety and traceability of medical procedures respecting the principles of health protection. Continuous education improves the quality of nursing health care and increases the effectiveness of patient care, consequently maintaining and enhancing patient safety. Patient health problems impose the need of appropriate, planned and timely nursing care and treatment. In providing quality nursing care, attention is focused on the patient and his/her needs in order to maintain and increase their safety, satisfaction, independence and recovery or peaceful death, so the health and nursing practices must be systematized, planned and based on knowledge and experience. Health and nursing care of patients at risk of developing acute and chronic wounds or already suffering from some form of this imply preventive measures that are provided through patient education, motivation, monitoring, early recognition of risk factors and causes, and reducing or removing them through the prescribed necessary medical treatment which is safe depending on the patient health status. Except for preventive measures, nursing care of patients who already suffer from some form of acute or chronic wounds is focused on the care and treatment of damaged tissue by providing appropriate and timely diagnosis, timely and proper evaluation of the wound and patient general status, knowledge and understanding of the wide range of local, oral and parenteral therapy and treatment, aiming to increase patient safety by preventing progression of the patient general condition and local wound status and reducing the possibility of developing infection or other complications of the underlying disease. In the overall patient management, through nursing process, medical interventions are implemented and aimed to maintain and optimize health status, prevent complications of existing diseases and

  12. Approaches in Health Human Resource Forecasting: A Roadmap for Improvement

    Science.gov (United States)

    Rafiei, Sima; Mohebbifar, Rafat; Hashemi, Fariba; Ezzatabadi, Mohammad Ranjbar; Farzianpour, Fereshteh

    2016-01-01

    Introduction Forecasting the demand and supply of health manpower in an accurate manner makes appropriate planning possible. The aim of this paper was to review approaches and methods for health manpower forecasting and consequently propose the features that improve the effectiveness of this important process of health manpower planning. Methods A literature review was conducted for studies published in English from 1990–2014 using Pub Med, Science Direct, Pro Quest, and Google Scholar databases. Review articles, qualitative studies, retrospective and prospective studies describing or applying various types of forecasting approaches and methods in health manpower forecasting were included in the review. The authors designed an extraction data sheet based on study questions to collect data on studies’ references, designs, and types of forecasting approaches, whether discussed or applied, with their strengths and weaknesses Results Forty studies were included in the review. As a result, two main categories of approaches (conceptual and analytical) for health manpower forecasting were identified. Each approach had several strengths and weaknesses. As a whole, most of them were faced with some challenges, such as being static and unable to capture dynamic variables in manpower forecasting and causal relationships. They also lacked the capacity to benefit from scenario making to assist policy makers in effective decision making. Conclusions An effective forecasting approach is supposed to resolve all the deficits that exist in current approaches and meet the key features found in the literature in order to develop an open system and a dynamic and comprehensive method necessary for today complex health care systems. PMID:27790343

  13. Intervention studies for improving global health and health care: An important arena for epidemiologists

    Directory of Open Access Journals (Sweden)

    Gunnar Kvåle

    2009-10-01

    Full Text Available Marginalised populations in many low- and middle-income countries experience an increasing burden of disease, in sub-Saharan Africa to a large extent due to faltering health systems and serious HIV epidemics. Also other poverty related diseases (PRDs are prevalent, especially respiratory and diarrhoeal diseases in children, malnutrition, maternal and perinatal health problems, tuberculosis and malaria. Daily, nearly 30,000 children under the age of 5 die, most from preventable causes, and 8,000 people die from HIV infections. In spite of the availability of powerful preventive and therapeutic tools for combating these PRDs, their implementation, especially in terms of equitable delivery, leaves much to be desired. The research community must address this tragic gap between knowledge and implementation. Epidemiologists have a very important role to play in conducting studies on diseases that account for the largest share of the global disease burden. A shift of focus of epidemiologic research towards intervention studies addressing health problems of major public health importance for disadvantaged population groups is needed. There is a need to generate an evidence-base for interventions that can be implemented on a large scale; this can result in increased funding of health promotion programs as well as enable rational prioritization and integration between different health interventions. This will require close and synergetic teamwork between epidemiologists and other professions across disciplines and sectors. In this way epidemiologists can contribute significantly to improve health and optimise health care delivery for marginalized populations.

  14. Biological control of vaginosis to improve reproductive health

    Directory of Open Access Journals (Sweden)

    P Mastromarino

    2014-01-01

    Full Text Available The human vaginal microbiota plays an important role in the maintenance of a woman′s health, as well as of her partner′s and newborns′. When this predominantly Lactobacillus community is disrupted, decreased in abundance and replaced by different anaerobes, bacterial vaginosis (BV may occur. BV is associated with ascending infections and obstetrical complications, such as chorioamnionitis and preterm delivery, as well as with urinary tract infections and sexually transmitted infections. In BV the overgrowth of anaerobes produces noxious substances like polyamines and other compounds that trigger the release of pro-inflammatory cytokines interleukin (IL-1 β and IL-8. BV can profoundly affect, with different mechanisms, all the phases of a woman′s life in relation to reproduction, before pregnancy, during fertilization, through and at the end of pregnancy. BV can directly affect fertility, since an ascending dissemination of the involved species may lead to tubal factor infertility. Moreover, the increased risk of acquiring sexually transmitted diseases contributes to damage to reproductive health. Exogenous strains of lactobacilli have been suggested as a means of re-establishing a normal healthy vaginal flora. Carefully selected probiotic strains can eliminate BV and also exert an antiviral effect, thus reducing viral load and preventing foetal and neonatal infection. The administration of beneficial microorganisms (probiotics can aid recovery from infection and restore and maintain a healthy vaginal ecosystem, thus improving female health also in relation to reproductive health.

  15. Forensic mental health assessment in France: recommendations for quality improvement.

    Science.gov (United States)

    Combalbert, Nicolas; Andronikof, Anne; Armand, Marine; Robin, Cécile; Bazex, Hélène

    2014-01-01

    The quality of forensic mental health assessment has been a growing concern in various countries on both sides of the Atlantic, but the legal systems are not always comparable and some aspects of forensic assessment are specific to a given country. This paper describes the legal context of forensic psychological assessment in France (i.e. pre-trial investigation phase entrusted to a judge, with mental health assessment performed by preselected professionals called "experts" in French), its advantages and its pitfalls. Forensic psychiatric or psychological assessment is often an essential and decisive element in criminal cases, but since a judiciary scandal which was made public in 2005 (the Outreau case) there has been increasing criticism from the public and the legal profession regarding the reliability of clinical conclusions. Several academic studies and a parliamentary report have highlighted various faulty aspects in both the judiciary process and the mental health assessments. The heterogeneity of expert practices in France appears to be mainly related to a lack of consensus on several core notions such as mental health diagnosis or assessment methods, poor working conditions, lack of specialized training, and insufficient familiarity with the Code of Ethics. In this article we describe and analyze the French practice of forensic psychologists and psychiatrists in criminal cases and propose steps that could be taken to improve its quality, such as setting up specialized training courses, enforcing the Code of Ethics for psychologists, and calling for consensus on diagnostic and assessment methods.

  16. An Effective Model for Improving Global Health Nursing Competence

    Directory of Open Access Journals (Sweden)

    Sunjoo Kang

    2016-09-01

    Full Text Available This paper developed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by implementing four programs. All programs were conducted with students majoring nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students’ needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, most of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students’ reflective journals was examined. Additionally, students’ awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre and post-program implementation. We discuss how identifying students’ needs regarding global nursing competence when developing appropriate curricula.

  17. An Effective Model for Improving Global Health Nursing Competence

    Science.gov (United States)

    Kang, Sun-Joo

    2016-01-01

    This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students’ needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, some of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students’ reflective journals was examined. Additionally, students’ awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre- and post-program implementation. The importance of identifying students’ needs regarding global nursing competence when developing appropriate curricula is discussed. PMID:27679793

  18. An Effective Model for Improving Global Health Nursing Competence.

    Science.gov (United States)

    Kang, Sun-Joo

    2016-01-01

    This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students' needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, some of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students' reflective journals was examined. Additionally, students' awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre- and post-program implementation. The importance of identifying students' needs regarding global nursing competence when developing appropriate curricula is discussed.

  19. Community oral health literacy: improving use of oral-health care guarantee in children aged 6.

    Directory of Open Access Journals (Sweden)

    Marco Cornejo-Ovalle

    2013-08-01

    Full Text Available The assessment of comprehensive oral health care for children aged 6 (GES-6years showed low utilization of this guarantee, with lower use for children from municipal public schools. The empowerment and health literacy of parents improve their role as oral-health promoters for their children. Objective: To implement and to assess a strategy of empowerment and health literacy of the community about their guaranteed health rights to increase the use of GES-6years. Methods: A mixed design. Using qualitative methodology we will design a communication tool, culturally and socially appropriate to be sent to the beneficiary community of this guarantee. Using a nonrandomized community trial, this instrument designed to empower and improve oral health literacy on GES-6 guarantee, will be sent as personalized letter (intervention signed by the mayor of the municipality with a message aimed to children beneficiaries for GES -6years and another addressed to their parents/guardians. Schools would be selected from clusters (communes of the two regions selected for convenience. Communes will be randomly selected amog those whose authorities agree to participate, and will be selected as for intervention or control. Data analysis will assess the differences in the prevalence of use of this guarantee among children from municipal schools belonging to the intervention or control arm.

  20. Improving motivation among primary health care workers in Tanzania: a health worker perspective

    DEFF Research Database (Denmark)

    Manongi, Rachel N; Marchant, Tanya C; Bygbjerg, Ib Christian

    2006-01-01

    in the primary health care facilities in Kilimanjaro Region, Tanzania, in terms of their motivation to work, satisfaction and frustration, and to identify areas for sustainable improvement to the services they provide.The primary issues arising pertain to complexities of multitasking in an environment of staff...

  1. Improving Urban Watershed Health Through Suburban Infill Design and Development

    OpenAIRE

    2011-01-01

    Up to 75 percent of new construction between 2000 and 2030 may â be redirected inward or into more compact, mixed-use suburban developments (Nelson, 2004). If this assertion is even nearly true, and if the goals of the Clean Water Act are to be met in the next generation of American cities, then we must find feasible and effective ways of improving urban watershed health using retrofit and infill development as a primary means. The aim of this study is to evaluate the patterns and approache...

  2. Improving the Health Industry with Stock Management Techniques

    Directory of Open Access Journals (Sweden)

    Luiz Henrique Machado Cequeira

    2006-12-01

    Full Text Available Considering that the health industry has changed radically along the years, the efficient professional management of entities connected to this segment is fundamental. Modern techniques, such as demand forecast and stock management, contribute to a better management of scarce and critical resources which might put human lives at risk. The present study describes the use of quantitative techniques for supply forecast and stock management of a blood bank from a given hospital. The demonstration of the viability of these techniques broke paradigms. Furthermore, it has fomented new studies with emphasis on improving procedures and rationalization. It has also brought an improvement in terms of the institution operations, increasing the level of efficiency.

  3. PPACA and public health: creating a framework to focus on prevention and wellness and improve the public's health.

    Science.gov (United States)

    Majette, Gwendolyn Roberts

    2011-01-01

    PPACA epitomizes comprehensive health care reform legislation. Public health, disease prevention, and wellness were integral considerations in its development. This article reveals the author's personal experiences while working on the framework for health care reform in the United States Senate and reviews activity in the United States House of Representatives. This insider's perspective delineates PPACA's positive effect on public health by examining the infrastructure Congress designed to focus on prevention, wellness, and public health, with a particular focus on the National Prevention, Health Promotion and Public Health Council; the National Prevention, Health Promotion, Public Health, and Integrative Health Care Strategy; and the Prevention and Public Health Fund. The Council, strategy, and fund are especially important because they reflect compliance with some of the Institute of Medicine's recommendations to improve public health in the United States, as well as international health and human rights norms that protect the right to health.

  4. Improving motivation among primary health care workers in Tanzania: a health worker perspective

    Directory of Open Access Journals (Sweden)

    Bygbjerg Ib Christian

    2006-03-01

    Full Text Available Abstract In Tanzania access to urban and rural primary health care is relatively widespread, yet there is evidence of considerable bypassing of services; questions have been raised about how to improve functionality. The aim of this study was to explore the experiences of health workers working in the primary health care facilities in Kilimanjaro Region, Tanzania, in terms of their motivation to work, satisfaction and frustration, and to identify areas for sustainable improvement to the services they provide. The primary issues arising pertain to complexities of multitasking in an environment of staff shortages, a desire for more structured and supportive supervision from managers, and improved transparency in career development opportunities. Further, suggestions were made for inter-facility exchanges, particularly on commonly referred cases. The discussion highlights the context of some of the problems identified in the results and suggests that some of the preferences presented by the health workers be discussed at policy level with a view to adding value to most services with minimum additional resources.

  5. Tongue Scrapers Only Slightly Reduce Bad Breath

    Science.gov (United States)

    ... your desktop! more... Tongue Scrapers Only Slightly Reduce Bad Breath Article Chapters Tongue Scrapers Only Slightly Reduce ... oral cavity. Reviewed: January 2012 Related Articles: Halitosis (Bad Breath) Do You Have Traveler's Breath? Does a ...

  6. Improving personal health records for patient-centered care

    Science.gov (United States)

    Feldman, Henry J; Ross, Stephen E; Safran, Charles

    2010-01-01

    Objective To assess the patient-centeredness of personal health records (PHR) and offer recommendations for best practice guidelines. Design Semi-structured interviews were conducted in seven large early PHR adopter organizations in 2007. Organizations were purposively selected to represent a variety of US settings, including medium and large hospitals, ambulatory care facilities, insurers and health plans, government departments, and commercial sectors. Measurements Patient-centeredness was assessed against a framework of care that includes: (1) respect for patient values, preferences, and expressed needs; (2) information and education; (3) access to care; (4) emotional support to relieve fear and anxiety; (5) involvement of family and friends; (6) continuity and secure transition between healthcare providers; (7) physical comfort; (8) coordination of care. Within this framework we used evidence for patient preferences (where it exists) to compare existing PHR policies, and propose a best practice model. Results Most organizations enable many patient-centered functions such as data access for proxies and minors. No organization allows patient views of clinical progress notes, and turnaround times for PHR reporting of normal laboratory results can be up to 7 days. Conclusion Findings suggest patient-centeredness for personal health records can be improved, and recommendations are made for best practice guidelines. PMID:20190063

  7. Integrated yoga therapy for improving mental health in managers

    Directory of Open Access Journals (Sweden)

    Tikhe Sham Ganpat

    2011-01-01

    Full Text Available Background: Managers′ lives have become a never-ending race against time, technology, and targets. This race creates tension, which leads to dissatisfaction and frustration and eventually manifests itself as psychological and physiological stress with mental and emotional drain. This modern lifestyle intensifies the stress leading to "Excessive Tension" and consequent deterioration in "Executive Efficiency." Objective: To assess mental health in managers undergoing yoga-based Self-Management of Excessive Tension (SMET program. Materials and Methods: 72 managers with 48.75±3.86 years of mean age were participated in this study of single group pre-post design. The General Health Questionnaire data were taken on the first and sixth day of 5 days SMET program. Results: The data analysis showed 68.25% decrease (P<0.001 in somatic symptoms, 66.29% decrease (P<0.001 in anxiety and insomnia, 65.00% decrease (P<0.001 in social dysfunction, 87.08% decrease (P<0.001 in severe depression, and 71.47% decrease (P<0.001 in all medical complaints. Conclusion: These results suggest that participation in a SMET program was associated with improvement in mental health and may have implications for "Executive Efficiency."

  8. Breath in the technoscientific imaginary.

    Science.gov (United States)

    Rose, Arthur

    2016-12-01

    Breath has a realist function in most artistic media. It serves to remind the reader, the viewer or the spectator of the exigencies of the body. In science fiction (SF) literature and films, breath is often a plot device for human encounters with otherness, either with alien peoples, who may not breathe oxygen, or environments, where there may not be oxygen to breathe. But while there is a technoscientific quality to breath in SF, especially in its attention to physiological systems, concentrating on the technoscientific threatens to occlude other, more affective aspects raised by the literature. In order to supplement the tendency to read SF as a succession of technoscientific accounts of bodily experience, this paper recalls how SF texts draw attention to the affective, non-scientific qualities of breath, both as a metonym for life and as a metaphor for anticipation. Through an engagement with diverse examples from SF literature and films, this article considers the tension between technoscientific and affective responses to breath in order to demonstrate breath's co-determinacy in SF's blending of scientific and artistic discourses.

  9. BREATHE to Understand©

    Science.gov (United States)

    Swisa, Maxine

    2015-01-01

    BREATHE is an acronym for Breathe, Reflect, Empathize, Accept, Thank, Hearten, Engage. The addition of Understand allows for a holistic approach to living a healthy and balanced life both inside and outside the classroom. This paper took form as a result of my personal, spiritual journey, as well as my teaching practice. I noticed that the…

  10. Repository on maternal child health: Health portal to improve access to information on maternal child health in India

    Directory of Open Access Journals (Sweden)

    Khanna Rajesh

    2013-01-01

    Full Text Available Abstract Background Quality and essential health information is considered one of the most cost-effective interventions to improve health for a developing country. Healthcare portals have revolutionalized access to health information and knowledge using the Internet and related technologies, but their usage is far from satisfactory in India. This article describes a health portal developed in India aimed at providing one-stop access to efficiently search, organize and share maternal child health information relevant from public health perspective in the country. Methods The portal ‘Repository on Maternal Child Health’ was developed using an open source content management system and standardized processes were followed for collection, selection, categorization and presentation of resource materials. Its usage is evaluated using key performance indicators obtained from Google Analytics, and quality assessed using a standardized checklist of knowledge management. The results are discussed in relation to improving quality and access to health information. Results The portal was launched in July 2010 and provides free access to full-text of 900 resource materials categorized under specific topics and themes. During the subsequent 18 months, 52,798 visits were registered from 174 countries across the world, and more than three-fourth visits were from India alone. Nearly 44,000 unique visitors visited the website and spent an average time of 4 minutes 26 seconds. The overall bounce rate was 27.6%. An increase in the number of unique visitors was found to be significantly associated with an increase in the average time on site (p-value 0.01, increase in the web traffic through search engines (p-value 0.00, and decrease in the bounce rate (p-value 0.03. There was a high degree of agreement between the two experts regarding quality assessment carried out under the three domains of knowledge access, knowledge creation and knowledge transfer (Kappa

  11. Going mobile: how mobile personal health records can improve health care during emergencies.

    Science.gov (United States)

    Bouri, Nidhi; Ravi, Sanjana

    2014-03-05

    Personal health records (PHRs), in contrast to electronic health records (EHRs) or electronic medical records (EMRs), are health records in which data are accessible to patients and not just providers. In recent years, many systems have enabled PHRs to be available in a mobile format. Mobile PHRs (mPHRs) allow patients to access health information via the Internet or telecommunication devices, such as mobile phones, personal digital assistants, and tablet computers. mPHRs have the potential to help patients and providers identify medical conditions and prescriptions from numerous locations, which may minimize medical errors and identify improvements to health behaviors during emergencies, when patients present to a new provider, or EHRs are not accessible. Despite their benefits, numerous challenges inhibit the adoption and further development of mPHRs, including integration into overall health technology infrastructure and legal and security concerns. This paper identifies the benefits of mPHRs during emergencies and the remaining challenges impeding full adoption and use, and provides recommendations to federal agencies to enhance support and use of mPHRs.

  12. Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Storgaard, Filip Holst; Pedersen, Christina Gravgaard; Jensen, Majbritt Lykke

    Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome.......Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome....

  13. Improvement of teamwork in health care through interprofessional education

    Directory of Open Access Journals (Sweden)

    Simin Dragana

    2010-01-01

    Full Text Available Introduction. Collaboration, within and between healthcare teams, facilitates effective healthcare. Internationally, the development of interprofessional education, as a means to facilitate more effective teamwork in health care, has been recognized for over forty years. Objective. The aim of this paper is to evaluate students' attitudes toward the influence of interprofessional education on improvement of collaboration and teamwork. Methods. The research was conducted by interviewing students at the Medical Faculty in Novi Sad in the form of cross-sectional study. The study sample included students from two undergraduate programmes: School of Nursing (n=52 and Integrated Studies of Medicine (n=53. Students admitted to the research had to be exposed to clinical experience. The instrument used in this study was the Readiness for Interprofessional Learning Scale (RIPLS. Results. As many as 93.3% of students indicated that basics of teamwork skills should be obtained prior to graduation, whereas 96.2% considered that interprofessional education would enable them to improve mutual trust and respect. The majority of interviewees indicated that patients would ultimately benefit if healthcare students worked together to solve patient problems. Multivariate procedures MANOVA p<0.05 and discriminative analysis p<0.05 of students' attitudes toward teamwork and collaboration showed significant differences between the students of medicine and nursing. Conclusion. The students of the Integrated Studies of Medicine and School of Nursing had a positive attitude toward the influence of interprofessional education on the improvement of collaboration and teamwork.

  14. Do multiple micronutrient interventions improve child health, growth, and development?

    Science.gov (United States)

    Ramakrishnan, Usha; Goldenberg, Tamar; Allen, Lindsay H

    2011-11-01

    Micronutrient deficiencies are common and often co-occur in many developing countries. Several studies have examined the benefits of providing multiple micronutrient (MMN) interventions during pregnancy and childhood, but the implications for programs remain unclear. The key objective of this review is to summarize what is known about the efficacy of MMN interventions during early childhood on functional outcomes, namely, child health, survival, growth, and development, to guide policy and identify gaps for future research. We identified review articles including meta-analyses and intervention studies that evaluated the benefits of MMN interventions (3 or more micronutrients) in children (child morbidity, anemia, and growth. Two studies found no effects on child mortality. The findings for respiratory illness and diarrhea are mixed, although suggestive of benefit when provided as fortified foods. There is evidence from several controlled trials (>25) and 2 meta-analyses that MMN interventions improve hemoglobin concentrations and reduce anemia, but the effects were small compared to providing only iron or iron with folic acid. Two recent meta-analyses and several intervention trials also indicated that MMN interventions improve linear growth compared to providing a placebo or single nutrients. Much less is known about the effects on MMN interventions during early childhood on motor and mental development. In summary, MMN interventions may result in improved outcomes for children in settings where micronutrient deficiencies are widespread.

  15. Breathe easy in Seattle : addressing asthma disparities through healthier housing

    Energy Technology Data Exchange (ETDEWEB)

    Krieger, J.W.; Rabkin, J.C. [Seattle and King County, Seattle Public Health, Seattle, WA (United States); Takaro, T.K. [Simon Fraser Univ., Burnaby, BC (Canada). Faculty of Health Sciences

    2008-07-01

    The prevalence of mortality associated with asthma in children in the United States has significantly increased over the past two decades and remains high. This paper described three home intervention projects that spanned the spectrum from individual behaviour change to improving housing quality. It described 2 healthy homes projects and 1 project known as Breathe Easy Homes. The first healthy home project involved randomly assigning 274 low-income asthmatic children to a high or low intensity group. Community health workers (CHWs) visited all homes to assess exposures, develop an action plan, and provide bedding encasements. The high intensity group received cleaning equipment and an average of 7 additional visits over a year while the low group received only the initial visit. In the second healthy home project, 309 low-income asthmatic children were randomly assigned to a CHW intervention group or usual care group. All participants received clinic based asthma education from a nurse. The breathe easy homes project involved using a pre-post design to examine the benefits of a new home designed to reduce asthma trigger on outcomes among 35 low-income children with asthma. All homes received a detailed inspection by a remediation coordinator who identified conditions associated with exposure to asthma triggers, such as moisture and mould, dust, pets, tobacco smoke and wood smoke. Mitigative actions included the use of proper ventilation, vacuuming with a high efficiency particulate filter and avoiding the use of fireplaces and wood stoves. It was concluded that home visits increased asthma control behaviours, reduced urgent health services, improved caregiver quality-of-life and decreased asthma symptoms. 93 refs., 3 tabs., 1 fig.

  16. Right time, right place: improving access to health service through effective retention and distribution of health workers.

    Science.gov (United States)

    Crettenden, Ian; Poz, Mario Dal; Buchan, James

    2013-11-25

    This editorial introduces the 'Right time, Right place: improving access to health service through effective retention and distribution of health workers' thematic series. This series draws from studies in a range of countries and provides new insights into what can be done to improve access to health through more effective human resources policies, planning and management. The primary focus is on health workforce distribution and retention.

  17. Project-based teaching in health informatics: a course on health care quality improvement.

    Science.gov (United States)

    Moehr, J R; Berenji, G R; Green, C J; Kagolovsky, Y

    2001-01-01

    Teaching the skills and knowledge required in health informatics [1] is a challenge because the skill of applying knowledge in real life requires practice. We relate the experience with introducing a practice component to a course in "Health Care Quality Improvement". Working health care professionals were invited to bring an actual quality problem from their place of work and to work alongside students in running the problem through a quality improvement project lifecycle. Multiple technological and process oriented teaching innovations were employed including project sessions in observation rooms, video recording of these sessions, generation of demonstration examples and distance education components. Both students and their collaborators from the work place developed proficiency in applying quality improvement methods as well as in experiencing the realities of group processes, information gaps and organizational constraints. The principles used to achieve high involvement of the whole class, the employed resources and technical support are described. The resulting academic and practical achievements are discussed in relation to the alternative instructional modalities, and with respect to didactic implications for similar endeavors and beyond to other fields such as systems engineering.

  18. Improving animal health and livestock productivity to reduce poverty.

    Science.gov (United States)

    Pradère, J-P

    2014-12-01

    This study is based on scientific publications, statistics and field observations. It shows the importance of livestock in the economy and in the risk management strategies implemented by poor farming households. A comparison of livestock performance trends with the evolution of rural poverty in developing countries indicates that growth in livestock production alone is not enough to reduce rural poverty. To help reduce poverty, sustainable production should be based on productivity gains. Prerequisites for improving productivity include better public policies, enhanced research and the reduction of animal disease risk. The study draws attention to the economic, social and environmental consequences of inadequate support for animal health and production in the least developed countries, especially those of sub-Saharan Africa.

  19. forming bases of health-improvement competence of students

    Directory of Open Access Journals (Sweden)

    Muntian V.S.

    2012-11-01

    Full Text Available The questions of optimization of educational process are considered on the basis of forming to health-improvement competence of student young people. Basic factors, influencing on the confidence of man in the capabilities, are selected: successful experience in the past; vicariation teaching; verbal persuasion; interiorization of motivation; succession of the teaching programs. It is marked that at forming of competence it is necessary to take into account the role of motivation, degree of estimation of the capabilities and confidence in the possibilities. Forming cognitive activity, positive motivation and steady interest to employments are the basic constituents of successful development of personality. It is marked that forming of competence foresees: providing knowledge about the methods of activity; the real application of knowledge is in practical activity; interiorization of motivation and individual approach; it is providing of succession of the teaching programs.

  20. Demystifying and improving organizational culture in health-care.

    Science.gov (United States)

    Pellegrin, Karen L; Currey, Hal S

    2011-01-01

    Organizational culture is defined as the shared values and beliefs that guide behavior within each organization, and it matters because it is related to performance. While culture is generally considered important, it is mysterious and intangible to most leaders. The first step toward understanding organizational culture is to measure it properly. This chapter describes methods for measuring culture in health-care organizations and how these methods were implemented in a large academic medical center. Because of the consistent empirical link between the dimension of communication, other culture dimensions, and employee satisfaction, special attention is focused in this area. Specifically, a case study of successful communication behaviors during a major "change management" initiative at a large academic medical center is described. In summary, the purpose of this chapter is to demystify the concept of culture and demonstrate how to improve it.

  1. Reactive species and diabetes: counteracting oxidative stress to improve health.

    Science.gov (United States)

    Pérez-Matute, Patricia; Zulet, M Angeles; Martínez, J Alfredo

    2009-12-01

    Oxidative stress is at the very core of metabolism. Reactive species behave as true second messengers that control important cellular functions. However, under pathological conditions, abnormally large concentrations of these species may lead to permanent changes in signal transduction and gene expression. Attenuation of oxidative stress as a way to improve several diseases such as diabetes has flourished as one of the main challenges of research. The lack of evidence to prove the benefits from antioxidant compounds has led to boost these strategies. Inhibition of reactive oxygen species (ROS) production through the development of inhibitors against NADPH oxidase and mitochondria offers an alternative approach to conventional antioxidant therapies. There is a need to understand oxidative stress process to implement health-disorder approaches.

  2. Thoracic radiotherapy and breath control: current prospects; Radiotherapie thoracique et controle de la respiration: perspectives actuelles

    Energy Technology Data Exchange (ETDEWEB)

    Reboul, F.; Mineur, L.; Paoli, J.B.; Bodez, V.; Oozeer, R.; Garcia, R. [Institut Sainte-Catherine, 84 - Avignon (France)

    2002-11-01

    Three-dimensional conformal radiotherapy (3D CRT) is adversely affected by setup error and organ motion. In thoracic 3D CRT, breathing accounts for most of intra-fraction movements, thus impairing treatment quality. Breath control clearly exhibits dosimetric improvement compared to free breathing, leading to various techniques for gated treatments. We review benefits of different breath control methods -i.e. breath-holding or beam gating, with spirometric, isometric or X-ray respiration sensor- and argument the choice of expiration versus inspiration, with consideration to dosimetric concerns. All steps of 3D-CRT can be improved with breath control. Contouring of organs at risk (OAR) and target are easier and more accurate on breath controlled CT-scans. Inter- and intra-fraction target immobilisation allows smaller margins with better coverage. Lung outcome predictors (NTCP, Mean Dose, LV20, LV30) are improved with breath-control. In addition, inspiration breath control facilitates beam arrangement since it widens the distance between OAR and target, and leaves less lung normal tissue within the high dose region. Last, lung density, as of CT scan, is more accurate, improving dosimetry. Our institutions choice is to use spirometry driven, patient controlled high-inspiration breath-hold; this technique gives excellent immobilization results, with high reproducibility, yet it is easy to implement and costs little extra treatment time. Breath control, whatever technique is employed, proves superior to free breathing treatment when using 3D-CRT. Breath control should then be used whenever possible, and is probably mandatory for IMRT. (authors)

  3. Genomics to benefit livestock production: improving animal health

    Directory of Open Access Journals (Sweden)

    Graham Stuart Plastow

    2016-06-01

    Full Text Available ABSTRACT The primary principle underlying the application of genomics is that it has the most value for difficult and expensive to measure traits. These traits will differ between species and probably also between markets. Maintenance of health will be one of the biggest challenges for efficient livestock production in the next few decades. This challenge will only increase in the face of demand for animal protein, resistance to existing drugs, and the pressure to reduce the use of antibiotics in agriculture. There is probably genetic variation in susceptibility for all diseases but little has been done to make use of this variation to date. In part this is because it is very difficult as well as expensive to measure this variation. This suggests that genomics should provide one of the ways of tackling the challenge of improving animal health. This paper will discuss the concepts of resistance, variation in susceptibility, and resilience; provide examples and present some recent results in cattle and pigs; and briefly discuss the application of gene editing in relation to disease resistance.

  4. A participatory model for improving occupational health and safety: improving informal sector working conditions in Thailand.

    Science.gov (United States)

    Manothum, Aniruth; Rukijkanpanich, Jittra; Thawesaengskulthai, Damrong; Thampitakkul, Boonwa; Chaikittiporn, Chalermchai; Arphorn, Sara

    2009-01-01

    The purpose of this study was to evaluate the implementation of an Occupational Health and Safety Management Model for informal sector workers in Thailand. The studied model was characterized by participatory approaches to preliminary assessment, observation of informal business practices, group discussion and participation, and the use of environmental measurements and samples. This model consisted of four processes: capacity building, risk analysis, problem solving, and monitoring and control. The participants consisted of four local labor groups from different regions, including wood carving, hand-weaving, artificial flower making, and batik processing workers. The results demonstrated that, as a result of applying the model, the working conditions of the informal sector workers had improved to meet necessary standards. This model encouraged the use of local networks, which led to cooperation within the groups to create appropriate technologies to solve their problems. The authors suggest that this model could effectively be applied elsewhere to improve informal sector working conditions on a broader scale.

  5. A Systematic Approach to Multiple Breath Nitrogen Washout Test Quality

    Science.gov (United States)

    Klingel, Michelle; Pizarro, Maria Ester; Hall, Graham L.; Ramsey, Kathryn; Foong, Rachel; Saunders, Clare; Robinson, Paul D.; Webster, Hailey; Hardaker, Kate; Kane, Mica; Ratjen, Felix

    2016-01-01

    Background Accurate estimates of multiple breath washout (MBW) outcomes require correct operation of the device, appropriate distraction of the subject to ensure they breathe in a manner representative of their relaxed tidal breathing pattern, and appropriate interpretation of the acquired data. Based on available recommendations for an acceptable MBW test, we aimed to develop a protocol to systematically evaluate MBW measurements based on these criteria. Methods 50 MBW test occasions were systematically reviewed for technical elements and whether the breathing pattern was representative of relaxed tidal breathing by an experienced MBW operator. The impact of qualitative and quantitative criteria on inter-observer agreement was assessed across eight MBW operators (n = 20 test occasions, compared using a Kappa statistic). Results Using qualitative criteria, 46/168 trials were rejected: 16.6% were technically unacceptable and 10.7% were excluded due to inappropriate breathing pattern. Reviewer agreement was good using qualitative criteria and further improved with quantitative criteria from (κ = 0.53–0.83%) to (κ 0.73–0.97%), but at the cost of exclusion of further test occasions in this retrospective data analysis. Conclusions The application of the systematic review improved inter-observer agreement but did not affect reported MBW outcomes. PMID:27304432

  6. A Systematic Approach to Multiple Breath Nitrogen Washout Test Quality.

    Directory of Open Access Journals (Sweden)

    Renee Jensen

    Full Text Available Accurate estimates of multiple breath washout (MBW outcomes require correct operation of the device, appropriate distraction of the subject to ensure they breathe in a manner representative of their relaxed tidal breathing pattern, and appropriate interpretation of the acquired data. Based on available recommendations for an acceptable MBW test, we aimed to develop a protocol to systematically evaluate MBW measurements based on these criteria.50 MBW test occasions were systematically reviewed for technical elements and whether the breathing pattern was representative of relaxed tidal breathing by an experienced MBW operator. The impact of qualitative and quantitative criteria on inter-observer agreement was assessed across eight MBW operators (n = 20 test occasions, compared using a Kappa statistic.Using qualitative criteria, 46/168 trials were rejected: 16.6% were technically unacceptable and 10.7% were excluded due to inappropriate breathing pattern. Reviewer agreement was good using qualitative criteria and further improved with quantitative criteria from (κ = 0.53-0.83% to (κ 0.73-0.97%, but at the cost of exclusion of further test occasions in this retrospective data analysis.The application of the systematic review improved inter-observer agreement but did not affect reported MBW outcomes.

  7. Applying Lean principles and Kaizen rapid improvement events in public health practice.

    Science.gov (United States)

    Smith, Gene; Poteat-Godwin, Annah; Harrison, Lisa Macon; Randolph, Greg D

    2012-01-01

    This case study describes a local home health and hospice agency's effort to implement Lean principles and Kaizen methodology as a rapid improvement approach to quality improvement. The agency created a cross-functional team, followed Lean Kaizen methodology, and made significant improvements in scheduling time for home health nurses that resulted in reduced operational costs, improved working conditions, and multiple organizational efficiencies.

  8. Visualizing Breath using Digital Holography

    Science.gov (United States)

    Hobson, P. R.; Reid, I. D.; Wilton, J. B.

    2013-02-01

    Artist Jayne Wilton and physicists Peter Hobson and Ivan Reid of Brunel University are collaborating at Brunel University on a project which aims to use a range of techniques to make visible the normally invisible dynamics of the breath and the verbal and non-verbal communication it facilitates. The breath is a source of a wide range of chemical, auditory and physical exchanges with the direct environment. Digital Holography is being investigated to enable a visually stimulating articulation of the physical trajectory of the breath as it leaves the mouth. Initial findings of this research are presented. Real time digital hologram replay allows the audience to move through holographs of breath-born particles.

  9. Using Digital Crumbs from an Electronic Health Record to Identify, Study and Improve Health Care Teams

    Science.gov (United States)

    Gray, James E; Feldman, Henry; Reti, Shane; Markson, Larry; Lu, Xiaoning; Davis, Roger B.; Safran, Charles A

    2011-01-01

    We have developed a novel approach, the Digital Crumb Investigator, for using data collected as a byproduct of Electonic Health Record (EHR) use to help define care teams and care processes. We are developing tools and methods to utilize these routinely collected data to visualize and quantify care networks across acute care and ambulatory settings We have chosen a clinical care domain where clinicians use EHRs in their offices, on the maternity wards and in the neonatal intensive care units as a test paradigm for this technology. The tools and methods we deliver should readily translate to other health care settings that collect behind-the-scenes electronic metadata such as audit trails. We believe that by applying the methods of social networking to define clinical relationships around a patient’s care we will enable new areas of research into the usage of EHRs to promote patient safety and other improvements in care. PMID:22195103

  10. Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges.

    Science.gov (United States)

    Gresenz, Carole Roan; Hoch, Emily; Eibner, Christine; Rudin, Robert S; Mattke, Soeren

    2016-05-09

    Overhauling the individual health insurance market-including through the creation of health insurance exchanges-was a key component of the Patient Protection and Affordable Care Act's multidimensional approach to addressing the long-standing problem of the uninsured in the United States. Despite succeeding in enrolling millions of Americans, the exchanges still face several challenges, including poor consumer experience, high operational and development costs, and incomplete market penetration. In light of these challenges, analysts considered a different model for the exchanges-privately facilitated exchanges-which could address these challenges and deepen the Affordable Care Act's impact. In this model, the government retains control over sovereign exchange functions but allows the private sector to assume responsibility for more-peripheral exchange functions, such as developing and sustaining exchange websites. Although private-sector entities have already undertaken exchange-related functions on a limited basis, privately facilitated exchanges could conceivably relieve the government of its responsibility for front-end website operations and consumer decision-support functions entirely. A shift to privately facilitated exchanges could improve the consumer experience, increase enrollment, and lower costs for state and federal governments. A move to such a model requires, nonetheless, managing its risks, such as reduced consumer protection, increased consumer confusion, and the possible lack of a viable revenue base for privately facilitated exchanges, especially in less populous states. On net, the benefits are large enough and the risks sufficiently manageable to seriously consider such a shift. This paper provides background information and more detail on the analysts' assessment.

  11. Toward improved public health outcomes from urban nature.

    Science.gov (United States)

    Shanahan, Danielle F; Lin, Brenda B; Bush, Robert; Gaston, Kevin J; Dean, Julie H; Barber, Elizabeth; Fuller, Richard A

    2015-03-01

    There is mounting concern for the health of urban populations as cities expand at an unprecedented rate. Urban green spaces provide settings for a remarkable range of physical and mental health benefits, and pioneering health policy is recognizing nature as a cost-effective tool for planning healthy cities. Despite this, limited information on how specific elements of nature deliver health outcomes restricts its use for enhancing population health. We articulate a framework for identifying direct and indirect causal pathways through which nature delivers health benefits, and highlight current evidence. We see a need for a bold new research agenda founded on testing causality that transcends disciplinary boundaries between ecology and health. This will lead to cost-effective and tailored solutions that could enhance population health and reduce health inequalities.

  12. Using reality mining to improve public health and medicine.

    Science.gov (United States)

    Pentland, Alex; Lazer, David; Brewer, Devon; Heibeck, Tracy

    2009-01-01

    both to individuals and communities. With the aid of data-mining algorithms, these data could shed light on individual patterns of behavior and even on the well-being of communities, creating new ways to improve public health and medicine. To illustrate, consider two examples of how reality mining may benefit individual health care. By taking advantage of special sensors in mobile phones, such as the microphone or the accelerometers built into newer devices such as Apple's iPhone, important diagnostic data can be captured. Clinical pilot data demonstrate that it may be possible to diagnose depression from the way a person talks--a depressed person tends to speak more slowly, a change that speech analysis software on a phone might recognize more readily than friends or family do. Similarly, monitoring a phone's motion sensors can also reveal small changes in gait, which could be an early indicator of ailments such as Parkinson's disease. Within the next few years reality mining will become more common, thanks in part to the proliferation and increasing sophistication of mobile phones. Many handheld devices now have the processing power of low-end desktop computers, and they can also collect more varied data, due to components such as GPS chips that track location. The Chief Technology Officer of EMC, a large digital storage company, estimates that this sort of personal sensor data will balloon from 10% of all stored information to 90% within the next decade. While the promise of reality mining is great, the idea of collecting so much personal information naturally raises many questions about privacy. It is crucial that behavior-logging technology not be forced on anyone. But legal statutes are lagging behind data collection capabilities, making it particularly important to begin discussing how the technology will and should be used. Therefore, an additional focus of this chapter will be the development of a legal and ethical framework concerning the data used by reality

  13. Physical Activity: A Tool for Improving Health (Part 3--Recommended Amounts of Physical Activity for Optimal Health)

    Science.gov (United States)

    Gallaway, Patrick J.; Hongu, Nobuko

    2016-01-01

    By promoting physical activities and incorporating them into their community-based programs, Extension professionals are improving the health of individuals, particularly those with limited resources. This article is the third in a three-part series describing the benefits of physical activity for human health: (1) biological health benefits of…

  14. One Health - Transdisciplinary Opportunities for SETAC Leadership in Integrating and Improving the Health of People, Animals, and the Environment

    Science.gov (United States)

    One Health is a collaborative, transdisciplinary effort working locally, nationally, and globally to improve health for people,animals, plants, and the environment. The term is relatively new (from ?2003), and it is increasingly common to see One Health included by name in interi...

  15. Combating healthcare corruption and fraud with improved global health governance.

    Science.gov (United States)

    Mackey, Tim K; Liang, Bryan A

    2012-10-22

    Corruption is a serious threat to global health outcomes, leading to financial waste and adverse health consequences. Yet, forms of corruption impacting global health are endemic worldwide in public and private sectors, and in developed and resource-poor settings alike. Allegations of misuse of funds and fraud in global health initiatives also threaten future investment. Current domestic and sectorial-level responses are fragmented and have been criticized as ineffective. In order to address this issue, we propose a global health governance framework calling for international recognition of "global health corruption" and development of a treaty protocol to combat this crucial issue.

  16. Combating healthcare corruption and fraud with improved global health governance

    Directory of Open Access Journals (Sweden)

    Mackey Tim K

    2012-10-01

    Full Text Available Abstract Corruption is a serious threat to global health outcomes, leading to financial waste and adverse health consequences. Yet, forms of corruption impacting global health are endemic worldwide in public and private sectors, and in developed and resource-poor settings alike. Allegations of misuse of funds and fraud in global health initiatives also threaten future investment. Current domestic and sectorial-level responses are fragmented and have been criticized as ineffective. In order to address this issue, we propose a global health governance framework calling for international recognition of “global health corruption” and development of a treaty protocol to combat this crucial issue.

  17. Combating healthcare corruption and fraud with improved global health governance

    Science.gov (United States)

    2012-01-01

    Corruption is a serious threat to global health outcomes, leading to financial waste and adverse health consequences. Yet, forms of corruption impacting global health are endemic worldwide in public and private sectors, and in developed and resource-poor settings alike. Allegations of misuse of funds and fraud in global health initiatives also threaten future investment. Current domestic and sectorial-level responses are fragmented and have been criticized as ineffective. In order to address this issue, we propose a global health governance framework calling for international recognition of “global health corruption” and development of a treaty protocol to combat this crucial issue. PMID:23088820

  18. Research of health-related dangerous factors in adult patients of sleep breath disorder%睡眠呼吸紊乱成人患者健康相关危险因素调查

    Institute of Scientific and Technical Information of China (English)

    李学忠; 刘洪英; 李心沁; 蔡晓岚

    2014-01-01

    目的:探讨成人睡眠呼吸紊乱( sleep breathing disorder, SBD)患者健康相关危险因素,为此类患者的健康管理提供科学依据。方法对3000例18岁以上SDB患者进行问卷调查,收集身高、体质量及饮食运动等信息,采用多元逐步Logistic回归分析,探讨该类人群中健康相关危险因素。结果发放调查问卷3000份,回收有效问卷2596份,有效应答率为86.5%。成人SBD患者缺乏体育运动、肥胖、吸烟、饮酒、高盐高脂饮食的比例较高。多因素Logistic回归分析表明,SDB患者在缺乏体育运动的同时,存在吸烟和高盐高脂饮食的相关问题,男性、年龄和高学历是保护因素( P<0.05);肥胖的相关影响因素分别为:男性、年龄、饮酒和高盐高脂饮食,高学历是保护因素(P<0.05);饮酒的相关影响因素分别为:男性、年龄、肥胖、吸烟和高盐高脂饮食(P<0.05);高盐高脂饮食的同时,SDB患者同时存在肥胖、吸烟、饮酒和缺乏体育运动的问题,高学历是保护因素( P<0.05)。结论应针对成人SBD患者的生活习惯,开展相应的健康教育和行为干预,积极探索该类人群健康管理的卫生模式。%Objective To investigate health-related behavior and its affecting factors in adult patients with sleep breath disorder( SBD) and provide dangerous evidence for health management services.Methods 2 596 patients aged above 18 years in clinic were invited to our research from May 20011 to Dec 2013.Questionnaire included height, body weight, diet, physical exercise and health-related behavior factors.Multivariate stepwise logistic regression was used for statistics analysis.Results The effective responding rate was 86.5%.In adult patients with sleep breath disorder, the incidence of lack of physical exercise, obesity, smoking, drinking and diet high in salt and fat was in high proportion. In multivariate

  19. Breathing detection with a portable impedance measurement system: first measurements.

    Science.gov (United States)

    Cordes, Axel; Foussier, Jerome; Leonhardt, Steffen

    2009-01-01

    For monitoring the health status of individuals, detection of breathing and heart activity is important. From an electrical point of view, it is known that breathing and heart activity change the electrical impedance distribution in the human body over the time due to ventilation (high impedance) and blood shifts (low impedance). Thus, it is possible to detect both important vital parameters by measuring the impedance of the thorax or the region around lung and heart. For some measurement scenarios it is also essential to detect these parameters contactless. For instance, monitoring bus drivers health could help to limit accidents, but directly connected systems limit the drivers free moving space. One measurement technology for measuring the impedance changes in the chest without cables is the magnetic impedance tomography (MIT). This article describes a portable measurement system we developed for this scenario that allows to measure breathing contactless. Furthermore, first measurements with five volunteers were performed and analyzed.

  20. Sleep-disordered breathing and mortality: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Naresh M Punjabi

    2009-08-01

    Full Text Available BACKGROUND: Sleep-disordered breathing is a common condition associated with adverse health outcomes including hypertension and cardiovascular disease. The overall objective of this study was to determine whether sleep-disordered breathing and its sequelae of intermittent hypoxemia and recurrent arousals are associated with mortality in a community sample of adults aged 40 years or older. METHODS AND FINDINGS: We prospectively examined whether sleep-disordered breathing was associated with an increased risk of death from any cause in 6,441 men and women participating in the Sleep Heart Health Study. Sleep-disordered breathing was assessed with the apnea-hypopnea index (AHI based on an in-home polysomnogram. Survival analysis and proportional hazards regression models were used to calculate hazard ratios for mortality after adjusting for age, sex, race, smoking status, body mass index, and prevalent medical conditions. The average follow-up period for the cohort was 8.2 y during which 1,047 participants (587 men and 460 women died. Compared to those without sleep-disordered breathing (AHI: or=30.0 events/h sleep-disordered breathing were 0.93 (95% CI: 0.80-1.08, 1.17 (95% CI: 0.97-1.42, and 1.46 (95% CI: 1.14-1.86, respectively. Stratified analyses by sex and age showed that the increased risk of death associated with severe sleep-disordered breathing was statistically significant in men aged 40-70 y (hazard ratio: 2.09; 95% CI: 1.31-3.33. Measures of sleep-related intermittent hypoxemia, but not sleep fragmentation, were independently associated with all-cause mortality. Coronary artery disease-related mortality associated with sleep-disordered breathing showed a pattern of association similar to all-cause mortality. CONCLUSIONS: Sleep-disordered breathing is associated with all-cause mortality and specifically that due to coronary artery disease, particularly in men aged 40-70 y with severe sleep-disordered breathing. Please see later in the

  1. 21 CFR 868.5965 - Positive end expiratory pressure breathing attachment.

    Science.gov (United States)

    2010-04-01

    ... attachment. 868.5965 Section 868.5965 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... Positive end expiratory pressure breathing attachment. (a) Identification. A positive end expiratory pressure (PEEP) breathing attachment is a device attached to a ventilator that is used to elevate...

  2. A REVIEW OF THE US EPA'S SINGLE BREATH CANISTER (SBC) METHOD FOR EXHALED VOLATILE ORGANIC BIOMARKERS

    Science.gov (United States)

    Exhaled alveolar breath can provide a great deal of information about an individual?s health and previous exposure to potentially harmful xenobiotic materials. Because breath can be obtained noninvasively and its constituents directly reflect concentrations in the blood, its us...

  3. Past, Present, and Future of eHealth and mHealth Research to Improve Physical Activity and Dietary Behaviors.

    Science.gov (United States)

    Vandelanotte, Corneel; Müller, Andre M; Short, Camille E; Hingle, Melanie; Nathan, Nicole; Williams, Susan L; Lopez, Michael L; Parekh, Sanjoti; Maher, Carol A

    2016-03-01

    Because physical inactivity and unhealthy diets are highly prevalent, there is a need for cost-effective interventions that can reach large populations. Electronic health (eHealth) and mobile health (mHealth) solutions have shown promising outcomes and have expanded rapidly in the past decade. The purpose of this report is to provide an overview of the state of the evidence for the use of eHealth and mHealth in improving physical activity and nutrition behaviors in general and special populations. The role of theory in eHealth and mHealth interventions is addressed, as are methodological issues. Key recommendations for future research in the field of eHealth and mHealth are provided.

  4. “Do You Wanna Breathe or Eat?”: Parent Perspectives on Child Health Consequences of Food Insecurity, Trade-Offs, and Toxic Stress

    OpenAIRE

    Knowles, Molly; Rabinowich, Jenny; Ettinger de Cuba, Stephanie; Cutts, Diana Becker; Chilton, Mariana

    2015-01-01

    Objectives This study among 51 parents of young children under age four investigated how parents that report marginal, low and very low food security characterize how trade-offs associated with food insecurity affect parents’ mental health and child well-being. Methods We carried out 51 semi-structured audio-recorded interviews after participants responded to a survey regarding food security status and maternal depressive symptoms. Each interview was transcribed. Through a content analysis, w...

  5. A decade devoted to improving online health information quality.

    Science.gov (United States)

    Boyer, Celia; Geissbuhler, Antoine

    2005-01-01

    Created in 1995 in response to consumer enthusiasm for the World Wide Web, Health On the Net FoundationHealth On the Net Foundation: http://www.healthonnet.org/ has developed solutions to address the problem of potentially dangerous online health and medical information. Then as now, no international legal framework regulated online content, and consumers needed to be given the means to check the reliability and the relevance of health information [[1

  6. The Coronary Health Improvement Projects Impact on Lowering Eating, Sleep, Stress, and Depressive Disorders

    Science.gov (United States)

    Merrill, Ray M.; Aldana, Stephen G.; Greenlaw, Roger L.; Diehl, Hans A.

    2008-01-01

    Background: The Coronary Health Improvement Project (CHIP) is designed to lower cardiovascular risk factors among a group of generally healthy individuals through health education. Purpose: This study will evaluate the efficacy of the CHIP intervention at improving eating, sleep, stress, and depressive disorders. Methods: A health education…

  7. Ethical analysis to improve decision-making on health technologies

    DEFF Research Database (Denmark)

    Saarni, Samuli I; Hofmann, Bjørn; Lampe, Kristian

    2008-01-01

    Health technology assessment (HTA) is the multidisciplinary study of the implications of the development, diffusion and use of health technologies. It supports health-policy decisions by providing a joint knowledge base for decision-makers. To increase its policy relevance, HTA tries to extend be...

  8. A Pilot of Interventions to Improve Health Care in Adolescents with Intellectual Disability

    Science.gov (United States)

    Lennox, Nicholas G.; Rey-Conde, Therese F.; Faint, Sonya L.

    2008-01-01

    Background: People with intellectual disability often have poor health which may be improved through better health advocacy and enhanced communication with their general practitioner. To this end, we examined the use of the Comprehensive Health Assessment Program (CHAP) and the "Ask" health diary previously developed for adults with intellectual…

  9. Standardization of exhaled breath condensate (EBC) collection using a feedback regulated breathing pattern

    Science.gov (United States)

    Collection of exhaled breath condensate (EBC) fluid by cooling of expired breath is a potentially valuable approach for the detection of biomarkers associated with disease or exposure to xenobiotics. EBC is generally collected using unregulated breathing patterns, perceived to el...

  10. Health sector employment growth calls for improvements in labor productivity.

    Science.gov (United States)

    Hofmarcher, Maria M; Festl, Eva; Bishop-Tarver, Leslie

    2016-08-01

    While rising costs of healthcare have put increased fiscal pressure on public finance, job growth in the health sector has had a stabilizing force on overall employment levels - not least in times of economic crises. In 2014 EU-15 countries employed 21 million people in the health and social care sector. Between 2000 and 2014 the share of employed persons in this sector rose from 9.5% to 12.5% of the total labor force in EU-15 countries. Over time labor input growth has shifted towards residential care activities and social work while labor in human health activities including hospitals and ambulatory care still comprises the major share. About half of the human health labor force works in hospital. Variation of health and social care employment is large even in countries with generally comparable institutional structures. While standard measures of productivity in health and social care are not yet comparable across countries, we argue that labor productivity of a growing health work force needs more attention. The long-term stability of the health system will require care delivery models that better utilize a growing health work force in concert with smart investments in digital infrastructure to support this transition. In light of this, more research is needed to explain variations in health and social care labor endowments, to identify effective policy measures of labor productivity enhancement including enhanced efforts to develop comparable productivity indicators in these areas.

  11. Effects of diaphragm breathing exercise and feedback breathing exercise on pulmonary function in healthy adults

    OpenAIRE

    Yong, Min-Sik; Lee, Hae-Yong; Lee, Yun-Seob

    2017-01-01

    [Purpose] The present study investigated effects of diaphragm breathing exercise and feedback breathing exercise on respiratory function. [Subjects and Methods] Thirty-one subjects were randomly assigned to two groups; the feedback breathing exercise group and the maneuver-diaphragm exercise group. The feedback breathing exercise group was asked to breathe with feedback breathing device, and the maneuver-diaphragm exercise group was asked to perform diaphragm respiration. Respiratory function...

  12. Learning and applying new quality improvement methods to the school health setting.

    Science.gov (United States)

    Elik, Laurel L

    2013-11-01

    A school health registered nurse identified medication administration documentation errors by unlicensed assistive personnel (UAP) in a system of school health clinics in an urban setting. This nurse applied the Lean Six Sigma Define, Measure, Analyze, Improve, Control process of improvement methodology to effectively improve the process. The UAP of medication administration documentation error rate improved from 68% to 35%. This methodology may be used by school nurses to collaboratively look at ways to improve processes at the point of care.

  13. Improving Dental Health in Underserved Communities | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... please turn Javascript on. Feature: Oral Health Improving Dental Health in Underserved Communities Past Issues / Summer 2012 ... Colorado pediatrician Dr. Patty Braun. "Brown or missing teeth don't help kids—or adults—one bit." ...

  14. Improving health service delivery organisational performance in health systems: a taxonomy of strategy areas and conceptual framework for strategy selection.

    Science.gov (United States)

    Pallas, Sarah W; Curry, Leslie; Bashyal, Chhitij; Berman, Peter; Bradley, Elizabeth H

    2012-03-01

    Health systems strengthening (HSS) is a priority for global health funders, policy-makers and practitioners. Although many HSS efforts have focused on policy levers such as financing approaches, payment schemes or regulatory reforms, less attention has been directed to targeting the organisations that deliver health services such as hospitals, health centres and clinics. Evidence suggests that the impact of organisation-level interventions varies by context; however, we lack a general framework for integrating organisational context into performance improvement strategies for health service delivery organisations. Drawing on open systems theories from organisational behaviour and management as well as a review of 181 empirical studies of health service delivery organisations in low- and middle-income countries, we propose a taxonomy of seven strategy areas for improving organisational performance as well as a multistage conceptual framework for selecting among them. We propose that the choice of strategy for improving health service delivery organisational performance should be informed by: (i) the root cause of the organisation's performance gap; (ii) the environmental conditions facing the organisation; and (iii) the implementation capability of the organisation. We also highlight conditions under which different strategy areas may be expected to be optimally effective. The approaches presented in this paper offer a way for health system decision-makers and researchers to systematically assess and incorporate organisational context in the process of developing strategies to improve the performance of health service delivery organisations and, ultimately, of health systems.

  15. Improving America's health care system by investing in information technology.

    Science.gov (United States)

    Coye, Molly Joel; Bernstein, William S

    2003-01-01

    Large-scale investment in health care information technology (IT) infrastructure will not take place without leadership by the federal government. But how the federal government supports the financing of health care IT is critical. Health care IT development has multiple aspects, but it is fundamentally a problem of community infrastructure development. A policy approach that has had consistent success in financing our country's essential physical infrastructure in transportation and environmental protection will be well suited to fostering health care IT infrastructure as well. We propose the creation of a health care IT revolving loan fund program to invest public dollars in health care IT infrastructure projects through community-level nonprofit lending agencies.

  16. One health-Transdisciplinary opportunities for SETAC leadership in integrating and improving the health of people, animals, and the environment.

    Science.gov (United States)

    Aguirre, A Alonso; Beasley, Val R; Augspurger, Tom; Benson, William H; Whaley, Janet; Basu, Niladri

    2016-10-01

    One Health is a collaborative, transdisciplinary effort working locally, nationally, and globally to improve health for people, animals, plants, and the environment. The term is relatively new (from ∼2003), and it is increasingly common to see One Health included by name in interinstitutional research partnerships, conferences, communications, and organizational frameworks, particularly those championed by the human health and veterinary medical communities. Environmental quality is arguably the least developed component within the One Health framework, but can be guided by expertise within the Society of Environmental Toxicology and Chemistry (SETAC). Despite SETAC's long history of tripartite (academic, government, business) interdisciplinary environmental science activities, the term "One Health" is seldom used in SETAC communications (i.e., many of SETAC's activities are guided by One Health, but it is called by other names in SETAC's journals, newsletters, and presentations). Accordingly, the objective of this Focus article is to introduce the One Health concept to the SETAC membership. The article discusses the origins, evolution, and utility of the One Health approach as an organizational framework and provides key examples of ways in which SETAC expertise can benefit the One Health community. The authors assert that One Health needs SETAC and, to be most effective, SETAC needs One Health. Given that One Health to date has focused too little on the environment, on ecosystems, and on contaminants, SETAC's constructive involvement in One Health presents an opportunity to accelerate actions that will ultimately better protect human and ecosystem health. Environ Toxicol Chem 2016;35:2383-2391. © 2016 SETAC.

  17. Using TQM to improve management of home health aides.

    Science.gov (United States)

    Dansky, K H; Brannon, D

    1996-12-01

    Home health aides are at the front line of the home health industry, raising quality of care issues and human resource (HR) management challenges. Total quality management (TQM) provides a framework to help meet those challenges. The authors investigated the relationship between TQM and HR effectiveness in home health agencies. Results suggest that TQM practices are related to HR effectiveness. Suggestions are offered to make human resource management consistent with a TQM culture.

  18. Don't You Dare Breathe That Air!

    Science.gov (United States)

    American Lung Association, New York, NY.

    Designed for elementary school students, the workbook focuses on the unhealthy and unpleasant effects of air pollution. Space is provided for students to draw pictures of: (1) how breathing polluted air can make people feel, (2) what polluted air can do to people's health--especially if they smoke cigarettes, (3) what air pollution can do to the…

  19. 21 CFR 862.3050 - Breath-alcohol test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Breath-alcohol test system. 862.3050 Section 862.3050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... diagnosis of alcohol intoxication. (b) Classification. Class I....

  20. Health IT for Patient Safety and Improving the Safety of Health IT.

    Science.gov (United States)

    Magrabi, Farah; Ong, Mei-Sing; Coiera, Enrico

    2016-01-01

    Alongside their benefits health IT applications can pose new risks to patient safety. Problems with IT have been linked to many different types of clinical errors including prescribing and administration of medications; as well as wrong-patient, wrong-site errors, and delays in procedures. There is also growing concern about the risks of data breach and cyber-security. IT-related clinical errors have their origins in processes undertaken to design, build, implement and use software systems in a broader sociotechnical context. Safety can be improved with greater standardization of clinical software and by improving the quality of processes at different points in the technology life cycle, spanning design, build, implementation and use in clinical settings. Oversight processes can be set up at a regional or national level to ensure that clinical software systems meet specific standards. Certification and regulation are two mechanisms to improve oversight. In the absence of clear standards, guidelines are useful to promote safe design and implementation practices. Processes to identify and mitigate hazards can be formalised via a safety management system. Minimizing new patient safety risks is critical to realizing the benefits of IT.

  1. Increased Prevalence of Sleep-Disordered Breathing in Adults

    Science.gov (United States)

    Peppard, Paul E.; Young, Terry; Barnet, Jodi H.; Palta, Mari; Hagen, Erika W.; Hla, Khin Mae

    2013-01-01

    Sleep-disordered breathing is a common disorder with a range of harmful sequelae. Obesity is a strong causal factor for sleep-disordered breathing, and because of the ongoing obesity epidemic, previous estimates of sleep-disordered breathing prevalence require updating. We estimated the prevalence of sleep-disordered breathing in the United States for the periods of 1988–1994 and 2007–2010 using data from the Wisconsin Sleep Cohort Study, an ongoing community-based study that was established in 1988 with participants randomly selected from an employed population of Wisconsin adults. A total of 1,520 participants who were 30–70 years of age had baseline polysomnography studies to assess the presence of sleep-disordered breathing. Participants were invited for repeat studies at 4-year intervals. The prevalence of sleep-disordered breathing was modeled as a function of age, sex, and body mass index, and estimates were extrapolated to US body mass index distributions estimated using data from the National Health and Nutrition Examination Survey. The current prevalence estimates of moderate to severe sleep-disordered breathing (apnea-hypopnea index, measured as events/hour, ≥15) are 10% (95% confidence interval (CI): 7, 12) among 30–49-year-old men; 17% (95% CI: 15, 21) among 50–70-year-old men; 3% (95% CI: 2, 4) among 30–49-year-old women; and 9% (95% CI: 7, 11) among 50–70 year-old women. These estimated prevalence rates represent substantial increases over the last 2 decades (relative increases of between 14% and 55% depending on the subgroup). PMID:23589584

  2. "Lifetime Fitness for Health" Course Assessment: Implications for Curriculum Improvement

    Science.gov (United States)

    Cardinal, Bradley J.; Cardinal, Marita K.; Burger, Molly E.

    2005-01-01

    Every other year, comprehensive school health education programs and policies are assessed nationally using the School Health Education Profile (SHEP) survey (Grunbaum et al., 1998). The data are collected in modules that are completed by different stakeholders within the school system. As part of a cooperative agreement with the Centers for…

  3. Improving World Health: A Least Cost Strategy. Worldwatch Paper 59.

    Science.gov (United States)

    Chandler, William U.

    Least-cost health strategies designed to attack the world's leading causes of unnecessary death are explored. Section 1 emphasizes the value of primary health-care procedures--midwifery, maternal education on breastfeeding and weaning, vaccinations, oral rehydration of victims of diarrhea, and antibiotics against respiratory infections--in…

  4. Improving Adherence to Hand Hygiene among Health Care Workers

    Science.gov (United States)

    Maskerine, Courtney; Loeb, Mark

    2006-01-01

    Increased adherence to hand hygiene is widely acknowledged to be the most important way of reducing infections in health care facilities. Despite evidence of benefit, adherence to hand hygiene among health care professionals remains low. Several behavioral and organizational theories have been proposed to explain this. As a whole, the success of…

  5. Physician and provider education for improving health and eliminating disparities.

    Science.gov (United States)

    Rust, George; Pattillo, Roland A; Matthews, Roland; Dubois, Anne M

    2007-01-01

    The Sixth Annual Primary Care and Prevention Conference and the Eleventh Annual HeLa Women's Health Conference was held on September 11-13, 2006 in Atlanta, Georgia. The reports in this supplement of Ethnicity & Disease provide a sample of the presentations made during the primary care and women's health sessions.

  6. Improving somatic health of outpatients with severe mental illness

    NARCIS (Netherlands)

    Van Hasselt, Fenneke M.; Oud, Marian J. T.; Krabbe, Paul F. M.; Postma, Maarten J.; Loonen, A.J.M.

    2014-01-01

    Background: Patients with severe mental illness (SMI) experience a 13-to 30-year reduction in life expectancy compared with the general population. The majority of these deaths can be attributed to somatic health problems. The risk on somatic health problems is partly increased due to a reduced abil

  7. Improving health insurance coverage in Ghana : a case study

    NARCIS (Netherlands)

    Kotoh, A.M.

    2013-01-01

    Ghana is one of the first sub-Saharan African countries to introduce national health insurance to ensure more equity in access to health care. The response of the population has been disappointing, however. This study describes and examines an experiment with so called 'problem-solving groups' that

  8. Realizing the promise of social psychology in improving public health.

    Science.gov (United States)

    Klein, William M P; Shepperd, James A; Suls, Jerry; Rothman, Alexander J; Croyle, Robert T

    2015-02-01

    The theories, phenomena, empirical findings, and methodological approaches that characterize contemporary social psychology hold much promise for addressing enduring problems in public health. Indeed, social psychologists played a major role in the development of the discipline of health psychology during the 1970s and 1980s. The health domain allows for the testing, refinement, and application of many interesting and important research questions in social psychology, and offers the discipline a chance to enhance its reach and visibility. Nevertheless, in a review of recent articles in two major social-psychological journals (Personality and Social Psychology Bulletin and Journal of Personality and Social Psychology), we found that only 3.2% of 467 studies explored health-related topics. In this article, we identify opportunities for research at the interface of social psychology and health, delineate barriers, and offer strategies that can address these barriers as the discipline continues to evolve.

  9. Nutrition and Health Disparities: The Role of Dairy in Improving Minority Health Outcomes

    Directory of Open Access Journals (Sweden)

    Constance Brown-Riggs

    2015-12-01

    Full Text Available Consuming a balanced diet, such as the food groups represented on MyPlate, is key to improving health disparities. Despite the best of intentions, however, the dietary guidelines can be culturally challenging, particularly when it comes to dairy consumption. Many African and Hispanic Americans avoid milk and dairy products—key contributors of three shortfall nutrients (calcium, potassium and vitamin D—because many people in these populations believe they are lactose intolerant. However, avoiding dairy can have significant health effects. An emerging body of evidence suggests that yogurt and other dairy products may help support reduced risk of heart disease, hypertension, obesity, and type 2 diabetes—conditions that disproportionately impact people of color. For this reason, the National Medical Association and the National Hispanic Medical Association issued a joint consensus statement recommending African Americans consume three to four servings of low-fat dairy every day. Cultured dairy products could play an important role in addressing these recommendations. Because of the presence of lactase-producing cultures, yogurt is often a more easily digestible alternative to milk, and thus more palatable to people who experience symptoms of lactose intolerance. This was a key factor cited in the final rule to include yogurt in the Special Supplemental Nutrition Program for Women, Infants, and Children.

  10. Oral Health Glossary

    Science.gov (United States)

    ... About | Contact InfoBites Quick Reference Learn more Children's Oral Health Mouth Breathing Can Cause Major Health Problems Over ... news feeds delivered directly to your desktop! more... Oral Health Glossary Article Chapters Oral Health Glossary print full ...

  11. Human resource leadership: the key to improved results in health

    Directory of Open Access Journals (Sweden)

    O'Neil Mary L

    2008-06-01

    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.

  12. Human resource leadership: the key to improved results in health.

    Science.gov (United States)

    O'Neil, Mary L

    2008-01-01

    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.

  13. Improving Community Health Using an Outcome-Oriented CQI Approach to Community-Engaged Health Professions Education

    Science.gov (United States)

    Clithero, Amy; Ross, Simone Jacquelyn; Middleton, Lyn; Reeve, Carole; Neusy, Andre-Jacques

    2017-01-01

    Health professionals providing health-care services must have the relevant competencies and clinical experiences needed to improve population health outcomes in different contexts. Current models of health profession education often fail to produce a fit-for-purpose workforce ready and willing to provide relevant, quality care to underserved communities. Evidence is emerging that community-engaged and socially accountable health workforce education, i.e., aligned with priority health needs, produces a workforce ready and willing to work in partnership with underserved regions. This model of education fosters greater affiliation between education and service delivery systems and requires institutions to measure graduate outcomes and institutional impact. The Training for Health Equity Network (THEnet), a partnership of socially accountable health workforce education institutions, has developed and tested a Social Accountability Framework for Health Workforce Education (the Framework) and toolkit to improve alignment of health workforce education with outcomes to assess how well education institutions meet the needs of the communities they serve. The Framework links education and service delivery creating a continuous quality improvement feedback loop to ensure that education addresses needs and maximizes impact on the quality of service delivery. The Framework also provides a unifying set of guidelines for health workforce policy and planning, accreditation, education, research, and service delivery. A key element to ensuring consistent high quality service delivery is an appropriately trained and equitably distributed workforce. An effective and comprehensive mechanism for evaluation is the method of CQI which links the design, implementation, accreditation, and evaluation of health workforce education with health service delivery and health outcomes measurement. PMID:28289678

  14. Improving the use of competencies in public health education.

    Science.gov (United States)

    Bennett, Christina Juris; Walston, Stephen L

    2015-03-01

    Competency-based education is the present and future of public health education. As programs have adopted competencies, many have struggled and continue to struggle with actual implementation and curricular redesign. We experienced these problems at The University of Oklahoma College of Public Health; thus, we propose an adaptable and replicable process to better implement competencies and evaluate student mastery of them throughout any public health program. We specifically recommend adopting mission-based competencies followed by a longitudinal evaluation plan like the model provided.

  15. Breathing Valley Fever

    Centers for Disease Control (CDC) Podcasts

    2014-02-04

    Dr. Duc Vugia, chief of the Infectious Diseases Branch in the California Department of Public Health, discusses Valley Fever.  Created: 2/4/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/5/2014.

  16. Do Nonresidential Fathers' Financial Support and Contact Improve Children's Health?

    Science.gov (United States)

    Hofferth, Sandra L; Pinzon, Angela M

    2011-06-01

    Nonresidential father investment of time and money has been shown to ameliorate the negative consequences of family dissolution on children's behavior and achievement; however, no research has shown whether this investment also has positive effects on child health. Using data from the Early Childhood Longitudinal Survey, Kindergarten cohort, this research uses a two-wave cross-lagged model to examine how child support and contact are associated with maternal reports of children's physical health over time following parental separation. Child support in kindergarten is not associated with child health in third grade. Instead, children who are healthier in kindergarten receive greater financial support from their father. Although contact and child support are positively related, greater contact is not associated with better child health.

  17. Improving oral health in Pakistan using dental hygienists.

    Science.gov (United States)

    Shah, M A; Darby, M L; Bauman, D B

    2011-02-01

    This paper reviews the healthcare system, available dental care, and oral health status of people in Pakistan. Considering the enormous unmet oral health needs, the insufficient supply of dental professionals and the current unstructured dental hygiene curriculum in Pakistan, a mission, vision, and goals for professional dental hygiene in Pakistan is recommended. The authors offer recommendations for competency-based dental hygiene education and practice, professional credentialing, a practice act, and a dental hygiene scope of practice to promote the health, welfare, and quality of life of the Pakistani people. Specifically, the authors recommend increasing the number of quality dental hygiene programs, establishing the dental hygienist as a primary care provider of oral health services, enhancing current dental hygiene curriculum, and establishing a dental hygiene council with responsibility for educational requirements and regulation of dental hygienists in Pakistan.

  18. The Health Assessment Longitudinal File imperative: foundation for improving the health of the force.

    Science.gov (United States)

    Kemper, Judith A; Donahue, Donald A; Harris, Judith S

    2003-08-01

    A smaller active duty force and an increased operational tempo have made the Reserve components (RC) essential elements in the accomplishment of the mission of the U.S. Army. One critical factor in meeting mission is maintaining the optimal health of each soldier. Baseline health data about the RC is currently not being collected, even though increasing numbers of reserve soldiers are being activated. The Annual Health Certification and Survey is being developed as a way to meet the RCs' statutory requirement for annual certification of health while at the same time generating and tracking baseline data on each reservist in a longitudinal health file, the Health Assessment Longitudinal File. This article discusses the Annual Health Certification Questionnaire/Health Assessment Longitudinal File, which will greatly enhance the Army's ability to accurately certify the health status of the RC and track health in relation to training, mission activities, and deployment.

  19. Cardiovascular and Respiratory Effect of Yogic Slow Breathing in the Yoga Beginner: What Is the Best Approach?

    Directory of Open Access Journals (Sweden)

    Heather Mason

    2013-01-01

    Full Text Available Slow breathing increases cardiac-vagal baroreflex sensitivity (BRS, improves oxygen saturation, lowers blood pressure, and reduces anxiety. Within the yoga tradition slow breathing is often paired with a contraction of the glottis muscles. This resistance breath “ujjayi” is performed at various rates and ratios of inspiration/expiration. To test whether ujjayi had additional positive effects to slow breathing, we compared BRS and ventilatory control under different breathing patterns (equal/unequal inspiration/expiration at 6 breath/min, with/without ujjayi, in 17 yoga-naive young healthy participants. BRS increased with slow breathing techniques with or without expiratory ujjayi ( or higher except with inspiratory + expiratory ujjayi. The maximal increase in BRS and decrease in blood pressure were found in slow breathing with equal inspiration and expiration. This corresponded with a significant improvement in oxygen saturation without increase in heart rate and ventilation. Ujjayi showed similar increase in oxygen saturation but slightly lesser improvement in baroreflex sensitivity with no change in blood pressure. The slow breathing with equal inspiration and expiration seems the best technique for improving baroreflex sensitivity in yoga-naive subjects. The effects of ujjayi seems dependent on increased intrathoracic pressure that requires greater effort than normal slow breathing.

  20. Field exercises are useful for improving public health emergency responses

    Directory of Open Access Journals (Sweden)

    Kirsty Hope

    2010-12-01

    Full Text Available Problem: Emergencies resulting from disease outbreaks and extreme environmental events present significant challenges for health services.Context: Preparing to effectively manage emergencies is a core activity in public health units. Field exercises support consolidation of biopreparedness by testing plans, identifying weaknesses, providing training opportunities and developing surge capacity.Action: An extended field exercise to test response to a novel influenza strain was conducted in New South Wales, Australia in September 2008, eight months before the influenza A(H1N1 2009 pandemic emerged. Lasting four days and involving over 300 participants, the exercise was set in the early response phase with the staggered presentation of 41 cases to 36 emergency departments in the health area. An additional 150 contacts were written into a complex scenario to test the public health response.Outcome: The subsequent pandemic emergence in mid-2009 offered a unique opportunity to assess the field exercise format for disaster preparedness. Most roles were adequately tested with recognized benefit during the actual pandemic response. However, the exercise did not adequately challenge the public health planning team that synthesizes surveillance data and forecasts risk, nor did it identify planning issues that became evident during the subsequent pandemic. Discussion: Field exercises offer the opportunity to rigorously test public health emergency preparedness but can be expensive and labour-intensive. Our exercise provided effective and timely preparation for the influenza A(H1N1 2009 pandemic but showed that more emphasis needs to be placed on the role and training of the public health planning team.

  1. Attacking poverty and improving health: a report on the WHO/State of Maryland International Health Congress, Baltimore, September 1997.

    Science.gov (United States)

    Jancloes, M; Martin, J D

    1998-04-01

    An international meeting, 'Investment Strategies for Healthy Urban Communities', in Baltimore in September 1997 called on the the business community, city authorities and the health professions to reduce poverty and its adverse health consequences, especially in urban areas, in both the industrialized and developing world. In addition to issuing the Baltimore Charter on partnership for a healthy urban future, the meeting had two main outcomes: the innovative concept of Business for Health, championed by progressive business leaders from Australia, Europe and the United States, to promote business principles to reduce poverty, create enterprises and improve people's health, especially in developing countries; and the establishment by health professionals of an information network between cities and countries on poverty and ill-health. Two follow-up meetings in London in December 1997 resulted in an action plan to create networks of health professional groups and representatives of the business community.

  2. Breastfeeding training improves health worker performance in rural Nigeria.

    Science.gov (United States)

    Davies-Adetugbo, A A; Fabiyi, A K; Ojoofeitimi, E O; Adetugbo, K

    1997-08-01

    The training of health workers in breastfeeding and lactation management is to enable them make correct breastfeeding recommendations to mothers. This study aims to provide answers to two research questions: what components of breastfeeding training are easily achieved with extension health workers, and what health worker variables affect these outcomes. Multivariable analysis of the outcomes of a controlled breastfeeding training programme for community health workers (CHW) in rural communities of Osun State, Nigeria, was performed by logistic regression. The results show that the training was the most powerful predictor of correct CHW recommendations on breastfeeding (OR = 60.25, p-0.0000), and of 'perfect' breastfeeding knowledge (OR = 192.49, p = 0.0000). Younger CHWs (in the age bracket 20 to 29 years) were significantly more likely to make correct recommendations on exclusive breastfeeding (OR = 3.02, p = 0.0304). Other CHW variables such as sex, experience, job status, and marital status did not make consistently significant independent contributions to the outcomes. The results suggest that breastfeeding education can enhance CHW professional recommendations on breastfeeding and should be extended to all categories of health workers.

  3. Quality Improvement Initiative in School-Based Health Centers across New Mexico

    Science.gov (United States)

    Booker, John M.; Schluter, Janette A.; Carrillo, Kris; McGrath, Jane

    2011-01-01

    Background: Quality improvement principles have been applied extensively to health care organizations, but implementation of quality improvement methods in school-based health centers (SBHCs) remains in a developmental stage with demonstration projects under way in individual states and nationally. Rural areas, such as New Mexico, benefit from the…

  4. Promoting health and advancing development through improved housing in low-income settings

    NARCIS (Netherlands)

    Haines, A.; Bruce, N.; Cairncross, S.; Davies, M.; Greenland, K.; Hiscox, A.F.; Lindsay, S.; Lindsay, T.; Satterthwaite, D.; Wilkinson, P.

    2013-01-01

    There is major untapped potential to improve health in low-income communities through improved housing design, fittings, materials and construction. Adverse effects on health from inadequate housing can occur through a range of mechanisms, both direct and indirect, including as a result of extreme w

  5. Improving maternal health in Kenya: Challenges and strategies for low resource nations.

    Science.gov (United States)

    Kagia, Jean

    2013-05-01

    In order to improve maternal health in low-resource countries, a multifaceted, culturally and religiously sensitive approach is needed. This approach includes working for political stability, increasing women's level of education, economic empowerment, strengthening existing health management systems, and wisely allocating human and material resources. Critically important material resources such as access to and production of food and clean water must be a top priority. In Kenya, our constitution respects life from conception as an individual's right. This means that there is need to set up strategies that improve maternal health and by extension improve the health of the unborn baby.

  6. Peer pressure and public reporting within healthcare setting: improving accountability and health care quality in hospitals.

    Science.gov (United States)

    Specchia, Maria Lucia; Veneziano, Maria Assunta; Cadeddu, Chiara; Ferriero, Anna Maria; Capizzi, Silvio; Ricciardi, Walter

    2012-01-01

    In the last few years, the need of public reporting of health outcomes has acquired a great importance. The public release of performance results could be a tool for improving health care quality and many attempts have been made in order to introduce public reporting programs within the health care context at different levels. It would be necessary to promote the introduction of a standardized set of outcome and performance measures in order to improve quality of health care services and to make health care providers aware of the importance of transparency and accountability.

  7. Integrating Literacy, Culture, and Language to Improve Health Care Quality for Diverse Populations

    Science.gov (United States)

    Andrulis, Dennis P.; Brach, Cindy

    2016-01-01

    Objective To understand the interrelationship of literacy, culture, and language and the importance of addressing their intersection. Methods Health literacy, cultural competence, and linguistic competence strategies to quality improvement were analyzed. Results Strategies to improve health literacy for low-literate individuals are distinct from strategies for culturally diverse and individuals with limited English proficiency (LEP). The lack of integration results in health care that is unresponsive to some vulnerable groups’ needs. A vision for integrated care is presented. Conclusion Clinicians, the health care team, and health care organizations have important roles to play in addressing challenges related to literacy, culture, and language. PMID:17931131

  8. Improving cereal grain carbohydrates for diet and health.

    Science.gov (United States)

    Lafiandra, Domenico; Riccardi, Gabriele; Shewry, Peter R

    2014-05-01

    Starch and cell wall polysaccharides (dietary fibre) of cereal grains contribute to the health benefits associated with the consumption of whole grain cereal products, including reduced risk of obesity, type 2 diabetes, cardiovascular disease and colorectal cancer. The physiological bases for these effects are reviewed in relation to the structures and physical properties of the polysaccharides and their behaviour (including digestion and fermentation) in the gastro-intestinal tract. Strategies for modifying the content and composition of grain polysaccharides to increase their health benefits are discussed, including exploiting natural variation and using mutagenesis and transgenesis to generate further variation. These studies will facilitate the development of new types of cereals and cereal products to face the major health challenges of the 21st century.

  9. Breath-holding and its breakpoint.

    Science.gov (United States)

    Parkes, M J

    2006-01-01

    This article reviews the basic properties of breath-holding in humans and the possible causes of the breath at breakpoint. The simplest objective measure of breath-holding is its duration, but even this is highly variable. Breath-holding is a voluntary act, but normal subjects appear unable to breath-hold to unconsciousness. A powerful involuntary mechanism normally overrides voluntary breath-holding and causes the breath that defines the breakpoint. The occurrence of the breakpoint breath does not appear to be caused solely by a mechanism involving lung or chest shrinkage, partial pressures of blood gases or the carotid arterial chemoreceptors. This is despite the well-known properties of breath-hold duration being prolonged by large lung inflations, hyperoxia and hypocapnia and being shortened by the converse manoeuvres and by increased metabolic rate. Breath-holding has, however, two much less well-known but important properties. First, the central respiratory rhythm appears to continue throughout breath-holding. Humans cannot therefore stop their central respiratory rhythm voluntarily. Instead, they merely suppress expression of their central respiratory rhythm and voluntarily 'hold' the chest at a chosen volume, possibly assisted by some tonic diaphragm activity. Second, breath-hold duration is prolonged by bilateral paralysis of the phrenic or vagus nerves. Possibly the contribution to the breakpoint from stimulation of diaphragm muscle chemoreceptors is greater than has previously been considered. At present there is no simple explanation for the breakpoint that encompasses all these properties.

  10. Improving health services in India: a different perspective.

    Science.gov (United States)

    Schweitzer, Julian

    2008-01-01

    Two papers in this volume focus on public finance and decentralization as central to resolving India's systemic public health crisis. However, some states and districts have achieved success despite serious financial and administrative deficits; this suggests that factors such as political commitment, community participation, human resource management, women's empowerment, and governance may be as or more important. The success of the National Rural Health Mission will depend on state and local institutional capacity, including strong partnerships with civil society organizations and private-sector actors. Increased resources and decentralization will not be sufficient by themselves.

  11. Exploring strategies to improve the health promotion orientation of Flemish sports clubs.

    Science.gov (United States)

    Meganck, Jeroen; Seghers, Jan; Scheerder, Jeroen

    2016-02-29

    Sports clubs are increasingly recognized as an innovative setting for health promotion, as exemplified by the health promoting sports club concept. This study aims to assess the health promotion orientation of both youth sports clubs (YSC) and adult sports clubs (ASC) in Flanders and to identify the motives and barriers as reported by their representatives as a basis for proposing intervention strategies to improve the health promotion orientation in sports clubs. A total of 253 Flemish sports clubs, consisting of 156 YSC and of 97 ASC, completed the online questionnaire, covering club characteristics (e.g. finances, human resources), perceived motives and barriers for health promotion and the health promoting sports club index. Even though YSC were more health promoting than ASC, the results indicated that all sports clubs could improve their health promotion orientation. The most consistent predictors of health promotion orientation are perceived motives index for YSC and perceived lack of resources for ASC. Based on these results, interventions to enhance the health promoting orientation need to tackle the lack of resources such as lack of expertise regarding health promotion. Interventions aimed specifically at YSC should emphasize the direct benefits, for example by demonstrating how health promotion helps clubs to improve the provision of high quality sports participation and by awarding a health promotion quality label.

  12. Crossing the quality chasm: lessons from health care quality improvement efforts in England

    OpenAIRE

    Madhok, Rajan

    2002-01-01

    The second report from the US Institute of Medicine Crossing the Quality Chasm, highlighted the deficiencies in health care quality in the USA, analyzed the contributory factors, and proposed 13 recommendations for improvements. Clearly, the challenges are enormous. Can anything be learned from the experiences of other countries? This article describes the author's experiences of health care quality improvement efforts in the National Health Service in England and their implications for the U...

  13. Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria

    OpenAIRE

    Okoli Ugo; Eze-Ajoku Ezinne; Oludipe Modupe; Spieker Nicole; Ekezie Winifred; Ohiri Kelechi

    2016-01-01

    Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected...

  14. Strength Training Improves Fatigue Resistance and Self-Rated Health in Workers with Chronic Pain

    DEFF Research Database (Denmark)

    Sundstrup, Emil; Jakobsen, Markus Due; Brandt, Mikkel;

    2016-01-01

    -rated health and pain. Time to fatigue, muscle strength, hand/wrist pain, and self-rated health improved significantly more following strength training than usual care (all P ... (Spearman's rho = -0.40; P = 0.01). In conclusion, specific strength training improves muscular fatigue resistance and self-rated health and reduces pain of the hand/wrist in manual workers with chronic upper limb pain. This trial is registered with ClinicalTrials.gov NCT01671267....

  15. Medical Student Mental Health 3.0: Improving Student Wellness Through Curricular Changes

    OpenAIRE

    Slavin, Stuart J.; Schindler, Debra L.; Chibnall, John T.

    2014-01-01

    Medical education can have significant negative effects on the well-being of medical students. To date, efforts to improve student mental health have focused largely on improving access to mental health providers, reducing the stigma and other barriers to mental health treatment, and implementing ancillary wellness programs. Still, new and innovative models that build on these efforts by directly addressing the root causes of stress that lie within the curriculum itself are needed to properly...

  16. Neural mechanisms underlying breathing complexity.

    Directory of Open Access Journals (Sweden)

    Agathe Hess

    Full Text Available Breathing is maintained and controlled by a network of automatic neurons in the brainstem that generate respiratory rhythm and receive regulatory inputs. Breathing complexity therefore arises from respiratory central pattern generators modulated by peripheral and supra-spinal inputs. Very little is known on the brainstem neural substrates underlying breathing complexity in humans. We used both experimental and theoretical approaches to decipher these mechanisms in healthy humans and patients with chronic obstructive pulmonary disease (COPD. COPD is the most frequent chronic lung disease in the general population mainly due to tobacco smoke. In patients, airflow obstruction associated with hyperinflation and respiratory muscles weakness are key factors contributing to load-capacity imbalance and hence increased respiratory drive. Unexpectedly, we found that the patients breathed with a higher level of complexity during inspiration and expiration than controls. Using functional magnetic resonance imaging (fMRI, we scanned the brain of the participants to analyze the activity of two small regions involved in respiratory rhythmogenesis, the rostral ventro-lateral (VL medulla (pre-Bötzinger complex and the caudal VL pons (parafacial group. fMRI revealed in controls higher activity of the VL medulla suggesting active inspiration, while in patients higher activity of the VL pons suggesting active expiration. COPD patients reactivate the parafacial to sustain ventilation. These findings may be involved in the onset of respiratory failure when the neural network becomes overwhelmed by respiratory overload We show that central neural activity correlates with airflow complexity in healthy subjects and COPD patients, at rest and during inspiratory loading. We finally used a theoretical approach of respiratory rhythmogenesis that reproduces the kernel activity of neurons involved in the automatic breathing. The model reveals how a chaotic activity in

  17. The networked patient : Sharing data to improve health?

    NARCIS (Netherlands)

    Heerings, M.

    2014-01-01

    For diabetes type 1 the development towards stricter regulation of blood-glucose levels is associated with lower risk of long term complications (such as neuropathy, nephropathy, retinopathy, cardiovascular disease). A stricter regulation changes disease management practices of patients and health c

  18. How to Improve the Health of American Adolescents.

    Science.gov (United States)

    Steinberg, Laurence

    2015-11-01

    The major threats to the health of American teenagers are behavioral-risky and reckless things adolescents do that threaten their well-being and that of others. The primary approach to preventing adolescent risk taking has been classroom-based health education. Yet, most systematic research indicates that even the best programs are successful mainly at changing adolescents' knowledge but not in altering their behavior. Research on adolescent brain development has revolutionized our understanding of this stage of life, but our approach to deterring adolescent risk taking remains grounded in old, antiquated, and erroneous views of the period. Classroom-based health education is an uphill battle against evolution and endocrinology, and it is not a fight we are likely to win. Instead of trying to change teenagers into something they are not, we should try to reduce the risks they are exposed to. We should spend less money and effort trying to influence how adolescents think, and focus more on limiting opportunities for their inherently immature judgment to hurt themselves or others. Although there is evidence that some programs aimed at strengthening adolescents' self-regulation may also deter risky behavior, our public health policies should emphasize changing the context in which adolescents live, rather than solely attempting to change adolescents themselves.

  19. Improved patient-reported health impact of multiple sclerosis

    DEFF Research Database (Denmark)

    Macdonell, Richard; Nagels, Guy; Laplaud, David-Axel

    2016-01-01

    BACKGROUND: Multiple sclerosis (MS) is a debilitating disease that negatively impacts patients' lives. OBJECTIVE: ENABLE assessed the effect of long-term prolonged-release (PR) fampridine (dalfampridine extended release in the United States) treatment on patient-perceived health impact in patients...

  20. Health informatics to improve the health of homeless and marginalised populations

    Directory of Open Access Journals (Sweden)

    Fatima Wurie

    2016-01-01

    the use of health informatics approaches, like VOT to improve the health of homeless and marginalised populations. METHODS & RESULTS: In a previous VOT pilot in London (July 2012 to March 2013 to explore VOT as a flexible alternative to DOT in clinically and/or socially complex TB cases, findings from 17 patients show that 80% of patients returned their video clips and 86% of scheduled VOT doses were observed to have been taken. Semi-structured interviews with patients with multi-drug resistant tuberculosis receiving VOT in London (Oct 2013 to March 2014: Patients reported very high levels of satisfaction as illustrated by the following quotes: “I was getting tired of DOT. I thought I would be a lot freer to continue with my daily life—all that time and effort you’ve saved me—I didn’t need much convincing. With the DOT, it felt like...there was some kind of stigma and for that reason they are monitoring you. It felt like being a criminal.” “I wouldn't have felt comfortable just meeting a person online—I would have been like, ‘who's that person, I don't even know him?’ But I'm really pleased you came all the way to my house, to make me comfortable and show me what to do...and I took it from there and it was really good." Mixed methods research approaches to explore patient acceptability of VOT intervention: Building upon previous pilot work current mixed methods research explores patient attitudes and acceptability of VOT will involve administration of the EQ5D survey instrument (at 2 and 6 months into treatment to capture impact of the VOT intervention on quality of life, patient satisfaction (using Likert scale; views on being asked to have treatment observed; to understand how VOT fits into patients’ lives and the effect of DOT/VOT on family, work and social life; to explore patient’s views on the levels of support available to them; identify technical difficulties with recording and submitting VOT clips. Semi-structured interviews and focus

  1. Making sense of mobile health data: an open architecture to improve individual- and population-level health.

    Science.gov (United States)

    Chen, Connie; Haddad, David; Selsky, Joshua; Hoffman, Julia E; Kravitz, Richard L; Estrin, Deborah E; Sim, Ida

    2012-08-09

    Mobile phones and devices, with their constant presence, data connectivity, and multiple intrinsic sensors, can support around-the-clock chronic disease prevention and management that is integrated with daily life. These mobile health (mHealth) devices can produce tremendous amounts of location-rich, real-time, high-frequency data. Unfortunately, these data are often full of bias, noise, variability, and gaps. Robust tools and techniques have not yet been developed to make mHealth data more meaningful to patients and clinicians. To be most useful, health data should be sharable across multiple mHealth applications and connected to electronic health records. The lack of data sharing and dearth of tools and techniques for making sense of health data are critical bottlenecks limiting the impact of mHealth to improve health outcomes. We describe Open mHealth, a nonprofit organization that is building an open software architecture to address these data sharing and "sense-making" bottlenecks. Our architecture consists of open source software modules with well-defined interfaces using a minimal set of common metadata. An initial set of modules, called InfoVis, has been developed for data analysis and visualization. A second set of modules, our Personal Evidence Architecture, will support scientific inferences from mHealth data. These Personal Evidence Architecture modules will include standardized, validated clinical measures to support novel evaluation methods, such as n-of-1 studies. All of Open mHealth's modules are designed to be reusable across multiple applications, disease conditions, and user populations to maximize impact and flexibility. We are also building an open community of developers and health innovators, modeled after the open approach taken in the initial growth of the Internet, to foster meaningful cross-disciplinary collaboration around new tools and techniques. An open mHealth community and architecture will catalyze increased mHealth efficiency

  2. Slow breathing and cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Ashish Chaddha

    2015-01-01

    Full Text Available Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine.

  3. Slow breathing and cardiovascular disease.

    Science.gov (United States)

    Chaddha, Ashish

    2015-01-01

    Cardiovascular disease is the leading cause of death for both men and women worldwide. Much emphasis has been placed on the primary and secondary prevention of cardiovascular disease. While depression and anxiety increase the risk of developing cardiovascular disease, cardiovascular disease also increases the risk of developing anxiety and depression. Thus, promoting optimal mental health may be important for both primary and secondary prevention of cardiovascular disease. Like lowering blood pressure, lipids, and body weight, lowering anger and hostility and improving depression and anxiety may also be an important intervention in preventive cardiology. As we strive to further improve cardiovascular outcomes, the next bridge to cross may be one of offering patients nonpharmacologic means for combating daily mental stress and promoting mental health, such as yoga and pranayama. Indeed, the best preventive cardiovascular medicine may be a blend of both Western and Eastern medicine.

  4. Noninvasive detection of lung cancer by analysis of exhaled breath

    Directory of Open Access Journals (Sweden)

    Denz Hubert

    2009-09-01

    Full Text Available Abstract Background Lung cancer is one of the leading causes of death in Europe and the western world. At present, diagnosis of lung cancer very often happens late in the course of the disease since inexpensive, non-invasive and sufficiently sensitive and specific screening methods are not available. Even though the CT diagnostic methods are good, it must be assured that "screening benefit outweighs risk, across all individuals screened, not only those with lung cancer". An early non-invasive diagnosis of lung cancer would improve prognosis and enlarge treatment options. Analysis of exhaled breath would be an ideal diagnostic method, since it is non-invasive and totally painless. Methods Exhaled breath and inhaled room air samples were analyzed using proton transfer reaction mass spectrometry (PTR-MS and solid phase microextraction with subsequent gas chromatography mass spectrometry (SPME-GCMS. For the PTR-MS measurements, 220 lung cancer patients and 441 healthy volunteers were recruited. For the GCMS measurements, we collected samples from 65 lung cancer patients and 31 healthy volunteers. Lung cancer patients were in different disease stages and under treatment with different regimes. Mixed expiratory and indoor air samples were collected in Tedlar bags, and either analyzed directly by PTR-MS or transferred to glass vials and analyzed by gas chromatography mass spectrometry (GCMS. Only those measurements of compounds were considered, which showed at least a 15% higher concentration in exhaled breath than in indoor air. Compounds related to smoking behavior such as acetonitrile and benzene were not used to differentiate between lung cancer patients and healthy volunteers. Results Isoprene, acetone and methanol are compounds appearing in everybody's exhaled breath. These three main compounds of exhaled breath show slightly lower concentrations in lung cancer patients as compared to healthy volunteers (p Conclusion GCMS-SPME is a relatively

  5. Implantable cardioverter defibrillator specific rehabilitation improves health cost outcomes

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Zwisler, Ann-Dorthe; Koch, Mette Bjerrum

    2015-01-01

    ) were randomized (1:1) to comprehensive cardiac rehabilitation or usual care. Outcomes were measured by implantable cardioverter defibrillator therapy history from patient records and national register follow-up on mortality, hospital admissions and costs. RESULTS: No significant differences were found...... of the rehabilitation group for exercise capacity, general and mental health. The aim of this paper is to explore the long-term health effects and cost implications associated with the rehabilitation programme; more specifically, (i) to compare implantable cardioverter defibrillator therapy history and mortality...... between rehabilitation and usual care groups; (ii) to examine the difference between rehabilitation and usual care groups in terms of time to first admission; and (iii) to determine attributable direct costs. METHODS: Patients with first-time implantable cardioverter defibrillator implantation (n = 196...

  6. Coordination in networks for improved mental health service

    Directory of Open Access Journals (Sweden)

    Johan Hansson

    2010-08-01

    Full Text Available Background: Well-organised clinical cooperation between health and social services has been difficult to achieve in Sweden as in other countries.Purpose: This paper presents an empirical study of a mental health coordination network in one area in Stockholm. The aim was to describe the development and nature of coordination within a mental health and social care consortium and to assess the impact on care processes and client outcomes.Method: Data was gathered through interviews with coordina­tors from three rehabilitation units. The interviews focused on coordination activities aimed at supporting the clients’ needs and investigated how the coordinators acted according to the consortium's holistic approach. Data on The Camberwell Assess­ment of Need (CAN-S showing clients’ satisfaction was used to assess on set of outcomes. Findings: The findings revealed different coordination activities and factors both helping and hindering the network coordination activities. One factor helping was the history of local and personal informal cooperation and shared responsibilities evident. Unclear roles and routines hindered cooperationPractical value: The contribution is an empirical example and a model for organisations establishing structures for network coordination. One lesson for current policy about integrated health care is to adapt and implement ”pair coordinators” where full structural integration is not possible. Another lesson, based on the idea of patient quality by coordinated care, is specific to adapt the work of the local psychiatric addictive team – an independent special team in the psychiatric outpatient care serving psychotic clients with complex addictive problems.

  7. Coordination in networks for improved mental health service

    Directory of Open Access Journals (Sweden)

    Johan Hansson

    2010-08-01

    Full Text Available Background: Well-organised clinical cooperation between health and social services has been difficult to achieve in Sweden as in other countries. Purpose: This paper presents an empirical study of a mental health coordination network in one area in Stockholm. The aim was to describe the development and nature of coordination within a mental health and social care consortium and to assess the impact on care processes and client outcomes. Method: Data was gathered through interviews with coordina­tors from three rehabilitation units. The interviews focused on coordination activities aimed at supporting the clients’ needs and investigated how the coordinators acted according to the consortium's holistic approach. Data on The Camberwell Assess­ment of Need (CAN-S showing clients’ satisfaction was used to assess on set of outcomes. Findings: The findings revealed different coordination activities and factors both helping and hindering the network coordination activities. One factor helping was the history of local and personal informal cooperation and shared responsibilities evident. Unclear roles and routines hindered cooperation Practical value: The contribution is an empirical example and a model for organisations establishing structures for network coordination. One lesson for current policy about integrated health care is to adapt and implement ”pair coordinators” where full structural integration is not possible. Another lesson, based on the idea of patient quality by coordinated care, is specific to adapt the work of the local psychiatric addictive team – an independent special team in the psychiatric outpatient care serving psychotic clients with complex addictive problems.

  8. Edible Mushrooms: Improving Human Health and Promoting Quality Life

    Directory of Open Access Journals (Sweden)

    María Elena Valverde

    2015-01-01

    Full Text Available Mushrooms have been consumed since earliest history; ancient Greeks believed that mushrooms provided strength for warriors in battle, and the Romans perceived them as the “Food of the Gods.” For centuries, the Chinese culture has treasured mushrooms as a health food, an “elixir of life.” They have been part of the human culture for thousands of years and have considerable interest in the most important civilizations in history because of their sensory characteristics; they have been recognized for their attractive culinary attributes. Nowadays, mushrooms are popular valuable foods because they are low in calories, carbohydrates, fat, and sodium: also, they are cholesterol-free. Besides, mushrooms provide important nutrients, including selenium, potassium, riboflavin, niacin, vitamin D, proteins, and fiber. All together with a long history as food source, mushrooms are important for their healing capacities and properties in traditional medicine. It has reported beneficial effects for health and treatment of some diseases. Many nutraceutical properties are described in mushrooms, such as prevention or treatment of Parkinson, Alzheimer, hypertension, and high risk of stroke. They are also utilized to reduce the likelihood of cancer invasion and metastasis due to antitumoral attributes. Mushrooms act as antibacterial, immune system enhancer and cholesterol lowering agents; additionally, they are important sources of bioactive compounds. As a result of these properties, some mushroom extracts are used to promote human health and are found as dietary supplements.

  9. Design of a breath analysis system for diabetes screening and blood glucose level prediction.

    Science.gov (United States)

    Yan, Ke; Zhang, David; Wu, Darong; Wei, Hua; Lu, Guangming

    2014-11-01

    It has been reported that concentrations of several biomarkers in diabetics' breath show significant difference from those in healthy people's breath. Concentrations of some biomarkers are also correlated with the blood glucose levels (BGLs) of diabetics. Therefore, it is possible to screen for diabetes and predict BGLs by analyzing one's breath. In this paper, we describe the design of a novel breath analysis system for this purpose. The system uses carefully selected chemical sensors to detect biomarkers in breath. Common interferential factors, including humidity and the ratio of alveolar air in breath, are compensated or handled in the algorithm. Considering the intersubject variance of the components in breath, we build subject-specific prediction models to improve the accuracy of BGL prediction. A total of 295 breath samples from healthy subjects and 279 samples from diabetic subjects were collected to evaluate the performance of the system. The sensitivity and specificity of diabetes screening are 91.51% and 90.77%, respectively. The mean relative absolute error for BGL prediction is 21.7%. Experiments show that the system is effective and that the strategies adopted in the system can improve its accuracy. The system potentially provides a noninvasive and convenient method for diabetes screening and BGL monitoring as an adjunct to the standard criteria.

  10. Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting

    Science.gov (United States)

    Skoufalos, Alexis; Medalia, Alice; Fendrick, A. Mark

    2016-01-01

    Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting Janice L. Clarke, RN, Alexis Skoufalos, EdD, Alice Medalia, PhD, and A. Mark Fendrick, MD Editorial: A Call to Action: David B. Nash, MD, MBA   S-2 Overview: Depression and the Population Health Imperative   S-3 Promoting Awareness of the Issues and Opportunities for Improvement   S-5 Cognitive Dysfunction in Affective Disorders   S-5 Critical Role of Employers in Improving Health Outcomes for Employees with Depression   S-6 Closing the Behavioral Health Professional and Process Gaps   S-6 Achieving the Triple Aim for Patients with Depressive Disorders   S-6 Improving the Experience of Care for Patients with Depression   S-6 Improving Quality of Care and Health Outcomes for Patients with Depression   S-7 Changing the Cost of Care Discussion from How Much to How Well   S-8 Panel Insights and Recommendations   S-9 Conclusion   S-10 PMID:27636743

  11. On Management Matters: Why We Must Improve Public Health Management Through Action: Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

    Science.gov (United States)

    Willacy, Erika; Bratton, Shelly

    2015-09-30

    Public health management is a pillar of public health practice. Only through effective management can research, theory, and scientific innovation be translated into successful public health action. With this in mind, the U.S. Centers for Disease Control and Prevention (CDC) has developed an innovative program called Improving Public Health Management for Action (IMPACT) which aims to address this critical need by building an effective cadre of public health managers to work alongside scientists to prepare for and respond to disease threats and to effectively implement public health programs. IMPACT is a 2-year, experiential learning program that provides fellows with the management tools and opportunities to apply their new knowledge in the field, all while continuing to serve the Ministry of Health (MoH). IMPACT will launch in 2016 in 2 countries with the intent of expanding to additional countries in future years resulting in a well-trained cadre of public health managers around the world.

  12. 自主呼吸试验联合B型脑钠肽浓度预测撤机成功率的价值%B-Type Natriuretic Peptide Improve Weaning Outcome Predicted by Spontaneous Breathing Trial

    Institute of Scientific and Technical Information of China (English)

    杨田军; 张德文; 吕世进; 王锦全; 刘宝

    2011-01-01

    目的 评价自主呼吸试验联合试验前后B型脑钠肽(BNP)变化情况是否能提高撤机成功率.方法 前瞻性队列研究,收集2008年7月至2010年12月安徽省立医院83例ICU住院需机械通气患者自主呼吸试验前30 min及90 min自主呼吸试验结束时血浆BNP数据.依撤机结局将患者分为成功组和失败组.正态分布数据采用t检验,非正态分布数据采用非参数独立样本及配对检验.用受试者工作特征(ROC)曲线评价自主呼吸试验前后BNP差值预测撤机成功率的价值.结果 83例患者中,撤机失败13例(15.7%).6例自主呼吸试验成功而撤机失败(占入选患者的7.2%,占撤机失败患者的46.2%).自主呼吸试验结束时BNP水平显著高于试验前.撤机成功组自主呼吸试验结束时BNP水平及上升幅度均明显小于撤机失败组(P <0.001).自主呼吸试验前后BNP差值预测撤机失败的ROC曲线下面积为0.94±0.03(P <0.001),以BNP上升123 pg/mL为拐点,预测撤机成功的敏感性为92.3%,特异性为91.4%.结论 自主试验前后BNP的变化可作为撤机结局的一种预测指标,联合自主呼吸试验能提高撤机的成功率.%Objective To determine whether B-type natriuretic peptide (BNP) levels combined with spontaneous breathing trial ( SBT) could improve the weaning outcome. Methods Eighty-three patients who were ready to undergo a 90-minute weaning trial (low-pressure support level) were enrolled . Weaning was considered to be successful if the patient passed the trial and sustained spontaneous breathing for more than 48 h after extubation. Plasma BNP was measured just before and at the end of the trial. All patients were divided into a weaning success group and a weaning failure group according to the outcomes of weaning. Categorical variables,expressed as percentages,were analyzed with a chi-square test or a Fisher's exact test. Continuous variables were expressed as median (25' -75" percentile) and were

  13. Screening Sleep Disordered Breathing in Stroke Unit

    Directory of Open Access Journals (Sweden)

    Kirsi Väyrynen

    2014-01-01

    Full Text Available In acute stroke, OSA has been found to impair rehabilitation and increase mortality but the effect of central apnea is more unclear. The aim of the present study was to evaluate the feasibility of using limited ambulatory recording system (sleep mattress to evaluate nocturnal breathing and EOG-electrodes for sleep staging in sleep disordered breathing (SDB diagnostics in mild acute cerebral ischemia patients and to discover the prevalence of various SDB-patterns among these patients. 42 patients with mild ischemic stroke or transient ischemic attack were studied. OSA was found in 22 patients (52.4%. Central apnea was found in two patients (4.8% and sustained partial obstruction in only one patient (2.4%. Sleep staging with EOG-electrodes only yielded a similar outcome as scoring with standard rules. OSA was found to be common even after mild stroke. Its early diagnosis and treatment would be favourable in order to improve recovery and reduce mortality. Our results suggest that OSA can be assessed by a limited recording setting with EOG-electrodes, sleep mattress, and pulse oximetry.

  14. A vision for the systematic monitoring and improvement of the quality of electronic health data.

    Science.gov (United States)

    Dixon, Brian E; Rosenman, Marc; Xia, Yuni; Grannis, Shaun J

    2013-01-01

    In parallel with the implementation of information and communications systems, health care organizations are beginning to amass large-scale repositories of clinical and administrative data. Many nations seek to leverage so-called Big Data repositories to support improvements in health outcomes, drug safety, health surveillance, and care delivery processes. An unsupported assumption is that electronic health care data are of sufficient quality to enable the varied use cases envisioned by health ministries. The reality is that many electronic health data sources are of suboptimal quality and unfit for particular uses. To more systematically define, characterize and improve electronic health data quality, we propose a novel framework for health data stewardship. The framework is adapted from prior data quality research outside of health, but it has been reshaped to apply a systems approach to data quality with an emphasis on health outcomes. The proposed framework is a beginning, not an end. We invite the biomedical informatics community to use and adapt the framework to improve health data quality and outcomes for populations in nations around the world.

  15. Lay health educators within primary care practices to improve cancer screening uptake for South Asian patients: challenges in quality improvement

    Science.gov (United States)

    Lofters, AK; Vahabi, M; Prakash, V; Banerjee, L; Bansal, P; Goel, S; Dunn, S

    2017-01-01

    Background Cancer screening uptake is known to be low among South Asian residents of Ontario. The objective of this pilot study was to determine if lay health educators embedded within the practices of primary care providers could improve willingness to screen and cancer screening uptake for South Asian patients taking a quality improvement approach. Materials and methods Participating physicians selected quality improvement initiatives to use within their offices that they felt could increase willingness to screen and cancer screening uptake. They implemented initiatives, adapting as necessary, for six months. Results Four primary care physicians participated in the study. All approximated that at least 60% of their patients were of South Asian ethnicity. All physicians chose to work with a preexisting lay health educator program geared toward South Asians. Health ambassadors spoke to patients in the office and telephoned patients. For all physicians, ~60% of South Asian patients who were overdue for cancer screening and who spoke directly to health ambassadors stated they were willing to be screened. One physician was able to track actual screening among contacted patients and found that screening uptake was relatively high: from 29.2% (colorectal cancer) to 44.6% (breast cancer) of patients came in for screening within six months of the first phone calls. Although physicians viewed the health ambassadors positively, they found the study to be time intensive and resource intensive, especially as this work was additional to usual clinical duties. Discussion Using South Asian lay health educators embedded within primary care practices to telephone patients in their own languages showed promise in this study to increase awareness about willingness to screen and cancer screening uptake, but it was also time intensive and resource intensive with numerous challenges. Future quality improvement efforts should further develop the phone call invitation process, as well as

  16. Can public health registry data improve Emergency Medical Dispatch?

    DEFF Research Database (Denmark)

    Andersen, M S; Christensen, E F; Jepsen, S B;

    2016-01-01

    BACKGROUND: Emergency Medical Dispatchers make decisions based on limited information. We aimed to investigate if adding demographic and hospitalization history information to the dispatch process improved precision. METHODS: This 30-day follow-up study evaluated time-critical emergencies in cont...

  17. Improving health care costing with resource consumption accounting.

    Science.gov (United States)

    Ozyapici, Hasan; Tanis, Veyis Naci

    2016-07-11

    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

  18. Improving chronic disease management with mobile health platform.

    Science.gov (United States)

    Lee, Do-Youn; Bae, Sungchul; Song, Joon Hyun; Yi, Byoung-Kee; Kim, Il Kon

    2013-01-01

    In modern society, aging and chronic disease is becoming common phenomenon due to the increasing numbers of elderly patients. To best treat this growing segment of the population, medical care should be based on constant vital sign monitoring. In this study, we propose a mobile vital sign measurement and data collection system for chronic disease management.. And we implemented a middle ware using Multi-Agent platform in SOS (Self-Organizing System) platform that transmits patient clinical data for services. We also implemented a HL7 messaging interface for interoperability of clinical data exchange. We propose health services on a self-organized software platform.

  19. Organisational learning and continuous improvement of health and safety in certified manufacturers

    DEFF Research Database (Denmark)

    Granerud, Lise; Rocha, Robson Sø

    2011-01-01

    and raise goals within health and safety on a continuous basis. The article examines how certified occupational and health management systems influence this process to evaluate how far they hinder or support learning. It presents a model with which it is possible to identify and analyse improvement...... that certified health and safety management does not obstruct learning, and can support advanced learning. Improvement practices with regard to health and safety are mainly dependent upon the firm’s overall organisational processes and do not automatically arise from the standard alone....

  20. Utilization of performance appraisal systems in health care organizations and improvement strategies for supervisors.

    Science.gov (United States)

    Chandra, Ashish; Frank, Zachary D

    2004-01-01

    Performance appraisal systems that are designed to objectively evaluate an employee's performance and then outline measures to be taken for improvements are essential for an organization to move ahead. These systems are often organization specific and health care organizations are no exception. However, health care managers seem to be more vocal and have often expressed dissatisfaction with the use of their company's performance appraisal system. This article is based on a case study of a health care organization's current performance appraisal techniques. This organization's current use of performance appraisals are discussed in brief, and strategies for health care organizations to improve their performance appraisal system have also been identified.

  1. Health-improving possibilities of usage of aerobics in the senior classes of comprehensive school.

    Directory of Open Access Journals (Sweden)

    Kravchuk T.N.

    2010-12-01

    Full Text Available In the article is opened health-improving possibilities of use of aerobics at physical training lessons in the senior classes. The technique of carrying out of lessons of physical training in the senior classes with use of different kinds of aerobics is proved and developed, and also their influence on indicators of health of senior pupils is investigated. It is shown that employment by aerobics promotes considerable improvement of health of senior pupils, increase of mood, state of health and activity.

  2. [Stahl, Leibniz, Hoffmann and breathing].

    Science.gov (United States)

    Carvallo, Sarah

    2006-01-01

    At the beginning of the XVIII th century, Wilhelm Gottfried Leibniz and Friedrich Hoffmann criticize Georg Ernst Stahl's medical theory. They differenciate between unsound and true reasonings. Namely, they validate Stahl's definition of breath but extracting it from its animist basis and placing it in an epistemology obeying to the principle of sufficient reason and to the mechanical model. The stahlian discovery consists in understanding breath as a calorific ventilation against the ancient conception; the iatromechanists recognize its accuracy, but they try then to transpose it to a mechanical model of ventilation. Using it in a different epistemological context implies that they analyze the idea of discovery "true" in its contents, but "wrong" in its hypothesis. It impels to examine the epistemology of medical knowledge, as science and therapeutics, and in its links with the other scientific theories. Thus, if Leibniz as philosopher and Hoffmann as doctor consider Stahl's animism so important, it is because its discoveries question the fundamental principles of medicine.

  3. A Proposed ‘Health Literate Care Model’ Would Constitute A Systems Approach To Improving Patients’ Engagement In Care

    OpenAIRE

    2013-01-01

    Improving health outcomes relies on patients’ full engagement in prevention, decision-making, and self-management activities. Health literacy, or people’s ability to obtain, process, communicate, and understand basic health information and services, is essential to those actions. Yet relatively few Americans are proficient in understanding and acting on available health information. We propose a Health Literate Care Model to improve patient engagement in health care. As health literacy strate...

  4. Feeding Health: Michael Pollan on Improving Public Health through the Food Systems

    Centers for Disease Control (CDC) Podcasts

    2009-08-19

    In this podcast, author Michael Pollan discusses his March 2009 visit to CDC and offers his thoughts on the intersection between the government, the food systems, and public health.  Created: 8/19/2009 by National Center for Environmental Health (NCEH), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Office of Sustainability.   Date Released: 4/15/2010.

  5. Efficient use of health care resources: the interaction between improved health and reduced health related income loss.

    Science.gov (United States)

    Hoel, Michael

    2002-11-01

    Cost effectiveness is a criterion that is often recommended for prioritizing between different types of health care. A modified use of this criterion can be justified as the outcome of a choice that is made "behind a veil of ignorance." Reduced health will in many cases also gives an income loss that is shared between the patient and society ar large. In the special case where the marginal utilities of health status (measured by QALYs) and income are independent of the health state, an efficient allocation of health resources is characterized by net marginal costs per QALY being equalized across different types of health care. Net marginal costs are equal to gross marginal costs minus the reduction in health related income losses due to treatment. In the general case where marginal utilities depend on the health state this rule must be modified.

  6. Effects of diaphragm breathing exercise and feedback breathing exercise on pulmonary function in healthy adults.

    Science.gov (United States)

    Yong, Min-Sik; Lee, Hae-Yong; Lee, Yun-Seob

    2017-01-01

    [Purpose] The present study investigated effects of diaphragm breathing exercise and feedback breathing exercise on respiratory function. [Subjects and Methods] Thirty-one subjects were randomly assigned to two groups; the feedback breathing exercise group and the maneuver-diaphragm exercise group. The feedback breathing exercise group was asked to breathe with feedback breathing device, and the maneuver-diaphragm exercise group was asked to perform diaphragm respiration. Respiratory function was evaluated when a subject sat on a chair comfortably. [Results] There was a significant difference in the functional vital capacity and slow vital capacity before and after all breathing exercises. There was a significant between-group difference in functional vital capacity. However, no between-group difference was found in slow vital capacity. [Conclusion] Diaphragm breathing exercise and feedback breathing exercise can affect respiratory function.

  7. Breathing Modes in Dusty Plasma

    Institute of Scientific and Technical Information of China (English)

    王晓钢; 王爽; 潘秋惠; 刘悦; 贺明峰

    2003-01-01

    Acoustic breathing modes of dusty plasmas have been investigated in a cylindricalsystem with an axial symmetry. The linear wave solution and a "dispersion" relation were derived.It was found that in an infinite area, the mode is reduced to a "classical" dust acoustic wave inthe region away from the center. If the dusty plasma is confined in a finite region, however, thebreathing (or heart-beating) behavior would be found as observed in many experiments.

  8. Taking action on the social determinants of health: improving health access for the urban poor in Mongolia

    Directory of Open Access Journals (Sweden)

    Lhamsuren Khandsuren

    2012-03-01

    Full Text Available Abstract Introduction In recent years, the country of Mongolia (population 2.8 million has experienced rapid social changes associated with economic growth, persisting socio-economic inequities and internal migration. In order to improve health access for the urban poor, the Ministry of Health developed a "Reaching Every District" strategy (RED strategy to deliver an integrated package of key health and social services. The aim of this article is to present findings of an assessment of the implementation of the RED strategy, and, on the basis of this assessment, articulate lessons learned for equitable urban health planning. Methods Principal methods for data collection and analysis included literature review, barrier analysis of health access and in-depth interviews and group discussions with health managers and providers. Findings The main barriers to health access for the urban poor relate to interacting effects of poverty, unhealthy daily living environments, social vulnerability and isolation. Implementation of the RED strategy has resulted in increased health access for the urban poor, as demonstrated by health staff having reached new clients with immunization, family planning and ante-natal care services, and increased civil registrations which enable social service provision. Organizational effects have included improved partnerships for health and increased motivation of the health workforce. Important lessons learned from the early implementation of the RED strategy include the need to form strong partnerships among stakeholders at each level of the health system and in the community, as well as the need to develop a specific financing strategy to address the needs of the very poor. The diverse social context for health in an urban poor setting calls for a decentralized planning and partnership strategy, but with central level commitment towards policy guidance and financing of pro-poor urban health strategies. Conclusions Lessons

  9. Running and Breathing in Mammals

    Science.gov (United States)

    Bramble, Dennis M.; Carrier, David R.

    1983-01-01

    Mechanical constraints appear to require that locomotion and breathing be synchronized in running mammals. Phase locking of limb and respiratory frequency has now been recorded during treadmill running in jackrabbits and during locomotion on solid ground in dogs, horses, and humans. Quadrupedal species normally synchronize the locomotor and respiratory cycles at a constant ratio of 1:1 (strides per breath) in both the trot and gallop. Human runners differ from quadrupeds in that while running they employ several phase-locked patterns (4:1, 3:1, 2:1, 1:1, 5:2, and 3:2), although a 2:1 coupling ratio appears to be favored. Even though the evolution of bipedal gait has reduced the mechanical constraints on respiration in man, thereby permitting greater flexibility in breathing pattern, it has seemingly not eliminated the need for the synchronization of respiration and body motion during sustained running. Flying birds have independently achieved phase-locked locomotor and respiratory cycles. This hints that strict locomotor-respiratory coupling may be a vital factor in the sustained aerobic exercise of endothermic vertebrates, especially those in which the stresses of locomotion tend to deform the thoracic complex.

  10. Community, service, and policy strategies to improve health care access in the changing urban environment.

    Science.gov (United States)

    Andrulis, D P

    2000-06-01

    Urban communities continue to face formidable historic challenges to improving public health. However, reinvestment initiatives, changing demographics, and growth in urban areas are creating changes that offer new opportunities for improving health while requiring that health systems be adapted to residents' health needs. This commentary suggests that health care improvement in metropolitan areas will require setting local, state, and national agendas around 3 priorities. First, health care must reorient around powerful population dynamics, in particular, cultural diversity, growing numbers of elderly, those in welfare-workplace transition, and those unable to negotiate an increasingly complex health system. Second, communities and governments must assess the consequences of health professional shortages, safety net provider closures and conversions, and new marketplace pressures in terms of their effects on access to care for vulnerable urban populations; they must also weigh the potential value of emerging models for improving those populations' care. Finally, governments at all levels should use their influence through accreditation, standards, tobacco settlements, and other financing streams to educate and guide urban providers in directions that respond to urban communities' health care needs.

  11. Organising health research systems as a key to improving health: the World Health Report 2013 and how to make further progress.

    Science.gov (United States)

    Hanney, Stephen R; González-Block, Miguel A

    2013-12-17

    The World Health Report 2013 provides a major boost to the health research community and, in particular, to those who believe that health research will make its greatest impact on improving health when it is organised through a systems approach. The World Health Report 2013, Research for Universal Health Coverage, starts with three key messages. Firstly, that universal health coverage, with full access to high-quality services, needs research evidence if it is to be achieved; second, all nations should conduct and use research; and finally, the report states that systems are needed to develop national research agendas, to raise funds, to strengthen research capacity, and to make effective use of research findings. Each of these themes is elaborated in the report and supported by extensive references.In this editorial, we first outline the key messages from the World Health Report 2013 and highlight the contributions made by papers from our journal, Health Research Policy and Systems. In addition, we discuss very recent papers that advance some issues even further. In particular, we consider new evidence both on how to achieve financial protection for those who use health services, and on whether healthcare professionals and organisations who engage in research provide an improved healthcare performance. Finally, we propose additional perspectives that add to the impressive body of evidence and analyses presented in the report. Specifically, we suggest that considering the needs of various stakeholders, as attempted in the UK, in parallel with analysing how to fulfil essential functions, should boost the prospects of successfully building and strengthening health research systems. This is important because research is vital for achieving universal health coverage, and consequently for improving the health of millions of people.

  12. Improving a mother to child HIV transmission programme through health system redesign: quality improvement, protocol adjustment and resource addition.

    Directory of Open Access Journals (Sweden)

    Michele S Youngleson

    Full Text Available BACKGROUND: Health systems that deliver prevention of mother to child transmission (PMTCT services in low and middle income countries continue to underperform, resulting in thousands of unnecessary HIV infections of newborns each year. We used a combination of approaches to health systems strengthening to reduce transmission of HIV from mother to infant in a multi-facility public health system in South Africa. METHODOLOGY/PRINCIPAL FINDINGS: All primary care sites and specialized birthing centers in a resource constrained sub-district of Cape Metro District, South Africa, were enrolled in a quality improvement (QI programme. All pregnant women receiving antenatal, intrapartum and postnatal infant care in the sub-district between January 2006 and March 2009 were included in the intervention that had a prototype-innovation phase and a rapid spread phase. System changes were introduced to help frontline healthcare workers to identify and improve performance gaps at each step of the PMTCT pathway. Improvement was facilitated and spread through the use of a Breakthrough Series Collaborative that accelerated learning and the spread of successful changes. Protocol changes and additional resources were introduced by provincial and municipal government. The proportion of HIV-exposed infants testing positive declined from 7.6% to 5%. Key intermediate PMTCT processes improved (antenatal AZT increased from 74% to 86%, PMTCT clients on HAART at the time of labour increased from 10% to 25%, intrapartum AZT increased from 43% to 84%, and postnatal HIV testing from 79% to 95% compared to baseline. CONCLUSIONS/SIGNIFICANCE: System improvement methods, protocol changes and addition/reallocation of resources contributed to improved PMTCT processes and outcomes in a resource constrained setting. The intervention requires a clear design, leadership buy-in, building local capacity to use systems improvement methods, and a reliable data system. A systems improvement

  13. Implantable cardioverter defibrillator specific rehabilitation improves health cost outcomes

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Zwisler, Ann-Dorthe; Koch, Mette Bjerrum;

    2015-01-01

    ) were randomized (1:1) to comprehensive cardiac rehabilitation or usual care. Outcomes were measured by implantable cardioverter defibrillator therapy history from patient records and national register follow-up on mortality, hospital admissions and costs. RESULTS: No significant differences were found...... was -6,789 USD/-5,593 Euro in favour of rehabilitation. CONCLUSION: No long-term health outcome benefits were found for the rehabilitation programme. However, the rehabilitation programme resulted in a reduction in total attributable direct costs.......OBJECTIVE: The Copenhagen Outpatient ProgrammE - implantable cardioverter defibrillator (COPE-ICD) trial included patients with implantable cardioverter defibrillators in a randomized controlled trial of rehabilitation. After 6-12 months significant differences were found in favour...

  14. Using ontologies to improve semantic interoperability in health data.

    Science.gov (United States)

    Liyanage, Harshana; Krause, Paul; De Lusignan, Simon

    2015-07-10

    The present-day health data ecosystem comprises a wide array of complex heterogeneous data sources. A wide range of clinical, health care, social and other clinically relevant information are stored in these data sources. These data exist either as structured data or as free-text. These data are generally individual person-based records, but social care data are generally case based and less formal data sources may be shared by groups. The structured data may be organised in a proprietary way or be coded using one-of-many coding, classification or terminologies that have often evolved in isolation and designed to meet the needs of the context that they have been developed. This has resulted in a wide range of semantic interoperability issues that make the integration of data held on these different systems changing. We present semantic interoperability challenges and describe a classification of these. We propose a four-step process and a toolkit for those wishing to work more ontologically, progressing from the identification and specification of concepts to validating a final ontology. The four steps are: (1) the identification and specification of data sources; (2) the conceptualisation of semantic meaning; (3) defining to what extent routine data can be used as a measure of the process or outcome of care required in a particular study or audit and (4) the formalisation and validation of the final ontology. The toolkit is an extension of a previous schema created to formalise the development of ontologies related to chronic disease management. The extensions are focused on facilitating rapid building of ontologies for time-critical research studies.

  15. Environmental Health and Aging: Activity, Exposure and Biological Models to Improve Risk Assessment and Health Promotion

    Science.gov (United States)

    The US Environmental Protection Agency (EPA) and other public health agencies are concerned that the environmental health of America’s growing population of older adults has not been taken into consideration in current approaches to risk assessment. The reduced capacity to respo...

  16. Evidence-Based Health Promotion in Nursing Homes: A Pilot Intervention to Improve Oral Health

    Science.gov (United States)

    Cadet, Tamara J.; Berrett-Abebe, Julie; Burke, Shanna L.; Bakk, Louanne; Kalenderian, Elsbeth; Maramaldi, Peter

    2016-01-01

    Nursing home residents over the age of 65 years are at high risk for poor oral health and related complications such as pneumonia and adverse diabetes outcomes. A preliminary study found that Massachusetts' nursing homes generally lack the training and resources needed to provide adequate oral health care to residents. In this study, an…

  17. An audit of the process of developing the Health Improvement Programme into Strategic and Financial Framework in two health authorities.

    Science.gov (United States)

    Carlisle, J; Shickle, D; Suckling, R; Singleton, C; Bentley, C

    2004-11-01

    Health Improvement Programmes (HImPs) are a means of documenting the health needs of a population and are intended to be translated into commissioning decisions by the Strategic and Financial Framework (SaFF). This paper examines some major influences on the process of translating the HImP into the SaFF. The Directors of Public Health in two Health Authorities were concerned that the development of the SaFF did not always represent a clear progression from the HImP. An audit to pinpoint where commissioning decisions did not match the identified health improvement needs in two Health Authorities was carried out between November 2000 and February 2001. The overall findings confirmed that needs identified in the HImPs were not fully reflected in the service provision described in the final SaFFs. The audit provided evidence that was useful in identifying major issues and influences that facilitated or hindered the development of the SaFF from the HImP. Some of the ways in which HImP priorities disappeared from the SaFF and non-HImP priorities appeared in it were also distinguished. The conclusion is that a clear, criterion-based process should enable health and social care communities and Primary Care Trusts to develop a more responsible commissioning process in future, and specific recommendations to that effect are made.

  18. Are patient surveys valuable as a service-improvement tool in health services? An overview

    Directory of Open Access Journals (Sweden)

    Patwardhan A

    2012-05-01

    Full Text Available Anjali Patwardhan,1 Charles H Spencer21Nationwide Children’s Hospital Columbus, 2Ohio State University, Columbus, OH, USAAbstract: Improving the quality of care in international health services was made a high priority in 1977. The World Health Assembly passed a resolution to greatly improveHealth for all” by the year 2000. Since 1977, the use of patient surveys for quality improvement has become a common practice in the health-care industry. The use of surveys reflects the concept that patient satisfaction is closely linked with that of organizational performance, which is in turn closely linked with organizational culture. This article is a review of the role of patient surveys as a quality-improvement tool in health care. The article explores the characteristics, types, merits, and pitfalls of various patient surveys, as well as the impact of their wide-ranging application in dissimilar scenarios to identify gaps in service provision. It is demonstrated that the conducting of patient surveys and using the results to improve the quality of care are two different processes. The value of patient surveys depends on the interplay between these two processes and several other factors that can influence the final outcome. The article also discusses the business aspect of the patient surveys in detail. Finally, the authors make future recommendations on how the patient survey tool can be best used to improve the quality of care in the health-care sector.Keywords: patient surveys, quality improvement, service gaps 

  19. Making systems work: the hard part of improving maternal health services in South Africa.

    Science.gov (United States)

    Thomas, Leena Susan; Jina, Ruxana; Tint, Khin San; Fonn, Sharon

    2007-11-01

    As part of a multi-country study, maternal health services were reviewed in one health district in Gauteng Province, South Africa. Poor record-keeping, inadequate supervision, poor levels of clinical knowledge and under-utilisation of midwife obstetric units were found. Interventions identified by local health service personnel to improve maternity care were developed, implemented and evaluated, included programme-specific (training in prevention of mother-to-child transmission of HIV and neonatal resuscitation) and system interventions (improving interpersonal relations and system functioning, use of routine data for monitoring purposes, improving supervision skills). This resulted in some positive outputs. Health worker knowledge and patient records improved, and there was some indication that supervision improved. However, system-wide interventions that could improve programmes were less successful. To build a learning organisation, a new culture of monitoring and evaluation, including routine self-evaluation, is required as core skills for all health workers. These data should be used at the point of collection. Changing reporting lines between programme and district managers may improve co-ordination between different authorities, and there is a need to enhance the manner in which staff are assessed, appraised, promoted and rewarded. Professional bodies who oversee training curricula, institutions that offer training, and institutions that provide funding for training and development need to take on the challenge of health systems development and avoid promoting programme-specific interventions only.

  20. Unmet Need: Improving mHealth Evaluation Rigor to Build the Evidence Base.

    Science.gov (United States)

    Mookherji, Sangeeta; Mehl, Garrett; Kaonga, Nadi; Mechael, Patricia

    2015-01-01

    mHealth-the use of mobile technologies for health-is a growing element of health system activity globally, but evaluation of those activities remains quite scant, and remains an important knowledge gap for advancing mHealth activities. In 2010, the World Health Organization and Columbia University implemented a small-scale survey to generate preliminary data on evaluation activities used by mHealth initiatives. The authors describe self-reported data from 69 projects in 29 countries. The majority (74%) reported some sort of evaluation activity, primarily nonexperimental in design (62%). The authors developed a 6-point scale of evaluation rigor comprising information on use of comparison groups, sample size calculation, data collection timing, and randomization. The mean score was low (2.4); half (47%) were conducting evaluations with a minimum threshold (4+) of rigor, indicating use of a comparison group, while less than 20% had randomized the mHealth intervention. The authors were unable to assess whether the rigor score was appropriate for the type of mHealth activity being evaluated. What was clear was that although most data came from mHealth projects pilots aimed for scale-up, few had designed evaluations that would support crucial decisions on whether to scale up and how. Whether the mHealth activity is a strategy to improve health or a tool for achieving intermediate outcomes that should lead to better health, mHealth evaluations must be improved to generate robust evidence for cost-effectiveness assessment and to allow for accurate identification of the contribution of mHealth initiatives to health systems strengthening and the impact on actual health outcomes.

  1. Continuous improvement and TQM in health care: an emerging operational paradigm becomes a strategic imperative.

    Science.gov (United States)

    Swinehart, K; Green, R F

    1995-01-01

    Argues that US health care is in a state of crisis. Escalating costs account for 13 per cent of GNP, making health care the third largest industry in the USA, and spending is expected to increase. Claims health-care providers need to control rising costs, improve productivity and flexibility, adopt appropriate technologies, and maintain competitive levels of quality and value. States that TQM may provide an environment that will focus on quality of patient care and continuous quality improvement at all levels of the organization including the governing body, the administrative, managerial, and clinical areas. Any new national or state health-care plan will force providers to be more efficient while maintaining quality standards. Concludes that it will be strategically imperative that health-care providers ranging from family physicians to major medical centres and suppliers ranging from laboratories to pharmaceutical firms establish methods for making rapid continuous improvement and total quality management the cornerstone of the strategic planning process.

  2. Etiopathogenetic Mechanisms of Pulmonary Hypertension in Sleep-Related Breathing Disorders

    Directory of Open Access Journals (Sweden)

    Ayodeji Adegunsoye

    2012-01-01

    Full Text Available Obstructive sleep apnea syndrome is a common disorder with significant health consequences and is on the rise in consonance with the obesity pandemic. In view of the association between sleep-disordered breathing and pulmonary hypertension as depicted by multiple studies, current clinical practice guidelines categorize obstructive sleep apnea as a risk factor for pulmonary hypertension and recommend an assessment for sleep disordered breathing in evaluating patients with pulmonary hypertension. The dysregulatory mechanisms associated with hypoxemic episodes observed in sleep related breathing disorders contribute to the onset of pulmonary hypertension and identification of these potentially treatable factors might help in the reduction of overall cardiovascular mortality.

  3. Volunteering for Clinical Trials Can Help Improve Health Care for Everyone

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Clinical Trials Volunteering for Clinical Trials Can Help Improve Health Care for Everyone Past ... healthy people to help," says Melanie Modlin about clinical trials. "We have a role to play in helping ...

  4. A public health academic-practice partnership to develop capacity for exercise evaluation and improvement planning.

    Science.gov (United States)

    Wright, Kate S; Thomas, Michael W; Durham, Dennis P; Jackson, Lillie M; Porth, Leslie L; Buxton, Mark

    2010-01-01

    In December 2006, Congress passed the Pandemic and All-Hazards Preparedness Act to improve the nation's public health preparedness and response capabilities. It includes the role of Centers for Public Health Preparedness (CPHPs) to establish a competency-based core curriculum and perform evaluation of impact on newly developed materials. The Heartland Center for Public Health Preparedness (HCPHP) at the Saint Louis University School of Public Health is part of the Centers for Disease Control and Prevention national CPHP network and is engaged with state and regional partners in workforce development, preparedness planning, evaluation, and multi-year exercise and training cycles. This includes development, implementation, and evaluation of the HCPHP Exercise Evaluation Training Program to improve the competence and capacity for exercise evaluation and improvement planning. This program is designed to enhance quality improvement and performance measurement capabilities to identify increase of workforce competence over time (maturity).

  5. Kaizen: a process improvement model for the business of health care and perioperative nursing professionals.

    Science.gov (United States)

    Tetteh, Hassan A

    2012-01-01

    Kaizen is a proven management technique that has a practical application for health care in the context of health care reform and the 2010 Institute of Medicine landmark report on the future of nursing. Compounded productivity is the unique benefit of kaizen, and its principles are change, efficiency, performance of key essential steps, and the elimination of waste through small and continuous process improvements. The kaizen model offers specific instruction for perioperative nurses to achieve process improvement in a five-step framework that includes teamwork, personal discipline, improved morale, quality circles, and suggestions for improvement.

  6. SU-E-J-185: A Systematic Review of Breathing Guidance in Radiation Oncology and Radiology

    Energy Technology Data Exchange (ETDEWEB)

    Pollock, S; Keall, P [University of Sydney, Sydney (Australia); Keall, R [Hammond Care Palliative and Supportive Care Service, Sydney, NSW (Australia)

    2015-06-15

    Purpose: The advent of image-guided radiation therapy (IGRT) has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion is the use of breathing guidance systems during imaging and treatment. A review of such research had not yet been performed, it was therefore our aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: Results of online database searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with the PRISMAStatement reporting standard (Preferred Reporting Items for Systematic reviews and Meta-Analyses) utilizing the PICOS approach (Participants, Intervention, Comparison, Outcome, Study design). Participants: Cancer patients, healthy volunteers. Intervention: Biofeedback breathing guidance systems. Comparison: No breathing guidance of the same breathing type. Outcome: Regularity of breathing signal and anatomic/tumor motion, medical image quality, radiation treatment margins and coverage, medical imaging and radiation treatment times. Study design: Quantitative and controlled prospective or retrospective trials. Results: The systematic search yielded a total of 479 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. The vast majority of investigated outcomes were significantly positively impacted by the use of breathing guidance; however, this was dependent upon the nature of the breathing guidance system and study design. In 25/27 studies significant improvements from the use of breathing guidance were observed. Conclusion: The results found here indicate that further clinical studies are warranted which quantify more comprehensively the

  7. Obesity prevention strategies: could food or soda taxes improve health?

    Science.gov (United States)

    Encarnação, R; Lloyd-Williams, F; Bromley, H; Capewell, S

    2016-03-01

    Evidence shows that one of the main causes for rising obesity rates is excessive consumption of sugar, which is due in large part to the high sugar content of most soda and juice drinks and junk foods. Worryingly, UK and global populations are consuming increasing amounts of sugary drinks and junk foods (high in salt, sugar and saturated fats). However, there is raised public awareness, and parents in particular want something to be done to curb the alarming rise in childhood obesity. Population-wide policies (i.e. taxation, regulation, legislation, reformulation) consistently achieve greater public health gains than interventions and strategies targeted at individuals. Junk food and soda taxes are supported by increasing evidence from empirical and modelling studies. The strongest evidence base is for a tax on sugar sweetened beverages, but in order to effectively reduce consumption, that taxation needs to be at least 20%. Empirical data from a number of countries which have implemented a duty on sugar or sugary drinks shows rapid, substantial benefits. In the UK, increasing evidence from recent scientific reports consistently support substantial reductions in sugar consumption through comprehensive strategies which include a tax. Furthermore, there is increasing public support for such measures. A sugar sweetened beverages tax will happen in the UK so the question is not 'If?' but 'When?' this tax will be implemented. And, crucially, which nation will get there first? England, Ireland, Scotland or Wales?

  8. [Public Health initiative for improved vaccination for asylum seekers].

    Science.gov (United States)

    Brockmann, Stefan O; Wjst, Stephanie; Zelmer, Ursula; Carollo, Stefanie; Schmid, Mirjam; Roller, Gottfried; Eichner, Martin

    2016-05-01

    The number of asylum seekers in Germany has increased dramatically in 2015. Their medical care includes the officially recommended vaccinations; yet, no detailed information on this is yet available in Germany. In light of the rising number of asylum seekers, we have developed a concept to facilitate their vaccination. This concept includes the coordination of different partners, the supply of vaccines and other materials through the local health office, and the cooperation with the local physicians' association. To evaluate and accelerate progress, we compared the number of vaccinations conducted by physicians independently of the vaccination concept with those conducted within the new concept. For the period of investigation, 2,256 new asylum seekers were temporarily accommodated in the facilities. The vaccination concept was applied in only some of the facilities. Twenty-eight percent of all asylum seekers (642) were vaccinated at least once; 89 % of the vaccinees (571) were vaccinated within the newly developed concept. In the facilities that were not included in this concept, only 6 % of the refugees were vaccinated, whereas in the facilities that were included up to 58 % were vaccinated. Even though the new concept has started successfully, further innovations are required to reach sufficient vaccination coverage among asylum seekers. In view of the large number of new asylum seekers expected, the adjustment and expansion of the new concept requires professional planning and coordination. Furthermore, additional resources are required.

  9. Improving district level health planning and priority setting in Tanzania through implementing accountability for reasonableness framework

    DEFF Research Database (Denmark)

    Maluka, Stephen; Kamuzora, Peter; Sebastián, Miguel San;

    2010-01-01

    In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania....... The objective of this paper is to explore the acceptability of Accountability for Reasonableness from the perspectives of the Council Health Management Team, local government officials, health workforce and members of user boards and committees....

  10. Audio-tactile stimulation: A tool to improve health and well-being?

    NARCIS (Netherlands)

    Dijk, E.O.; Nijholt, A.; Erp, J.B.F. van; Wolferen, G. van; Kuyper, E.

    2013-01-01

    Stimulation of the tactile sense or the hearing sense can be used to improve a person's health and well-being. For example, to make someone relax, feel better or sleep better. In this position paper, we present the concept of auditory-tactile stimulation for health and well-being. Through carefully

  11. Improving Genetics Education in Graduate and Continuing Health Professional Education: Workshop Summary

    Science.gov (United States)

    Berger, Adam C.; Johnson, Samuel G.; Beachy, Sarah H.; Olson, Steve

    2015-01-01

    Many health care providers do not have either the knowledge or the tools they need in order to apply genetic information in their day-to-day practices. This lack of support is contributing to a substantial delay in the translation of genetic research findings, when appropriate, into improvement in patient outcomes within the health care system.…

  12. Paradigmatic obstacles to improving the health of populations: implications for health policy

    Directory of Open Access Journals (Sweden)

    McKinlay John B.

    1998-01-01

    Full Text Available While there are promising developments in public health, most interventions (both at the individual and community levels remain focused on "downstream" tertiary treatments or one-on-one interventions. These efforts have their origins in the biomedical paradigm and risk factor epidemiology and the behavioral science research methods that serve as their handmaidens. This paper argues for a more appropriate balance of "downstream" efforts with a more appropriate whole population public health approach to health policy -what may be termed a social policy approach to healthy lifestyles rather than the current lifestyle approach to health policy. New, more appropriate research methods must be developed and applied to match these emerging levels of whole population intervention. We must avoid any disjunction between new upstream policy level interventions and the methods used to measure their effect -appropriate unto the intervention level must be the evaluation method thereof.

  13. Unlocking community capabilities for improving maternal and newborn health: participatory action research to improve birth preparedness, health facility access, and newborn care in rural Uganda

    Directory of Open Access Journals (Sweden)

    Elizabeth Ekirapa-Kiracho

    2016-11-01

    Full Text Available Abstract Background Community capacities and resources must be harnessed to complement supply side initiatives addressing high maternal and neonatal mortality rates in Uganda. This paper reflects on gains, challenges and lessons learnt from working with communities to improve maternal and newborn health in rural Uganda. Methods A participatory action research project was supported from 2012 to 2015 in three eastern districts. This project involved working with households, saving groups, sub county and district leaders, transporters and village health teams in diagnosing causes of maternal and neonatal mortality and morbidity, developing action plans to address these issues, taking action and learning from action in a cyclical manner. This paper draws from project experience and documentation, as well as thematic analysis of 20 interviews with community and district stakeholders and 12 focus group discussions with women who had recently delivered and men whose wives had recently delivered. Results Women and men reported increased awareness about birth preparedness, improved newborn care practices and more male involvement in maternal and newborn health. However, additional direct communication strategies were required to reach more men beyond the minority who attended community dialogues and home visits. Saving groups and other saving modalities were strengthened, with money saved used to meet transport costs, purchase other items needed for birth and other routine household needs. However saving groups required significant support to improve income generation, management and trust among members. Linkages between savings groups and transport providers improved women’s access to health facilities at reduced cost. Although village health teams were a key resource for providing information, their efforts were constrained by low levels of education, inadequate financial compensation and transportation challenges. Ensuring that the village health

  14. Challenges to improving maternal health in rural Nepal.

    Science.gov (United States)

    Thapa, S

    1996-05-01

    In the remote village of Martadi, in Bajura district of western Nepal, the total fertility rate is 7. 20% of newborns die before they reach age 1. Temporary migration, mainly to India, is common due to the inability of the rugged and rocky terrain to supply enough food. The existence of temporary migration and a high frequency of remarriage suggest a high rate of sexually transmitted diseases. The relatively new hospital is very much under used (e.g., only 35 patients in 1995). The office in Kolti that supplies vaccines to Martadi has gone at least six months without receiving any new child immunization drugs, despite the presence of an air service. During and after delivery, no one, not even family members or traditional birth attendants, can touch a woman, who is confined to a cow-shed to deliver and care for her child and herself alone. Yet sick animals receive care. A new mother also is required to bathe herself, often requiring a walk of many hours. Women often identify access to water as their top priority. Pregnant or postpartum women are forbidden from eating green vegetables because of the belief that they cause diarrhea. Sanitation is better now in Martadi than in the past. Diarrhea and vomiting were once very prevalent. The international organization, CARE, along with the Ministry of Local Development operate the Remote Area Basic Needs Project, which revolves around community organization, agroforestry, rural infrastructure, and primary health care. The project has helped villagers construct low-cost toilets. It provides training in basic hygiene. Households have kitchen-gardens. Many families are now eating green vegetables regularly. Fruit trees are being introduced. Villagers recognize the value of child immunization. Some small-scale drinking water systems are operating. Villagers are trained in repair and management of these systems. About 33% of women aged 15-49 want no more children. A first-ever outreach program for female sterilization services

  15. Improving communication skills in the Southeast Asian health care context.

    Science.gov (United States)

    Claramita, Mora; Susilo, Astrid Pratidina

    2014-12-01

    The aim of these two PhD thesis are to develop a guideline on doctor-patient communication skills based on cultural characteristics of Southeast Asian context and to develop communication skills training for nurses to enhance their contribution to the informed consent and shared decision making process, in the same context. These studies started with qualitative methods; including grounded theory methodology, by exploring doctors', patients', medical students' and nurses' perceptions on the current and desired communication skills in which influenced by culture. Based on the results, we design communication skills training and evaluate the training with quantitative methods, using pre and post test studies. Southeast Asian desired ideal partnership style in communicating with their doctors. More emphasize on basic skills such as listening to subtle non-verbal cues are needed for doctors and nurses. A guideline on doctor-patient communication tailored to local culture was developed as well as training for nurses using 4CID design to enhance their contribution to the shared decision making process. To promote two-way interaction between doctors and patients and between health professionals require mastering basic skills in communicating with people, such as explorations on the unspoken concern. In a culturally hierarchical context of Indonesia, this two-way interaction is quite a challenge. To generalize our studies to other culture, more studies with rigorous methods should follow. To promote the use of basic skills in communicating with patients to approach the desired partnership communication style in Southeast Asian context, we need to use local evidences.

  16. Water-Food-Nutrition-Health Nexus: Linking Water to Improving Food, Nutrition and Health in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Tafadzwanashe Mabhaudhi

    2016-01-01

    Full Text Available Whereas sub-Saharan Africa’s (SSA water scarcity, food, nutrition and health challenges are well-documented, efforts to address them have often been disconnected. Given that the region continues to be affected by poverty and food and nutrition insecurity at national and household levels, there is a need for a paradigm shift in order to effectively deliver on the twin challenges of food and nutrition security under conditions of water scarcity. There is a need to link water use in agriculture to achieve food and nutrition security outcomes for improved human health and well-being. Currently, there are no explicit linkages between water, agriculture, nutrition and health owing to uncoordinated efforts between agricultural and nutrition scientists. There is also a need to develop and promote the use of metrics that capture aspects of water, agriculture, food and nutrition. This review identified nutritional water productivity as a suitable index for measuring the impact of a water-food-nutrition-health nexus. Socio-economic factors are also considered as they influence food choices in rural communities. An argument for the need to utilise the region’s agrobiodiversity for addressing dietary quality and diversity was established. It is concluded that a model for improving nutrition and health of poor rural communities based on the water-food-nutrition-health nexus is possible.

  17. Water-Food-Nutrition-Health Nexus: Linking Water to Improving Food, Nutrition and Health in Sub-Saharan Africa.

    Science.gov (United States)

    Mabhaudhi, Tafadzwanashe; Chibarabada, Tendai; Modi, Albert

    2016-01-06

    Whereas sub-Saharan Africa's (SSA) water scarcity, food, nutrition and health challenges are well-documented, efforts to address them have often been disconnected. Given that the region continues to be affected by poverty and food and nutrition insecurity at national and household levels, there is a need for a paradigm shift in order to effectively deliver on the twin challenges of food and nutrition security under conditions of water scarcity. There is a need to link water use in agriculture to achieve food and nutrition security outcomes for improved human health and well-being. Currently, there are no explicit linkages between water, agriculture, nutrition and health owing to uncoordinated efforts between agricultural and nutrition scientists. There is also a need to develop and promote the use of metrics that capture aspects of water, agriculture, food and nutrition. This review identified nutritional water productivity as a suitable index for measuring the impact of a water-food-nutrition-health nexus. Socio-economic factors are also considered as they influence food choices in rural communities. An argument for the need to utilise the region's agrobiodiversity for addressing dietary quality and diversity was established. It is concluded that a model for improving nutrition and health of poor rural communities based on the water-food-nutrition-health nexus is possible.

  18. New Sports Nutritious Food for Health Improvement and Antioxidant Function

    Directory of Open Access Journals (Sweden)

    Zhilei Zheng

    2015-08-01

    Full Text Available The research aimed to explore the influence of new sports nutritious food (Hydrogen Water on exercise-induced oxidative stress injury and athletic ability of power organic skeletal muscle that is susceptible to oxidation attacks and in vivo basis and possible mechanism of hydrogen water in the process of selective oxidation. This study randomly divided 80 healthy male SD rats into 8 groups of quiet control group (EC, group A, exercise control group (EE, group B, hydrogen water injection before exercise group (EH, group C and joint hydrogen water injections before and after exercise group (EM, group D, with 10 rats in each group. The rest groups conducted adaptive low intensive treadmill running for 1 time every day before a week of the experiment except EC (group A. EH (group C conducted intraperitoneal injection of hydrogen water with 10 mL/kg before 1 min of exercise before formal experiment. EM (group D conducted intraperitoneal injection of hydrogen water immediately in 1 min before and after exercise. EE (group B conducted intraperitoneal injection with same volume normal saline. EE, EH and EM group conducted a one-time heavy intensive exhausted treadmill running by using Marra project. Group B, C, D conducted quantitative treadmill running, detected 3-NT, 8-OHdG value of skeletal muscle after 3 h of exercise in group A, B, C, D using Elisa method and measured MDA, SOD, GSH, T-AOC and level of O2-, H2O2 and •OH using chemical colorimetry. The results showed that hydrogen water can significantly prolong the duration of exercise to exhaustion of rats, which had significant anti-fatigue effect; and can significantly inhibit the aggravation of motility of O2-, H2O2 and •OH, remove in vivo cytotoxic substances •OH effectively, improve SOD and GSH, enhance T-AOC, improve minicirculation and reduce the damage of cells; joint hydrogen water injections before and after exercise had synergistic effect for the prevention and control of exercise

  19. Getting the product right: how competition policy can improve health care markets.

    Science.gov (United States)

    Sage, William M

    2014-06-01

    As hospital, physician, and health insurance markets consolidate and change in response to health care reform, some commentators have called for vigorous enforcement of the federal antitrust laws to prevent the acquisition and exercise of market power. In health care, however, stricter antitrust enforcement will benefit consumers only if it accounts for the competitive distortions caused by the sector's long history of government regulation. This article directs policy makers to a neglected dimension of health care competition that has been altered by regulation: the product. Competition may have failed to significantly lower costs, increase access, or improve quality in health care because we have been buying and selling the wrong things. Competition policy makers-meaning both antitrust enforcers and regulators-should force the health care industry to define and market products that can be assembled and warranted to consumers while keeping emerging sectors such as mHealth free from overregulation, wasteful subsidy, and appropriation by established insurer and provider interests.

  20. Study protocol: national research partnership to improve primary health care performance and outcomes for Indigenous peoples

    Directory of Open Access Journals (Sweden)

    McDermott Robyn

    2010-05-01

    Full Text Available Abstract Background Strengthening primary health care is critical to reducing health inequity between Indigenous and non-Indigenous Australians. The Audit and Best practice for Chronic Disease Extension (ABCDE project has facilitated the implementation of modern Continuous Quality Improvement (CQI approaches in Indigenous community health care centres across Australia. The project demonstrated improvements in health centre systems, delivery of primary care services and in patient intermediate outcomes. It has also highlighted substantial variation in quality of care. Through a partnership between academic researchers, service providers and policy makers, we are now implementing a study which aims to 1 explore the factors associated with variation in clinical performance; 2 examine specific strategies that have been effective in improving primary care clinical performance; and 3 work with health service staff, management and policy makers to enhance the effective implementation of successful strategies. Methods/Design The study will be conducted in Indigenous community health centres from at least six States/Territories (Northern Territory, Western Australia, New South Wales, South Australia, Queensland and Victoria over a five year period. A research hub will be established in each region to support collection and reporting of quantitative and qualitative clinical and health centre system performance data, to investigate factors affecting variation in quality of care and to facilitate effective translation of research evidence into policy and practice. The project is supported by a web-based information system, providing automated analysis and reporting of clinical care performance to health centre staff and management. Discussion By linking researchers directly to users of research (service providers, managers and policy makers, the partnership is well placed to generate new knowledge on effective strategies for improving the quality of primary

  1. Let's Talk About Sex! - Improving sexual health for patients in stroke rehabilitation.

    Science.gov (United States)

    Guo, Meiqi; Bosnyak, Stephanie; Bontempo, Tiziana; Enns, Amie; Fourie, Candice; Ismail, Farooq; Lo, Alex

    2015-01-01

    Sexual health contributes greatly to quality of life. Research shows that stroke survivors want to learn and talk about sexual health, but are not given information. In keeping with the Canadian Best Practice Recommendations for Stroke Care, this project aimed to provide all stroke rehabilitation inpatients with the opportunity to discuss sexual health concerns with healthcare providers at West Park Healthcare Centre, a rehabilitation and complex continuing care centre in Toronto. Gap analysis conducted via staff member interviews and retrospective chart reviews showed that close to no patients were given the opportunity to discuss sexual health concerns at baseline. Plan-Do-Study-Act (PDSA) methodology was used as the project framework. The changes implemented included a reminder system, standardization of care processes for sexual health, patient-centred time points for the delivery of sexual health discussions, and the development of a sexual health supported conversation tool for patients with aphasia. By the end of the ten month project period and after three PDSA cycles, the percentage of patients provided with the opportunity to discuss sexual health during inpatient rehabilitation increased to 80%. This quality improvement project successfully implemented the Canadian Best Practice Recommendations for Stroke Care with respect to sexual health. Lessons learned included the importance of early baseline data collection and advance planning for tools used in QI projects. Future projects may focus on improving the discussion of sexual health concerns during outpatient stroke rehabilitation.

  2. Universal health coverage in Latin American countries: how to improve solidarity-based schemes.

    Science.gov (United States)

    Titelman, Daniel; Cetrángolo, Oscar; Acosta, Olga Lucía

    2015-04-04

    In this Health Policy we examine the association between the financing structure of health systems and universal health coverage. Latin American health systems encompass a wide range of financial sources, which translate into different solidarity-based schemes that combine contributory (payroll taxes) and non-contributory (general taxes) sources of financing. To move towards universal health coverage, solidarity-based schemes must heavily rely on countries' capacity to increase public expenditure in health. Improvement of solidarity-based schemes will need the expansion of mandatory universal insurance systems and strengthening of the public sector including increased fiscal expenditure. These actions demand a new model to integrate different sources of health-sector financing, including general tax revenue, social security contributions, and private expenditure. The extent of integration achieved among these sources will be the main determinant of solidarity and universal health coverage. The basic challenges for improvement of universal health coverage are not only to spend more on health, but also to reduce the proportion of out-of-pocket spending, which will need increased fiscal resources.

  3. Benchmarking: a method for continuous quality improvement in health.

    Science.gov (United States)

    Ettorchi-Tardy, Amina; Levif, Marie; Michel, Philippe

    2012-05-01

    Benchmarking, a management approach for implementing best practices at best cost, is a recent concept in the healthcare system. The objectives of this paper are to better understand the concept and its evolution in the healthcare sector, to propose an operational definition, and to describe some French and international experiences of benchmarking in the healthcare sector. To this end, we reviewed the literature on this approach's emergence in the industrial sector, its evolution, its fields of application and examples of how it has been used in the healthcare sector. Benchmarking is often thought to consist simply of comparing indicators and is not perceived in its entirety, that is, as a tool based on voluntary and active collaboration among several organizations to create a spirit of competition and to apply best practices. The key feature of benchmarking is its integration within a comprehensive and participatory policy of continuous quality improvement (CQI). Conditions for successful benchmarking focus essentially on careful preparation of the process, monitoring of the relevant indicators, staff involvement and inter-organizational visits. Compared to methods previously implemented in France (CQI and collaborative projects), benchmarking has specific features that set it apart as a healthcare innovation. This is especially true for healthcare or medical-social organizations, as the principle of inter-organizational visiting is not part of their culture. Thus, this approach will need to be assessed for feasibility and acceptability before it is more widely promoted.

  4. Health Benefits of Urban Allotment Gardening: Improved Physical and Psychological Well-Being and Social Integration.

    Science.gov (United States)

    Soga, Masashi; Cox, Daniel T C; Yamaura, Yuichi; Gaston, Kevin J; Kurisu, Kiyo; Hanaki, Keisuke

    2017-01-12

    With an ever-increasing urban population, promoting public health and well-being in towns and cities is a major challenge. Previous research has suggested that participating in allotment gardening delivers a wide range of health benefits. However, evidence from quantitative analyses is still scarce. Here, we quantify the effects, if any, of participating in allotment gardening on physical, psychological and social health. A questionnaire survey of 332 people was performed in Tokyo, Japan. We compared five self-reported health outcomes between allotment gardeners and non-gardener controls: perceived general health, subjective health complaints, body mass index (BMI), mental health and social cohesion. Accounting for socio-demographic and lifestyle variables, regression models revealed that allotment gardeners, compared to non-gardeners, reported better perceived general health, subjective health complaints, mental health and social cohesion. BMI did not differ between gardeners and non-gardeners. Neither frequency nor duration of gardening significantly influenced reported health outcomes. Our results highlight that regular gardening on allotment sites is associated with improved physical, psychological and social health. With the recent escalation in the prevalence of chronic diseases, and associated healthcare costs, this study has a major implication for policy, as it suggests that urban allotments have great potential for preventative healthcare.

  5. Health Benefits of Urban Allotment Gardening: Improved Physical and Psychological Well-Being and Social Integration

    Directory of Open Access Journals (Sweden)

    Masashi Soga

    2017-01-01

    Full Text Available With an ever-increasing urban population, promoting public health and well-being in towns and cities is a major challenge. Previous research has suggested that participating in allotment gardening delivers a wide range of health benefits. However, evidence from quantitative analyses is still scarce. Here, we quantify the effects, if any, of participating in allotment gardening on physical, psychological and social health. A questionnaire survey of 332 people was performed in Tokyo, Japan. We compared five self-reported health outcomes between allotment gardeners and non-gardener controls: perceived general health, subjective health complaints, body mass index (BMI, mental health and social cohesion. Accounting for socio-demographic and lifestyle variables, regression models revealed that allotment gardeners, compared to non-gardeners, reported better perceived general health, subjective health complaints, mental health and social cohesion. BMI did not differ between gardeners and non-gardeners. Neither frequency nor duration of gardening significantly influenced reported health outcomes. Our results highlight that regular gardening on allotment sites is associated with improved physical, psychological and social health. With the recent escalation in the prevalence of chronic diseases, and associated healthcare costs, this study has a major implication for policy, as it suggests that urban allotments have great potential for preventative healthcare.

  6. Health Benefits of Urban Allotment Gardening: Improved Physical and Psychological Well-Being and Social Integration

    Science.gov (United States)

    Soga, Masashi; Cox, Daniel T. C.; Yamaura, Yuichi; Gaston, Kevin J.; Kurisu, Kiyo; Hanaki, Keisuke

    2017-01-01

    With an ever-increasing urban population, promoting public health and well-being in towns and cities is a major challenge. Previous research has suggested that participating in allotment gardening delivers a wide range of health benefits. However, evidence from quantitative analyses is still scarce. Here, we quantify the effects, if any, of participating in allotment gardening on physical, psychological and social health. A questionnaire survey of 332 people was performed in Tokyo, Japan. We compared five self-reported health outcomes between allotment gardeners and non-gardener controls: perceived general health, subjective health complaints, body mass index (BMI), mental health and social cohesion. Accounting for socio-demographic and lifestyle variables, regression models revealed that allotment gardeners, compared to non-gardeners, reported better perceived general health, subjective health complaints, mental health and social cohesion. BMI did not differ between gardeners and non-gardeners. Neither frequency nor duration of gardening significantly influenced reported health outcomes. Our results highlight that regular gardening on allotment sites is associated with improved physical, psychological and social health. With the recent escalation in the prevalence of chronic diseases, and associated healthcare costs, this study has a major implication for policy, as it suggests that urban allotments have great potential for preventative healthcare. PMID:28085098

  7. Infant breathing rate counter based on variable resistor for pneumonia

    Science.gov (United States)

    Sakti, Novi Angga; Hardiyanto, Ardy Dwi; La Febry Andira R., C.; Camelya, Kesa; Widiyanti, Prihartini

    2016-03-01

    Pneumonia is one of the leading causes of death in new born baby in Indonesia. According to WHO in 2002, breathing rate is very important index to be the symptom of pneumonia. In the Community Health Center, the nurses count with a stopwatch for exactly one minute. Miscalculation in Community Health Center occurs because of long time concentration and focus on two object at once. This calculation errors can cause the baby who should be admitted to the hospital only be attended at home. Therefore, an accurate breathing rate counter at Community Health Center level is necessary. In this work, resistance change of variable resistor is made to be breathing rate counter. Resistance change in voltage divider can produce voltage change. If the variable resistance moves periodically, the voltage will change periodically too. The voltage change counted by software in the microcontroller. For the every mm shift at the variable resistor produce average 0.96 voltage change. The software can count the number of wave generated by shifting resistor.

  8. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

    Directory of Open Access Journals (Sweden)

    Kangolle Alfred CT

    2010-10-01

    Full Text Available Abstract Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1 Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2 Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3 Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1 Capacity building in oncology health services research, policy and planning relevant to developing countries. (2 Development of high-quality health data sources. (3 More oncology-related economic evaluations in developing countries. (4 Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and

  9. Coupled Ethical-Epistemic Analysis of Public Health Research and Practice: Categorizing Variables to Improve Population Health and Equity.

    Science.gov (United States)

    Katikireddi, S Vittal; Valles, Sean A

    2015-01-01

    The categorization of variables can stigmatize populations, which is ethically problematic and threatens the central purpose of public health: to improve population health and reduce health inequities. How social variables (e.g., behavioral risks for HIV) are categorized can reinforce stigma and cause unintended harms to the populations practitioners and researchers strive to serve. Although debates about the validity or ethical consequences of epidemiological variables are familiar for specific variables (e.g., ethnicity), these issues apply more widely. We argue that these tensions and debates regarding epidemiological variables should be analyzed simultaneously as ethical and epistemic challenges. We describe a framework derived from the philosophy of science that may be usefully applied to public health, and we illustrate its application.

  10. Oral breathing: new early treatment protocol

    Directory of Open Access Journals (Sweden)

    Gloria Denotti

    2014-01-01

    Full Text Available Oral breathing is a respiratory dysfunction that affects approximately 10-15% of child population. It is responsable of local effects and systemic effects, both immediate and long-term. They affect the growth of the subject and his physical health in many ways: pediatric, psycho-behavioral and cognitive. The etiology is multifactorial. It’s important the establishment of a vicious circle involving more areas and it is essential to stop it as soon as possible. In order to correct this anomaly, the pediatric dentist must be able to make a correct diagnosis to treat early the disfunction and to avoid the onset of cascade mechanisms. Who plays a central role is the pediatrician who first and frequently come into contact with little patients. He can identify the anomalies, and therefore collaborate with other specialists, including the dentist. The key aspect that guides us in the diagnosis, and allows us to identify the oral respirator, is the “adenoid facies”. The purpose of the study is to highlight the importance and benefits of an early and multidisciplinary intervention (pediatric, orthopedic-orthodontic-functional. A sample of 20 patients was selected with the following inclusion criteria: mouth breathing, transverse discrepancy > 4 mm, early mixed dentition, central and lateral permenent incisors, overjet increased, lip and nasal incompetence, snoring and/or sleep apnea episodes. The protocol of intervention includes the use of the following devices and procedures: a maxillary rapid expander (to correct the transverse discrepancy, to increase the amplitude of the upper respiratory airway and to reduce nasal resistances tract in association with myo-functional devices (nasal stimulator and oral obturator. They allow the reconstruction of a physiological balance between the perioral musculature and tongue, the acquisition of nasal and lips competence and the reduction of overjet. This protocol speeds up and stabilizes the results. The

  11. [Breath-analysis tests in gastroenetrological diagnosis].

    Science.gov (United States)

    Caspary, W F

    1975-12-01

    The introduction of a simple method for analysis of 14CO2 in breath allowed a more widely application of breath-tests in the diagnosis of gastroenterological diseases. During a breath-test a 14C-labelled compound is administered orally and 14CO2 is subsequently measured in breath by discontinuous samplings of 14CO2 by virtue of a trapping solution (hyamine hydroxide). Most helpful tests in gastroenterology are the 14C-glycyl-cholate breath test for detecting increased deconjugation of bile acids due to small intestinal bacterial overgrowth or bile acid malabsorption in ileal resection or Crohn's disease of the ileum, the 14C-lactose breath test in lactase deficiency, whereas the 14C-tripalmitin test seems less helpful in the diagnosis of fat malabsorption. A 14C-aminopyrine breath test may turn out to be a simple and valuable liver function test. Oral loading tests with breath analysis of H2 have shown to be helpful in the diagnosis of carbohydrate malabsorption, determination of intestinal transit time and intestinal gas production. Due to technical reasons (gas-chromatographie analysis) H2-breath analysis is still limited to research centers. Despite low radiation doses after oral administration of 14C-labelled compounds oral loading tests with H2- or 13C-analysis might be preferable in the future.

  12. Health and social care regulation in Wales: an integrated system of political, corporate and professional governance for improving public health.

    Science.gov (United States)

    Jewell, Tony; Wilkinson, Jane

    2008-11-01

    Wales is developing a unique integrated system of governance to improve public health, which is diverging from some recent developments in the rest of the UK but shares many common features. There is a focus on strengthening collaborative working and co-ordination between bodies inspecting, regulating and auditing health and social care. Systems are being developed that are proportionate to the level of risk, eliminate unnecessary burdens of external review and support the improvement of services for patients, service users and carers. This is consistent with the Assembly Government's aim to improve the way that public services are delivered in Wales, including strengthening input from the public in the planning, delivery and reporting of regulation and inspection work. The test in the future will be how far we can demonstrate quantitatively and qualitatively the added value from our uniquely Welsh approach, built as it is on devolution and the aspirations for small-country governance.

  13. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study

    Science.gov (United States)

    Heinzer, R; Vat, S; Marques-Vidal, P; Marti-Soler, H; Andries, D; Tobback, N; Mooser, V; Preisig, M; Malhotra, A; Waeber, G; Vollenweider, P; Tafti, M; Haba-Rubio, J

    2015-01-01

    Summary Background Sleep-disordered breathing is associated with major morbidity and mortality. However, its prevalence has mainly been selectively studied in populations at risk for sleep-disordered breathing or cardiovascular diseases. Taking into account improvements in recording techniques and new criteria used to define respiratory events, we aimed to assess the prevalence of sleep-disordered breathing and associated clinical features in a large population-based sample. Methods Between Sept 1, 2009, and June 30, 2013, we did a population-based study (HypnoLaus) in Lausanne, Switzerland. We invited a cohort of 3043 consecutive participants of the CoLaus/PsyCoLaus study to take part. Polysomnography data from 2121 people were included in the final analysis. 1024 (48%) participants were men, with a median age of 57 years (IQR 49–68, range 40–85) and mean body-mass index (BMI) of 25·6 kg/m2 (SD 4·1). Participants underwent complete polysomnographic recordings at home and had extensive phenotyping for diabetes, hypertension, metabolic syndrome, and depression. The primary outcome was prevalence of sleep-disordered breathing, assessed by the apnoea-hypopnoea index. Findings The median apnoea-hypopnoea index was 6·9 events per h (IQR 2·7–14·1) in women and 14·9 per h (7·2–27·1) in men. The prevalence of moderate-to-severe sleep-disordered breathing (≥15 events per h) was 23·4% (95% CI 20·9–26·0) in women and 49·7% (46·6–52·8) in men. After multivariable adjustment, the upper quartile for the apnoea-hypopnoea index (>20·6 events per h) was associated independently with the presence of hypertension (odds ratio 1·60, 95% CI 1·14–2·26; p=0·0292 for trend across severity quartiles), diabetes (2·00, 1·05–3·99; p=0·0467), metabolic syndrome (2·80, 1·86–4·29; p<0·0001), and depression (1·92, 1·01–3·64; p=0·0292). Interpretation The high prevalence of sleep-disordered breathing recorded in our population-based sample might

  14. Sleep disordered breathing in pregnancy

    Directory of Open Access Journals (Sweden)

    Bilgay Izci Balserak

    2015-12-01

    Sleep disordered breathing (SDB is very common during pregnancy, and is most likely explained by hormonal, physiological and physical changes. Maternal obesity, one of the major risk factors for SDB, together with physiological changes in pregnancy may predispose women to develop SDB. SDB has been associated with poor maternal and fetal outcomes. Thus, early identification, diagnosis and treatment of SDB are important in pregnancy. This article reviews the pregnancy-related changes affecting the severity of SDB, the epidemiology and the risk factors of SDB in pregnancy, the association of SDB with adverse pregnancy outcomes, and screening and management options specific for this population.

  15. Sport Mass Media Influence on Promoting Sports in Order to Improve Public Health

    Directory of Open Access Journals (Sweden)

    Majdy Ahmed Shawqi

    2012-03-01

    Full Text Available Mass media could be one of the tools used to promote a physically active lifestyle. It is a direct and potentially effective tool for reaching public with means, knowledge and information and helping them to understand the importance of a physically active lifestyle. The main purpose of the study was to discover the influence of mass media in promoting sports activities in order to improve health in Sultanate of Oman, and attempt to determine the effect of the mass media in promoting sports activities to improve health. The study sample consisted of 470 participants divide to five age groups (15-20, 21-25, 26-30, 31-35, 36-40, and over 40 years, respectively. The study used a mass mediasurvey to answer the main questions of the study. The results showed a weakness of mass media to encourage sports culture and exercise within different segments of society in order to improve health. Furthermore, it was a good signal that highlights the importance of mass media in promoting exercise in sport in order to improve health. In addition, the results of the study provide professionals in sports an adequate informationas to what mass media should be done to promote sports in order to improve health of the people of Oman. It recommend that mass media should embrace national projects to promote and encourage sport for health.

  16. Improving Hospital Efficiency Through Data-Driven Management: A Case Study of Health First, Florida.

    Science.gov (United States)

    Blanchard, Janice C; Rudin, Robert S

    2016-05-09

    This article presents a case study of how one health system-Health First, in Brevard County, Florida-addressed resource challenges by using Lean thinking enabled by information technology. Examining Health First provides an opportunity to learn about how one hospital system addressed these challenges by making fundamental changes in their operations, in advance of the shift toward accountable care. Three years after Health First embarked on an effort to streamline patient flow and improve throughput, adult transfers within the system have increased by more than 300 percent and emergency department times between admission and inpatient bed occupancy decreased by 37 percent.

  17. A novel educational programme to improve knowledge regarding health care-associated infection and hand hygiene.

    Science.gov (United States)

    Fitzpatrick, Maureen; Everett-Thomas, Ruth; Nevo, Igal; Shekhter, Ilya; Rosen, Lisa F; Scheinman, Stephen R; Arheart, Kristopher L; Birnbach, David J

    2011-06-01

    Lack of hand hygiene by health-care workers is the most significant cause of health care-associated infection. This programme was designed to make health-care workers want to wash their hands, to change their knowledge regarding hand hygiene and health care-associated infection, and influence practice. Improvement between pre- and post-test scores was statistically significant. Compliance is a multifactorial problem that involves knowledge and behaviour. Educational awareness and frequent reminders are critical to maintain high rates of hand hygiene compliance.

  18. Surgical correction of pectus carinatum improves perceived body image, mental health and self-esteem

    DEFF Research Database (Denmark)

    Knudsen, Marie Veje; Grosen, Kasper; Pilegaard, Hans K.

    2014-01-01

    PURPOSE: The purpose of this study was to assess the effects of surgical correction of pectus carinatum on health- related quality of life and self-esteem. METHODS: Between May 2012 and May 2013, a prospective observational single-center cohort study was conduct- ed on consecutive patients...... undergoing surgical correction of pectus carinatum at our institution. Patients filled in questionnaires on health-related quality of life and self-esteem before and six months after surgery. RESULTS: Disease-specific health-related quality of life was improved by 33% (95% CI: 23; 44%) according to responses...... to the Nuss Questionnaire modified for Adults. The improvement for generic mental health-related quality of life was 7% (95% CI: 3; 12%) in responses to the Short Form-36 Questionnaire. The improvement in self-esteem was 9% (95% CI: 2; 17%) as assessed with the Rosenberg Self-Esteem Scale. A Single Step...

  19. IMPROVEMENT OF SYSTEM OF MATERIAL STIMULATION AND MATERIAL ENCOURAGEMENT OF WORK OF HEALTH WORKERS

    Directory of Open Access Journals (Sweden)

    Elena Vladimirovna Deryabina

    2015-12-01

    Full Text Available In article are considered possibilities of a solution of the problem of quality of medical services by improvement of system of material stimulation and encouragement of health workers. Are developed the methodical recommendations about material stimulation and encouragement of work of medical personnel directed on increase of individual and collective productivity, improvement of quality of medical services.

  20. Generic project definitions for improvement of health care delivery: A case-base approach

    NARCIS (Netherlands)

    Niemeijer, G.C.; Does, R.J.M.M.; de Mast, J.; Trip, A.; van den Heuvel, J.

    2011-01-01

    Background: The purpose of this article is to create actionable knowledge, making the definition of process improvement projects in health care delivery more effective. Methods: This study is a retrospective analysis of process improvement projects in hospitals, facilitating a case-based reasoning a

  1. Health benefits from improved outdoor air quality and intervention in China.

    Science.gov (United States)

    Li, Shanshan; Williams, Gail; Guo, Yuming

    2016-07-01

    China is at its most critical stage of outdoor air quality management. In order to prevent further deterioration of air quality and to protect human health, the Chinese government has made a series of attempts to reduce ambient air pollution. Unlike previous literature reviews on the widespread hazards of air pollution on health, this review article firstly summarized the existing evidence of human health benefits from intermittently improved outdoor air quality and intervention in China. Contents of this paper provide concrete and direct clue that improvement in outdoor air quality generates various health benefits in China, and confirm from a new perspective that it is worthwhile for China to shift its development strategy from economic growth to environmental economic sustainability. Greater emphasis on sustainable environment design, consistently strict regulatory enforcement, and specific monitoring actions should be regarded in China to decrease the health risks and to avoid long-term environmental threats.

  2. Nutrition training improves health workers’ nutrition knowledge and competence to manage child undernutrition: a systematic review

    Directory of Open Access Journals (Sweden)

    Bruno F Sunguya

    2013-09-01

    Full Text Available Background: Medical and nursing education lack adequate practical nutrition training to fit the clinical reality that health workers face in their practices. Such a deficit creates health workers with poor nutrition knowledge and child undernutrition management practices. In-service nutrition training can help to fill this gap. However, no systematic review has examined its collective effectiveness. We thus conducted this study to examine the effectiveness of in-service nutrition training on health workers’ nutrition knowledge, counseling skills, and child undernutrition management practices. Methods: We conducted a literature search on nutrition interventions from PubMed/MEDLINE, CINAHL, EMBASE, ISI Web of Knowledge, and WHO regional databases. The outcome variables were nutrition knowledge, nutrition counseling skills, and undernutrition management practices of health workers. Due to heterogeneity, we conducted only descriptive analyses. Results: Out of 3910 retrieved articles, 25 were selected as eligible for the final analysis. A total of 18 studies evaluated health workers’ nutrition knowledge and showed improvement after training. A total of 12 studies with nutrition counseling as the outcome variable also showed improvement among the trained health workers. Sixteen studies evaluated health workers’ child undernutrition management practices. In all such studies, child undernutrition management practices and competence of health workers improved after the nutrition training intervention.Conclusion: In-service nutrition training improves quality of health workers by rendering them more knowledge and competence to manage nutrition-related conditions, especially child undernutrition. In-service nutrition training interventions can help to fill the gap created by the lack of adequate nutrition training in the existing medical and nursing education system. In this way, steps can be taken towards improving the overall nutritional status of

  3. Policy directions in urban health in developing countries--the slum improvement approach.

    Science.gov (United States)

    Harpham, T; Stephens, C

    1992-07-01

    The urban development, or housing, sector has a longer experience of addressing the problems of the urban poor in developing countries than the health sector. In recent years the policy of 'slum improvement', which involves both sectors, has attracted the support of international donors. This article documents the development of the slum improvement approach and addresses key issues of the approach which have implications for health planning: covering the poorest dwellers; relocation; land tenure; gentrification; debt burdens and the impact on women. Questions about the approach which still need answering are defined and a summary of the constraints in slum improvement and potential solutions is presented.

  4. Improving on-time performance in health care organizations: a case study.

    Science.gov (United States)

    Lapierre, S D; Batson, C; McCaskey, S

    1999-01-01

    In this paper, we propose a strategy to build a measurement system that helps improve on-time performance in health care organizations. We analyze the measurement system for monitoring the performance of daily start times of first surgeries in a U.S. hospital. Although surgeons appear to be the main cause of delay, efforts to improve their on-time performance alone are not sufficient to improve on-time performance for first surgeries. Therefore, working on the main source of delay to improve performance, as the Pareto principle suggests, does not always work in the health care context. Rather, we found that ameliorating the hospital's overall on-time performance achieves the desired result of improving surgeons' performance through a snowball effect (a self-reinforcing effect) and, consequently, the on-time performance for first surgeries also improves.

  5. Decreasing health disparities for people with disabilities through improved communication strategies and awareness.

    Science.gov (United States)

    Sharby, Nancy; Martire, Katharine; Iversen, Maura D

    2015-03-19

    Factors influencing access to health care among people with disabilities (PWD) include: attitudes of health care providers and the public, physical barriers, miscommunication, income level, ethnic/minority status, insurance coverage, and lack of information tailored to PWD. Reducing health care disparities in a population with complex needs requires implementation at the primary, secondary and tertiary levels. This review article discusses common barriers to health care access from the patient and provider perspective, particularly focusing on communication barriers and how to address and ameliorate them. Articles utilized in this review were published from 2005 to present in MEDLINE and CINAHL and written in English that focused on people with disabilities. Topics searched for in the literature include: disparities and health outcomes, health care dissatisfaction, patient-provider communication and access issues. Ineffective communication has significant impacts for PWD. They frequently believe that providers are not interested in, or sensitive to their particular needs and are less likely to seek care or to follow up with recommendations. Various strategies for successful improvement of health outcomes for PWD were identified including changing the way health care professionals are educated regarding disabilities, improving access to health care services, and enhancing the capacity for patient centered care.

  6. Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting.

    Science.gov (United States)

    Hodgkinson, Stacy; Godoy, Leandra; Beers, Lee Savio; Lewin, Amy

    2017-01-01

    Poverty is a common experience for many children and families in the United States. Children low-income household has been linked to poor health and increased risk for mental health problems in both children and adults that can persist across the life span. Despite their high need for mental health services, children and families living in poverty are least likely to be connected with high-quality mental health care. Pediatric primary care providers are in a unique position to take a leading role in addressing disparities in access to mental health care, because many low-income families come to them first to address mental health concerns. In this report, we discuss the impact of poverty on mental health, barriers to care, and integrated behavioral health care models that show promise in improving access and outcomes for children and families residing in the contexts of poverty. We also offer practice recommendations, relevant to providers in the primary care setting, that can help improve access to mental health care in this population.

  7. Improving the Health of Our Nation (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2014-11-06

    While life expectancy in the U.S. has reached an all-time high, certain behaviors continue to compromise our health. This podcast discusses how to live longer, healthier lives.  Created: 11/6/2014 by MMWR.   Date Released: 11/6/2014.

  8. Improving the Health of Our Nation (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2014-11-06

    Life expectancy in the U.S. has reached an all-time high, thanks to advances in medical treatments and prevention strategies. However, certain behaviors continue to compromise our health. In this podcast, Dr. Kathleen Ethier discusses ways to live a longer, healthier life.  Created: 11/6/2014 by MMWR.   Date Released: 11/6/2014.

  9. Outreach services to improve access to health care in South Africa: lessons from three community health worker programmes

    Directory of Open Access Journals (Sweden)

    Nonhlanhla Nxumalo

    2013-01-01

    Full Text Available Introduction: In South Africa, there are renewed efforts to strengthen primary health care and community health worker (CHW programmes. This article examines three South African CHW programmes, a small local non-governmental organisation (NGO, a local satellite of a national NGO, and a government-initiated service, that provide a range of services from home-based care, childcare, and health promotion to assist clients in overcoming poverty-related barriers to health care. Methods: The comparative case studies, located in Eastern Cape and Gauteng, were investigated using qualitative methods. Thematic analysis was used to identify factors that constrain and enable outreach services to improve access to care. Results: The local satellite (of a national NGO, successful in addressing multi-dimensional barriers to care, provided CHWs with continuous training focused on the social determinants of ill-health, regular context-related supervision, and resources such as travel and cell-phone allowances. These workers engaged with, and linked their clients to, agencies in a wide range of sectors. Relationships with participatory structures at community level stimulated coordinated responses from service providers. In contrast, an absence of these elements curtailed the ability of CHWs in the small NGO and government-initiated service to provide effective outreach services or to improve access to care. Conclusion: Significant investment in resources, training, and support can enable CHWs to address barriers to care by negotiating with poorly functioning government services and community participation structures.

  10. Tunable fiber laser based photoacoustic spectrometer for breath ammonia analysis during hemodialysis

    Science.gov (United States)

    Wang, J. W.; Xie, H.; Liang, L. R.; Zhang, W.; Peng, W.; Yu, Q. X.

    2011-11-01

    A photoacoustic (PA) spectrometer based on a near-IR tunable fiber laser is developed and used for breath ammonia analysis. We successfully measured the breath ammonia level variation of six patients with end-stage renal disease while they were undergoing hemodialysis in the hospital. The measurement results showed that the initial concentration level of the breath ammonia were from 1600 to 2200 ppb before dialysis treatment, the levels decreased to 200-600 ppb in the end stage of dialysis, which close to the levels of healthy persons. Further improvement and applications of this PA spectrometer are discussed.

  11. Observations Illustrating the Use of Health Informatics to Link Public Health Immunization Registries and Pharmacies to Increase Adult Immunization Rates and Improve Population Health Outcomes.

    Science.gov (United States)

    Popovich, Michael; Altstadter, Brandy; Popovich, Lara Hargraves

    2016-01-01

    The Health Information Technology for Economic and Clinical Health (HITECH) Act encourages health information exchange between clinical care and public health through Meaningful Use measures. Meaningful Use specifically identifies objectives to support a number of public health programs including immunizations, cancer registries, syndromic surveillance, and disease case reports. The objective is to improve public and population health. Stage 2 of Meaningful Use focused on compliance to sending of information to public health. The next phase focuses on bi-directional information exchange to support immunization intelligence and to empower providers, pharmacists, and the consumer. The HITECH Act Stage 2 initiative provided incentive and motivation for healthcare providers to encourage their Electronic Medical Record (EMR) vendors to implement data exchanges with public health, with the expected result being timely awareness of health risks. The empowerment nugget in the HITECH Act is not in the compliance reporting to public health. The nugget is the ability for a provider to receive relevant information on the patient or consumer currently in front of them or to those they will connect to through their outreach efforts. The ability for public health to retain current immunization records of individuals from a variety of providers supports their program goals to increase immunization rates and mitigate the risk of vaccine-preventable disease (VPD). The ability for providers to receive at the point of service more complete immunization histories integrated with decision support enhances their delivery of care, thereby reducing the risk of VPD to their patients. Indirectly payers benefit through healthcare cost savings and when the focus is expanded from a health model to a business model, there are significant return on investment (ROI) opportunities that exponentially increase the value of a bi-directional immunization data exchange. This paper will provide

  12. Mental Health in Sport (MHS): Improving the Early Intervention Knowledge and Confidence of Elite Sport Staff.

    Science.gov (United States)

    Sebbens, Joshua; Hassmén, Peter; Crisp, Dimity; Wensley, Kate

    2016-01-01

    Mental illnesses are as prevalent among elite athletes as in the general population. Despite this, there is little research examining how to enhance mental health literacy or helping behaviors in elite sport environments. A Mental Health in Sport (MHS) workshop was therefore developed and its effects on mental health literacy and confidence studied in 166 coaches and support staff working with elite athletes and teams in Australia. Results indicated that participants increased their knowledge of the signs and symptoms of common mental illnesses and were more confident in helping someone who may be experiencing a mental health problem. We conclude that even a very brief intervention can be effective in improving the mental health literacy and confidence of key persons in elite sport environments, and may promote early intervention and timely referral of elite athletes with mental health concerns to appropriate professionals.

  13. Opportunities and challenges of cloud computing to improve health care services.

    Science.gov (United States)

    Kuo, Alex Mu-Hsing

    2011-09-21

    Cloud computing is a new way of delivering computing resources and services. Many managers and experts believe that it can improve health care services, benefit health care research, and change the face of health information technology. However, as with any innovation, cloud computing should be rigorously evaluated before its widespread adoption. This paper discusses the concept and its current place in health care, and uses 4 aspects (management, technology, security, and legal) to evaluate the opportunities and challenges of this computing model. Strategic planning that could be used by a health organization to determine its direction, strategy, and resource allocation when it has decided to migrate from traditional to cloud-based health services is also discussed.

  14. Mobile health applications: the patchwork of legal and liability issues suggests strategies to improve oversight.

    Science.gov (United States)

    Yang, Y Tony; Silverman, Ross D

    2014-02-01

    Mobile health (mHealth) technology has facilitated the transition of care beyond the traditional hospital setting to the homes of patients. Yet few studies have evaluated the legal implications of the expansion of mHealth applications, or "apps." Such apps are affected by a patchwork of policies related to medical licensure, privacy and security protection, and malpractice liability. For example, the privacy protections of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 may apply to only some uses of the apps. Similarly, it is not clear what a doctor's malpractice liability would be if he or she injured a patient as the result of inaccurate information supplied by the patient's self-monitoring health app. This article examines the legal issues related to the oversight of health apps, discusses current federal regulations, and suggests strategies to improve the oversight of these apps.

  15. Protective supplied breathing air garment

    Science.gov (United States)

    Childers, Edward L.; von Hortenau, Erik F.

    1984-07-10

    A breathing air garment for isolating a wearer from hostile environments containing toxins or irritants includes a suit and a separate head protective enclosure or hood engaging a suit collar in sealing attachment. The hood and suit collar are cylindrically shaped and dimensioned to enable the wearer to withdraw his hands from the suit sleeves to perform manual tasks within the hood interior. Breathing air is supplied from an external air line with an air delivery hose attached to the hood interior. The hose feeds air into an annular halo-like fiber-filled plenum having spaced discharge orifices attached to the hood top wall. A plurality of air exhaust/check valves located at the suit extremities cooperate with the hood air delivery system to provide a cooling flow of circulating air from the hood throughout the suit interior. A suit entry seal provided on the suit rear torso panel permits access into the suit and is sealed with an adhesive sealing flap.

  16. Aligning health information technologies with effective service delivery models to improve chronic disease care

    Science.gov (United States)

    Bauer, Amy M.; Thielke, Stephen M.; Katon, Wayne; Unützer, Jürgen; Areán, Patricia

    2014-01-01

    Objective Healthcare reforms in the United States, including the Affordable Care and HITECH Acts, and the NCQA criteria for the Patient Centered Medical Home have promoted health information technology (HIT) and the integration of general medical and mental health services. These developments, which aim to improve chronic disease care have largely occurred in parallel, with little attention to the need for coordination. In this article, the fundamental connections between HIT and improvements in chronic disease management are explored. We use the evidence-based collaborative care model as an example, with attention to health literacy improvement for supporting patient engagement in care. Method A review of the literature was conducted to identify how HIT and collaborative care, an evidence-based model of chronic disease care, support each other. Results Five key principles of effective collaborative care are outlined: care is patient-centered, evidence-based, measurement-based, population-based, and accountable. The potential role of HIT in implementing each principle is discussed. Key features of the mobile health paradigm are described, including how they can extend evidence-based treatment beyond traditional clinical settings. Conclusion HIT, and particularly mobile health, can enhance collaborative care interventions, and thus improve the health of individuals and populations when deployed in integrated delivery systems. PMID:24963895

  17. Point-of-Care Diagnostics for Improving Maternal Health in South Africa.

    Science.gov (United States)

    Mashamba-Thompson, Tivani P; Sartorius, Benn; Drain, Paul K

    2016-08-31

    Improving maternal health is a global priority, particularly in high HIV-endemic, resource-limited settings. Failure to use health care facilities due to poor access is one of the main causes of maternal deaths in South Africa. "Point-of-care" (POC) diagnostics are an innovative healthcare approach to improve healthcare access and health outcomes in remote and resource-limited settings. In this review, POC testing is defined as a diagnostic test that is carried out near patients and leads to rapid clinical decisions. We review the current and emerging POC diagnostics for maternal health, with a specific focus on the World Health Organization (WHO) quality-ASSURED (Affordability, Sensitivity, Specificity, User friendly, Rapid and robust, Equipment free and Delivered) criteria for an ideal point-of-care test in resource-limited settings. The performance of POC diagnostics, barriers and challenges related to implementing POC diagnostics for maternal health in rural and resource-limited settings are reviewed. Innovative strategies for overcoming these barriers are recommended to achieve substantial progress on improving maternal health outcomes in these settings.

  18. Effectiveness of motivational interviewing at improving oral health: a systematic review

    Science.gov (United States)

    Cascaes, Andreia Morales; Bielemann, Renata Moraes; Clark, Valerie Lyn; Barros, Aluísio J D

    2014-01-01

    OBJECTIVE To analyze the effectiveness of motivational interviewing (MI) at improving oral health behaviors (oral hygiene habits, sugar consumption, dental services utilization or use of fluoride) and dental clinical outcomes (dental plaque, dental caries and periodontal status). METHODS A systematic search of PubMed, LILACS, SciELO, PsyINFO, Cochrane and Google Scholar bibliographic databases was conducted looking for intervention studies that investigated MI as the main approach to improving the oral health outcomes investigated. RESULTS Of the 78 articles found, ten met the inclusion criteria, all based on randomized controlled trials. Most studies (n = 8) assessed multiple outcomes. Five interventions assessed the impact of MI on oral health behaviors and nine on clinical outcomes (three on dental caries, six on dental plaque, four on gingivitis and three on periodontal pockets). Better quality of evidence was provided by studies that investigated dental caries, which also had the largest population samples. The evidence of the effect of MI on improving oral health outcomes is conflicting. Four studies reported positive effects of MI on oral health outcomes whereas another four showed null effect. In two interventions, the actual difference between groups was not reported or able to be recalculated. CONCLUSIONS We found inconclusive effectiveness for most oral health outcomes. We need more and better designed and reported interventions to fully assess the impact of MI on oral health and understand the appropriate dosage for the counseling interventions. PMID:24789647

  19. Integrating community outreach into a quality improvement project to promote maternal and child health in Ghana.

    Science.gov (United States)

    Cofie, Leslie E; Barrington, Clare; Akaligaung, Akalpa; Reid, Amy; Fried, Bruce; Singh, Kavita; Sodzi-Tettey, Sodzi; Barker, Pierre M

    2014-01-01

    Quality improvement (QI) is used to promote and strengthen maternal and child health services in middle- and low-income countries. Very little research has examined community-level factors beyond the confines of health facilities that create demand for health services and influence health outcomes. We examined the role of community outreach in the context of Project Fives Alive!, a QI project aimed at improving maternal and under-5 outcomes in Ghana. Qualitative case studies of QI teams across six regions of Ghana were conducted. We analysed the data using narrative and thematic techniques. QI team members used two distinct outreach approaches: community-level outreach, including health promotion and education efforts through group activities and mass media communication; and direct outreach, including one-on-one interpersonal activities between health workers, pregnant women and mothers of children under-5. Specific barriers to community outreach included structural, cultural, and QI team-level factors. QI efforts in both rural and urban settings should consider including context-specific community outreach activities to develop ties with communities and address barriers to health services. Sustaining community outreach as part of QI efforts will require improving infrastructure, strengthening QI teams, and ongoing collaboration with community members.

  20. Effectiveness of motivational interviewing at improving oral health: a systematic review

    Directory of Open Access Journals (Sweden)

    Andreia Morales Cascaes

    2014-02-01

    Full Text Available OBJECTIVE : To analyze the effectiveness of motivational interviewing (MI at improving oral health behaviors (oral hygiene habits, sugar consumption, dental services utilization or use of fluoride and dental clinical outcomes (dental plaque, dental caries and periodontal status. METHODS : A systematic search of PubMed, LILACS, SciELO, PsyINFO, Cochrane and Google Scholar bibliographic databases was conducted looking for intervention studies that investigated MI as the main approach to improving the oral health outcomes investigated. RESULTS : Of the 78 articles found, ten met the inclusion criteria, all based on randomized controlled trials. Most studies (n = 8 assessed multiple outcomes. Five interventions assessed the impact of MI on oral health behaviors and nine on clinical outcomes (three on dental caries, six on dental plaque, four on gingivitis and three on periodontal pockets. Better quality of evidence was provided by studies that investigated dental caries, which also had the largest population samples. The evidence of the effect of MI on improving oral health outcomes is conflicting. Four studies reported positive effects of MI on oral health outcomes whereas another four showed null effect. In two interventions, the actual difference between groups was not reported or able to be recalculated. CONCLUSIONS : We found inconclusive effectiveness for most oral health outcomes. We need more and better designed and reported interventions to fully assess the impact of MI on oral health and understand the appropriate dosage for the counseling interventions.

  1. National Institute of Environmental Health Sciences: 50 Years of Advancing Science and Improving Lung Health.

    Science.gov (United States)

    Antony, Veena B; Redlich, Carrie A; Pinkerton, Kent E; Balmes, John; Harkema, Jack R

    2016-11-15

    The American Thoracic Society celebrates the 50th anniversary of the National Institute of Environmental Health Sciences (NIEHS). The NIEHS has had enormous impact through its focus on research, training, and translational science on lung health. It has been an advocate for clean air both in the United States and across the world. The cutting-edge science funded by the NIEHS has led to major discoveries that have broadened our understanding of the pathogenesis and treatment for lung disease. Importantly, the NIEHS has developed and fostered mechanisms that require cross-cutting science across the spectrum of areas of inquiry, bringing together environmental and social scientists with clinicians to bring their expertise on specific areas of investigation. The intramural program of the NIEHS nurtures cutting-edge science, and the extramural program encourages investigator-initiated research while at the same time providing broader direction through important initiatives. Under the umbrella of the NIEHS and guided by Dr. Linda Birnbaum, the director of the NIEHS, important collaborative programs, such as the Superfund Program and the National Toxicology Program, work to discover mechanisms to protect from environmental toxins. The American Thoracic Society has overlapping goals with the NIEHS, and the strategic plans of both august bodies converge to synergize on population lung health. These bonds must be tightened and highlighted as we work toward our common goals.

  2. Improving access to electronic health records for people with intellectual disability: a qualitative study.

    Science.gov (United States)

    van Dooren, Kate; Lennox, Nick; Stewart, Madeline

    2013-01-01

    People with intellectual disability represent ~2-3% of the Australian population and experience elevated rates of mortality and morbidity compared with the general population. People with intellectual disability, and their families and carers, must keep track of extensive medical information while also managing turnover of paid staff, general practitioners and other health professionals, making them beneficiaries of Australia's new eHealth record system. Although they are key users, there is a lack of knowledge about the accessibility of the system for individuals with intellectual disability, or those responsible for managing their health information. This is a missed opportunity to improve the lives of an already overlooked group. This study aimed to identify the facilitators and barriers to registering for an eHealth record network for people with intellectual disability and those supporting them to manage their health information. We interviewed potential users of eHealth records, including four people with intellectual disability, three family members and two residential support workers. Our findings suggest that decision-makers involved in the roll-out of the eHealth record networks should incorporate 'reasonable accommodations' to improve accessibility for people with intellectual disability and those who support them to manage their health information. This includes identifying and eliminating the barriers to accessibility of eHealth records and taking appropriate measures to promote access to individuals with intellectual disability. People with intellectual disability and the people who support them are a diverse group with a range of abilities. The translation of their views into practice will help to improve the eHealth system for this and other vulnerable population groups.

  3. The assessment of the breath hold and the free breath methods about the blood flow evaluation by using phase contrast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Ho [Dept. of Radiology, Konkuk Medical center, Seoul (Korea, Republic of)

    2016-06-15

    Measurement of cardiac blood flow using the magnetic resonance imaging has been limited due to breathing and involuntary movements of the heart. The present study attempted to improve the accuracy of cardiac blood flow testing through phase contrast magnetic resonance imaging by presenting the adequate breathing method and imaging variables by comparing the measurement values of cardiac blood flow. Each was evaluated by comparing the breath hold retrospective 1NEX and non breath hold retrospective 1-3NEX in the ascending aorta and descending aorta. As a result, the average blood flow amount/ velocity of the breath hold retrosepctive 1NEX method in the ascending aorta were 96.17±19.12 ml/sec, 17.04±4.12 cm/sec respectively, which demonstrates a statistically significant difference(p<0.05) with the non-breath hold retrospective method 1NEX of 72.31±13.27 ml and 12.32±3.85. On the other hand, the average 2NEX blood flow and mean flow velocity is 101.90±24.09, 16.84±4.32, 3NEX 103.06±25.49, 16.88±4.19 did not show statistically significant differences(p>0.05).The average blood flow amount/ velocity of the breath hold retrospective 1NEX method in the descending aorta were 76.68±19.72 ml/s, and 22.23±4.8, which did not demonstrate a significant difference in comparison to non-breath hold retrospective method 1-3 NEX. Therefore, the non breath hold retrospective method does not significantly differ in terms of cardiac blood flow in comparison with the breath hold retrospective method in accordance with the increase of NEX, so pediatric patients or patients who are not able to breathe well must have the diagnostic value of their cardiac blood flow tests improved.

  4. Improving health care quality and safety: the role of collective learning

    Directory of Open Access Journals (Sweden)

    Singer SJ

    2015-11-01

    Full Text Available Sara J Singer,1–4 Justin K Benzer,4–6 Sami U Hamdan4,6 1Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA; 2Department of Medicine, Harvard Medical School, Boston, MA, USA; 3Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA; 4Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA; 5VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA; 6Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, USA Abstract: Despite decades of effort to improve quality and safety in health care, this goal feels increasingly elusive. Successful examples of improvement are infrequently replicated. This scoping review synthesizes 76 empirical or conceptual studies (out of 1208 originally screened addressing learning in quality or safety improvement, that were published in selected health care and management journals between January 2000 and December 2014 to deepen understanding of the role that collective learning plays in quality and safety improvement. We categorize learning activities using a theoretical model that shows how leadership and environmental factors support collective learning processes and practices, and in turn team and organizational improvement outcomes. By focusing on quality and safety improvement, our review elaborates the premise of learning theory that leadership, environment, and processes combine to create conditions that promote learning. Specifically, we found that learning for quality and safety improvement includes experimentation (including deliberate experimentation, improvisation, learning from failures, exploration, and exploitation, internal and external knowledge acquisition, performance monitoring and comparison, and training. Supportive learning environments are characterized by team characteristics like psychological

  5. 42 CFR 84.141 - Breathing gas; minimum requirements.

    Science.gov (United States)

    2010-10-01

    ... Respirators § 84.141 Breathing gas; minimum requirements. (a) Breathing gas used to supply supplied-air respirators shall be respirable breathing air and contain no less than 19.5 volume-percent of oxygen....

  6. Taxing soft drinks in the Pacific: implementation lessons for improving health.

    Science.gov (United States)

    Thow, Anne Marie; Quested, Christine; Juventin, Lisa; Kun, Russ; Khan, A Nisha; Swinburn, Boyd

    2011-03-01

    A tax on soft drinks is often proposed as a health promotion strategy for reducing their consumption and improving health outcomes. However, little is known about the processes and politics of implementing such taxes. We analysed four different soft drink taxes in Pacific countries and documented the lessons learnt regarding the process of policy agenda-setting and implementation. While local social and political context is critically important in determining policy uptake, these case studies suggest strategies for health promotion practitioners that can help to improve policy uptake and implementation. The case studies reveal interaction between the Ministries of Health, Finance and Revenue at every stage of the policy making process. In regard to agenda-setting, relevance to government fiscal priorities was important in gaining support for soft drink taxes. The active involvement of health policy makers was also important in initiating the policies, and the use of existing taxation mechanisms enabled successful policy implementation. While the earmarking of taxes for health has been widely recommended, the revenue may be redirected as government priorities change. Health promotion practitioners must strategically plan for agenda-setting, development and implementation of intersectoral health-promoting policies by engaging with stakeholders in finance at an early stage to identify priorities and synergies, developing cross-sectoral advocacy coalitions, and basing proposals on existing legislative mechanisms where possible.

  7. How Does a Hopping Kangaroo Breathe?

    Science.gov (United States)

    Giuliodori, Mauricio J.; Lujan, Heidi L.; Janbaih, Hussein; DiCarlo, Stephen E.

    2010-01-01

    We developed a model to demonstrate how a hopping kangaroo breathes. Interestingly, a kangaroo uses less energy to breathe while hopping than while standing still. This occurs, in part, because rather than using muscle power to move air into and out of the lungs, air is pulled into (inspiration) and pushed out of (expiration) the lungs as the…

  8. Relationships between hippocampal activity and breathing patterns

    DEFF Research Database (Denmark)

    Harper, R M; Poe, G R; Rector, D M;

    1998-01-01

    Single cell discharge, EEG activity, and optical changes accompanying alterations in breathing patterns, as well as the knowledge that respiratory musculature is heavily involved in movement and other behavioral acts, implicate hippocampal regions in some aspects of breathing control. The control...

  9. End-stage renal disease: a proving ground for quality improvement in health care.

    Science.gov (United States)

    Rutherford, W E; Gibney, R

    1997-05-01

    This article chronicles the health care quality improvement efforts that relate to patients with end stage renal disease (ESRD). The emphasis is on quality improvement as a management system as opposed to the quality improvements that resulted from strictly technical dialysis-related issues. The government has exercised considerable oversight on the ESRD program because of its growth and cost. History has shown that quality assurance (QA) has had little effect on improving quality or decreasing cost. The philosophy, methods, and tools of continuous quality improvement (CQI) have been shown to work in health care. CQI is a management system that offers hope for higher quality affordable health care. Computer technology is at last sophisticated enough to permit the collection of large amounts of clinical data at the point of care. This will permit CQI methods and tools to be applied generally at reasonable costs. Physicians in general and nephrologists in particular are beginning to understand the managed care environment. They are beginning to understand the paradigm shift that is required to effect the changes necessary for physicians to assume their leadership role in health care. This article reviews the quality efforts of the past and present. It discusses the strengths and weaknesses of efforts to improve quality and lastly presents a vision for the future.

  10. Global policy for improvement of oral health in the 21st century--implications to oral health research of World Health Assembly 2007, World Health Organization

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2009-01-01

    or adjustment of oral health programmes at national level. Clinical and public health research has shown that a number of individual, professional and community preventive measures are effective in preventing most oral diseases. However, advances in oral health science have not yet benefited the poor...... and disadvantaged populations worldwide. The major challenges of the future will be to translate knowledge and experiences in oral disease prevention and health promotion into action programmes. The WHO Global Oral Health Programme invites the international oral health research community to engage further......The World Health Organization (WHO) Global Oral Health Programme has worked hard over the past 5 years to increase the awareness of oral health worldwide as oral health is important component of general health and quality of life. Meanwhile, oral disease is still a major public health problem...

  11. [Leadership and vision in the improvement of universal health care coverage in low-income countries].

    Science.gov (United States)

    Meda, Ziemlé Clément; Konate, Lassina; Ouedraogo, Hyacinthe; Sanou, Moussa; Hercot, David; Sombie, Issiaka

    2011-01-01

    In Burkina Faso, as in most developing countries, the operational level of the health system is made up of Health Districts (HDs), the activities of which are typically coordinated by the District Team (DT). Assessing the the core functions of DTs, as described by WHO, shows two important weaknesses. Firstly, instructions from "above" are often implemented rather passively: DTs tend not to display much leadership. Secondly, the current organisation, based on input financing and centralised planning, does not sufficiently promote either the vision or research functions of DTs. In this article, we report our experience in the Orodora HD in Burkina Faso, where the DT's leadership and vision proved to be essential ingredients for effective health action in the district. Our description of six interventions implemented between 2004 and 2008 shows how DT leadership and vision have improved outputs at the HD level. Until 2004, the district applied static health planning. The health system was insufficiently financed and performed poorly. Faced with this situation, the DT decided to set up several priority interventions based on health care access criteria and patient concerns, while respecting and contextualizing national norms and objectives. Six interventions were then implemented. The first was ensure that quality blood (meeting transfusion security norms) was available at the District Hospital (DH), by picking blood up from the regional blood transfusion center weekly. This speeded up care at the DH, reduced the number of cases referred to the regional hospital for transfusion, and reduced neonatal and maternal mortality. The second intervention sought to improve the skills of health workers in managing emergency cases and to improve relationships with the referral hospital through the reintroduction of counter-referral procedures. This led to a decrease in unnecessary referrals and also reduced the mortality rates of serious cases. The third intervention, by

  12. Pulse pressure variation to predict fluid responsiveness in spontaneously breathing patients: tidal vs. forced inspiratory breathing.

    Science.gov (United States)

    Hong, D M; Lee, J M; Seo, J H; Min, J J; Jeon, Y; Bahk, J H

    2014-07-01

    We evaluated whether pulse pressure variation can predict fluid responsiveness in spontaneously breathing patients. Fifty-nine elective thoracic surgical patients were studied before induction of general anaesthesia. After volume expansion with hydroxyethyl starch 6 ml.kg(-1) , patients were defined as responders by a ≥ 15% increase in the cardiac index. Haemodynamic variables were measured before and after volume expansion and pulse pressure variations were calculated during tidal breathing and during forced inspiratory breathing. Median (IQR [range]) pulse pressure variation during forced inspiratory breathing was significantly higher in responders (n = 29) than in non-responders (n = 30) before volume expansion (18.2 (IQR 14.7-18.2 [9.3-31.3])% vs. 10.1 (IQR 8.3-12.6 [4.8-21.1])%, respectively, p breathing could predict fluid responsiveness (area under the curve 0.910, p breathing can be used to guide fluid management in spontaneously breathing patients.

  13. Discriminating between Nasal and Mouth Breathing

    CERN Document Server

    Curran, Kevin; Coyle, Damian

    2010-01-01

    The recommendation to change breathing patterns from the mouth to the nose can have a significantly positive impact upon the general well being of the individual. We classify nasal and mouth breathing by using an acoustic sensor and intelligent signal processing techniques. The overall purpose is to investigate the possibility of identifying the differences in patterns between nasal and mouth breathing in order to integrate this information into a decision support system which will form the basis of a patient monitoring and motivational feedback system to recommend the change from mouth to nasal breathing. Our findings show that the breath pattern can be discriminated in certain places of the body both by visual spectrum analysis and with a Back Propagation neural network classifier. The sound file recoded from the sensor placed on the hollow in the neck shows the most promising accuracy which is as high as 90%.

  14. Abortion--the breath of life.

    Science.gov (United States)

    Joling, R J

    1974-01-01

    A scholarly review of medical-legal and biblical authority on the su bject of abortion supports abortion as a woman's right when it is performed before the fetus has had its "breath of life." Based on biblical evidence, a person becomes a living being when the soul, the "breath of life" is breathed into it. Without the "breath of life" no person exists. A fetus less than 28 weeks old is incapable of breathing alone; thus an aborted fetus that age is not truly a living human being capable of surviving independently of its mother's womb. Legal aspects include supreme, local and state court decisions defining abortion. It is ultimately expected that each person will determine what approach to take towards the abortion question. Abortion is still a personal problem regardless of supreme court decisions or ecclesiastical determinants. Religion and moral concepts should be the guiding conscience involved in the question of abortion.

  15. Rapid eye movement sleep in breath holders.

    Science.gov (United States)

    Kohyama, J; Hasegawa, T; Shimohira, M; Fukumizu, M; Iwakawa, Y

    2000-07-01

    One-night polysomnography was performed on seven subjects suffering from breath-holding spells, including one whose death was suggested to be a consequence of a breath-holding spell. The fatal case showed no rapid eye movements (REMs) during REM sleep, although he exhibited REMs during wakefulness. The average numbers of both REMs and bursts of REMs in REM sleep in the other six breath holders were significantly lower than those in age-matched controls. The breath holders showed no airway obstruction, desaturation, or sleep fragmentation. Since the rapid ocular activity in REM sleep is generated in the brain stem, we hypothesized that a functional brainstem disturbance is involved in the occurrence of breath-holding spells.

  16. Forest Cover Associated with Improved Child Health and Nutrition: Evidence from the Malawi Demographic and Health Survey and Satellite Data

    Science.gov (United States)

    Johnson, Kiersten B.; Jacob, Anila; Brown, Molly Elizabeth

    2013-01-01

    Healthy forests provide human communities with a host of important ecosystem services, including the provision of food, clean water, fuel, and natural medicines. Yet globally, about 13 million hectares of forests are lost every year, with the biggest losses in Africa and South America. As biodiversity loss and ecosystem degradation due to deforestation continue at unprecedented rates, with concomitant loss of ecosystem services, impacts on human health remain poorly understood. Here, we use data from the 2010 Malawi Demographic and Health Survey, linked with satellite remote sensing data on forest cover, to explore and better understand this relationship. Our analysis finds that forest cover is associated with improved health and nutrition outcomes among children in Malawi. Children living in areas with net forest cover loss between 2000 and 2010 were 19% less likely to have a diverse diet and 29% less likely to consume vitamin A-rich foods than children living in areas with no net change in forest cover. Conversely, children living in communities with higher percentages of forest cover were more likely to consume vitamin A-rich foods and less likely to experience diarrhea. Net gain in forest cover over the 10-year period was associated with a 34% decrease in the odds of children experiencing diarrhea (P5.002). Given that our analysis relied on observational data and that there were potential unknown factors for which we could not account, these preliminary findings demonstrate only associations, not causal relationships, between forest cover and child health and nutrition outcomes. However, the findings raise concerns about the potential short- and long-term impacts of ongoing deforestation and ecosystem degradation on community health in Malawi, and they suggest that preventing forest loss and maintaining the ecosystems services of forests are important factors in improving human health and nutrition outcomes.

  17. Health logistics is a profession: improving the performance of health in developing countries

    Directory of Open Access Journals (Sweden)

    B. Silve

    2009-01-01

    Full Text Available “We can now prevent or treat most illnesses by using known and inexpensive techniques, the problem lies elsewhere: it consists in providing personnel, medicines, vaccines and information to those in need, at the appropriate time, in sufficient quantity, reliable and sustainable manner, and at a cost acceptable”. WHO’s report “Health and MDGs for development” “Given the recognized need for health logistics officers and the present lack of such officers in the countries, WHO/AFRO, UNICEF, Bioforce and partners should urge countries to create positions of health logistics officers in health management teams, coordinate their efforts and mobilize necessary resources to initiate adequate training in logistics for health in support of present move toward greater integration of public health interventions”. Task Force on Immunization Meeting, Maputo, 2006« À l’heure actuelle, nous pouvons prévenir ou traiter la plupart des maladies avec des techniques connues et peu onéreuses, le problème est de réussir à fournir du personnel, des médicaments, des vaccins et des informations aux personnes qui en ont besoin, au bon moment, en quantité suffisante, de manière fiable et durable et à un coût acceptable ».Rapport de l’OMS « La Santé et les Objectifs du Millénaire pour le développement »« Étant donné le besoin notoire de logisticiens de santé et le manque actuel de tels professionnels dans les pays, l’OMS/AFRO, l’UNICEF, Bioforce et leurs partenaires doivent encourager les pays à créer des postes de logisticien de santé dans les équipes de gestion de la santé, coordonner leurs efforts et mobiliser les ressources nécessaires pour initier une formation appropriée en logistique de santé afin de soutenir les mesures actuelles en faveur d’une meilleure intégration des interventions de santé publique. » Réunion de la Task Force on Immunization, Maputo, 2006 «Actualmente somos capaces de impedir

  18. [Short time counseling in medical practice for improving health behaviour: problems and solutions].

    Science.gov (United States)

    Neuner-Jehle, Stefan; Schmid, Margareta; Grüninger, Ueli

    2014-02-26

    Health related behaviour is a main determinant of chronic disease. Family physicians have an important role in the support of patients to improve their health behaviour, but relevant barriers should be addressed. In the new "Health Coaching KHM" program, patients and physicians are working as a team in four steps (sensitize - create motivation - plan - act). In this process, physicians' communication skills (which are trained within the program) are of utmost importance. In a pilot study with 20 family physicians and 1045 patients acceptance and feasibility were excellent: Every second participant improved her or his behaviour in the area of choice by at least one (of two possible) categories. For dissemination improving framework is crucial.

  19. Decreased Consumption of Branched-Chain Amino Acids Improves Metabolic Health

    Directory of Open Access Journals (Sweden)

    Luigi Fontana

    2016-07-01

    Full Text Available Protein-restricted (PR, high-carbohydrate diets improve metabolic health in rodents, yet the precise dietary components that are responsible for these effects have not been identified. Furthermore, the applicability of these studies to humans is unclear. Here, we demonstrate in a randomized controlled trial that a moderate PR diet also improves markers of metabolic health in humans. Intriguingly, we find that feeding mice a diet specifically reduced in branched-chain amino acids (BCAAs is sufficient to improve glucose tolerance and body composition equivalently to a PR diet via metabolically distinct pathways. Our results highlight a critical role for dietary quality at the level of amino acids in the maintenance of metabolic health and suggest that diets specifically reduced in BCAAs, or pharmacological interventions in this pathway, may offer a translatable way to achieve many of the metabolic benefits of a PR diet.

  20. Effect of physical therapy scoliosis specific exercises using breathing pattern on adolescent idiopathic scoliosis

    OpenAIRE

    2016-01-01

    [Purpose] This study was performed to confirm physical therapy scoliosis specific exercises on adolescent idiopathic scoliosis patients. [Subject and Methods] A 15-year-old male middle school student with scoliosis. Cobb’s angle, angle of rotation of the spine, and breathing pattern were measured before and after 8 weeks training. [Results] After 8 weeks training, Cobb’s angle, angle of rotation of the spine, and breathing pattern were improved better. [Conclusion] These results indicate that...

  1. Can life coaching improve health outcomes? - A systematic review of intervention studies

    DEFF Research Database (Denmark)

    Ammentorp, Jette; Uhrenfeldt, Lisbeth; Angel, Flemming;

    2013-01-01

    In recent years, coaching has received special attention as a method to improve healthy lifestyle behaviours. The fact that coaching has found its way into healthcare and may provide new ways of engaging the patients and making them accountable for their health, justifies the need for an overview...... coaching and life coaching. In this review, we will only focus on the latter method and on that basis assess the health related outcomes of life coaching....

  2. Joint Commission on Accreditation of Hospitals--twenty-five years of promoting improved health care services.

    Science.gov (United States)

    McCleary, D

    1977-09-01

    A brief history of the Joint Commission on Accreditation of Hospitals (JCAH), as well as its structure, purpose and activities, is presented. The procedure for developing JCAH standards for health care facilities is discussed. Also presented are the survey and accreditation processes. It is concluded that as long as the United States values its tradition of voluntarism and believes in positive motivation, the JCAH will be an effective influence on improved health care services.

  3. Addressing poverty, education, and gender equality to improve the health of women worldwide.

    Science.gov (United States)

    Tyer-Viola, Lynda A; Cesario, Sandra K

    2010-01-01

    The Millennium Development Goals (MDG) that target alleviating poverty, improving primary education, and fostering gender equity are important as a foundation to promote world health. Achieving these goals will create an environment for healthy lives for women and children. Poverty, education, and gender equality, although undeniably linked, need to be addressed individually. Nurses have the capacity and political will to address MDGs and to contribute to the health and well-being of the world population.

  4. Comparing the implementation of team approaches for improving diabetes care in community health centers

    OpenAIRE

    Wees, P.J. van der; Friedberg, M.W.; Guzman, E.; Ayanian, J.Z.; Rodriguez, H.P.

    2014-01-01

    Background Patient panel management and community-based care management may be viable strategies for community health centers to improve the quality of diabetes care for vulnerable patient populations. The objective of our study was to clarify implementation processes and experiences of integrating office-based medical assistant (MA) panel management and community health worker (CHW) community-based management into routine care for diabetic patients. Methods Mixed m...

  5. Analysis of Productivity Improvement Act for Clinical Staff Working in the Health System: A Qualitative Study

    OpenAIRE

    Vali, Leila; Tabatabaee, Seyed Saeed; Kalhor, Rohollah; Amini, Saeed; Kiaei, Mohammad Zakaria

    2015-01-01

    Introduction: The productivity of healthcare staff is one of the main issues for health managers. This study explores the concept of executive regulation of Productivity Improvement Act of clinical staff in health. Methods: In this study phenomenological methodology has been employed. The data were collected through semi-structured interviews and focus group composed of 10 hospital experts and experts in human resources department working in headquarter of Mashhad University of Medical Scienc...

  6. The Contextualized Technology Adaptation Process (CTAP): Optimizing Health Information Technology to Improve Mental Health Systems.

    Science.gov (United States)

    Lyon, Aaron R; Wasse, Jessica Knaster; Ludwig, Kristy; Zachry, Mark; Bruns, Eric J; Unützer, Jürgen; McCauley, Elizabeth

    2016-05-01

    Health information technologies have become a central fixture in the mental healthcare landscape, but few frameworks exist to guide their adaptation to novel settings. This paper introduces the contextualized technology adaptation process (CTAP) and presents data collected during Phase 1 of its application to measurement feedback system development in school mental health. The CTAP is built on models of human-centered design and implementation science and incorporates repeated mixed methods assessments to guide the design of technologies to ensure high compatibility with a destination setting. CTAP phases include: (1) Contextual evaluation, (2) Evaluation of the unadapted technology, (3) Trialing and evaluation of the adapted technology, (4) Refinement and larger-scale implementation, and (5) Sustainment through ongoing evaluation and system revision. Qualitative findings from school-based practitioner focus groups are presented, which provided information for CTAP Phase 1, contextual evaluation, surrounding education sector clinicians' workflows, types of technologies currently available, and influences on technology use. Discussion focuses on how findings will inform subsequent CTAP phases, as well as their implications for future technology adaptation across content domains and service sectors.

  7. Secondary Data Analysis of National Surveys in Japan Toward Improving Population Health.

    Science.gov (United States)

    Ikeda, Nayu

    2016-01-01

    Secondary data analysis of national health surveys of the general population is a standard methodology for health metrics and evaluation; it is used to monitor trends in population health over time and benchmark the performance of health systems. In Japan, the government has established electronic databases of individual records from national surveys of the population's health. However, the number of publications based on these datasets is small considering the scale and coverage of the surveys. There appear to be two major obstacles to the secondary use of Japanese national health survey data: strict data access control under the Statistics Act and an inadequate interdisciplinary research environment for resolving methodological difficulties encountered when dealing with secondary data. The usefulness of secondary analysis of survey data is evident with examples from the author's previous studies based on vital records and the National Health and Nutrition Surveys, which showed that (i) tobacco smoking and high blood pressure are the major risk factors for adult mortality from non-communicable diseases in Japan; (ii) the decrease in mean blood pressure in Japan from the late 1980s to the early 2000s was partly attributable to the increased use of antihypertensive medication and reduced dietary salt intake; and (iii) progress in treatment coverage and control of high blood pressure is slower in Japan than in the United States and Britain. National health surveys in Japan are an invaluable asset, and findings from secondary analyses of these surveys would provide important suggestions for improving health in people around the world.

  8. Designing a national plan for improving sexual health in Iran: An experience of an Islamic country

    Science.gov (United States)

    Damari, Behzad; Tabrizchi, Narges; Riazi-Isfahani, Sahand

    2016-01-01

    Background: Prevalence of sexual dysfunction varies from 20% to 40% in men and women in different studies in Iran. Despite its high prevalence, it seems that this issue has been neglected, particularly in Islamic countries. The aim of this study was to assess sexual health in Iran. This was a mixed method study. Methods: Data were collected through evaluating country’s sexual health programs and literature review. Sexual health status was drafted and formed following a sound analysis by stakeholders. After conducting interviews and focus group discussions, the main points of the meetings, influencing factors of the present status and oncoming strategies were obtained upon experts’ opinions. Results: Review of general policies and the literature showed that although there is adequate support for improving sexual health status in the country, sexual health status has been decreased in the last decade. Based on Iranian sexual health indicators and experts’ opinions, the focus points could be divided into the following groups: Structural and functional –political, legal-behavior, and cultural. Conclusion: Breaking the taboo of sexual health issues would require attention from the policy makers especially in Islamic nations to facilitate the steps on the road to sexual health. In this regard, clarified vision, strategic goals and interventional policies are proposed. An inter-sectional cooperation is needed to implement interventions to promote sexual health status. PMID:27683648

  9. Effect of interventions to improve health care services for ethnic minority populations

    Directory of Open Access Journals (Sweden)

    Louise Forsetlund

    2011-03-01

    Full Text Available Objectives: Since the early 1990s there has been an increasing awareness of social and ethnic inequity in health and for the last few years there has also been an increasing focus on disparities in the quality of health services to ethnic minority groups. The aim of this review was to collect and summarise in a systematic and transparent manner the effect of interventions to improve health care services for ethnic minorities.Methods: We searched several medical databases for systematic reviews and randomised controlled trials. Two researchers independently screened for and selected studies, assessed risk of bias, extracted data and graded the quality of the evidence for each outcome in the included studies. The analysis was done qualitatively by describing studies and presenting them in tables.Results: We included 19 primary studies. The interventions were targeted at reducing clinical, structural and organisational barriers against good quality health care services. Eight studies examined the effect of educational interventions in improving outcomes within cross-cultural communication, smoking cessation, asthma care, cancer screening and mental health care. In six comparisons the effect of reminders for improving health care services and patient outcomes within cancer screening and diabetes care was examined. Two studies compared professional remote interpretation services to traditional interpretation services, two studies compared ethnic matching of client and therapist and two studies examined the effect of providing additional support in the form of more personnel in the treatment of diabetes and kidney transplant patients. Most patients were African-Americans and Latin-Americans and all ages were represented.Conclusions: Educational interventions and electronic reminders to physicians may in some contexts improve health care and health outcomes for minority patients. The quality of the evidence varied from low to very low. The quality of

  10. Improving child health promotion practices in multiple sectors – outcomes of the Swedish Salut Programme

    Directory of Open Access Journals (Sweden)

    Edvardsson Kristina

    2012-10-01

    Full Text Available Abstract Background To improve health in the population, public health interventions must be successfully implemented within organisations, requiring behaviour change in health service providers as well as in the target population group. Such behavioural change is seldom easily achieved. The purpose of this study was to examine the outcomes of a child health promotion programme (The Salut Programme on professionals’ self-reported health promotion practices, and to investigate perceived facilitators and barriers for programme implementation. Methods A before-and-after design was used to measure programme outcomes, and qualitative data on implementation facilitators and barriers were collected on two occasions during the implementation process. The sample included professionals in antenatal care, child health care, dental services and open pre-schools (n=144 pre-implementation in 13 out of 15 municipalities in a Swedish county. Response rates ranged between 81% and 96% at the four measurement points. Results Self-reported health promotion practices and collaboration were improved in all sectors at follow up. Significant changes included: 1 an increase in the extent to which midwives in antenatal care raised issues related to men’s violence against women, 2 an increase in the extent to which several lifestyle topics were raised with parents/clients in child health care and dental services, 3 an increased use of motivational interviewing (MI and separate ‘fathers visits’ in child health care 4 improvements in the supply of healthy snacks and beverages in open pre-schools and 5 increased collaboration between sectors. Main facilitators for programme implementation included cross-sectoral collaboration and sector-specific work manuals/questionnaires for use as support in everyday practice. Main barriers included high workload, and shortage of time and staff. Conclusion This multisectoral programme for health promotion, based on sector

  11. Health-Improving Rehabilitation Program of Pysical Education at Higher School

    Directory of Open Access Journals (Sweden)

    V. M. Naskalov

    2013-01-01

    Full Text Available The research is aimed to explore the efficiency of innovative technologies and increase the health-improving effect as a result of physical training in ecologically unfavorable conditions. A health-improving rehabilitation program, containing a set of modern means of physical rehabilitation and recreation in combination with physical exercises, was worked out to carry out the pedagogical experiment. The program includes the hydromassage, stretching exercises with biomechanical stimulation and exercises for developing weightlifting abilities. Apart from this, the interval hypoxic training was used in ‘artificially created’ favorable ecological conditions for detoxication. The students at Polotsk State University took part in the experiment. Among the assessment criteria applied by the author, there are generally acknowledged methods identifying the development of physical qualities, external respiration functions, body fat and other components composition. The experiment revealed that the innovative program had enhanced the health-improving effect compared to the traditional training programs, which was expressed by the statistically valid increase of the students’ speed- strength characteristics, flexibility, external respiration functions as well as the body fat decrease. Therefore, in order to increase a health-improving effect of physical training, the author recommends considering the specific ecological and hygienic conditions of a particular region to create the corresponding programs for group and individual health protection and recovery. The research findings can be used in physical education process at universities situated in the regions with unfavorable ecological conditions. 

  12. Personalised Medicine: A New Approach to Improving Health in Indigenous Australian Populations.

    Science.gov (United States)

    Rae, Kym M; Grimson, Steve; Pringle, Kirsty G

    2017-01-06

    Personalised medicine is a newly emerging field with much to offer to all populations in improved clinical treatment options. Since the 1970s, clinicians and researchers have all been working towards improving the health of Indigenous Australians. However, there has been little research on the impact of genetics on Indigenous health, how genetic and environmental factors interact to contribute to poor health in Indigenous people, and how genetic factors specific to Indigenous people affect their responses to particular treatments. This short review highlights the urgent need for more genetic studies specific to Indigenous people in order to provide more appropriate care and to improve health outcomes. This paper explores why genetic work with Indigenous communities has been limited, how personalised medicine could benefit Indigenous communities, and highlights a number of specific instances in which personalised medicine has been critical for improving morbidity and mortality in other high-risk groups. In order to take the next step in advancing the health of Indigenous peoples, targeted research into the genetic factors behind chronic diseases is critically needed. This research may allow clinicians a better understanding of how genetic factors interact with environmental factors to influence an Indigenous Australian's individual risk of disease, prognosis, and response to therapies. It is hoped that this knowledge will produce clinical interventions that will help deliver clearly targeted, more appropriate care to this at-risk population.

  13. Medical student mental health 3.0: improving student wellness through curricular changes.

    Science.gov (United States)

    Slavin, Stuart J; Schindler, Debra L; Chibnall, John T

    2014-04-01

    Medical education can have significant negative effects on the well-being of medical students. To date, efforts to improve student mental health have focused largely on improving access to mental health providers, reducing the stigma and other barriers to mental health treatment, and implementing ancillary wellness programs. Still, new and innovative models that build on these efforts by directly addressing the root causes of stress that lie within the curriculum itself are needed to properly promote student wellness. In this article, the authors present a new paradigm for improving medical student mental health, by describing an integrated, multifaceted, preclinical curricular change program implemented through the Office of Curricular Affairs at the Saint Louis University School of Medicine starting in the 2009-2010 academic year. The authors found that significant but efficient changes to course content, contact hours, scheduling, grading, electives, learning communities, and required resilience/mindfulness experiences were associated with significantly lower levels of depression symptoms, anxiety symptoms, and stress, and significantly higher levels of community cohesion, in medical students who participated in the expanded wellness program compared with those who preceded its implementation. The authors discuss the utility and relevance of such curricular changes as an overlooked component of change models for improving medical student mental health.

  14. Improving the effectiveness of electronic health record-based referral processes.

    Science.gov (United States)

    Esquivel, Adol; Sittig, Dean F; Murphy, Daniel R; Singh, Hardeep

    2012-09-13

    Electronic health records are increasingly being used to facilitate referral communication in the outpatient setting. However, despite support by technology, referral communication between primary care providers and specialists is often unsatisfactory and is unable to eliminate care delays. This may be in part due to lack of attention to how information and communication technology fits within the social environment of health care. Making electronic referral communication effective requires a multifaceted "socio-technical" approach. Using an 8-dimensional socio-technical model for health information technology as a framework, we describe ten recommendations that represent good clinical practices to design, develop, implement, improve, and monitor electronic referral communication in the outpatient setting. These recommendations were developed on the basis of our previous work, current literature, sound clinical practice, and a systems-based approach to understanding and implementing health information technology solutions. Recommendations are relevant to system designers, practicing clinicians, and other stakeholders considering use of electronic health records to support referral communication.

  15. National health expenditure projections, 2012-22: slow growth until coverage expands and economy improves.

    Science.gov (United States)

    Cuckler, Gigi A; Sisko, Andrea M; Keehan, Sean P; Smith, Sheila D; Madison, Andrew J; Poisal, John A; Wolfe, Christian J; Lizonitz, Joseph M; Stone, Devin A

    2013-10-01

    Health spending growth through 2013 is expected to remain slow because of the sluggish economic recovery, continued increases in cost-sharing requirements for the privately insured, and slow growth for public programs. These factors lead to projected growth rates of near 4 percent through 2013. However, improving economic conditions, combined with the coverage expansions in the Affordable Care Act and the aging of the population, drive faster projected growth in health spending in 2014 and beyond. Expected growth for 2014 is 6.1 percent, with an average projected growth of 6.2 percent per year thereafter. Over the 2012-22 period, national health spending is projected to grow at an average annual rate of 5.8 percent. By 2022 health spending financed by federal, state, and local governments is projected to account for 49 percent of national health spending and to reach a total of $2.4 trillion.

  16. Improving adolescent health policy: incorporating a framework for assessing state-level policies.

    Science.gov (United States)

    Brindis, Claire D; Moore, Kristin

    2014-01-01

    Many US policies that affect health are made at the state, not the federal, level. Identifying state-level policies and data to analyze how different policies affect outcomes may help policy makers ascertain the usefulness of their public policies and funding decisions in improving the health of adolescent populations. A framework for describing and assessing the role of federal and state policies on adolescent health and well-being is proposed; an example of how the framework might be applied to the issue of teen childbearing is included. Such a framework can also help inform analyses of whether and how state and federal policies contribute to the variation across states in meeting adolescent health needs. A database on state policies, contextual variables, and health outcomes data can further enable researchers and policy makers to examine how these factors are associated with behaviors they aim to impact.

  17. Can universal pre-kindergarten programs improve population health and longevity? Mechanisms, evidence, and policy implications.

    Science.gov (United States)

    Muennig, Peter

    2015-02-01

    Recent research has found that children who attended pre-kindergarten programs in childhood were more likely to be healthy as adults. One intuitive way of improving population health and longevity may therefore be to invest in pre-kindergarten programs. However, much of the research linking pre-kindergarten programs to health is very recent and has not been synthesized. In this paper, I review the mechanisms linking pre-kindergarten programs in childhood to adult longevity, and the experimental evidence backing up these linkages. I conclude with a critical exploration of whether investments in pre-kindergarten programs could also serve as investments in public health.

  18. Time Breath of Psychological Theories

    DEFF Research Database (Denmark)

    Tateo, Luca; Valsiner, Jaan

    2015-01-01

    Psychology as a self-aspiring, ambitious, developmental science faces the crucial limit of time—both theoretically and practically. The issue of time in constructing psychology’s theories is a major unresolved metatheoretical task. This raises several questions about generalization of knowledge......: which is the time length of breath of psychological theories? Which is the temporal dimension of psychological processes? In this article we discuss the role of different axiomatic assumptions about time in the construction of psychological theories. How could different theories include a concept...... of time—or fail to do that? How can they generalize with respect to time? The different conceptions of time often remain implicit, while shaping the concepts used in understanding psychological processes. Any preconception about time in human development will foster the generalizability of theory, as well...

  19. High-intensity intermittent swimming improves cardiovascular health status for women with mild hypertension

    DEFF Research Database (Denmark)

    Mohr, Magni; Nordsborg, Nikolai Baastrup; Lindenskov, Annika;

    2014-01-01

    To test the hypothesis that high-intensity swim training improves cardiovascular health status in sedentary premenopausal women with mild hypertension, sixty-two women were randomized into high-intensity (n = 21; HIT), moderate-intensity (n = 21; MOD), and control groups (n = 20; CON). HIT...... high-intensity intermittent swimming is an effective training strategy to improve cardiovascular health and physical performance...... in sedentary women with mild hypertension. Adaptations are similar with high- and moderate-intensity training, despite markedly less total time spent and distance covered in the high-intensity group....

  20. Human Genome Epidemiology : A scientific foundation for using genetic information to improve health and prevent disease

    Directory of Open Access Journals (Sweden)

    Stefania Boccia

    2005-03-01

    Full Text Available

    Human health is determined by the interplay of genetic factors and the environment. In this context the recent advances in human genomics are expected to play a central role in medicine and public health by providing genetic information for disease prediction and prevention.

    After the completion of the human genome sequencing, a fundamental step will be represented by the translation of these discoveries into meaningful actions to improve health and prevent diseases, and the field of epidemiology plays a central role in this effort. These are some of the issues addressed by Human Genome Epidemiology –A scientific foundation for using genetic information to improve health and prevent disease, a volume edited by Prof. M. Khoury, Prof. J. Little, Prof.W. Burke and published by Oxford university Press 2004.

    This book describes the important role that epidemiological methods play in the continuum from gene discovery to the development and application of genetic tests. The Authors calls this continuum human genome epidemiology (HuGE to denote an evolving field of inquiry that uses systematic applications of epidemiological methods to assess the impact of human genetic variation on health and disease.

    The book is divided into four sections and it is structured to allow readers to proceed systematically from the fundamentals of genome technology and discovery, to the epidemiological approaches, to gene characterisation, to the evaluation of genetic tests and their use in health services and public health.

  1. Impact of simple conventional and Telehealth solutions on improving mental health in Afghanistan.

    Science.gov (United States)

    Khoja, Shariq; Scott, Richard; Husyin, Nida; Durrani, Hammad; Arif, Maria; Faqiri, Faqir; Hedayat, Ebadullah; Yousufzai, Wahab

    2016-12-01

    For more than a century Afghanistan has been unstable, facing decades of war, social problems, and intense poverty. As a result, many of the population suffer from a variety of mental health problems. The Government recognises the situation and has prioritised mental health, but progress is slow and services outside of Kabul remain poor. An international collaborative implemented a project in Badakshan province of Afghanistan using conventional and simple low-cost e-Health solutions to address the four most common issues: depression, psychosis, post-traumatic stress disorder, and substance abuse. Conventional town hall meetings informed community members to raise awareness and knowledge. In addition, an android-based mobile application used the World Health Organization's Mental Health Gap Action Programme guidelines and protocols to: collect information from community healthcare workers; provide referral services to patients; provide blended learning to improve providers' mental health knowledge, skills, and practice; and to provide store-and-forward and live consultations. Preliminary evaluation of the intervention shows enhanced access to care for remote communities, decreased stigma, and improved quality of health services. Primary care workers are also able to bridge the gap in consultations for rural and remote communities, connecting them with specialists and providing better access to care.

  2. Are migrants health policies aimed at improving access to quality healthcare? An analysis of Spanish policies.

    Science.gov (United States)

    Vázquez, María Luisa; Terraza-Núñez, Rebeca; S-Hernández, Silvia; Vargas, Ingrid; Bosch, Lola; González, Andrea; Pequeño, Sandra; Cantos, Raquel; Martínez, Juan Ignacio; López, Luís Andrés

    2013-12-01

    Although until April 2012, all Spanish citizens regardless of their origin, residence status and work situation were entitled to health care, available evidence suggested inadequate access for immigrants. Following the Aday and Andersen model, we conducted an analysis of policy elements that affect immigrants' access to health care in Spain, based on documentary analysis of national policies and selected regional policies related to migrant health care. Selected documents were (a) laws and plans in force at the time containing migrant health policies and (b) evaluations. The analysis included policy principles, objectives, strategies and evaluations. Results show that the national and regional policies analyzed are based on the principle that health care is a right granted to immigrants by law. These policies include strategies to facilitate access to health care, reducing barriers for entry to the system, for example simplifying requirements and raising awareness, but mostly they address the necessary qualities for services to be able to attend to a more diverse population, such as the adaptation of resources and programs, or improved communication and training. However, limited planning was identified in terms of their implementation, necessary resources and evaluation. In conclusion, the policies address relevant barriers of access for migrants and signal improvements in the health system's responsiveness, but reinforcement is required in order for them to be effectively implemented.

  3. Connecting the Dots: How U.S. Global Health Programs Can Improve International Health Regulation Compliance

    Science.gov (United States)

    2014-12-01

    the budget allocated to AFHSC is projected to grow by $6.053 million for the purpose of biosurveillance .167 The strategic model for the organization...Response System,” AFHSC. 166 Melinda Moore, Gail Fisher, and Clare Stevens, Toward Integrated DoD Biosurveillance : Assessment and Opportunities (Santa...L. Russell et al., “The Global Emerging Infection Surveillance and Response System (GEIS), a U.S. Government Tool for Improved Global Biosurveillance

  4. Are Improvements in Child Health Due to Increasing Status of Women in Developing Nations?

    Science.gov (United States)

    Heaton, Tim B

    2015-01-01

    This research tests the hypothesis that change over time in women's status leads to improvements in their children's health. Specifically, we examine whether change in resources and empowerment in mother's roles as biological mothers, caregivers, and providers and social contexts that promote the rights and representation of and investment in women are associated with better nutritional status and survival of young children. Analysis is based on a broad sample of countries (n = 28), with data at two or more points in time to enable examination of change. Key indicators of child health show improvement in the last 13 years in developing nations. Much of this improvement--90 percent of the increase in nutritional status and 47 percent of the reduction in mortality--is associated with improving status of women. Increased maternal education, control over reproduction, freedom from violence, access to health care, legislation and enforcement of women's rights, greater political representation, equality in the education system, and lower maternal mortality are improving children's health. These results imply that further advancement of women's position in society would be beneficial.

  5. One Small Step at a Time: Implementing Continuous Quality Improvement in Child and Youth Mental Health Services

    Science.gov (United States)

    Chovil, Nicole

    2009-01-01

    Continuous quality improvement (CQI) is increasingly being adopted by health care, including child and youth mental health services. As part of the commitment to ongoing quality improvement, child and youth mental health teams in the Fraser region in British Columbia undertook CQI projects over a one year period (2007-2008). The projects covered a…

  6. What are the effective ways to translate clinical leadership into health care quality improvement?

    Directory of Open Access Journals (Sweden)

    McSherry R

    2016-02-01

    Full Text Available Robert McSherry,1 Paddy Pearce2 1School of Health and Social Care, University of Teesside, Middlesbrough, 2PKP Consulting, Yarm, United Kingdom Abstract: The presence and/or absence of effective leaders in health care can have a stark consequence on the quality and outcomes of care. The delivery of safe, quality, compassionate health care is dependent on having effective clinical leaders at the frontline. In light of the Kirkup and Francis reports, this article explores some ways of translating clinical leadership into health care quality improvement. This is achieved by exploring what is clinical leadership and why and how this is important to health care quality improvement, clinical leadership, and a duty of candor, along with the importance clinical leadership plays in the provision of quality care improvement and outcomes. Clinical leaders are not predefined roles but emerge from the complex clinical setting by gaining an acquired expertise and from how they then internalize this to develop and facilitate sound relationships within a team. Clinical leaders are effective in facilitating innovation and change through improvement. This is achieved by recognizing, influencing, and empowering individuals through effective communication in order to share and learn from and with each other in practice. The challenge for health care organizations in regard to creating organizational cultures where a duty of candor exists is not to reinvent the wheel by turning something that is simple into something complex, which can become confusing to health care workers, patients, and the public. By focusing on the clinical leader's role and responsibilities we would argue they play a crucial and pivotal role in influencing, facilitating, supporting, and monitoring that this duty of candor happens in practice. This may be possible by highlighting where and how the duty of candor can be aligned within existing clinical governance frameworks. Keywords: governance

  7. Medically unexplained dyspnea:psychophysiological characteristics and role of breathing therapy

    Institute of Scientific and Technical Information of China (English)

    HAN Jiang-na 韩江娜; ZHU Yuan-jue 朱元珏; LI Shun-wei 李舜伟; LUO Dong-mei 雒冬梅; HU Zheng 胡征; Van Diest I; De Peuter S; Van de Woestijne KP; Van den Bergh O

    2004-01-01

    Background Medically unexplained dyspnea occurs commonly in medical settings and remains poorly understood. This study was conducted to investigate the psychophysiological characteristics of medically unexplained dyspnea and the efficacy of breathing retraining for these patients.Methods A group of patients with medically unexplained dyspnea were compared to patients with a variety of organic lung diseases and healthy subjects. In another group of patients, the influence of breathing therapy on complaints, anxiety, and breath-holding was evaluated for an average of 1.5 years. Results Patients with medically unexplained dyspnea reported more intense dyspnea than patients with a variety of organic lung diseases. Additionally, they were anxious and presented a broad range of symptoms in daily life and under challenge, for instance voluntary hyperventilation. More than one third of them qualified for panic disorder. They had shorter breath-holding time at rest, less increase in breath-holding time and higher chances of showing a "paradoxical" decrease of breath-holding time after hyperventilation. A combination of PaO2, forced expiratory volume in one second (FEV1), and anxiety measures distinguished them from organic dyspnea. Breathing retraining profoundly improved their symptoms and decreased the level of state and trait anxiety. Moreover, they better tolerated the voluntary hyperventilation and the symptoms induced were also markedly decreased after therapy. Breath-holding time was prolonged and PetCO2 in a representative group of patients increased. Conclusions Patients with medically unexplained dyspnea appear to have the feature of a "psychosomatic" patient: an anxious patient with a wide variety of symptoms of different organ systems that do not have an organic basis. They can be distinguished from organic dyspnea using a small set of physiological and psychological measures. Breathing retraining turns out to be an effective therapy for those "difficult to

  8. Breath acetone monitoring by portable Si:WO{sub 3} gas sensors

    Energy Technology Data Exchange (ETDEWEB)

    Righettoni, Marco; Tricoli, Antonio; Gass, Samuel [Particle Technology Laboratory, Department of Mechanical and Process Engineering ETH Zurich, CH-8092 Zurich (Switzerland); Schmid, Alex; Amann, Anton [Univ.-Clinic for Anesthesia, Innsbruck Medical University, A-6020 Innsbruck (Austria); Breath Research Institute of the Austrian Academy of Sciences, A-6850 Dornbirn (Austria); Pratsinis, Sotiris E., E-mail: sotiris.pratsinis@ptl.mavt.ethz.ch [Particle Technology Laboratory, Department of Mechanical and Process Engineering ETH Zurich, CH-8092 Zurich (Switzerland)

    2012-08-13

    Highlights: Black-Right-Pointing-Pointer Portable sensors were developed and tested for monitoring acetone in the human breath. Black-Right-Pointing-Pointer Acetone concentrations down to 20 ppb were measured with short response times (<30 s). Black-Right-Pointing-Pointer The present sensors were highly selective to acetone over ethanol and water. Black-Right-Pointing-Pointer Sensors were applied to human breath: good agreement with highly sensitive PTR-MS. Black-Right-Pointing-Pointer Tests with people at rest and during physical activity showed the sensor robustness. - Abstract: Breath analysis has the potential for early stage detection and monitoring of illnesses to drastically reduce the corresponding medical diagnostic costs and improve the quality of life of patients suffering from chronic illnesses. In particular, the detection of acetone in the human breath is promising for non-invasive diagnosis and painless monitoring of diabetes (no finger pricking). Here, a portable acetone sensor consisting of flame-deposited and in situ annealed, Si-doped epsilon-WO{sub 3} nanostructured films was developed. The chamber volume was miniaturized while reaction-limited and transport-limited gas flow rates were identified and sensing temperatures were optimized resulting in a low detection limit of acetone ({approx}20 ppb) with short response (10-15 s) and recovery times (35-70 s). Furthermore, the sensor signal (response) was robust against variations of the exhaled breath flow rate facilitating application of these sensors at realistic relative humidities (80-90%) as in the human breath. The acetone content in the breath of test persons was monitored continuously and compared to that of state-of-the-art proton transfer reaction mass spectrometry (PTR-MS). Such portable devices can accurately track breath acetone concentration to become an alternative to more elaborate breath analysis techniques.

  9. Application of LaserBreath-001 for breath acetone measurement in subjects with diabetes mellitus

    Science.gov (United States)

    Wang, Zhennan; Sun, Meixiu; Chen, Zhuying; Zhao, Xiaomeng; Li, Yingxin; Wang, Chuji

    2016-11-01

    Breath acetone is a promising biomarker of diabetes mellitus. With an integrated standalone, on-site cavity ringdown breath acetone analyzer, LaserBreath-001, we tested breath samples from 23 type 1 diabetic (T1D) patients, 312 type 2 diabetic (T2D) patients, 52 healthy subjects. In the cross-sectional studies, the obtained breath acetone concentrations were higher in the diabetic subjects compared with those in the control group. No correlation between breath acetone and simultaneous BG was observed in the T1D, T2D, and healthy subjects. A moderate positive correlation between the mean individual breath acetone concentrations and the mean individual BG levels was observed in the 20 T1D patients without ketoacidosis. In a longitudinal study, the breath acetone concentrations in a T1D patient with ketoacidosis decreased significantly and remained stable during the 5-day hospitalization. The results from a relatively large number of subjects tested indicate that an elevated mean breath acetone concentration exists in diabetic patients in general. Although many physiological parameters affect breath acetone concentrations, fast (diabetic screening and management under a specifically controlled condition.

  10. Diagnostics in a digital age: an opportunity to strengthen health systems and improve health outcomes.

    Science.gov (United States)

    Peeling, Rosanna W

    2015-11-01

    Diagnostics play a critical role in clinical decision making, and in disease control and prevention. Rapid point-of-care (POC) tests for infectious diseases can improve access to diagnosis and patient management, but the quality of these tests vary, quality of testing is often not assured and there are few mechanisms to capture test results for surveillance when the testing is so decentralised. A new generation of POC molecular tests that are highly sensitive and specific, robust and easy to use are now available for deployment in low resource settings. Decentralisation of testing outside of the laboratory can put tremendous stress on the healthcare system and presents challenges for training and quality assurance. A feature of many of these POC molecular devices is that they are equipped with data transmission capacities. In a digital age, it is possible to link data from diagnostic laboratories and POC test readers and devices to provide data on testing coverage, disease trends and timely information for early warning of infectious disease outbreaks to inform design or optimisation of disease control and elimination programmes. Data connectivity also allows control programmes to monitor the quality of tests and testing, and optimise supply chain management; thus, increasing the efficiency of healthcare systems and improving patient outcomes.

  11. An Ultrasonic Contactless Sensor for Breathing Monitoring

    Directory of Open Access Journals (Sweden)

    Philippe Arlotto

    2014-08-01

    Full Text Available The monitoring of human breathing activity during a long period has multiple fundamental applications in medicine. In breathing sleep disorders such as apnea, the diagnosis is based on events during which the person stops breathing for several periods during sleep. In polysomnography, the standard for sleep disordered breathing analysis, chest movement and airflow are used to monitor the respiratory activity. However, this method has serious drawbacks. Indeed, as the subject should sleep overnight in a laboratory and because of sensors being in direct contact with him, artifacts modifying sleep quality are often observed. This work investigates an analysis of the viability of an ultrasonic device to quantify the breathing activity, without contact and without any perception by the subject. Based on a low power ultrasonic active source and transducer, the device measures the frequency shift produced by the velocity difference between the exhaled air flow and the ambient environment, i.e., the Doppler effect. After acquisition and digitization, a specific signal processing is applied to separate the effects of breath from those due to subject movements from the Doppler signal. The distance between the source and the sensor, about 50 cm, and the use of ultrasound frequency well above audible frequencies, 40 kHz, allow monitoring the breathing activity without any perception by the subject, and therefore without any modification of the sleep quality which is very important for sleep disorders diagnostic applications. This work is patented (patent pending 2013-7-31 number FR.13/57569.

  12. Decreased chewing activity during mouth breathing.

    Science.gov (United States)

    Hsu, H-Y; Yamaguchi, K

    2012-08-01

    This study examined the effect of mouth breathing on the strength and duration of vertical effect on the posterior teeth using related functional parameters during 3 min of gum chewing in 39 nasal breathers. A CO(2) sensor was placed over the mouth to detect expiratory airflow. When no airflow was detected from the mouth throughout the recording period, the subject was considered a nasal breather and enrolled in the study. Electromyographic (EMG) activity was recorded during 3 min of gum chewing. The protocol was repeated with the nostrils occluded. The strength of the vertical effect was obtained as integrated masseter muscle EMG activity, and the duration of vertical effect was also obtained as chewing stroke count, chewing cycle variation and EMG activity duration above baseline. Baseline activity was obtained from the isotonic EMG activity during jaw movement at 1.6 Hz without making tooth contact. The duration represented the percentage of the active period above baseline relative to the 3-min chewing period. Paired t-test and repeated analysis of variance were used to compare variables between nasal and mouth breathing. The integrated EMG activity and the duration of EMG activity above baseline, chewing stroke count and chewing cycle significantly decreased during mouth breathing compared with nasal breathing (Pmouth breathing was significantly greater than nasal breathing (PMouth breathing reduces the vertical effect on the posterior teeth, which can affect the vertical position of posterior teeth negatively, leading to malocclusion.

  13. An ultrasonic contactless sensor for breathing monitoring.

    Science.gov (United States)

    Arlotto, Philippe; Grimaldi, Michel; Naeck, Roomila; Ginoux, Jean-Marc

    2014-08-20

    The monitoring of human breathing activity during a long period has multiple fundamental applications in medicine. In breathing sleep disorders such as apnea, the diagnosis is based on events during which the person stops breathing for several periods during sleep. In polysomnography, the standard for sleep disordered breathing analysis, chest movement and airflow are used to monitor the respiratory activity. However, this method has serious drawbacks. Indeed, as the subject should sleep overnight in a laboratory and because of sensors being in direct contact with him, artifacts modifying sleep quality are often observed. This work investigates an analysis of the viability of an ultrasonic device to quantify the breathing activity, without contact and without any perception by the subject. Based on a low power ultrasonic active source and transducer, the device measures the frequency shift produced by the velocity difference between the exhaled air flow and the ambient environment, i.e., the Doppler effect. After acquisition and digitization, a specific signal processing is applied to separate the effects of breath from those due to subject movements from the Doppler signal. The distance between the source and the sensor, about 50 cm, and the use of ultrasound frequency well above audible frequencies, 40 kHz, allow monitoring the breathing activity without any perception by the subject, and therefore without any modification of the sleep quality which is very important for sleep disorders diagnostic applications. This work is patented (patent pending 2013-7-31 number FR.13/57569).

  14. Breathing and sleep at high altitude.

    Science.gov (United States)

    Ainslie, Philip N; Lucas, Samuel J E; Burgess, Keith R

    2013-09-15

    We provide an updated review on the current understanding of breathing and sleep at high altitude in humans. We conclude that: (1) progressive changes in pH initiated by the respiratory alkalosis do not underlie early (48 h), complex cellular and neurochemical re-organization occurs both in the peripheral chemoreceptors as well as within the central nervous system. The latter is likely influenced by central acid-base changes secondary to the extent of the initial respiratory responses to initial exposure to high altitude; (3) sleep at high altitude is disturbed by various factors, but principally by periodic breathing; (4) the extent of periodic breathing during sleep at altitude intensifies with duration and severity of exposure; (5) complex interactions between hypoxic-induced enhancement in peripheral and central chemoreflexes and cerebral blood flow--leading to higher loop gain and breathing instability--underpin this development of periodic breathing during sleep; (6) because periodic breathing may elevate rather than reduce mean SaO2 during sleep, this may represent an adaptive rather than maladaptive response; (7) although oral acetazolamide is an effective means to reduce periodic breathing by 50-80%, recent studies using positive airway pressure devices to increase dead space, hyponotics and theophylline are emerging but appear less practical and effective compared to acetazolamide. Finally, we suggest avenues for future research, and discuss implications for understanding sleep pathology.

  15. Improving reproductive health knowledge in rural China--a web-based strategy.

    Science.gov (United States)

    Tang, Songyuan; Tian, Lichuan; Cao, Wei Wei; Zhang, Kaining; Detels, Roger; Li, Virginia C

    2009-01-01

    In China, one of the major problems in upgrading rural health services is the difficulty of communicating between the rural and urban areas. Enabling local agencies to access the Internet in resource-poor areas can provide an efficient means of diffusing current training and information and will have far-reaching policy implications. To test the feasibility of using the Internet to deliver needed health information to the countryside, the UCLA School of Public Health and the Institute of Health Studies of Kunming Medical College (IHS-KMC) collaborated in an experimental website project to improve the quality of reproductive health services to promote women's health in three rural counties of Yunnan. The project involved the county government and the Bureau of Public Health, the Bureau of Family Planning; the Bureau of Education, Women's Federation, and the Maternal and Child Health Station targeting village health workers and teachers; women's cadres. Three counties, matched on socioeconomic status, participated in the study and were randomized to receive three programs. Nanhua County received computer skill training and logistic support including a planning workshop for information diffusion. Mouding County received computers only. Dayao, the control county, did not receive the full program until the conclusion of the project. The study demonstrated that the use of a website to disseminate health information in remote rural areas is not only feasible but that it also will be enthusiastically adopted by local health workers and interested parties. Moreover, the knowledge was diffused from the primary population of village doctors, family planning workers, women's cadres, and teachers to the secondary population of villagers and students.

  16. Front-line worker engagement: greening health care, improving worker and patient health, and building better jobs.

    Science.gov (United States)

    Chenven, Laura; Copeland, Danielle

    2013-01-01

    Frontline workers have a great deal to contribute to improving environmental sustainability of their employers and the health of workers and patients. This article discusses a national project of the Healthcare Career Advancement Program, funded by the U.S. Department of Labor to support green jobs development. Implementation was accomplished through a labor/management collaboration between union locals and 11 employers in four regions throughout the United States. The project developed and implemented a model of training and education for environmental service workers and other frontline health-care workers in hospital settings that supported systems change and built new roles for these workers. It empowered them to contribute to triple bottom line outcomes in support of People (patients, workers, the community), Planet (environmental sustainability and a lower carbon footprint), and Profit (cost savings for the institutions). In the process workers more clearly articulated their important role as a part of the healthcare team and learned how they could contribute to improved patient and worker health and safety.

  17. Geographic information system for improving maternal and newborn health: recommendations for policy and programs.

    Science.gov (United States)

    Molla, Yordanos B; Rawlins, Barbara; Makanga, Prestige Tatenda; Cunningham, Marc; Ávila, Juan Eugenio Hernández; Ruktanonchai, Corrine Warren; Singh, Kavita; Alford, Sylvia; Thompson, Mira; Dwivedi, Vikas; Moran, Allisyn C; Matthews, Zoe

    2017-01-11

    This correspondence argues and offers recommendations for how Geographic Information System (GIS) applied to maternal and newborn health data could potentially be used as part of the broader efforts for ending preventable maternal and newborn mortality. These recommendations were generated from a technical consultation on reporting and mapping maternal deaths that was held in Washington, DC from January 12 to 13, 2015 and hosted by the United States Agency for International Development's (USAID) global Maternal and Child Survival Program (MCSP). Approximately 72 participants from over 25 global health organizations, government agencies, donors, universities, and other groups participated in the meeting.The meeting placed emphases on how improved use of mapping could contribute to the post-2015 United Nation's Sustainable Development Goals (SDGs), agenda in general and to contribute to better maternal and neonatal health outcomes in particular. Researchers and policy makers have been calling for more equitable improvement in Maternal and Newborn Health (MNH), specifically addressing hard-to-reach populations at sub-national levels. Data visualization using mapping and geospatial analyses play a significant role in addressing the emerging need for improved spatial investigation at subnational scale. This correspondence identifies key challenges and recommendations so GIS may be better applied to maternal health programs in resource poor settings. The challenges and recommendations are broadly grouped into three categories: ancillary geospatial and MNH data sources, technical and human resources needs and community participation.

  18. How does breathing frequency affect the performance of an N95 filtering facepiece respirator and a surgical mask against surrogates of viral particles?

    Science.gov (United States)

    He, Xinjian; Reponen, Tiina; McKay, Roy; Grinshpun, Sergey A

    2014-01-01

    Breathing frequency (breaths/min) differs among individuals and levels of physical activity. Particles enter respirators through two principle penetration pathways: faceseal leakage and filter penetration. However, it is unknown how breathing frequency affects the overall performance of N95 filtering facepiece respirators (FFRs) and surgical masks (SMs) against viral particles, as well as other health-relevant submicrometer particles. A FFR and SM were tested on a breathing manikin at four mean inspiratory flows (MIFs) (15, 30, 55, and 85 L/min) and five breathing frequencies (10, 15, 20, 25, and 30 breaths/min). Filter penetration (Pfilter) and total inward leakage (TIL) were determined for the tested respiratory protection devices against sodium chloride (NaCl) aerosol particles in the size range of 20 to 500 nm. "Faceseal leakage-to-filter" (FLTF) penetration ratios were calculated. Both MIF and breathing frequency showed significant effects (p breathing frequency increased TIL for the N95 FFR whereas no clear trends were observed for the SM. Increasing MIF increased Pfilter and decreased TIL resulting in decreasing FLTF ratio. Most of FLTF ratios were >1, suggesting that the faceseal leakage was the primary particle penetration pathway at various breathing frequencies. Breathing frequency is another factor (besides MIF) that can significantly affect the performance of N95 FFRs, with higher breathing frequencies increasing TIL. No consistent trend of increase or decrease of TIL with either MIF or breathing frequency was observed for the tested SM. To potentially extend these findings beyond the manikin/breathing system used, future studies are needed to fully understand the mechanism causing the breathing frequency effect on the performance of respiratory protection devices on human subjects.

  19. Improving the Validity and Reliability of a Health Promotion Survey for Physical Therapists

    Science.gov (United States)

    Stephens, Jaca L.; Lowman, John D.; Graham, Cecilia L.; Morris, David M.; Kohler, Connie L.; Waugh, Jonathan B.

    2013-01-01

    Purpose Physical therapists (PTs) have a unique opportunity to intervene in the area of health promotion. However, no instrument has been validated to measure PTs’ views on health promotion in physical therapy practice. The purpose of this study was to evaluate the content validity and test-retest reliability of a health promotion survey designed for PTs. Methods An expert panel of PTs assessed the content validity of “The Role of Health Promotion in Physical Therapy Survey” and provided suggestions for revision. Item content validity was assessed using the content validity ratio (CVR) as well as the modified kappa statistic. Therapists then participated in the test-retest reliability assessment of the revised health promotion survey, which was assessed using a weighted kappa statistic. Results Based on feedback from the expert panelists, significant revisions were made to the original survey. The expert panel reached at least a majority consensus agreement for all items in the revised survey and the survey-CVR improved from 0.44 to 0.66. Only one item on the revised survey had substantial test-retest agreement, with 55% of the items having moderate agreement and 43% poor agreement. Conclusions All items on the revised health promotion survey demonstrated at least fair validity, but few items had reasonable test-retest reliability. Further modifications should be made to strengthen the validity and improve the reliability of this survey. PMID:23754935

  20. Federal Enactment of Healthy Homes Legislation in the United States to Improve Public Health

    Directory of Open Access Journals (Sweden)

    Alesia Coralie Ferguson

    2016-03-01

    Full Text Available Not all homes across America are ‘healthy’ homes. This contributes to the poor health of Americans and exacerbates existing health conditions costing millions each year in health care cost. Newer research is being conducted into strategies to alleviate biological, chemical and physical hazards in the home, and various programs exist to assist the homeowner in making improvements in the quality of their home. Not every homeowner or renter nationwide or within community localities has access to these strategies or programs that could potentially improve their home environment and therefore the health of their family. The objective of this article is to propose elements of a policy to address this inconsistency and variation. This proposal centers around the federal enactment of a national policy demanding that each state implements a healthy homes program tailored to fit their specific state housing and health needs. Members of Congress from States that have successfully implemented healthy home programs should champion this policy. Organizations that recognize the impact of housing on health should support the development of a national healthy homes strategy. This article will discuss the need, outcomes, stakeholders, and minimum requirements of such a policy.

  1. [Dutch Institute for Health Care Improvement revised guideline, 'Sexually transmitted diseases and neonatal herpes'

    NARCIS (Netherlands)

    Bleker, O.P.; Meijden, W.I. van der; Wittenberg, J.; Bergen, J.E. van; Boeke, A.J.; Doornum, G.J.J. van; Henquet, C.J.; Galama, J.M.D.; Postma, M.J.; Prins, J.M.; Voorst Vader, P.C. van

    2003-01-01

    The Dutch Institute for Health Care Improvement revised guideline, 'Sexually transmitted diseases and neonatal herpes' summarises the current scientific position on the diagnosis and treatment of a great number of sexually transmitted diseases (STD) and neonatal herpes. Symptomatic treatment of susp

  2. Comparing the implementation of team approaches for improving diabetes care in community health centers

    NARCIS (Netherlands)

    Wees, P.J. van der; Friedberg, M.W.; Guzman, E.; Ayanian, J.Z.; Rodriguez, H.P.

    2014-01-01

    BackgroundPatient panel management and community-based care management may be viable strategies for community health centers to improve the quality of diabetes care for vulnerable patient populations. The objective of our study was to clarify implementation processes and experiences of integrating o

  3. Improving access to essential health care services: The case of Israel

    NARCIS (Netherlands)

    W.P.M.M. van de Ven (Wynand)

    2016-01-01

    textabstractIn a recent article in this journal Simon-Tuval, Horev and Kaplan argue that in order to improve the protection of consumers there might be a need to impose a threshold on the medical loss ratio (MLR) for voluntary health insurance (VHI) in Israel [1]. Their argument is that VHI in Israe

  4. Improving Women's Sexual Health: A Quantitative Evaluation of an Educational Intervention for Healthcare Professionals

    Science.gov (United States)

    Blair, Britney; Arnow, B. A.; Haas, Amie; Millheiser, Leah

    2013-01-01

    Forty-three per cent of women in the USA report some type of sexual complaint and these complaints have been shown to negatively impact quality of life and overall well-being. With proper training and experience, healthcare professionals are in a unique position to help their patients improve their sexual health. The present study was designed to…

  5. Joined-up Working: Improving Young People's Sexual Health and Enhancing Social Inclusion?

    Science.gov (United States)

    Philip, Kate; Shucksmith, Janet; Tucker, Janet; van Teijlingen, Edwin; Immamura, Mari; Penfold, Suzanne

    2006-01-01

    This paper builds on debates about the meaning and definition of social exclusion through an empirical analysis undertaken as part of a four-year evaluation study of a Scottish demonstration project on young peoples' sexual health. It examines how interventions to improve sexual well-being might be construed as a way of promoting social inclusion,…

  6. Toward a sustainable cement industry in 2020 : improvement of the environmental, health & safety performance

    NARCIS (Netherlands)

    2001-01-01

    This background document concentrates on technical and managerial aspects of Environmental, Health & Safety Performance (EHS) control in the cement industry. It gives an overview of options for improvement toward a sustainable cement production in 2020. Energy consumption and use of alternative fuel

  7. Characteristics of Effective Interventions in Improving Young People's Sexual Health: A Review of Reviews

    Science.gov (United States)

    Poobalan, Amudha S.; Pitchforth, Emma; Imamura, Mari; Tucker, Janet S.; Philip, Kate; Spratt, Jenny; Mandava, Lakshmi; van Teijlingen, Edwin

    2009-01-01

    The purpose of this paper is to conduct a review of reviews to identify characteristics of effective sex and relationship education (SRE) interventions and/or programmes in young people to improve sexual health and identify barriers and facilitators for implementation. Six bibliographic databases were searched from 1986 to 2006 for systematic…

  8. Modeling energy efficiency to improve air quality and health effects of China's cement industry

    NARCIS (Netherlands)

    Zhang, Shaohui; Worrell, Ernst; Crijns-Graus, Wina; Krol, Maarten; de Bruine, Marco; Geng, Guangpo; Wagner, Fabian; Cofala, Janusz

    2016-01-01

    Actions to reduce the combustion of fossil fuels often decrease GHG emissions as well as air pollutants and bring multiple benefits for improvement of energy efficiency, climate change, and air quality associated with human health benefits. The China's cement industry is the second largest energy co

  9. Improving district level health planning and priority setting in Tanzania through implementing accountability for reasonableness framework

    DEFF Research Database (Denmark)

    Maluka, Stephen; Kamuzora, Peter; Sebastián, Miguel San

    2010-01-01

    In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania...

  10. How to do better health reform: a snapshot of change and improvement initiatives in the health systems of 30 countries.

    Science.gov (United States)

    Braithwaite, Jeffrey; Matsuyama, Yukihiro; Mannion, Russell; Johnson, Julie; Bates, David W; Hughes, Cliff

    2016-09-21

    Health systems are continually being reformed. Why, and how? To answer these questions, we draw on a book we recently contributed, Healthcare Reform, Quality and Safety: Perspectives, Participants, Partnerships and Prospects in 30 Countries We analyse the impact that these health-reform initiatives have had on the quality and safety of care in an international context-that is, in low-, middle- and high-income countries-Argentina, Australia, Brazil, Chile, China, Denmark, England, Ghana, Germany, the Gulf states, Hong Kong, India, Indonesia, Israel, Italy, Japan, Mexico, Myanmar, New Zealand, Norway, Oman, Papua New Guinea (PNG), South Africa, the USA, Scotland and Sweden. Popular reforms in less well-off countries include boosting equity, providing infrastructure, and reducing mortality and morbidity in maternal and child health. In countries with higher GDP per capita, the focus is on new IT systems or trialling innovative funding models. Wealthy or less wealthy, countries are embracing ways to enhance quality of care and keep patients safe, via mechanisms such as accreditation, clinical guidelines and hand hygiene campaigns. Two timely reminders are that, first, a population's health is not determined solely by the acute system, but is a product of inter-sectoral effort-that is, measures to alleviate poverty and provide good housing, education, nutrition, running water and sanitation across the population. Second, all reformers and advocates of better-quality of care should include well-designed evaluation in their initiatives. Too often, improvement is assumed, not measured. That is perhaps the key message.

  11. Improved health among people living with HIV/AIDS who received packages of proven preventive health interventions, Amhara, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Ciara E O'Reilly

    Full Text Available In 2009, basic care packages (BCP containing health products were distributed to HIV-infected persons in Ethiopia who were clients of antiretroviral therapy clinics. To measure health impact, we enrolled clients from an intervention hospital and comparison hospital, and then conducted a baseline survey, and 7 bi-weekly home visits. We enrolled 405 intervention group clients and 344 comparison clients. Intervention clients were more likely than comparison clients to have detectable chlorine in stored water (40% vs. 1%, p<0.001, soap (51% vs. 36%, p<0.001, and a BCP water container (65% vs. 0%, p<0.001 at every home visit. Intervention clients were less likely than comparison clients to report illness (44% vs. 67%, p<0.001 or health facility visits for illness (74% vs. 95%, p<0.001, and had lower median illness scores (1.0 vs. 3.0, p<0.05. Participation in the BCP program appeared to improve reported health outcomes.

  12. On Applying Six Sigma To Improving The Relationship Quality Of Fitness And Health Clubs

    Directory of Open Access Journals (Sweden)

    Kuei-Mei Cheng

    2013-11-01

    Full Text Available Running a fitness and health club is a service-intensive business. Although it is not an easy job to provide high quality and satisfying services to customers, it is in fact the ultimate goal for most fitness and health clubs. For this reason, providing quality services and building a good relationship with customers has become an important issue for operating and managing a fitness and health club. This study adopts Six Sigma and the performance evaluation matrix as two major research tools. By implementing the steps (define, measure, analyze, improve, and control of Six Sigma and through the nine performance boxes generated by the importance-satisfaction matrix (with importance as the horizontal axis and satisfaction as the vertical axis of Importance-Performance Analysis (IPA, this study aims to specifically identify the services most requested by customers in an effort to provide highly satisfying services and improve relationship quality.

  13. Continuous quality improvement in acute health care: creating a holistic and integrated approach.

    Science.gov (United States)

    Sewell, N

    1997-01-01

    Reviews the range of quality activity in a National Health Service hospital trust, using a staff questionnaire survey, self-assessment against the Baldrige Quality Award criteria, and the application of the SERVQUAL approach to service quality assessment. Reviews the acute health care quality programme literature. Finds that there are needs for greater integration of quality effort, to engage with patients in a more meaningful manner, and to achieve greater commitment and involvement from clinicians and managers. Identifies lack of time and resources as a major barrier to greater application of quality programmes. Explores ways of developing a more holistic and integrated programme of quality improvement. Describes the creation and implementation of a model for continuous improvement in health care quality.

  14. INFLUENCE OF MUSIC THERAPY AND BREATHING EXERCISES ON ANXIETY IN POST-OPERATIVE CARDIAC DISEASED INDIVIDUALS

    Directory of Open Access Journals (Sweden)

    C. Janardan

    2016-02-01

    Full Text Available Background: Asian Indians have a higher operative and overall increased mortality following coronary bypass surgery. They also have higher rates of post operative complications and repeat surgeries. Apart from physiological complications like post-operative pain, atelectasis, deep vein thrombosis, the psychological disorders are like anxiety and stress also predominantly play a major role in the morbidity of the post-surgical conditions. The aim of study is to know the influence of music therapy and breathing exercises on post-surgical cardiac diseased individuals. To evaluate the influence of music therapy and breathing exercises on physiological parameters(BP,HR,RR in post surgical cardiac diseased individuals by using electro cardio monitor and state-trait anxiety scale. Methods: Subjects were randomly divided into two groups. Experimental group, where the subjects received music therapy and breathing exercises. Control group, where the subjects received breathing exercises. All the participants were assessed with STAI scale and physiological parameters like blood pressure, heart rate and respiration rate for both groups before and after the treatment. Paired sample t-test was used to compare the STAI scale and physiological parameters within the groups. Result: Results showed a significant improvement in both the groups but, more improvement was seen in experimental group compared to control group. Conclusion: Results suggested that music therapy and breathing exercises influences more effective than breathing exercises alone.

  15. Effects of slow deep breathing at high altitude on oxygen saturation, pulmonary and systemic hemodynamics.

    Directory of Open Access Journals (Sweden)

    Grzegorz Bilo

    Full Text Available Slow deep breathing improves blood oxygenation (Sp(O2 and affects hemodynamics in hypoxic patients. We investigated the ventilatory and hemodynamic effects of slow deep breathing in normal subjects at high altitude. We collected data in healthy lowlanders staying either at 4559 m for 2-3 days (Study A; N = 39 or at 5400 m for 12-16 days (Study B; N = 28. Study variables, including Sp(O2 and systemic and pulmonary arterial pressure, were assessed before, during and after 15 minutes of breathing at 6 breaths/min. At the end of slow breathing, an increase in Sp(O2 (Study A: from 80.2±7.7% to 89.5±8.2%; Study B: from 81.0±4.2% to 88.6±4.5; both p<0.001 and significant reductions in systemic and pulmonary arterial pressure occurred. This was associated with increased tidal volume and no changes in minute ventilation or pulmonary CO diffusion. Slow deep breathing improves ventilation efficiency for oxygen as shown by blood oxygenation increase, and it reduces systemic and pulmonary blood pressure at high altitude but does not change pulmonary gas diffusion.

  16. COPD: Learn More, Breathe Better

    Science.gov (United States)

    ... Health Information for the Public » Educational Campaigns & Programs » COPD (Chronic Obstructive Pulmonary Disease) Join the conversation: A ... the National Institutes of Health. Get the Facts COPD is on the rise—more than 15 million ...

  17. The Nuka System of Care: improving health through ownership and relationships

    Directory of Open Access Journals (Sweden)

    Katherine Gottlieb

    2013-08-01

    Full Text Available Southcentral Foundation’s Nuka System of Care, based in Anchorage, Alaska, is a result of a customer-driven overhaul of what was previously a bureaucratic system centrally controlled by the Indian Health Service. Alaska Native people are in control as the “customer-owners” of this health care system. The vision and mission focus on physical, mental, emotional, and spiritual wellness and working together as a Native Community. Coupled with operational principles based on relationships, core concepts and key points, this framework has fostered an environment for creativity, innovation and continuous quality improvement. Alaska Native people have received national and international recognition for their work and have set high standards for performance excellence, community engagement, and overall impact on population health. In this article, the health care transformation led by Alaska Native people is described and the benefits and results of customer ownership and the relationship-based Nuka System of Care are discussed.

  18. Management Systems for Organic EggProduction - Aiming to Improve AnimalHealth and Welfare

    DEFF Research Database (Denmark)

    Hegelund, Lene

    one production period. In the second part of the project a generic HACCP system was developed, using an expert panel analysis. The two management tools have very different approaches to improving animal health and welfare, and subsequently different methods, cost and advantages. This makes them......Animal health and welfare is an important part of organic husbandry, both in terms of the organic principles and owing to the consumer interest. But problems in the organic egg production resulting in high mortality and feather pecking, have led to the need for management tools in order to secure...... animal health and welfare. The aim of the project is to develop management tools for the organic egg production, aimed to secure animal health and welfare in the flocks. In the first part of the project a welfare assessment system for organic egg production was developed and tested on 10 fl ocks during...

  19. 呼吸放松联合音乐疗法改善肝癌动脉化疗栓塞病人术中焦虑情绪及疼痛的研究%Breathing relaxed music therapy to improve liver artery chemotherapy embolism patients anxiety and pain research

    Institute of Scientific and Technical Information of China (English)

    杨涛涛; 孙敬梅; 张春婷; 莫庆国

    2015-01-01

    Purpose Breathing relaxed music therapy to improve liver artery chemotherapy embolism patient anxiety and observe the effect of pain. Evaluation method 60 patients with liver cancer interventional surgery in the operating room,the control group accepted routine nursing intervention operation,the experimental group on the basis of conventional nursing care to give music combination breathing relaxation therapy. Observed two groups of intraoperatie state anxiety and pain of patients, (SaS) and (VaS) for two groups of patients for anxiety,pain.Results The experimental group after intervention and SaS score of VaS scores were lower than control group (P< 0.01) difference was statistically significant;Conclusion Breathing relaxed joint music therapy can reduce patient tension,relieve pain,improve the patients tolerated.%目的:呼吸放松联合音乐疗法改善肝癌动脉化疗栓塞病人术中焦虑情绪及疼痛的效果观察。评价方法:选择肝动脉化疗栓塞手术的患者60例,平均分为实验组和对照组,对照组予以介入手术常规护理,实验组在基础护理上增加呼吸放松联合音乐疗法。观察两组病人术中焦虑状态及疼痛情况,采用焦虑自评量表(SaS)和疼痛视觉模拟量表(VaS)对两组病人的焦虑、疼痛情况进行比较。结果:干预后实验组病人的SaS评分及VaS分值均低于对照组(P<0.01)差异有统计学意义;结论:呼吸放松联合音乐疗法可减轻病人紧张情绪,缓解疼痛,提高病人手术的耐受性。

  20. An asthma and diabetes quality improvement project: enhancing care in clinics and community health centers.

    Science.gov (United States)

    Silver, Alan; Figge, James; Haskin, Donna L; Pryor, Veronica; Fuller, Karen; Lemme, Thomas; Li, Nancy; O'Brien, Mary Jane

    2011-04-01

    Asthma and diabetes are major chronic conditions in the United States, particularly in the Medicaid population. The majority of care for these diseases occurs at ambulatory practice sites. The New York State Department of Health Office of Health Insurance Programs (OHIP) worked with IPRO, the New York State Medicare quality improvement organization, to develop and implement a quality improvement project (QIP) for these conditions. The approach was based upon the Chronic Care Model and used an iterative academic-detailing methodology. Clinics and community health centers volunteered to participate and used IPRO-collected data with audit and feedback to improve their practices. Several metrics significantly improved for asthma (e.g., use of anti-inflammatory long term controller agents, assessment of asthma severity, use of asthma action plans) and for diabetes (e.g., lipid testing and control, A1c testing). Key organizational elements of success included senior medical leadership commitment and practice site quality improvement team meetings. OHIP has used the QIP experience to begin patient-centered medical home implementation in New York State.