Full Text Available Abstract Background Published practical examples of how to bridge gaps between research, policy and practice in health systems research in Sub Saharan Africa are scarce. The aim of our study was to use a case study approach to analyse how and why different operational health research projects in Africa have contributed to health systems strengthening and promoted equity in health service provision. Methods Using case studies we have collated and analysed practical examples of operational research projects on health in Sub-Saharan Africa which demonstrate how the links between research, policy and action can be strengthened to build effective and pro-poor health systems. To ensure rigour, we selected the case studies using pre-defined criteria, mapped their characteristics systematically using a case study development framework, and analysed the research impact process of each case study using the RAPID framework for research-policy links. This process enabled analysis of common themes, successes and weaknesses. Results 3 operational research projects met our case study criteria: HIV counselling and testing services in Kenya; provision of TB services in grocery stores in Malawi; and community diagnostics for anaemia, TB and malaria in Nigeria. Political context and external influences: in each case study context there was a need for new knowledge and approaches to meet policy requirements for equitable service delivery. Collaboration between researchers and key policy players began at the inception of operational research cycles. Links: critical in these operational research projects was the development of partnerships for capacity building to support new services or new players in service delivery. Evidence: evidence was used to promote policy dialogue around equity in different ways throughout the research cycle, such as in determining the topic area and in development of indicators. Conclusion Building equitable health systems means
Lusi Herawati Sunyoto Usman Mark Zuidgeest
as indicators. Flowmap tool is used to analyze catchment area of each health facility using different transport modes choice:becak and public transport for poor group and motorcycle and car for non-poor group with different travel time within 30, 60 and more than 60 minutes. It is concluded that there was an accessibility difference between poor and non-poor group. The accessibility to the health facilities of poor group was lower than non-poor group. This condition occurred because the government policy of equitable access to health service facility did not pay attention to accessibility of poor group.
Weale, Albert; Kieslich, Katharina; Littlejohns, Peter; Tugendhaft, Aviva; Tumilty, Emma; Weerasuriya, Krisantha; Whitty, Jennifer A
Purpose - The purpose of this paper is to introduce the special issue on improving equitable access to health care through increased public and patient involvement (PPI) in prioritization decisions by discussing the conceptualization, scope and rationales of PPI in priority setting that inform the special issue. Design/methodology/approach - The paper employs a mixed-methods approach in that it provides a literature review and a conceptual discussion of the common themes emerging in the field of PPI and health priority setting. Findings - The special issue focuses on public participation that is collective in character, in the sense that the participation relates to a social, not personal, decision and is relevant to whole groups of people and not single individuals. It is aimed at influencing a decision on public policy or legal rules. The rationales for public participation can be found in democratic theory, especially as they relate to the social and political values of legitimacy and representation. Originality/value - The paper builds on previous definitions of public participation by underlining its collective character. In doing so, it develops the work by Parry, Moyser and Day by arguing that, in light of the empirical evidence presented in this issue, public participatory activities such as protests and demonstrations should no longer be labelled unconventional, but should instead be labelled as "contestatory participation". This is to better reflect a situation in which these modes of participation have become more conventional in many parts of the world.
National Aeronautics and Space Administration — Abstract: Building health management is an important part in running an efficient and cost-effective building. Many problems in a building’s system can go undetected...
Allen, Joseph G; MacNaughton, Piers; Laurent, Jose Guillermo Cedeno; Flanigan, Skye S; Eitland, Erika Sita; Spengler, John D
Green building design is becoming broadly adopted, with one green building standard reporting over 3.5 billion square feet certified to date. By definition, green buildings focus on minimizing impacts to the environment through reductions in energy usage, water usage, and minimizing environmental disturbances from the building site. Also by definition, but perhaps less widely recognized, green buildings aim to improve human health through design of healthy indoor environments. The benefits related to reduced energy and water consumption are well-documented, but the potential human health benefits of green buildings are only recently being investigated. The objective of our review was to examine the state of evidence on green building design as it specifically relates to indoor environmental quality and human health. Overall, the initial scientific evidence indicates better indoor environmental quality in green buildings versus non-green buildings, with direct benefits to human health for occupants of those buildings. A limitation of much of the research to date is the reliance on indirect, lagging and subjective measures of health. To address this, we propose a framework for identifying direct, objective and leading "Health Performance Indicators" for use in future studies of buildings and health.
Zúñiga F, Alejandra
This paper analyzes the constitutional problems that the private health system has faced as a result of the recent decisions of the Constitutional Court and the Supreme Court of Chile in defense of the right to health care and nondiscrimination. It also reviews the comparative literature on health systems that have been successful in the task of reconciling the demands of equity and efficiency in the delivery of health care in the private health sector, in accordance with the constitutional principles of equality and nondiscrimination.
Dutta, Mousumi; Husain, Zakir
In this paper, we examine the relationship between socio-economic status (SES) and the usage of in-patient services, and analyze the impact of introducing health insurance in India - a major developing country with poor health outcomes. In contrast to results of similar works undertaken for developed countries, our results reveal that the positive relation between usage of in-patient services and SES persists even in the presence of health insurance. This implies that health insurance is unable to eliminate the inequities in accessing healthcare services that stem from disparities in SES. In fact, insurance aggravates inequity in the healthcare market. The study is based on unit-level data from the 2005-06 Morbidity and Health Care Survey undertaken by National Sample Survey Organization.
Bottiani, Jessika H; Bradshaw, Catherine P; Mendelson, Tamar
In response to persistent racial disparities in academic and behavioral outcomes between Black and White students, equitable school climate has drawn attention as a potential target for school reform. This study examined differences in Black and White students' experiences of school climate and explored whether indicators of school organizational health and staff burnout moderated differences in students' school experiences by race. Utilizing hierarchical linear modeling with a sample of 18,397 Black students (n=6228) and White students (n=12,169) and 2391 school staff in 53 schools, we found a consistent pattern of racial inequalities, such that Black students reported less positive experiences than White students across three indicators of school climate (caring γ=-0.08, porganizational health and student-reported school climate (e.g., staff affiliation and student-perceived equity, γ=0.07, porganizational health indicators were more strongly associated with positive perceptions of school climate among White students than Black students, translating into greater racial disparities in perceived school climate at schools with greater organizational health (e.g., supportive leadership by race on student-perceived engagement, γ=-0.03, p=.042). We also found negative associations between staff-reported burnout and students' experience of equity, such that the racial gap was smaller in schools with high ratings of burnout (γ=0.04, p=.002). These findings have implications for educators and education researchers interested in promoting school social contexts that equitably support student engagement and success.
Full Text Available Abstract Background Although most donor and development agency attention is focussed on communicable diseases in Kenya, the importance of non-communicable diseases including mental health and mental illness is increasingly apparent, both in their own right and because of their influence on health, education and social goals. Mental illness is common but the specialist service is extremely sparse and primary care is struggling to cope with major health demands. Non health sectors e.g. education, prisons, police, community development, gender and children, regional administration and local government have significant concerns about mental health, but general health programmes have been surprisingly slow to appreciate the significance of mental health for physical health targets. Despite a people centred post colonial health delivery system, poverty and global social changes have seriously undermined equity. This project sought to meet these challenges, aiming to introduce sustainable mental health policy and implementation across the country, within the context of extremely scarce resources. Methods A multi-faceted and comprehensive programme which combined situation appraisal to inform planning, sustained intersectoral policy dialogue at national and regional level; establishment of a health sector system for coordination, supervision and training of at each level (national, regional, district and primary care; development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at national, regional, district and local levels; public education; and integration of mental health into health management systems. Results The programme has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, annual operational plans, mental health policy guidelines
Full Text Available Background: The importance of the social determinants of health (SDH and barriers to the access and utilization of healthcare have been widely recognized but not previously studied in the context of universal healthcare coverage (UHC in Brazil and other developing countries. Objective: To evaluate a set of proposed indicators of SDH and barriers to the access and utilization of healthcare – proposed by the SDH unit of the World Health Organization – with respect to their relevance in tracking progress in moving toward equitable population health and UHC in Brazil. Design: This study had a mixed methodology, combining a quantitative analysis of secondary data from governmental sources with a qualitative study comprising two focus group discussions and six key informant interviews. The set of indicators tested covered a broad range of dimensions classified by three different domains: environment quality; accountability and inclusion; and livelihood and skills. Indicators were stratified according to income quintiles, urbanization, race, and geographical region. Results: Overall, the indicators were adequate for tracking progress in terms of the SDH, equity, gender, and human rights in Brazil. Stratifications showed inequalities. The qualitative analysis revealed that many of the indicators were well known and already used by policymakers and health sector managers, whereas others were considered less useful in the Brazilian context. Conclusions: Monitoring and evaluation practices have been developed in Brazil, and the set of indicators assessed in this study could further improve these practices, especially from a health equity perspective. Socioeconomic inequalities have been reduced in Brazil in the last decade, but there is still much work to be done in relation to addressing the SDH.
Full Text Available Abstract Background Adequate resource allocation is an important factor to ensure equity in health care. Previous reimbursement models have been based on age, gender and socioeconomic factors. An explanatory model based on individual need of primary health care (PHC has not yet been used in Sweden to allocate resources. The aim of this study was to examine to what extent the ACG case-mix system could explain concurrent costs in Swedish PHC. Methods Diagnoses were obtained from electronic PHC records of inhabitants in Blekinge County (approx. 150,000 listed with public PHC (approx. 120,000 for three consecutive years, 2004-2006. The inhabitants were then classified into six different resource utilization bands (RUB using the ACG case-mix system. The mean costs for primary health care were calculated for each RUB and year. Using linear regression models and log-cost as dependent variable the adjusted R2 was calculated in the unadjusted model (gender and in consecutive models where age, listing with specific PHC and RUB were added. In an additional model the ACG groups were added. Results Gender, age and listing with specific PHC explained 14.48-14.88% of the variance in individual costs for PHC. By also adding information on level of co-morbidity, as measured by the ACG case-mix system, to specific PHC the adjusted R2 increased to 60.89-63.41%. Conclusion The ACG case-mix system explains patient costs in primary care to a high degree. Age and gender are important explanatory factors, but most of the variance in concurrent patient costs was explained by the ACG case-mix system.
Bornehag, Carl-Gustaf; Blomquist, G.; Gyntelberg, F.;
in the epidemiological literature. A literature search identified 590 peer-reviewed articles of which 61 have been the foundation for this review. The review shows that "dampness" in buildings appears to increase the risk for health effects in the airways, such as cough, wheeze and asthma. Relative risks...
Virgilio Mariano Salazar Torres
Full Text Available Background: Traditional forms of masculinity strongly influence men's and women's wellbeing. Objective: This study has two aims: (i to explore notions of various forms of masculinities in young Nicaraguan men participating in programs addressing sexual health, reproductive health, and/or gender equality and (ii to find out how these young men perceive their involvement in actions aimed at reducing violence against women (VAW. Design: A qualitative grounded theory study. Data were collected through six focus groups and two in-depth interviews with altogether 62 young men. Results: Our analysis showed that the informants experienced a process of change, labeled ‘Expanding your mind’, in which we identified four interrelated subcategories: The apprentice, The responsible/respectful man, The proactive peer educator, and ‘The feminist man’. The process showed how an increased awareness of gender inequities facilitated the emergence of values (respect and responsibility and behavior (thoughtful action that contributed to increase the informant's critical thinking and agency at individual, social, and political levels. The process was influenced by individual and external factors. Conclusions: Multiple progressive masculinities can emerge from programs challenging patriarchy in this Latin American setting. The masculinities identified in this study show a range of attitudes and behaviors; however, all lean toward more equitable gender relations. The results suggest that learning about sexual and reproductive health does not directly imply developing more gender-equitable attitudes and behaviors or a greater willingness to prevent VAW. It is paramount that interventions to challenge machismo in this setting continue and are expanded to reach more young men.
In recent years health and comfort problems associated with the indoor climate have come to constitute a problem in Sweden. To come to grips with this a nationwide educational campaign on Buildings and Health is being run. It is directed to those involved in planning, project design, construction and management of buildings. The objective is to convey a body of knowledge to the many occupational and professional groups in the construction sector on how to avoid indoor climate problems in homes, schools, offices and other workplaces. The campaign is being run by the Swedish National Board of Housing and Planning and the Swedish Council for Building Research, in co-operation with various organizations and companies in the construction industry, and with municipalities and authorities. The knowledge which is being disseminated through the campaign is summarized in this compendium. figs., tabs.
As reported in last month's HEJ, the new Sustainable Development Strategy for the Health, Public Health and Social Care System for 2014-20 rightly emphasises the importance of the built environment to health and well-being. Chris Hall, the BRE's health sector lead, says this message 'stretches far beyond hospitals and healthcare buildings into the communities and homes that people live in'. Here he highlights some of the key elements relating to the current carbon efficiency of healthcare buildings, considers the impact of 'good' housing on health and preventing illness, and looks forward to a series of joint IHEEM and BRE 'Building Sustainable Development' mini-conference events planned in the run-up to October's Healthcare Estates 2014 event in response to the new Strategy, designed to share ideas and good practice on sustainable estates issues. The first takes place in London later this month (see panel below).
Clausen, Geo; Rode, Carsten; Bornehag, Carl-Gustaf;
on air distribution in indoor spaces. Particularly, using CFD models, it should be possible to study the local conditions in the vicinity of the human body.· Modelling and experimental investigation of humidity transfer and energy consumption in buildings. The research aims at establishing complete...... of the factors that influence the well being of occupants in the indoor climate. The perspective of this knowledge should be widened such that it will be possible to carry out an integral optimisation of a high indoor air quality in durable, low energy consuming buildings.While located at DTU, the centre......A so-called Engineering Research Centre on Indoor Climate and Energy has been established in 1998 at the Technical University of Denmark (DTU). For the first five years the centre is supported by the Danish Technical Research Council by almost 8 million DKK per year and by DTU by 6 permanent...
Evaluation of a demonstration primary health care project in rural Guatemala: the influence of predisposing, enabling and need factors on immunization coverage, equitable use of health care services and application of treatment guidelines.
Fort, Meredith P; Grembowski, David; Heagerty, Patrick; Lim, Stephen S; Mercer, Mary Anne
In high- and low-resource settings, care is often provided inequitably, with more and higher-quality services being offered to those who need them less. We evaluated the influence of predisposing, enabling and need characteristics on immunization coverage and use of health services in a population-based primary health care model called the Inclusive Health Model in rural Guatemala. We also analyzed providers' application of treatment guidelines for children with pneumonia. A longitudinal cohort design was used from 2006 to 2009 to analyze data from the model's two demonstration sites. We found a significant positive association between families' health risk level and their use of health care services, with the model providing more services to those with greater need. Services are not provided differentially for those families with a higher or lower wealth level or selected sociodemographic characteristics. Distance from a clinic is significantly associated with lower service use, but this constraint decreases with time. Implementation of treatment guidelines does not vary with different provider characteristics. The Inclusive Health Care model's aim of offering care equitably to families living in its catchment area is reflected in these findings. This study offers an approach and conceptual model for tracking equity in service delivery that may be applicable in other settings.
Colarossi, Lisa G.; Dean, Randa; Balakumar, Kavitha; Stevens, Alexandra
We present an organizational capacity building program that is a systemic approach to training professionals, creating organizational policies and practices, and enhancing the physical environment with materials about sexual and reproductive health. The evaluation of four different organizations showed increases over six months in: staff reports…
Kirkeby, Inge Mette; Jensen, Bjarne Bruun; Larsen, Kristian;
Aim: To investigate the kinds of knowledge practitioners use when planning and designing for health in school buildings. Methods: Twelve semi-structured qualitative interviews were conducted with architects, teachers and officials to investigate use of knowledge in the making of school buildings.......-dependent. It makes the knowledge vulnerable. Conclusions: Special attention has to be paid by research to concepts and principles to guide the decision-making in practice. Further is recommended to consider new kinds of collaboration between researchers and practitioners....
Full Text Available Background: South Africa is currently undergoing major health system restructuring in an attempt to improve health outcomes and reduce inequities in access. Such inequities exist between private and public health care and within the public health system itself. Experience shows that rural health care can be disadvantaged in policy formulation despite good intentions. The objective of this study was to identify the major challenges and priority interventions for rural health care provision in South Africa thereby contributing to pro-rural health policy dialogue. Methods: The Delphi technique was used to develop consensus on a list of statements that was generated through interviews and literature review. A panel of rural health practitioners and other stakeholders was asked to indicate their level of agreement with these statements and to rank the top challenges in and interventions required for rural health care. Results: Response rates ranged from 83% in the first round (n=44 to 64% in the final round (n=34. The top five priorities were aligned to three of the WHO health system building blocks: human resources for health (HRH, governance, and finance. Specifically, the panel identified a need to focus on recruitment and support of rural health professionals, the employment of managers with sufficient and appropriate skills, a rural-friendly national HRH plan, and equitable funding formulae. Conclusion: Specific policies and strategies are required to address the greatest rural health care challenges and to ensure improved access to quality health care in rural South Africa. In addition, a change in organisational climate and a concerted effort to make a career in rural health appealing to health care workers and adequate funding for rural health care provision are essential.
... 7 Agriculture 10 2010-01-01 2010-01-01 false Equitable treatment. 1400.8 Section 1400.8... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS General Provisions § 1400.8 Equitable treatment. (a... Administrator deems necessary to provide fair and equitable treatment to such person or legal entity....
Bell, Judith; Standish, Marion
In America today, millions of people leave their homes in a protracted and often futile search for healthy food for their families. Many walk out their front doors and see nothing but fast-food outlets and convenience stores selling high-fat, high-sugar processed foods; others see no food vendors of any kind. Without affordable fresh food options, especially fruit and vegetables, adults and children face fundamental challenges to making the healthy food choices that are essential for nutritio...
Whether they are the outcome of global immigration trends, residential living patterns, or educational reform efforts such as detracking, heterogeneous classrooms pose considerable pedagogical challenges for educators. This article describes a systemic approach to restructuring the classroom with the goal of establishing and maintaining an…
Pentaris, F. P.; Makris, J. P.; Stonham, J.; Vallianatos, F.
Monitoring the structural state of a building is essential for the safety of the people who work, live, visit or just use it as well as for the civil protection of urban areas. Many factors can affect the state of the health of a structure, namely man made, like mistakes in the construction, traffic, heavy loads on the structures, explosions, environmental impacts like wind loads, humidity, chemical reactions, temperature changes and saltiness, and natural hazards like earthquakes and landslides. Monitoring the health of a structure provides the ability to anticipate structural failures and secure the safe use of buildings especially those of public services. This work reviews the state of the art and the challenges of a wireless Structural Health Monitoring (WiSHM). Literature review reveals that although there is significant evolution in wireless structural health monitoring, in many cases, monitoring by itself is not enough to predict when a structure becomes inappropriate and/or unsafe for use, and the damage or low durability of a structure cannot be revealed (Chintalapudi, et al., 2006; Ramos, Aguilar, & Lourenço, 2011). Several features and specifications of WiSHM like wireless sensor networking, reliability and autonomy of sensors, algorithms of data transmission and analysis should still be evolved and improved in order to increase the predictive effectiveness of the SHM (Jinping Ou & Hui Li, 2010; Lu & Loh, 2010) . Acknowledgments This work was supported in part by the ARCHEMEDES III Program of the Ministry of Education of Greece and the European Union in the framework of the project entitled «Interdisciplinary Multi-Scale Research of Earthquake Physics and Seismotectonics at the front of the Hellenic Arc (IMPACT-ARC) ».
Detmer Don E
Full Text Available Abstract Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries. The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin
Full Text Available Following the lead of Slow Medicine, the Association of Nurses of Internal Medicine (ANÌMO saw the opportunity to build, through an analysis of the professional practice, an alliance between health professionals and citizens in order to support and facilitate informed choices. From this revision emerged The Decalogue, a document which summarizes the fundamental pillars of the slow nursing to guarantee a sober respectful and equitable care during the hospitalization.
Garcia, Ana Maria Delgado; Cuello, Rafael Oliver
Education is one of the pillars in which a Welfare State is effectively based on in order to achieve an equitable distribution of wealth. In contemporary society, knowledge and education are among the most appreciated goods, and everyone should have the right to acquire them, without distinction of gender, race, age, health or religion. From our…
Full Text Available Malaysia has good environmental laws toprotect the outdoor environment and public health.However there are no laws governing indoor air quality(IAQ and the knowledge among the public about itsimportance is also lacking. Environmental professionalsthink it is not a priority and this influences the policydecisions in the country. Therefore there is a need tocreate awareness by way of research, education andother promotional activities. What is much needed atthis time is the establishment of standards for theconduct of risk assessment studies. To establishstandards we need reliable data which can be used todevelop appropriate guidelines for the purpose ofmitigation and adaptation programmes. IAQ can havesignificant influence on health resulting in drop inproductivity and economy of a country. It has beenestimated that in the US, building related illnesses(BRI symptoms have a relationship with decrease (3 to5% in work performance in an affected populationresulting in an annual loss of US$60 billion in revenue.However, based on efficient management programmesthey have also projected that the potential annualsavings can be in the region of US$10 to 30 billion. Thisestablishes that fact that good management programmesbased on efficient guidelines is of economic value to acountry and wellbeing of the population. The IMU hasembarked on a research programme to collect themuch-needed data for the framing of a good IAQguideline for Malaysia.
Onunaku, Ngozi; Gilkerson, Linda; Ahlers, Therese
Onunaku, Ahlers, and Gilkerson describe Illinois's effort to build infant mental health capacity within the Part C Early Intervention system and Wisconsin's effort to build capacity for infant and early childhood mental health services statewide across all systems that serve children. Because of multiple funding streams, families often experience…
Peercy, Chavanne; Svenson, Nanette
As developing countries continue to battle poverty despite strong economic growth, understanding the relationship between equity and human development becomes increasingly important. In this context, equity is not equivalent to equality for any specific outcome such as health status, education or income. It is an objective ideal whereby people's achievements are increasingly dependent upon personal effort, choice and initiative rather than predetermined characteristics such as race, gender and socioeconomic background. As such, equity becomes an issue of moral equality based on the belief that people should be treated as equals, with equal access to life chances. This ideal pursues equal access to public services, infrastructure and rights for all citizens, including the right to education. While evidence suggests that education builds healthier, richer, more equitable societies, research on this has focused predominantly on primary and secondary schooling. The authors of this paper begin with an extensive review of existing research and relevant literature. In the second part of their article, they then report on their own study which furthers the discussion by exploring connections between tertiary education and development using equity as a reflection of human development - a holistic extension of economic development. After extracting relevant data from a number of available world reports by the United Nations, the World Bank and other organisations, they carried out a cross-national statistical analysis designed to examine the relationship between tertiary enrolment levels and a composite equity variable. Their results indicate a strong association between higher post-secondary education levels and higher levels of social equity.
McIntyre, Sue; Dale, Helen; Gabler, Carol
Health literacy, the ability to obtain and understand information and services to make good health decisions, has received much attention recently. Literacy is a stronger predictor of health status than age, income, race, ethnicity, employment status, or educational level. Inadequate health literacy costs the United States an estimated $100-$236…
Scales, Peter C.
Discusses research identifying and examining specific "developmental assets": positive building blocks that all children and youth need for success. Discusses the role of these assets in health promotion and risk reduction. Outlines specific actions educators can take to build 12 of these developmental assets. Notes the special place of health…
McGreevy, Paul D
The lengthy association of humans with horses has established traditional equestrian techniques that have served military and transport needs well. Although effective, these techniques have by-passed the research findings of modern psychologists, who developed the fundamentals of learning theory. That said, the pools of equestrian debate are far from stagnant. The latest wave of horse whisperers has offered some refinements and some novel interpretations of the motivation of horses undergoing training. Additionally, the Fédération Equestre Internationale (FEI) has introduced the concept of the 'happy equine athlete' and, in the light of the hyperflexion (Rollkür) debate, recently examined the possible effects of some novel dressage modalities on equine 'happiness'. However, many still question the welfare of the ridden horse since it is largely trained using negative reinforcement, has to respond to pressure-based signals and is seldom asked to work for positive rewards. Science holds tremendous promise for removing emotiveness from the horse-riding welfare debate by establishing how much rein tension is too much; how much contact is neutral; how contact can be measured; how discomfort can be measured; how pain can be measured; and how learned helplessness manifests in horses. These are some of the topics addressed by equitation science, an emerging discipline that combines learning theory, physics and ethology to examine the salience and efficacy of horse-training techniques.
Full Text Available This conceptual paper addresses the health policy goal of equitable access to health care from a perspective that highlights the role of choice. It sketches a framework around the three access dimensions availability, affordability, and acceptability. The "degree of fit" with respect to each of these dimensions between the health system and individuals or communities plays a role in determining the level of access to health services by outlining the existing choice set. Yet it is the degree of informedness about the choices that ultimately determines access to health services. Access is therefore defined as the freedom to utilize. The paper focuses on information and its properties, which cut across the dimensions of access. It is argued that equity-oriented health policy should stimulate communicative action in order to empower individuals and communities by expanding their subjective choice sets.Este artigo conceitual discute a meta política do acesso eqüitativo à assistência em saúde, com um foco especial no papel da escolha. Estabelece um arcabouço teórico baseado nas três dimensões do acesso: disponibilidade, acessibilidade financeira e aceitabilidade. No que diz respeito a cada uma dessas dimensões, o "grau de ajuste" entre o sistema de saúde e os indivíduos ou comunidades tem um papel determinante no nível de acesso aos serviços de saúde, na medida em que define o conjunto de escolhas. No entanto, em última análise, é o grau de informação sobre as escolhas que determina o acesso aos serviços de saúde. Portanto, acesso é definido como liberdade de utilização. O artigo analisa a informação e suas características (que atravessam as diversas dimensões do acesso, argumentando que uma política de saúde eqüitativa deve estimular a ação comunicativa para fortalecer os indivíduos e as comunidades na expansão dos seus conjuntos de escolhas subjetivas.
Pekkanen, Juha; Lampi, Jussi
Moisture damages of buildings increase respiratory symptoms and the risk of development of new cases of asthma. Scientific evidence of possible other health effects of moisture damages is scanty but they cause plenty of concern. The management of indoor air problems is further hampered by the lack of health-based limit values. Patients having symptoms from indoor air present a challenge to the doctor, because our ability to apply scientific data to an individual building or patient is very limited Although the factors increasing asthma and respiratory symptoms in buildings with moisture damage are not known in detail, every attempt should be made to prevent and correct the moisture damages.
Diamond, Carol; Ricciardi, Lygeia
For nationwide health information exchange to succeed, consumers must trust that their data are being managed responsibly. Regional and other networks that create the nationwide exchange should make consumer trust a priority that is factored into every decision they make. Connecting for Health's Common Framework offers a starting point.
Whatley, Mariamne H.
This article presents an overview of issues related to sex equity in sexuality education. Goals which might represent sex equitable sexuality education include eliminating double standards, and redefining sexuality education. (IAH)
Keogh, Brian; Daly, Louise; Sharek, Danika; De Vries, Jan; McCann, Edward; Higgins, Agnes
Objectives: The aim of this study was to evaluate a Health Service Executive (HSE) Foundation Programme in Sexual Health Promotion (FPSHP) with a specific emphasis on capacity building. Design: A mixed-method design using both quantitative and qualitative methods was used to collect the data. Setting: The FPSHP was delivered to staff working in…
Mihinova, D; Pieckova, E
Microscopic fungi are important biological pollutants in the indoor environment, they are spread generally: on building materials, carpets, ceiling tiles, insulations, any surfaces, wallpapers, or in heating, ventilation, and air conditioning systems. Molds are able to grow on any materials, as long as moisture and oxygen are available. Exposure to fungi in indoor environments (esp. in water-damaged buildings) can cause adverse health effects, such as allergy, asthma, hypersensitivity pneumonia, mucous membrane irritation, different toxic effects, or even mycoses (in immunocompromised individuals) - alone or in combination. As serious adverse health effects could be caused antifungal prevention is an absolute need.This review article summarizes the occurrence of fungi in the indoor environment of buildings and their contribution to occupants´ health problems, and preventive measures against molds (Tab. 1, Fig. 1, Ref. 48).
Full Text Available Investment in wild animal health has not kept pace with investment in health programs for agriculture or people. Previous arguments of the inherent value of wildlife or the possible public health or economic consequences of fish or terrestrial wildlife diseases have failed to motivate sufficient, sustained funding. Wildlife health programs are often funded on an issue-by-issue basis, most often in response to diseases that have already emerged, rather than being funded to protect and promote the health of wild animals on an ongoing basis. We propose that one explanation for this situation is the lack of business cases that explains the value of wild animal health programs to funders. This paper proposes a set of building blocks that inform the creation of wildlife health business cases. The building blocks are a series of questions derived from a literature review, the experience of directors of two large national wildlife health programs and lessons learned in developing a draft business case for one of those programs. The six building blocks are: (1 Know what you are trying to achieve; (2 Describe your capabilities; (3 Identify factors critical to your success; (4 Describe the value you can bring to supporters; (5 Identify who needs your services and why; and (6 Share the plan.
Hanney, Stephen R; González Block, Miguel A
Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS) provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics related to the above
González Block Miguel
Full Text Available Abstract Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics
Objective: A survey was conducted of health sciences libraries to obtain information about newer buildings, additions, remodeling, and renovations. Method: An online survey was developed, and announcements of survey availability posted to three major email discussion lists: Medical Library Association (MLA), Association of Academic Health Sciences Libraries (AAHSL), and MEDLIB-L. Previous discussions of library building projects on email discussion lists, a literature review, personal communications, and the author's consulting experiences identified additional projects. Results: Seventy-eight health sciences library building projects at seventy-three institutions are reported. Twenty-two are newer facilities built within the last ten years; two are space expansions; forty-five are renovation projects; and nine are combinations of new and renovated space. Six institutions report multiple or ongoing renovation projects during the last ten years. Conclusions: The survey results confirm a continuing migration from print-based to digitally based collections and reveal trends in library space design. Some health sciences libraries report loss of space as they move toward creating space for “community” building. Libraries are becoming more proactive in using or retooling space for concentration, collaboration, contemplation, communication, and socialization. All are moving toward a clearer operational vision of the library as the institution's information nexus and not merely as a physical location with print collections. PMID:20428277
Roulet, C.A.; Flourentzou, F.; Foradini, F.; Bluyssen, P.; Cox, C.; Aizlewood, C.
In order to comply with sustainable development policy, the minimum that buildings should achieve are a healthy, comfortable and energy-efficient environment. Criteria for individually assessing each of the many criteria are known: the occupant's perceived health; the provided thermal, visual and ac
Terwoert, J.; Ustailieva, E.
This e-fact provides information on the work-related risk factors and the occupational safety and health (OSH) issues associated the planning and construction of green buildings, their maintenance, renovation (retrofitting), demolition, on-site waste collection. Some of these OSH risks are new compa
Leidel, James [Oakland Univ., Rochester, MI (United States)
The grant objectives of the DOE grant funded project have been successfully completed. The Human Health Building (HHB) was constructed and opened for occupancy for the Fall 2012 semester of Oakland University. As with any large construction project, some issues arose which all were overcome to deliver the project on budget and on time. The facility design is a geothermal / solar-thermal hybrid building utilizing both desiccant dehumidification and variable refrigerant flow heat pumps. It is a cooling dominant building with a 400 ton cooling design day load, and 150 ton heating load on a design day. A 256 vertical borehole (320 ft depth) ground source heat pump array is located south of the building under the existing parking lot. The temperature swing and performance over 2013 through 2015 shows the ground loop is well sized, and may even have excess capacity for a future building to the north (planned lab facility). The HHB achieve a US Green Building Counsel LEED Platinum rating by collecting 52 of the total 69 available LEED points for the New Construction v.2 scoring checklist. Being Oakland's first geothermal project, we were very pleased with the building outcome and performance with the energy consumption approximately 1/2 of the campus average facility, on a square foot basis.
This paper is written in response to Angela Chapman and Allan Feldman's research study, "Cultivation of science identity through authentic science in an urban high school". I utilize this forum piece to extend the call for "awakening a dialogue" that critically assesses the effectiveness of current K-12 science education research in addressing the needs of populations of color. I take the opportunity to first discuss elements of what an equitable research focus might look like. I finish by critiquing and ultimately commending the authors on the degree to which they succeed in demonstrating an equitable approach to the design and carrying out of their study.
Full Text Available Background: The ‘EquitAble’ project carried out content analyses of policies and collected and analysed qualitative and quantitative data concerning access to health services in Sudan, Malawi, Namibia and South Africa. Our particular concern was to address the situation of people with disabilities, although not in isolation from other marginalised or vulnerable groups.Objectives: This article reports on the content, context, process and impact of project EquitAble, funded by the European Commission Seventh Research Framework Programme, which brought together researchers from Ireland, Norway, South Africa, Namibia, Sudan and Malawi.Method: After the 4-year project ended in February 2013, all members of the consortium were asked to anonymously complete a bespoke questionnaire designed by the coordinating team. The purpose of the questionnaire was to capture the views of those who collaborated on the research project in relation to issues of content, context, process and impact of the EquitAble project.Results: Our results indicated some of the successes and challenges encountered by our consortium.Conclusion: We identified contextual and process learning points, factors often not discussed in papers, which typically focus on the reporting of the ‘content’ of results.
Negin, Joel; Martiniuk, Alexandra; Morgan, Chris; Davies, Philip; Zwi, Anthony
There has been increasing focus on the role of health systems in low and middle-income countries. Despite this, very little evidence exists on how best to build health systems program and research capacity in educational programs. The current experiences in building capacity in health systems in five of the most prominent global health programs at Australian universities are outlined. The strengths and weaknesses of various approaches and techniques are provided along with examples of global practice in order to provide a foundation for future discussion and thus improvements in global health systems education.
Abiodun Olatunji Abisuga
Full Text Available In order to maintain a healthy learning environment, diagnosis and management of defects in the educational facility are paramount. The preliminary results of the ongoing research reported here seek to identify defects associated with educational buildings and their effects on the health of polytechnic students and staff in Nigeria. A questionnaire survey, including 34 defects based on a post-occupancy evaluation (POE was used to establish relationships with the health of polytechnic students and staff. Two hundred (200 respondents were randomly selected based on their schools (faculty within Lagos State Polytechnic. Descriptive and inferential statistics were used for analysis of the collected data. The results of the study indicate that defects such as plumbing and dampness problems, cobwebs and dust, are prominent in the institution. Also the relationship between building conditions (defects and health problems was established, with the predictors of the health problems. Based on the findings, it is important for designers and managers of facilities within tertiary institutions to develop and implement design and maintenance policies targeted at minimizing the likelihood of plumbing, dampness, electrical, cobweb and dust problems in educational buildings due to the health risks induced by the defects. It is evident that effective maintenance schedules and policies should be put in place to ensure that facilities are not left to decay before replacement.
For regional planning and approval procedures for building projects of a certain order of magnitude and power rating according to the German Federal Act on the Prevention of Emissions with Integrated Environmental Impact Assessment (EIA), the German public health departments, acting as public authorities, increasingly perform health impact assessments (HIA). The amended Act on Environmental Impact Assessment, the Decree on industrial plants which require approval (4th Federal Decree on Emission Prevention) and the Health Service Acts of the Federal States of Germany form the legal basis for the assessment of health issues with regard to approval procedures for building and investment projects. In the framework of the "Action Programme for the Environment and Health", the present article aims at making this process binding and to ensure responsibility and general involvement of the Public Health departments in all German Federal States. Future criteria, basic principles and procedures for single-case testing as well as assessment standards should meet these requirements. The Federal Ministry for the Environment and the Federal Ministry for Health should agree on Health Impact Assessment (HIA ) as well as on the relaxant stipulations in their procedures and general administrative regulations for implementing the Environmental Impact Assessment Act (EIA). Current EIA procedures focus on urban development and road construction, industrial investment projects, intensive animal husbandry plants, waste incineration plants, and wind energy farms. This paper illustrates examples meeting with varying degrees of public acceptance. However, being involved in the regional planning procedure for the project "Extension of the federal motorway A 14 from Magdeburg to Schwerin", the Public Health Service also shares global responsibility for health and climate protection. Demands for shortest routing conflict with objectives of environmental protection which should be given long
Pierard, M.; Hall, C.; Konig von Borstel, U.; Averis, A.; Hawson, L.; Mclean, A.; Nevison, C.; Visser, E.K.; McGreevy, P.
Within the emerging discipline of Equitation Science, the application of consistent methodology, including robust objective measures, is required for sound scientific evaluation. This report aims to provide an evaluation of current methodology and to propose some initial guidelines for future resear
Tuomisto, Jouni T; Niittynen, Marjo; Pärjälä, Erkki
consumption. Active climate mitigation policies will also, aside of their long term global impacts, have short term local impacts, both positive and negative, on public health. Our main objective was to develop a generic open impact model to estimate health impacts of emissions due to heat and power...... facilities may have rapid and large impacts on emissions. However, the life cycle impacts of different fuels is somewhat an open question. CONCLUSIONS: In conclusion, we were able to develop a practical model for city-level assessments promoting evidence-based policy in general and health aspects...... consumption of buildings. In addition, the model should be usable for policy comparisons by non-health experts on city level with city-specific data, it should give guidance on the particular climate mitigation questions but at the same time increase understanding on the related health impacts and the model...
Clifton C. Addison
Full Text Available Building Collaborative Health Promotion Partnerships: The Jackson Heart Study. Background: Building a collaborative health promotion partnership that effectively employs principles of community-based participatory research (CBPR involves many dimensions. To ensure that changes would be long-lasting, it is imperative that partnerships be configured to include groups of diverse community representatives who can develop a vision for long-term change. This project sought to enumerate processes used by the Jackson Heart Study (JHS Community Outreach Center (CORC to create strong, viable partnerships that produce lasting change. Methods: JHS CORC joined with community representatives to initiate programs that evolved into comprehensive strategies for addressing health disparities and the high prevalence of cardiovascular disease (CVD. This collaboration was made possible by first promoting an understanding of the need for combined effort, the desire to interact with other community partners, and the vision to establish an effective governance structure. Results: The partnership between JHS CORC and the community has empowered and inspired community members to provide leadership to other health promotion projects. Conclusion: Academic institutions must reach out to local community groups and together address local health issues that affect the community. When a community understands the need for change to respond to negative health conditions, formalizing this type of collaboration is a step in the right direction.
Rogers, Juliet L; Johnson, Timothy R B; Warner, Patricia; Thorson, Jayne A; Punch, Margaret R
The Women's Health Program at the University of Michigan was established in 1993 and has developed into a successful, federally supported program that links clinical research and education activities across the University. It has focused on human resource capacity building, sustainable financial support and infrastructure, and adaptability to change and opportunities. Widely accepted standards, demonstrated value, committed leaders/champions, and participatory culture have contributed to its success and are important to its future.
Terwoert, J.; Ustailieva, E.
This e-fact provides information on the work-related risk factors and the occupational safety and health (OSH) issues associated the planning and construction of green buildings, their maintenance, renovation (retrofitting), demolition, on-site waste collection. Some of these OSH risks are new compared with traditional construction sites and are associated with new green materials, technologies or design. Other risks are well-known to the construction sector but they arise in new situations o...
Smith, Lillian Upton; Waddell, Lisa; Kyle, Joseph; Hand, Gregory A
Given the limited resources available to public health, it is critical that university programs complement the development needs of agencies. Unfortunately, academic and practice public health entities have long been challenged in building sustainable collaborations that support practice-based research, teaching, and service. The academic health department concept offers a promising solution. In South Carolina, the partners started their academic health department program with a small grant that expanded into a dynamic infrastructure that supports innovative professional exchange and development programs. This article provides a background and describes the key elements of the South Carolina model: joint leadership, a multicomponent memorandum of agreement, and a shared professional development mission. The combination of these elements allows the partners to leverage resources and deftly respond to challenges and opportunities, ultimately fostering the sustainability of the collaboration.
The focus of this review is on driving neuroplasticity in a positive direction using evidence-based interventions that also have the potential to improve general health. One goal is to provide an overview of the many ways new neuroscience can inform treatment protocols to empower and motivate clients to make the lifestyle choices that could help build brain power and could increase adherence to healthy lifestyle changes that have also been associated with simultaneously enhancing vigorous longevity, health, happiness, and wellness. Another goal is to explore the use of a focus in clinical practice on helping clients appreciate this new evidence and use evolving neuroscience in establishing individualized goals, designing strategies for achieving them and increasing treatment compliance. The timing is urgent for such interventions with goals of enhancing brain health across the lifespan and improving statistics on dementia worldwide.
Hanney, Stephen R; González-Block, Miguel A
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.
Stenner, R.D.; Baechler, M.C.
Indoor air quality can be impacted by hundreds of different chemicals. More than 900 different organic compounds alone have been identified in indoor air. Health effects that could arise from exposure to individual pollutants or mixtures of pollutants cover the full range of acute and chronic effects, including largely reversible responses, such as rashes and irritations, to the irreversible toxic and carcinogenic effects. These indoor contaminants are emitted from a large variety of materials and substances that are widespread components of everyday life. Pacific Northwest Laboratory conducted a search of the peer-reviewed literature on health effects associated with indoor air contaminants for the Bonneville Power Administration to aid the agency in the preparation of environmental documents. Results are reported in two volumes. Volume 1 summarizes the results of the search of the peer-reviewed literature on health effects associated with a selected list of indoor air contaminants. In addition, the report discusses potential health effects of polychlorinated biphenyls and chlorofluorocarbons. All references to the literature reviewed are found in this document Volume 2. Volume 2 provides detailed information from the literature reviewed, summarizes potential health effects, reports health hazard ratings, and discusses quantitative estimates of carcinogenic risk in humans and animals. Contaminants discussed in this report are those that; have been measured in the indoor air of a public building; have been measured (significant concentrations) in test situations simulating indoor air quality (as presented in the referenced literature); and have a significant hazard rating. 38 refs., 7 figs., 23 tabs.
C.R. CHE HASSAN
Full Text Available The construction industry is known as one of the most hazardous activities. Therefore, safety on the job site is an important aspect with respect to the overall safety in construction. This paper assesses the safety level perception of the construction building workers towards safety, health and environment on a construction job site in Kuala Lumpur, Malaysia. The above study was carried out by choosing 5 selected large building construction projects and 5 small building construction projects respectively in and around Kuala Lumpur area. In the present study, an exhaustive survey was carried out in these 10 project site areas using a standard checklist and a detailed developed questionnaire. The checklist comprised 17 divisions of safety measurements which are considered and perceived to be important from the safety point of view and was assessed based on the score obtained. The questionnaire comprised the general information with 36 safety attitude statements on a 1-5 Likert scale which was distributed to 100 construction workers. The results of the checklist show the difference of safety levels between the large and small projects. The study revealed that the large projects shown a high and consistent level in safety while the small projects shown a low and varied safety levels. The relationship between the factors can be obtained from the questionnaire. They are organizational commitment, factor influencing communication among workmates, worker related factors, personal role and supervisors’ role factors, obstacles to safety and safe behavior factors and management commitment at all levels in line with the management structure and risk taking behavioral factors. The findings of the present study revealed invaluable indications to the construction managers especially in improving the construction workers’ attitude towards safety, health and environment and hence good safety culture in the building construction industries.
Mike Y Osei-Atweneboana
Full Text Available Capacity building in health research generally, and helminthiasis research particularly, is pivotal to the implementation of the research and development agenda for the control and elimination of human helminthiases that has been proposed thematically in the preceding reviews of this collection. Since helminth infections affect human populations particularly in marginalised and low-income regions of the world, they belong to the group of poverty-related infectious diseases, and their alleviation through research, policy, and practice is a sine qua non condition for the achievement of the United Nations Millennium Development Goals. Current efforts supporting research capacity building specifically for the control of helminthiases have been devised and funded, almost in their entirety, by international donor agencies, major funding bodies, and academic institutions from the developed world, contributing to the creation of (not always equitable North-South "partnerships". There is an urgent need to shift this paradigm in disease-endemic countries (DECs by refocusing political will, and harnessing unshakeable commitment by the countries' governments, towards health research and capacity building policies to ensure long-term investment in combating and sustaining the control and eventual elimination of infectious diseases of poverty. The Disease Reference Group on Helminth Infections (DRG4, established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR, was given the mandate to review helminthiases research and identify research priorities and gaps. This paper discusses the challenges confronting capacity building for parasitic disease research in DECs, describes current capacity building strategies with particular reference to neglected tropical diseases and human helminthiases, and outlines recommendations to redress the balance of alliances and partnerships for health research between the developed countries of
Roulet, C.A.; Johner, N.; Foradini, F.; Bluyssen, P.; Cox, C.; Oliveira Fernandes, E.; Müller, B.; Aizlewood, C.
Within the European research project Health Optimisation Protocol for Energy-efficient Building (HOPE), 96 apartment buildings and 64 office buildings (of which approximately 75% have been designed to be energy-efficient) were investigated. The building characteristics were assessed according to a c
Thaiprayoon, Suriwan; Smith, Richard
A rapid expansion of trade liberalization in Thailand during the 1990s raised a critical question for policy transparency from various stakeholders. Particular attention was paid to a bilateral trade negotiation between Thailand and USA concerned with the impact of the 'Trade-Related Aspects of Intellectual Rights (TRIPS) plus' provisions on access to medicines. Other trade liberalization effects on health were also concerning health actors. In response, a number of interagency committees were established to engage with trade negotiations. In this respect, Thailand is often cited as a positive example of a country that has proactively sought, and achieved, trade and health policy coherence. This article investigates this relationship in more depth and suggests lessons for wider study and application of global health diplomacy (GHD). This study involved semi-structured interviews with 20 people involved in trade-related health negotiations, together with observation of 9 meetings concerning trade-related health issues. Capacity to engage with trade negotiations appears to have been developed by health actors through several stages; starting from the Individual (I) understanding of trade effects on health, through Nodes (N) that establish the mechanisms to enhance health interests, Networks (N) to advocate for health within these negotiations, and an Enabling environment (E) to retain health officials and further strengthen their capacities to deal with trade-related health issues. This INNE model seems to have worked well in Thailand. However, other contextual factors are also significant. This article suggests that, in building capacity in GHD, it is essential to educate both health and non-health actors on global health issues and to use a combination of formal and informal mechanisms to participate in GHD. And in developing sustainable capacity in GHD, it requires long term commitment and strong leadership from both health and non-health sectors.
Full Text Available Abstract Background Building research capacity in health services has been recognised internationally as important in order to produce a sound evidence base for decision-making in policy and practice. Activities to increase research capacity for, within, and by practice include initiatives to support individuals and teams, organisations and networks. Little has been discussed or concluded about how to measure the effectiveness of research capacity building (RCB Discussion This article attempts to develop the debate on measuring RCB. It highlights that traditional outcomes of publications in peer reviewed journals and successful grant applications may be important outcomes to measure, but they may not address all the relevant issues to highlight progress, especially amongst novice researchers. They do not capture factors that contribute to developing an environment to support capacity development, or on measuring the usefulness or the 'social impact' of research, or on professional outcomes. The paper suggests a framework for planning change and measuring progress, based on six principles of RCB, which have been generated through the analysis of the literature, policy documents, empirical studies, and the experience of one Research and Development Support Unit in the UK. These principles are that RCB should: develop skills and confidence, support linkages and partnerships, ensure the research is 'close to practice', develop appropriate dissemination, invest in infrastructure, and build elements of sustainability and continuity. It is suggested that each principle operates at individual, team, organisation and supra-organisational levels. Some criteria for measuring progress are also given. Summary This paper highlights the need to identify ways of measuring RCB. It points out the limitations of current measurements that exist in the literature, and proposes a framework for measuring progress, which may form the basis of comparison of RCB
Within the context of postgraduate education, the majority of curriculum design for allied healthcare practitioners has stemmed from assumptions that learning is a one-dimensional concept with definitive starting and completion points, undertaken by the individual in pursuit of knowledge. This knowledge is perceived as being consumed by the learner and that it requires a formalized process of teaching in order to separate it from the rest of everyday activity and experience. This article charts the strategic development of a new and innovative approach to needs-led educational provision within multidisciplinary health care in higher education through the deconstruction of traditional approaches to teaching and learning. It also presents the case for merging the theoretical underpinnings of situated learning with the concept of problem-based learning, in which knowledge is created rather than consumed within the context of a new and innovative programme that seeks to build capacity in and between professional disciplines across the healthcare arena.
This article describes a way to finance universal health care coverage that preserves much of the current financing system and replaces funds obtained from regressive sources with revenue from more progressive ones. New funding would be needed for 24 percent of health expenditures and would be raised through an increase in the federal personal income tax. Premiums are eliminated since their cost is the same to everyone regardless of income. Cost sharing and out-of-pocket spending for medically necessary services are also abolished. In a more equitably financed system, employers would pay a new payroll tax that raised the same amount of money they currently spend for employee health insurance premiums; this would require a payroll tax of about 7 percent. Revenue from an increase in federal personal income taxes would replace household out-of-pocket expenditures for medically necessary services and payments for insurance premiums. For the average, middle-income family, the tax increase would total $731 in 1998. In exchange for the tax increase, no American or American employer would need to buy health insurance or face out-of-pocket charges for any medically indicated health care.
Full Text Available An equitable domination has interesting application in the contextof social networks. In a network, nodes with nearly equal capacitymay interact with each other in a better way. In the societypersons with nearly equal status, tend to be friendly. In thispaper, we introduce new variant of equitable domination of agraph. Basic properties and some interesting results have beenobtained.
Bluyssen, P.M.; Cox, C.W.J.; Maroni, M.; Boschi, N.; Raw, G.; Roulet, C.A.; Foradini, F.
In January 2002, a new European project named HOPE (Health Optimization Protocol for Energy-efficient Buildings) started with 14 participants from nine European countries. The final goal of the project is to provide the means to increase the number of energy-efficient buildings, i.e. buildings that
Vermund, Sten H; Sahasrabuddhe, Vikrant V; Khedkar, Sheetal; Jia, Yujiang; Etherington, Carol; Vergara, Alfredo
The Institute for Global Health at Vanderbilt enables the expansion and coordination of global health research, service, and training, reflecting the university's commitment to improve health services and outcomes in resource-limited settings. Global health encompasses both prevention via public health and treatment via medical care, all nested within a broader community-development context. This has fostered university-wide collaborations to address education, business/economics, engineering, nursing, and language training, among others. The institute is a natural facilitator for team building and has been especially helpful in organizing institutional responses to global health solicitations from the National Institutes of Health (NIH), Centers for Disease Control (CDC), and other funding agencies. This center-without-walls philosophy nurtures noncompetitive partnerships among and within departments and schools. With extramural support from the NIH and from endowment and developmental investments from the school of medicine, the institute funds new pilot projects to nurture global educational and research exchanges related to health and development. Vanderbilt's newest programs are a CDC-supported HIV/AIDS service initiative in Africa and an overseas research training program for health science graduate students and clinical fellows. New opportunities are available for Vanderbilt students, staff, and faculty to work abroad in partnership with international health projects through a number of Tennessee institutions now networked with the institute. A center-without-walls may be a model for institutions contemplating strategic investments to better organize service and teaching opportunities abroad, and to achieve greater successes in leveraging extramural support for overseas and domestic work focused on tropical medicine and global health.
Building community capacity for health promotion in small rural communities is essential if health promotion research is to yield sustainable outcomes. Since its inception, capacity-building has been a stated goal of the Delta Nutrition Intervention Research initiative, a tri-state collaboration in ...
Hämäläinen, R.M.; Dijkman, A.; Guobjörg Asgeirsdóttir, A.; Broek, K. van den; Haratau, T.; Kuhn, K.; Masanotti, G.; Pyzalski, J.; Scheppingen, A. van; Solé, M.D.; Ylikoski, M.
This publication is an outcome of the project Workplace Health Promotion (WHP): National Health Policies and Strategies in an Enlarging Europe, carried out during 2005-2007. The guideline aims to offer ideas and ways to build partnerships by providing background for partnership building, a brief des
MacNaughton, Piers; Spengler, John; Vallarino, Jose; Santanam, Suresh; Satish, Usha; Allen, Joseph
Green buildings are designed to have low environmental impacts and improved occupant health and well-being. Improvements to the built environment including ventilation, lighting, and materials have resulted in improved indoor environmental quality (IEQ) in green buildings, but the evidence around occupant health is currently centered around environmental perceptions and self-reported health. To investigate the objective impact of green buildings on health, we tracked IEQ, self-reported health, and heart rate in 30 participants from green and conventional buildings for two weeks. 24 participants were then selected to be relocated to the Syracuse Center of Excellence, a LEED platinum building, for six workdays. While they were there, ventilation, CO2, and volatile organic compound (VOC) levels were changed on different days to match the IEQ of conventional, green, and green+ (green with increased ventilation) buildings. Participants reported improved air quality, odors, thermal comfort, ergonomics, noise and lighting and fewer health symptoms in green buildings prior to relocation. After relocation, participants consistently reported fewer symptoms during the green building conditions compared to the conventional one, yet symptom counts were more closely associated with environmental perceptions than with measured IEQ. On average, participants had 4.7 times the odds of reporting a lack of air movement, 1.4 more symptoms (p-value = 0.019) and a 2 bpm higher heart rate (p-value green and conventional buildings is driven by both environmental perceptions and physiological pathways.
Benedek, C.M. [Univ. of Alberta, Edmonton, Alberta (Canada). Dept. of Civil and Environmental Engineering; Rilett, L.R. [Texas A and M Univ., College Station, TX (United States). Dept. of Civil Engineering
In the past 10 years increased importance has been placed on public participation and environmental concerns in transportation system decision-making. While there are numerous societal objectives to consider when planning and operating a transportation system, it is not clear whether the optimal strategy with respect to one objective is also the optimal strategy with respect to the other objectives. This paper examines how new objectives and environmental considerations can be modeled within the traditional, macroscopic traffic assignment methodology. In addition, a new methodology for modeling the assignment of vehicles in realistic networks is developed based on equitable, rather than user-equilibrium or system-optimal, principles. The basic premise is that with the advent of intelligent transportation systems (ITS) the operation of the transportation system based on the objectives of the general public, rather than the traveling public and system operators, is feasible. A methodology for modeling these situations is required. All of the approaches discussed here were tested on a calibrated network from Edmonton, Alberta, Canada.
Yousafzai, Aisha K; Rasheed, Muneera A; Daelmans, Bernadette; Manji, Sheila; Arnold, Caroline; Lingam, Raghu; Muskin, Joshua; Lucas, Jane E
The effectiveness of interventions promoting healthy child growth and development depends upon the capacity of the health system to deliver a high-quality intervention. However, few health workers are trained in providing integrated early child-development services. Building capacity entails not only training the frontline worker, but also mobilizing knowledge and support to promote early child development across the health system. In this paper, we present the paradigm shift required to build effective partnerships between health workers and families in order to support children's health, growth, and development, the practical skills frontline health workers require to promote optimal caregiving, and the need for knowledge mobilization across multiple institutional levels to support frontline health workers. We present case studies illustrating challenges and success stories around capacity development. There is a need to galvanize increased commitment and resources to building capacity in health systems to deliver early child-development services.
Downey, Laura H; Castellanos, Diana Cuy; Yadrick, Kathy; Threadgill, Paula; Kennedy, Betty; Strickland, Earline; Prewitt, T Elaine; Bogle, Margaret
Since its inception, capacity building has been a stated goal of the Delta Nutrition Intervention Research Initiative, a tri-state collaboration in the Lower Mississippi Delta to address high rates of chronic disease. Textual analysis of project documents identifies and describes strategies carried out to foster capacity building. Strategies to build community capacity include fostering participation, cultivating leadership opportunities, training community members as co-researchers, securing community resources, and implementing the intervention together. Incorporating capacity-building approaches in health promotion and nutrition-intervention programming in rural communities provides a means to enhance potential for sustainability of health outcomes and developed effectiveness.
Kronick, D A; Bowden, V M; Olivier, E R
The new University of Texas Health Science Center at San Antonio Library opened in June 1983, replacing the 1968 library building. Planning a new library building provides an opportunity for the staff to rethink their philosophy of service. Of paramount concern and importance is the need to convey this philosophy to the architects. This paper describes the planning process and the building's external features, interior layouts, and accommodations for technology. Details of the move to the building are considered and various aspects of the building are reviewed. Images PMID:3995205
Trujillo, Matthew D; Plough, Alonzo
For generations, Americans' health has been unequally influenced by income, education, ethnicity, and geography. Health care systems have operated largely apart from each other and from community life. The definition of health has been the "absence of illness," rather than the recognition that all aspects of our lives should support health. Today, a growing number of communities, regions, and states are working to redefine what it means to get and stay healthy by addressing the multiple determinants of health. The requirements of federal health care reform are changing who has access to care, how care is paid for and delivered, and how patients and providers interact. Coordinated efforts to promote wellness and prevent diseases are proliferating among a diverse set of stakeholders. These developments in health and in society present a window of opportunity for real societal transformation-a chance to catalyze a national movement that demands and supports a widely shared, multifaceted vision for a Culture of Health. To address this challenge, the Robert Wood Johnson Foundation has embarked on a strategic direction to use the tools of a large national philanthropy to catalyze a social movement which we are calling Building a Culture of Health. This article presents the Foundation's new model for a Culture of Health, the trans-disciplinary research that developed a set of metrics that tie to the model, and the community engagement activities undertaken in the development of both the model and metrics. The model and associated metrics and extensive communication, in addition to partnership, and grant funding strategies, represent a culture change strategy being implemented over 20 years. Addressing underlying inequities in health affirming life conditions and improving social cohesion across diverse groups to take action to improve theses condition lay at the heart of this strategy.
... COMMISSION AXA Equitable Life Insurance Company, et al.; Notice of Application July 7, 2010. AGENCY... Act. APPLICANTS: AXA Equitable Life Insurance Company (``AXA Equitable''), Separate Account 45 of AXA... (``Separate Account FP'') (together, ``AXA Equitable Separate Accounts''), MONY Life Insurance Company...
Building on its experience as a principal participant in the President's Emergency Plan for AIDS Relief, the Department of Health and Human Services has embarked on a new era of global initiatives that ultimately will protect the health of Americans. The Global Health Strategy announced by health and human services secretary Kathleen Sebelius in January 2012 recognizes that the health of Americans is intertwined with that of the rest of the world. The initiative features ten objectives that range from enhanced global health surveillance and preventing infectious diseases and health threats to health diplomacy. The Global Health Strategy is designed to make optimal use of the department's many specialty agencies and their considerable technical and programmatic expertise. The strategy moves beyond the President's Emergency Plan for AIDS Relief to redefine Health and Human Services' role outside US borders in addressing the health challenges of the twenty-first century.
Weber, Eileen; Polkey, Bryan
Many Americans need both health care and legal interventions to maximize their opportunities for health. Medical-legal partnerships (MLPs), also known as health care legal partnerships (HLPs), bring the power of law to health care to reduce barriers and negative social determinants of health. The two terms--HLP and MLP--are used interchangeably in this article. Growing research shows that these partnerships can improve care, improve health, enhance interprofessional collaboration, and improve the financial status of patients and providers. HLPs take many forms, depending on their settings and resources. A health care legal partnership learning collaborative that brings leaders of diverse HLPs together to share experiences and best practices can help expand this effective model and enhance its potential for collective impact in improving population health.
Heward, Sue; Hutchins, Cheryl; Keleher, Helen
Contemporary health promotion is now a well-defined discipline with a strong (albeit diverse) theoretical base, proven technologies (based on program planning) for addressing complex social problems, processes to guide practice and a body of evidence of efficacy and increasingly, effectiveness. Health promotion has evolved principally within the health sector where it is frequently considered optional rather than core business. To maximize effectiveness, quality health promotion technologies and practices need to be adopted as core business by the health sector and by organizations in other sectors. It has proven difficult to develop the infrastructure, workforce and resource base needed to ensure the routine introduction of high-quality health promotion into organizations. Recognizing these problems, this paper explores the use of organizational theory and practice in building the capacity of organizations to design, deliver and evaluate health promotion effectively and efficiently. The paper argues that organizational change is an essential but under-recognized function for the sustainability of health promotion practice and a necessary component of capacity-building frameworks. The interdependence of quality health promotion with organizational change is discussed in this paper through three case studies. While each focused on different aspects of health promotion development, the centrality of organizational change in each of them was striking. This paper draws out elements of organizational change to demonstrate that health promotion specialists and practitioners, wherever they are located, should be building organizational change into both their practice and capacity-building frameworks because without it, effectiveness and sustainability are at risk.
Full Text Available This study proposes the establishment of an environmental health information management platform providing residential users with a comfortable, healthy indoor environment. Taking the S House as an example, the study: (1 assigned environmental health performance indicators, (2 established constraints to maintain environmental conditions, and (3 provided optimized management control mechanisms and methods. The environmental health information management platform provides an optimized control and solution pathway ensuring the quality of the indoor health environment and equipment energy conservation.
Hoffmann, Diane E; Rowthorn, Virginia
Local health officials are called upon every day to implement the programs, enforce the regulations, and take the actions that protect the health of the citizens in their districts. These responsibilities and duties are created and regulated by a complex interplay of federal, state, and local law. Not only is an understanding of these laws necessary to carry out public health activities on a daily basis, but many public health scholars and practitioners also believe that the law can be used as a tool to take proactive steps to improve public health. Unfortunately, many local public health officials do not have access to the legal assistance they need to address the various legal questions that confront them. This deficit makes it harder for them to meet their day-to-day responsibilities and makes it much more difficult for them to use the law proactively as a method to improve public health in their communities. In addition, many of the attorneys who provide legal support to public health departments do not have the time or resources to develop a thorough and up-to-date understanding of public health law. This paper examines the experience of a number of local health offices in obtaining legal advice and of attorneys who provide legal advice and assistance to local health departments and assesses different models for organizing and financing the provision of legal services to local public health officials.
Glista, Sandra; Petersons, Maija
An interdisciplinary team from various college allied health departments implemented Project AGE: Alliance for Gerontology Education to develop content to infuse in courses on the themes of age and culture, assistive technology, collaboration, and consumer health education. One goal was to foster interaction among allied health students to prepare…
安伟; 杜萍; 张鹭鹭
近年来,地震、泥石流、洪水等重大自然灾害的侵袭,给我国经济和社会发展造成了巨大的损失.在灾后重建工作中,卫生系统占有举足轻重的地位,其核心是卫生资源的重新配置.卫生资源配置的水平和效果直接影响着重建效果和卫生服务水平.效率与公平是卫生资源配置的2个准则,如何在保证配置效率最大化的同时,坚持公平的价值取向和伦理诉求,实现包括健康权利、资源分布和制度保障等方面的公平性目标,需要从伦理学的角度进行深入思考.%In recent years, natural calamities such as earthquakes, debris flows and floods have caused great loss to the development of economy and society. In post-calamity reconstruction, the health system plays an extremely important role, particularly in the reallocation of health resources. The rationality and effectiveness of health resource allocation are directly associated with the efficiency of reconstruction and quality of medical sendees. Efficiency and equity are the two principles of health resource allocation. Further thoughts are deserved from the view of ethics concerning how to keep the value and ethical orientation of equity while maximizing the efficiency of health resource allocation and how to realize the equity goals in health rights, resource distribution and institutional guarantee.
Martini, I.; Discoli, C.; Rosenfeld, E. [Instituto de Estudios del Habitat (IDEHAB), Facultad de Arquitectura y Urbanismo, Universidad Nacional de La Plata, La Plata, Buenos Aires (Argentina)
The public health network in Argentina consists of a wide variety of buildings presenting a complex system of services and structures. In order to modulate and study the energy behaviour of each type of health facility, a database of Energy-Productive Building Modules (Modulos Edilicios Energeticos Productivos: MEEP) was built. This involved evaluating the interactions among physical spaces, building envelope, infrastructure, and equipment usage with the energy consumption, for each specialty service provided in the most common buildings present in the health service network. The MEEP database enables investigators to: (i) Obtain detailed information on each facility. (ii) Identify variables critical to an energy consumption perspective. (iii) Detect areas of over consumption and/or inadequate infrastructure. (iv) Gather essential reference material for the design of health facilities and other similar sectors. The information of each MEEP can be summarized in typological charts. (author)
This article is based a presentation delivered to the Fifth Annual Building Global Alliances Symposium, "The Challenges of Migration for Health Professional Women," convened by CGFNS International, Philadelphia, PA, December 8, 2008.
Eckman, Molly; Gorski, Irena; Mehta, Khanjan
Mobile health, or mHealth, technology has the potential to improve health care access in the developing world. However, the majority of mHealth projects do not expand beyond the pilot stage. A core reason why is because they do not account for the individual needs and wants of those involved. A collaborative approach is needed to integrate the perspectives of all stakeholders into the design and operation of mHealth endeavours. Design thinking is a methodology used to develop and evaluate novel concepts for systems. With roots in participatory processes and self-determined pathways, design thinking provides a compelling framework to understand and apply the needs of diverse stakeholders to mHealth project development through a highly iterative process. The methodology presented in this article provides a structured approach to apply design thinking principles to assess the feasibility of novel mHealth endeavours during early conceptualisation.
Full Text Available Abstract Background We determine efficient, equitable and mixed efficient-equitable allocations of a male circumcision (MC intervention reducing female to male HIV transmission in South Africa (SA, as a case study of an efficiency-equity framework for resource allocation in HIV prevention. Methods We present a mathematical model developed with epidemiological and cost data from the nine provinces of SA. The hypothetical one-year-long MC intervention with a budget of US$ 10 million targeted adult men 15–49 years of age in SA. The intervention was evaluated according to two criteria: an efficiency criterion, which focused on maximizing the number of HIV infections averted by the intervention, and an equity criterion (defined geographically, which focused on maximizing the chance that each male adult individual had access to the intervention regardless of his province. Results A purely efficient intervention would prevent 4,008 HIV infections over a year. In the meantime, a purely equitable intervention would avert 3,198 infections, which represents a 20% reduction in infection outcome as compared to the purely efficient scenario. A half efficient-half equitable scenario would prevent 3,749 infections, that is, a 6% reduction in infection outcome as compared to the purely efficient scenario. Conclusions This paper provides a framework for resource allocation in the health sector which incorporates a simple equity metric in addition to efficiency. In the specific context of SA with a MC intervention for the prevention of HIV, incorporation of geographical equity only slightly reduces the overall efficiency of the intervention.
Debrand, Thierry; Dourgnon, Paul
The Institut de Recherche et Documentation en Economie de la Santé (IRDES) Workshop on Applied Health Economics and Policy Evaluation aims at disseminating health economic research's newest findings and enhancing the community's capacity to address issues that are relevant to public policy. The 2010 program consisted of 16 articles covering a vast range of topics, such as health insurance, social health inequalities and health services research. While most of the articles embedded theoretical material, all had to include empirical material in order to favor more applied and practical discussions and results. The 2010 workshop is to be the first of a series of annual workshops in Paris gathering together researchers on health economics and policy evaluation. The next workshop is to be held at IRDES in June 2011.
Restall, Gayle; Strutt, Carolyn
The participation of people who use mental health services in service planning and evaluation has become increasingly important in recent years. Health planners and people who use services are seeking information about how to enable participation that is meaningful and impacts positively on service delivery. This qualitative study explored the perspectives of people who use mental health services on participation in mental health service planning and evaluation. Sixty-three people from diverse backgrounds participated in either a focus group or interview. Themes were extracted from the data and resulted in a conceptual framework that can be used to guide the development and evaluation of participation.
Poor oral health affects more than just the mouth. It can seriously compromise a person's general health, quality of life and life expectancy. Oral diseases can and do lead to systemic problems--damaging other parts of the body and resulting in the need for expensive emergency department visits, hospital stays and medications. The consequences of poor oral health, however, go far beyond damaging medical effects. Oral disease can also wreak economic havoc--keeping children out of school and adults home from work--not to mention lower productivity of workers in pain. Untreated oral diseases can also drive up health care costs in general. The good news is that with proper oral health care, both at home and in professional settings, many of the negative consequences associated with poor oral health can be prevented. The State of Texas has a unique and unprecedented opportunity to significantly increase access to oral health care for all Texans. Complying with the Frew agreement is a key priority. However, there are additional ways that Texas policymakers can improve the oral health of the state. In an effort to begin a constructive dialogue about improving the oral health of all Texans, the Texas Dental Association (TDA) with grant funding from the American Dental Association (ADA) commissioned an independent third-party report on the issue of access to oral health care in Texas modeled after the 2000 groundbreaking surgeon general's report, Oral Health in America. The TDA assembled a team of five nationally recognized dentists from both academia and private practice to oversee the project. The dentists (hereafter called the editorial review board or ERB) were asked to identify the state's most pressing issues, needs and challenges associated with improving the oral health of all Texans, with a special focus on the state's most vulnerable. The ERB looked carefully at the economic, medical and social consequences of untreated oral disease in Texas. It reviewed the
Vaishali R Lokhande
Full Text Available Background: The modern ship building industry, which encompasses the ship yards and marine equipment manufacturing, is an important and strategic industry. The various activities in modern ship building, maintenance, and repair have to be carried out at heights, or in closed confined spaces along with the added risk of exposure to chemicals and metal fumes. These activities expose the workers to various health hazards. Aims: This study was carried out with an aim to assess the health profile of workers in the ship building industry and to assess the occupational health issues related to ship building. Settings and Design: It was a cross-sectional study carried out on 100 randomly selected workers in a ship building yard in Mumbai, and their health profile was studied. Materials and Methods: The workers were enquired for history of co-morbidities, addictions and personal protective equipment use, health-related complaints, and were examined systemically as well as for bedside tests for hearing and detailed systemic examination as per the history or co-morbidity. Results: The important observations were those of prevalence of addictions (69%, irregular use of personal protective equipments (PPEs among 50% of paint workers, presence of hypertension (20%, overweight (53%, osteoarthritis (10%, hearing loss (25%, and poor self-care. Conclusions: Health education to the workers regarding occupational hazards and lifestyle diseases along with more emphasis on the use of PPEs with regular health examination needs reinforcement.
Rowlands, Gillian; Berry, Jonathan; Protheroe, Joanne
service, and industry perspectives. Suggested topics for action fell into four areas; improving health services, building health literacy skills in the population and workforce, recognizing the importance of public information developed outside the health arena, and funding for health literacy research...... and development. Following consideration of likely cost, impact, and feasibility, five suggested areas were prioritized for action, three involving improvements in the health service, and two involving the development of public health literacy skills. The importance of inter-sectoral approaches to this complex......, a significant proportion of people (43–61%) have literacy and numeracy skills below those needed to fully understand and use health materials. This paper describes a project designed to build on these findings with key stakeholders to develop an action plan to address a mismatch between population skills...
program; medical supported • Doctrine signed Dec 2010 • Training: > 200,000 trained to date • 8 courses on Navy eLearning • Formal curriculum delivered...Identify issues during post-deployment •Provide resources for issue resolution •Engage family and service members with process improvement 9 Reserve...building interventions to NSW Operators and their families in relation to screening, improving performance and creating family stability Impact
KE Yongjian; LIU Xinping; WANG Shouqing
The feasibility study of a public-private partnership (PPP) project is regarded as one of the critical factors for successful implementation,but unfortunately the common financial evaluation methods currently used only represent the benefits of the private sector.There is,therefore,an urgent need to develop an equitable financial evaluation method for PPP projects.This paper presents a comprehensive literature review that examines international practices.An equitable financial evaluation method was then developed taking into account the inherent characteristics of PPP projects using six separate indicators and Monte Carlo simulations.The result for a bridge project in Romania shows that the method combines the viewpoints of all the relevant stakeholders to achieve an equitable financial evaluation of PPP projects.
Airhihenbuwa, Collins O.; Ogedegbe, Gbenga; Iwelunmor, Juliet; Jean-Louis, Girardin; Williams, Natasha; Zizi, Freddy; Okuyemi, Kolawole
As the burden of noncommunicable diseases (NCDs) rises in settings with an equally high burden of infectious diseases in the Global South, a new sense of urgency has developed around research capacity building to promote more effective and sustainable public health and health care systems. In 2010, NCDs accounted for more than 2.06 million deaths…
Helen H Cui
Full Text Available Genome science and technologies are transforming life sciences globally in many ways, and becoming a highly desirable area for international collaboration to strengthen global health. The Genome Science Program at the Los Alamos National Laboratory is leveraging a long history of expertise in genomics research to assist multiple partner nations in advancing their genomics and bioinformatics capabilities. The capability development objectives focus on providing a molecular genomics-based scientific approach for pathogen detection, characterization, and biosurveillance applications. The general approaches include introduction of basic principles in genomics technologies, training on laboratory methodologies and bioinformatic analysis of resulting data, procurement and installation of next generation sequencing instruments, establishing bioinformatics software capabilities, and exploring collaborative applications of the genomics capabilities in public health. Genome centers have been established with public health and research institutions in the Republic of Georgia, Kingdom of Jordan, Uganda, and Gabon; broader collaborations in genomics applications have also been developed with research institutions in many other countries.
Full Text Available This paper presents architecture for health care data warehouse specific to cancer diseases which could be used by executive managers, doctors, physicians and other health professionals to support the healthcare process. The data today existing in multi sources with different formats makes it necessary to have some techniques for data integration. Executive managers need access to Information so that decision makers can react in real time to changing needs. Information is one of the most factors to an organization success that executive managers or physicians would need to base their decisions on, during decisionmaking. A health care data warehouse is therefore necessary to integrate the different data sources into a central data repository and analysis this data.
Bosi, Maria Lúcia Magalhães; Gastaldo, Denise
The article examines core elements of the national and international discussion on the required integration between research, policy and practice in public health, and provides input for this integration. Some conceptual barriers and other barriers at different spheres that interfere with the desired integration are discussed. Evidence has shown that research, policy and practice in health are not continuous, homogenous areas but rather involve different levels and actors. Their processes develop in different grounds supported by a variety of actions, paradigms and interests that are not conflict-free. Thus, this integration is a major challenge given its complexity and multiplicity of objective and subjective aspects.
Blank, Martin J.
Background: Growing health disparities have a negative impact on young people's educational achievement. Community schools that involve deep relationships with partners across multiple domains address these disparities by providing opportunities and services that promote healthy development of young people, and enable them to graduate from high…
Abrol, Dinesh; Sundararaman, T; Madhavan, Harilal; Joseph, K J
This article presents an overview of the changes that are taking place within the public and private health innovation systems in India including delivery of medical care, pharmaceutical products, medical devices, and Indian traditional medicine. The nature of the flaws that exist in the health innovation system is pinpointed. The response by the government, the health, technology and medical institutions, and the evolving industry is addressed on a national level. The article also discusses how the alignment of policies and institutions was developed within the scope of national health innovation systems, and how the government and the industry are dealing with the challenges to integrate health system, industry, and social policy development processes. Resumo: O artigo apresenta um panorama das mudanças atualmente em curso dentro dos sistemas público e privado de inovação em saúde na Índia, incluindo a prestação de serviços médicos, produtos farmacêuticos, dispositivos médicos e medicina tradicional indiana. É destacada a natureza das falhas que existem nos sistemas de inovação em saúde. As respostas do governo, das instituições médicas, de saúde e tecnologia e indústrias envolvidas, são abordadas em nível nacional. O artigo também discute como foi desenvolvido o alinhamento de políticas e instituições no escopo dos sistemas nacionais de inovação em saúde, e como governo e indústria estão lidando com os desafios para integrar o sistema de saúde, a indústria e o desenvolvimento de políticas sociais.
Yusif, Hadrat; Yussof, Ishak; Osman, Zulkifly
Public universities in Ghana are highly subsidised by the central government and account for about 80 per cent of university students in the country. Yet issues of fairness in terms of entry into the public university system have so far hardly been addressed. To find out whether participation in public university education is equitable, the…
Erb, Cathy Smeltzer
Effective teaching values the classroom as a learning community in which instructional approaches optimize learning for all students. Contrary to the principles of an equitable learning environment is the use of "me" language by teachers, a practice that promotes the role of teacher as high status and inadvertently excludes students from the…
... of: (1) Payment limitations under 7 CFR part 1400; (2) Payment limitations under a conservation program administered by the Secretary; or (3) The highly erodible land and wetland conservation... CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING EQUITABLE RELIEF FROM INELIGIBILITY §...
Maria Chiara Pievatolo
Full Text Available L'articolo di Andrea Passoni, Giustizia come equità e socialismo liberale, appena pubblicato nell'archivio "Giuliano Marini", discute l’idea rawlsiana di socialismo liberale, allo scopo di dimostrare che può essere almeno parzialmente riempire di significato tramite la promozione e lo sviluppo di un’economia di mercato di tipo cooperativo.
Personal Health Intervention Toolkit (PHIT) is an advanced cross-platform software framework targeted at personal self-help research on mobile devices. Following the subjective and objective measurement, assessment, and plan methodology for health assessment and intervention recommendations, the PHIT platform lets researchers quickly build mobile health research Android and iOS apps. They can (1) create complex data-collection instruments using a simple extensible markup language (XML) schema; (2) use Bluetooth wireless sensors; (3) create targeted self-help interventions based on collected data via XML-coded logic; (4) facilitate cross-study reuse from the library of existing instruments and interventions such as stress, anxiety, sleep quality, and substance abuse; and (5) monitor longitudinal intervention studies via daily upload to a Web-based dashboard portal. For physiological data, Bluetooth sensors collect real-time data with on-device processing. For example, using the BinarHeartSensor, the PHIT platform processes the heart rate data into heart rate variability measures, and plots these data as time-series waveforms. Subjective data instruments are user data-entry screens, comprising a series of forms with validation and processing logic. The PHIT instrument library consists of over 70 reusable instruments for various domains including cognitive, environmental, psychiatric, psychosocial, and substance abuse. Many are standardized instruments, such as the Alcohol Use Disorder Identification Test, Patient Health Questionnaire-8, and Post-Traumatic Stress Disorder Checklist. Autonomous instruments such as battery and global positioning system location support continuous background data collection. All data are acquired using a schedule appropriate to the app’s deployment. The PHIT intelligent virtual advisor (iVA) is an expert system logic layer, which analyzes the data in real time on the device. This data analysis results in a tailored app of interventions
Wachs, Joy E
Teamwork among occupational health and safety professionals, management, and employees is vital to solving today's complex problems cost-effectively. No single discipline can meet all the needs of workers and the workplace. However, teamwork can be time-consuming and difficult if attention is not given to the role of the team leader, the necessary skills of team members, and the importance of a supportive environment. Bringing team members together regularly to foster positive relationships and infuse them with the philosophy of strength in diversity is essential for teams to be sustained and work to be accomplished. By working in tandem, occupational health and safety professionals can become the model team in business and industry delivering on their promise of a safe and healthy workplace for America's work force.
Rütten, Alfred; Gelius, Peter
This article outlines a theoretical framework for an interactive, research-driven approach to building policy capacities in health promotion. First, it illustrates how two important issues in the recent public health debate, capacity building and linking scientific knowledge to policy action, are connected to each other theoretically. It then introduces an international study on an interactive approach to capacity building in health promotion policy. The approach combines the ADEPT model of policy capacities with a co-operative planning process to foster the exchange of knowledge between policy-makers and researchers, thus improving intra- and inter-organizational capacities. A regional-level physical activity promotion project involving governmental and public-law institutions, NGOs and university researchers serves as a case study to illustrate the potential of the approach for capacity building. Analysis and comparison with a similar local-level project indicate that the approach provides an effective means of linking scientific knowledge to policy action and to planning concrete measures for capacity building in health promotion, but that it requires sufficiently long timelines and adequate resources to achieve adequate implementation and sustainability.
Carneiro, Fernando Ferreira; Franco Netto, Guilherme; Corvalan, Carlos; de Freitas, Carlos Machado; Sales, Luiz Belino Ferreira
Despite its progress in terms of socio-economic indicators, Brazil is still unequal, which is due to an unequal and exclusionary historical process. In this paper we selected the Human Development Index - HDI and other social, economic, environmental and health indicators to exemplify this situation. We selected the municipalities that had the lowest HDI in the country in 2000 comparing their evolution over time between 2000 and 2010 by means of indicators linked to the economic, environmental and social pillars of sustainable development. These municipalities have an HDI classified as low (sustainable development with quality of life, the improvement of sanitation and education indicators should be a priority for Brazil.
Victoria L. Boggiano
Full Text Available Researchers are increasingly embarking on international qualitative health research projects, where unknown social structures and government systems make inquiry uniquely challenging. In this article, we document our experiences conducting two related studies on HIV/AIDS in Northern Vietnam. We describe how our research relied on harnessing the social capital of vital community stakeholders, such as key informants, interpreters, and host organizations, to effectively engage with government bodies on a macro level and with local communities on a microlevel. By highlighting our processes, pitfalls, and successes, we provide current and future scholars with strategies to use when conducting cross-national field research.
Full Text Available In many applications in sequencing and scheduling it is desirable to have an underlaying graph as equitably colored as possible. In this paper we survey recent theoretical results concerning conditions for equitable colorability of some graphs and recent theoretical results concerning the complexity of equitable coloring problem. Next, since the general coloring problem is strongly NP-hard, we report on practical experiments with some efficient polynomial-time algorithms for approximate equitable coloring of general graphs.
Taplin, Stephen H; Foster, Mary K; Shortell, Stephen M
The movement toward accountable care organizations and patient-centered medical homes will increase with implementation of the Affordable Care Act (ACA). The ACA will therefore give further impetus to the growing importance of teams in health care. Teams typically involve 2 or more people embedded in a larger social system who differentiate their roles, share common goals, interact with each other, and perform tasks affecting others. Multiple team types fit within this definition, and they all need support from leadership to succeed. Teams have been invoked as a necessary tool to address the needs of patients with multiple chronic conditions and to address medical workforce shortages. Invoking teams, however, is much easier than making them function effectively, so we need to consider the implications of the growing emphasis on teams. Although the ACA will spur team development, organizational leadership must use what we know now to train, support, and incentivize team function. Meanwhile, we must also advance research regarding teams in health care to give those leaders more evidence to guide their work.
Stenner, R.D.; Baechler, M.C.
Indoor air quality can conceivably be impacted by hundreds of different chemicals. More than 900 different organic compounds alone have been identified in indoor air. The health effects that could potentially arise from exposure to individual pollutants or mixtures of pollutants cover the full range of acute and chronic effects, including largely reversible responses, such as rashes and irritations, as well as irreversible toxic and carcinogenic effects. These indoor contaminants are emitted from a large variety of materials and substances that are widespread components of everyday life. Pacific Northwest Laboratory conducted a search of the peer-reviewed literature on health effects associated with indoor air contaminants for the Bonneville Power Administration to aid the agency in the preparation of environmental documents. The results of this search are reported in two volumes. Volume 1 is a summary of the results of the literature search; Volume 2 is the complete results of the literature search and contains all references to the material reviewed. 16 tabs.
... COMMISSION AXA Equitable Life Insurance Company, et al; Notice of Application January 31, 2013. AGENCY... the Act from Section 17(a) of the Act. Applicants: AXA Equitable Life Insurance Company (``AXA... Equitable Life Insurance Company, 1290 Avenue of Americas, New York, New York 10104; Patricia Louie,...
Marks-Sultan, Géraldine; Tsai, Feng-Jen; Anderson, Evan; Kastler, Florian; Sprumont, Dominique; Burris, Scott
A robust health infrastructure in every country is the most effective long-term preparedness strategy for global health emergencies. This includes not only health systems and their human resources, but also countries' legal infrastructure for health: the laws and policies that empower, obligate and sometimes limit government and private action. The law is also an important tool in health promotion and protection. Public health professionals play important roles in health law - from the development of policies, through their enforcement, to the scientific evaluation of the health impact of laws. Member States are already mandated to communicate their national health laws and regulations to the World Health Organization (WHO). In this paper we propose that WHO has the authority and credibility to support capacity-building in the area of health law within Member States, and to make national laws easier to access, understand, monitor and evaluate. We believe a strong case can be made to donors for the funding of a public health law centre or unit, that has adequate staffing, is robustly networked with its regional counterparts and is integrated into the main work of WHO. The mission of the unit or centre would be to define and integrate scientific and legal expertise in public health law, both technical and programmatic, across the work of WHO, and to conduct and facilitate global health policy surveillance.
Skinner Harvey A
Full Text Available Abstract Background Ongoing conflict in the Middle East poses a major threat to health and security. A project screening Arab and Israeli newborns for hearing loss provided an opportunity to evaluate ways for building cooperation. The aims of this study were to: a examine what attracted Israeli, Jordanian and Palestinian participants to the project, b describe challenges they faced, and c draw lessons learned for guiding cross-border health initiatives. Methods A case study method was used involving 12 key informants stratified by country (3 Israeli, 3 Jordanian, 3 Palestinian, 3 Canadian. In-depth interviews were tape-recorded, transcribed and analyzed using an inductive qualitative approach to derive key themes. Results Major reasons for getting involved included: concern over an important health problem, curiosity about neighbors and opportunities for professional advancement. Participants were attracted to prospects for opening the dialogue, building relationships and facilitating cooperation in the region. The political situation was a major challenge that delayed implementation of the project and placed participants under social pressure. Among lessons learned, fostering personal relationships was viewed as critical for success of this initiative. Conclusion Arab and Israeli health professionals were prepared to get involved for two types of reasons: a Project Level: opportunity to address a significant health issue (e.g. congenital hearing loss while enhancing their professional careers, and b Meta Level: concern about taking positive steps for building cooperation in the region. We invite discussion about roles that health professionals can play in building "cooperation networks" for underpinning health security, conflict resolution and global health promotion.
Guest, M. Aaron; Freedman, Darcy; Alia, Kassandra A.; Brandt, Heather M.; Friedman, Daniela B.
Community-university partnerships can lend themselves to the development of tools that encourage and promote future community health development. The electronic manual, “Building Farmacies,” describes an approach for developing capacity and sustaining a community health center-based farmers’ market that emerged through a community-university partnership. Manual development was guided by the Knowledge to Action Framework and experiences developing a multi-vendor, produce-only farmers’ market a...
Brown, Mark A
This article makes the case that current Agent Orange compensation policy for Vietnam War veterans is based neither wholly upon scientific findings about Agent Orange health effects nor on pure public health policy considerations. Rather, it is the logical culmination of decades of experience among policy makers and public health scientists trying to establish clear-cut, equitable, and scientifically defensible compensation policy in the face of limited relevant science and poor or nonexistent exposure data-all within the broader context of Veterans Affairs disability compensation policies, and a deep-seated commitment to support the men and women who served their country during the Vietnam War. Finally, attempts to update current policy will benefit from an understanding of this background.
Nichols, Barbara L
The following four articles are based on presentations delivered at Building Global Alliances V: The Challenges of Migration for Health Professional Women, held in Philadelphia on December 7-8, 2008 and hosted by CGFNS International (formerly the Commission on Graduates of Foreign Nursing Schools).
Bluyssen, P.M.; Fossati, S.; Mandin, C.; Cattaneo, A.; Carrer, P.
In the European project OFFICAIR a procedure has been prepared for the inventory and identification of associations between possible characteristics of European modern offices (building, sources and events) and health and comfort of office workers, via a questionnaire and a checklist including envir
Terwoert, J.; Ustailieva, E.
This checklist accompanies the e-fact on the same topic and aims to help identify the potential hazards to workers’ safety and health associated with the planning and construction of green buildings, their maintenance, renovation (retrofitting), demolition, and on-site waste collection. It also give
Lax, Leila; Scardamalia, Marlene; Watt-Watson, Judy; Hunter, Judith; Bereiter, Carl
This paper examines theoretical, pedagogical, and technological differences between two technologies that have been used in undergraduate interprofessional health sciences at the University of Toronto. One, a learning management system, WebCT 2.0, supports online coursework. The other, a Knowledge Building environment, Knowledge Forum 2.0,…
Palazuelos, Daniel; Dhillon, Ranu
Among many possible benefits, global health efforts can expand the skills and experience of U.S. clinicians, improve health for communities in need, and generate innovations in care delivery with relevance everywhere. Yet, despite high rates of interest among students and medical trainees to include global health opportunities in their training, there is still no clear understanding of how this interest will translate into viable and sustained global health careers after graduation. Building on a growing conversation about how to support careers in academic global health, this Perspective describes the practical challenges faced by physicians pursuing these careers after they complete training. Writing from their perspective as junior faculty at one U.S. academic health center with a dedicated focus on global health training, the authors describe a number of practical issues they have found to be critical both for their own career development and for the advice they provide their mentees. With a particular emphasis on the financial, personal, professional, and logistical challenges that young "expat" global health physicians in academic institutions face, they underscore the importance of finding ways to support these career paths, and propose possible solutions. Such investments would not only respond to the rational and moral imperatives of global health work and advance the mission of improving human health but also help to fully leverage the potential of what is already an unprecedented movement within academic medicine.
Full Text Available Abstract In developing countries building national health research systems is a movement similar to a political leadership contest. Increasingly, political campaigns to select leaders depend less on ideologies and political messages and more on promising change that will promptly improve the quality of life of the voters. In this process the benefits and risks of every action and statement made by the candidates are carefully assessed. Approaches currently promoted to strengthen health research within ministries of health in developing countries place emphasis on implementing logical steps towards building national health research systems including developing a national health research policy and strategic plan, conducting a situational analysis of research in the country, setting a national health research agenda, establishing research ethics and scientific committees, and building human and institutional capacity for health research management and conduct. Although these processes have successfully improved the standards of health research in some settings, many developing countries struggle to get the process going. One reason is that this approach does not deal with basic questions posed within a ministry of health, namely, "What is the political benefit of the ministry assuming control of the process?" and "What are the political implications for the ministry if another institution spearheads the process?" Seen from the perspective of non-governmental organizations, academic institutions and donors trying to support the processes of strengthening national health research systems, one of the foremost activities that needs to be undertaken is to analyze the political context of national health research and, on that basis, plan and implement appropriate political health research advocacy initiatives. This includes the development of explicit messages on the political benefits to the leadership in the ministry of health of their role in the
Warren, James; Morris, Emily; Enoch, Marcus; Padilla Magdaleno, Idalmis; Parra Arias, Zunilda; Guanche, Julia
The particular political, economic and social conditions of the state of Cuba, in the Caribbean, have created unique possibilities for the development of a sustainable transport system in its capital city, Havana. This paper reports on the outcomes of a project to identify the possibilities and priorities for a long-term strategy for equitable and sustainable mobility for Havana. This involved almost 100 participants from Cuba and the UK in the 12 months from June 2013.\\ud \\ud Overall, the st...
Ruxandra M. Petrescu-Mag
Full Text Available Concepts of Integrated Water Resources and River Basins Management are considered as key points to the question of how conflict can be avoided and international waters be managed. Over the last fifty years, countries have been engaged in more than 500 conflictive events over water. Almost 90% were disagreements over infrastructure and water quantity allocation. The Convention on the NonnavigationalUses of International Watercourses (1997 provides an important template for cooperation and equitable transboundary water-sharing.
Graham, J.H.; Krzysik, A.J.; Kovacic, D.A.; Duda, J.J.; Freeman, D.C.; Emlen, J.M.; Zak, J.C.; Long, W.R.; Wallace, M.P.; Chamberlin-Graham, C.; Nutter, J.P.; Balbach, H.E.
Ants are used as indicators of environmental change in disturbed landscapes, often without adequate understanding of their response to disturbance. Ant communities in the southeastern United States displayed a hump-backed species richness curve against an index of landscape disturbance. Forty sites at Fort Benning, in west-central Georgia, covered a spectrum of habitat disturbance (military training and fire) in upland forest. Sites disturbed by military training had fewer trees, less canopy cover, more bare ground, and warmer, more compact soils with shallower A-horizons. We sampled ground-dwelling ants with pitfall traps, and measured 15 habitat variables related to vegetation and soil. Ant species richness was greatest with a relative disturbance of 43%, but equitability was greatest with no disturbance. Ant abundance was greatest with a relative disturbance of 85%. High species richness at intermediate disturbance was associated with greater within-site spatial heterogeneity. Species richness was also associated with intermediate values of the normalized difference vegetation index (NDVI), a correlate of net primary productivity (NPP). Available NPP (the product of NDVI and the fraction of days that soil temperature exceeded 25 ??C), however, was positively correlated with species richness, though not with ant abundance. Species richness was unrelated to soil texture, total ground cover, and fire frequency. Ant species richness and equitability are potential state indicators of the soil arthropod community. Moreover, equitability can be used to monitor ecosystem change. ?? 2008 Elsevier Ltd.
Robiou Du Pont, Yann; Jeffery, M. Louise; Gütschow, Johannes; Rogelj, Joeri; Christoff, Peter; Meinshausen, Malte
Benchmarks to guide countries in ratcheting-up ambition, climate finance, and support in an equitable manner are critical but not yet determined in the context of the Paris Agreement. We identify global cost-optimal mitigation scenarios consistent with the Paris Agreement goals and allocate their emissions dynamically to countries according to five equity approaches. At the national level, China's Nationally Determined Contribution (NDC) is weaker than any of the five equity approaches, India's NDC is aligned with two, and the EU's and the USA's with three. Most developing countries' conditional (Intended) NDCs (INDCs) are more ambitious than the average of the five equity approaches under the 2 °C goal. If the G8 and China adopt the average of the five approaches, the gap between conditional INDCs and 2 °C-consistent pathways could be closed. For an equitable, cost-optimal achievement of the 1.5 °C target, emissions in 2030 are 21% lower (relative to 2010) than for 2 °C for the G8 and China combined, and 39% lower for remaining countries. Equitably limiting warming to 1.5 °C rather than 2 °C requires that individual countries achieve mitigation milestones, such as peaking or reaching net-zero emissions, around a decade earlier.
Shi, X M
The national health strategy is a reflection of a country on overall value and development vision of national health, and conducting this strategy will enhance and promote national development and people's welfare. In the current situation of building Healthy China during the 13th Five-Year Plan, it is important to learn experiences in this area from developed countries. This article mainly presents detailed introduction of the formulation, the implementation and the characteristics of National Health Strategies from the United States, United Kingdom and Japan, and also presents suggestions for the construction of Healthy China.
Scott, Richard E; Mars, Maurice
To ensure the benefits of e-Health are maximised, e-Health capacity building requires a formal and logical structure that describes broad areas that must be addressed. In this paper a Conceptual Framework for e-Health Training is derived that could guide well-thought-out and consistent development of future capacity building efforts. Consideration of e-health education needs is the mandate of the International Society for Telemedicine and eHealth (ISfTeH) Education Working Group. Through this Group a structured but generic 2 - 3 day telehealth training programme for healthcare professionals was developed and trialed, and the Group has been asked to develop a telehealth curriculum. Ongoing debate and feedback has made it clear that this is insufficient. In an effort to establish an Conceptual Framework for e-Health Training four aspects or levels of instruction are considered necessary at this time: 'education' of a small number of personnel leading to an academic graduate qualification (MSc, PhD); 'instruction' of a slightly larger number of personnel (e.g., to provide proficient network managers); 'teaching' of a still larger number of personnel in terms of the use of specific technologies, devices, and services; and 'awareness' of the general populace. Collectively this is referred to as e-health 'training'. If implemented in a coordinated and structured manner, such an approach would stimulate e-health growth and application globally. It would generate demand (awareness), allow that demand to be filled (teaching) and guided (instruction), with the focus on technologically appropriate and needs-based solutions (education). The Education Working Group intends to develop outlines of recommended instructional and informational content for training at each level. Here the four levels are highlighted and the terms, hierarchy, and descriptions of the Education Working Group's proposed approach to its Conceptual Framework for e-Health Training, are formalised.
Lindsay P. Galway
Full Text Available The shortcomings of public health research informed by reductionist and fragmented biomedical approaches and the emergence of wicked problems are fueling a renewed interest in ecological approaches in public health. Despite the central role of interdisciplinarity in the context of ecological approaches in public health research, inadequate attention has been given to the specific challenge of doing interdisciplinary research in practice. As a result, important knowledge gaps exist with regards to the practice of interdisciplinary research. We argue that explicit attention towards the challenge of doing interdisciplinary research is critical in order to effectively apply ecological approaches to public health issues. This paper draws on our experiences developing and conducting an interdisciplinary research project exploring the links among climate change, water, and health to highlight five specific insights which we see as relevant to building capacity for interdisciplinary research specifically, and which have particular relevance to addressing the integrative challenges demanded by ecological approaches to address public health issues. These lessons include: (i the need for frameworks that facilitate integration; (ii emphasize learning-by-doing; (iii the benefits of examining issues at multiple scales; (iv make the implicit, explicit; and (v the need for reflective practice. By synthesizing and sharing experiences gained by engaging in interdisciplinary inquiries using an ecological approach, this paper responds to a growing need to build interdisciplinary research capacity as a means for advancing the ecological public health agenda more broadly.
Horn, Michelle A; Rauscher, Alana B; Ardiles, Paola A; Griffin, Shannon L
Health Compass is an innovative, multiphased project that aims to transform health care practice and shift organizational culture by building the capacity of Provincial Health Services Authority (PHSA) health care providers to further promote the mental health and well-being of patients and families accessing PHSA's health care services. Health Compass was developed within a health promotion framework, which involved collaboration and engagement with stakeholders across all partnering PHSA agencies. This approach led to the development of an educational and training resource that contributes to increased capacity for mental health promotion within the health care setting. Based on interviews with Health Compass' internal Project Team and findings from a Stakeholder Engagement Evaluation Report, this article outlines the participatory approach taken to develop the Health Compass Mental Health Promotion Resource and E-Learning Tool. A number of key facilitators for collaboration and engagement are discussed, which may be particularly applicable to the implementation of a mental health promotion program or initiative within a complex health care setting.
Trowbridge, Matthew J; Worden, Kelly; Pyke, Christopher
The built environment-the constructed physical parts of the places where people live and work-is a powerful determinant of both individual and population health. Awareness of the link between place and health is growing within the public health sector and among built environment decision makers working in design, construction, policy, and both public and private finance. However, these decision makers lack the knowledge, tools, and capacity to ensure that health and well-being are routinely considered across all sectors of the built environment. The green building industry has successfully established environmental sustainability as a normative part of built environment practice, policy making, and investment. We explore the value of this industry's experience as a template for promoting health and well-being in the built environment.
Davis, Karen; Schoen, Cathy; Collins, Sara R
The presidential election has focused public attention on the need for health system reform--to ensure health insurance for all, to make health care more accessible and responsive to patients, and to slow the growth in health care cost. This issue brief sets forth a framework for expanding health coverage that offers Americans a choice of a product modeled on Medicare to those under age 65, made available through a national insurance connector. Coupled with reforms to Medicare provider payment, expansion of preventive health care, and improved information, such a strategy has the potential to achieve near-universal coverage and improve quality and access, while generating health system savings of $1.6 trillion over 10 years.
Pejtersen, Jan; Brohus, H.; Hyldgaard, C.E.
An intervention study was performed in an office building in which there were severe indoor climate complaints among the occupants. In one part of the building a new heating and ventilation strategy was implemented by renovating the HVAC system, and a carpet floor material was replaced with a low......-emitting vinyl floor; the other part of the building was kept unchanged, serving as a control. A comprehensive indoor climate investigation, including a questionnaire study of the occupants' comfort and health, was performed before and after the intervention. The intervention was performed after detailed...... laboratory studies on alternative flooring materials and alternative ventilation strategies. The occupants' adverse perceptions and symptoms were significantly reduced by the intervention. The improvement of the indoor climate was most pronounced in the cellular offices, where both the floor material...
Lackey, Mellanye; Swogger, Susan; McGraw, Kathleen A.
This paper describes how a large, academic health sciences library built capacity for supporting global health at its university and discusses related outcomes. Lean budgets require prioritization and organizational strategy. A committee, with leadership responsibilities assigned to one librarian, guided strategic planning and the pursuit of collaborative, global health outreach activities. A website features case studies and videos of user stories to promote how library partnerships successfully contributed to global health projects. Collaborative partnerships were formed through outreach activities and from follow-up to reference questions. The committee and a librarian's dedicated time established the library's commitment to help the university carry out its ambitious global agenda. PMID:24860264
Full Text Available The modern forms of organization are studied recreational health-building employments. Organization of employments in the clubs of fitness, visit of complex sporting buildings is presented. The analysis of publications in which authors examine the features of development of industry of fitness in market conditions is resulted. A questionnaire in which 1500 habitants of city took part in age 18-75 years is conducted. It is set that among polled most popular are clubs of fitness of middle level, where the cost of subscription is made by 20-50 dollars of the USA on a month. It is set that clubs of fitness visit mainly people of middle ages with the purpose of the complex making healthy, maintainance of beautiful physical form and attractive exterior. It is marked that to date clubs of fitness must be oriented mainly on health direction and to satisfy the psychological and social necessities of clients.
Ladyshewsky, Richard K
The development of competence is an ongoing journey, and one that is particularly punctuated in the early part of a health professional's career. These novice practitioners need to recognize that the challenges inherent in building competency might be resolved more readily by engaging with peers. This paper outlines what it means to be a novice practitioner, and how peer coaching can be used to support professional development in the allied health sciences. An overview of the reasoning process and how peer coaching and experiential learning can be used to build competence is described. A structured and formal approach to peer coaching is outlined in this paper. Novices who embrace this professional development strategy will find the model of coaching practice and underlying strategies described in this paper beneficial to their experience. The importance of formalizing the process and the underlying communication skills needed for coaching are described in detail with accompanying examples to illustrate the model in practice.
The International Society for Disease Surveillance (ISDS) celebrates its 10th annual meeting with the arrival of the 2011 ISDS Annual Conference, ‘Building the Future of Public Health Surveillance’. This milestone in the Society’s history is punctuated not only by the achievements of the disease surveillance community but also by the promise of what lies ahead. The Annual Conference brings together a community of researchers and practitioners focused on monitoring, understanding and improving...
Terwoert, J.; Ustailieva, E.
This checklist accompanies the e-fact on the same topic and aims to help identify the potential hazards to workers’ safety and health associated with the planning and construction of green buildings, their maintenance, renovation (retrofitting), demolition, and on-site waste collection. It also gives examples of preventive measures to address these hazards. Some of these OSH hazards are new compared with traditional construction sites and are associated with new green materials, technologies ...
.Result: Risk factors obtained over 0.5 for most of the risks that indicate the importance of Health in high-rise projects during construction phase. The results also showed that the health risks should be assessed before the start of the project in order to reduce or eliminate their impacts. .Conclusion: Safety risks in High-rise Building projects is very important. These risks have many impacts directly and indirectly on the time, quality and costs of projects. Therefore, evaluating and controlling each health risk in the design and implementation phases are essential. Most of the risks factors identified in this study, can be prevented by using personal protective equipment. The role of the training people involved in this projects are essential to use personal protective equipment.
Hurley, Sara Jane; Tuck, Jeremy
BACKGROUNDd: The dental health of the British Army has been reported as being in decline for the past 10 years, and this is having a significant impact on operations. One of the major factors in the decline is the increasing number of recruits who enlist with outstanding dental treatment needs. The current policy for provision of routine dental care to recruits targets resources toward those with the worst dental health and provides only emergency dental care for the remainder.AIMSs: The goal was to review recruit dental care provision, to determine whether improvements in the overall dental health of the trained Army could be made during recruit training.RESULTSs: It was found that >85% of recruit dental treatment need could be met with the routine provision of 2 hours of dental treatment during training.CONCLUSIONn: A horizontally equitable model of recruit dental care, whereby all recruits access routine dental care during training, has been recommended to and accepted by the chain of command.
Berman, Joshua; Mitambo, Collins; Matanje-Mwagomba, Beatrice; Khan, Shiraz; Kachimanga, Chiyembekezo; Wroe, Emily; Mwape, Lonia; van Oosterhout, Joep J; Chindebvu, Getrude; van Schoor, Vanessa; Puchalski Ritchie, Lisa M; Panisset, Ulysses; Kathyola, Damson
With the support of the World Health Organization's Evidence-Informed Policy Network, knowledge translation platforms have been developed throughout Africa, the Americas, Eastern Europe, and Asia to further evidence-informed national health policy. In this commentary, we discuss the approaches, activities and early lessons learned from the development of a Knowledge Translation Platform in Malawi (KTPMalawi). Through ongoing leadership, as well as financial and administrative support, the Malawi Ministry of Health has strongly signalled its intention to utilize a knowledge translation platform methodology to support evidence-informed national health policy. A unique partnership between Dignitas International, a medical and research non-governmental organization, and the Malawi Ministry of Health, has established KTPMalawi to engage national-level policymakers, researchers and implementers in a coordinated approach to the generation and utilization of health-sector research. Utilizing a methodology developed and tested by knowledge translation platforms across Africa, a stakeholder mapping exercise and initial capacity building workshops were undertaken and a multidisciplinary Steering Committee was formed. This Steering Committee prioritized the development of two initial Communities of Practice to (1) improve data utilization in the pharmaceutical supply chain and (2) improve the screening and treatment of hypertension within HIV-infected populations. Each Community of Practice's mandate is to gather and synthesize the best available global and local evidence and produce evidence briefs for policy that have been used as the primary input into structured deliberative dialogues. While a lack of sustained initial funding slowed its early development, KTPMalawi has greatly benefited from extensive technical support and mentorship by an existing network of global knowledge translation platforms. With the continued support of the Malawi Ministry of Health and the
Marla B. Hall
Full Text Available Racial and ethnic minority health data from a national perspective indicates there is much to learn in the public health workforce about the ongoing health disparities crisis. This suggests a level of urgency to assist our public health professionals in obtaining specific skills sets that will assist them in working better with vulnerable populations. The purpose of this research is to assess cultural competence knowledge and programmatic skill sets, utilizing an explorational case study, of individuals employed within an urban public health department. In order to effectively evaluate these constructs, a quantitative research approach was employed to examine participants’ knowledge and competencies of the subject matter. This data was further analyzed to determine if continuing education participation and training was correlated to the levels of culturally competent practice engagement and self-reported confidence. In addition, researchers obtained data on the availability of employer sponsored training opportunities. The data suggested when health professionals engage in cultural competence education, their level of awareness of unique characteristics between ethnic and racial minorities increased. Those who exhibited the healthiest behaviors, as it relates to effectively working with diverse populations, had a heightened sense of knowledge related to culture and healthcare services. Continuing education in cultural competence is an essential strategy for improving public health employees’ effectiveness in working with diverse clients and reducing racial and ethnic health disparities. As the finding illustrated, training programs must incorporate educational components which foster skill building to enable subsequent culturally appropriate clinical interactions.
A legally binding protocol on access to genetic resources and benefit-sharing is to be adopted by the 193 governments that are party to the Convention on Biological Diversity in October 2010 in Nagoya, Japan. The protocol aims to ensure that the benefits derived from the use of genetic resources are shared fairly and equitably with biodiversity-rich but financially poor countries. This could help reverse the rapid loss of biodiversity and genetic resources. But unless governments make some major progress in their final negotiating session, the protocol will make little difference.
Lyons, Renée; Dsouza, Nikeetha; Quigley, Cassie
This review explores Archer, Dawson, Seakins, and Wong's "Disorienting, fun or meaningful? Disadvantaged families' experiences of a science museum visit" by examining the analytic frameworks guiding this study. To expand on Archer et al.'s use of feminist post-structuralist theories of identity we draw from the theory of intersectionality to provide a more robust framework for analyzing barriers to engagement within an informal learning space. Our response to this work ends by exploring the types of solutions generated from an intersectionality framework—solutions aimed at transforming institutional programs and practices to create more equitable spaces for learning.
Lyons, Renée; Dsouza, Nikeetha; Quigley, Cassie
This review explores Archer, Dawson, Seakins, and Wong's "Disorienting, fun or meaningful? Disadvantaged families' experiences of a science museum visit" by examining the analytic frameworks guiding this study. To expand on Archer et al.'s use of feminist post-structuralist theories of identity we draw from the theory of intersectionality to provide a more robust framework for analyzing barriers to engagement within an informal learning space. Our response to this work ends by exploring the types of solutions generated from an intersectionality framework—solutions aimed at transforming institutional programs and practices to create more equitable spaces for learning.
Lopes, D. F.; Oliveira, M. D.; Costa, C. A. Bana e.
Risk matrices (RMs) are commonly used to evaluate health and safety risks. Nonetheless, they violate some theoretical principles that compromise their feasibility and use. This study describes how multiple criteria decision analysis methods have been used to improve the design and the deployment of RMs to evaluate health and safety risks at the Occupational Health and Safety Unit (OHSU) of the Regional Health Administration of Lisbon and Tagus Valley. ‘Value risk-matrices’ (VRMs) are built with the MACBETH approach in four modelling steps: a) structuring risk impacts, involving the construction of descriptors of impact that link risk events with health impacts and are informed by scientific evidence; b) generating a value measurement scale of risk impacts, by applying the MACBETH-Choquet procedure; c) building a system for eliciting subjective probabilities that makes use of a numerical probability scale that was constructed with MACBETH qualitative judgments on likelihood; d) and defining a classification colouring scheme for the VRM. A VRM built with OHSU members was implemented in a decision support system which will be used by OHSU members to evaluate health and safety risks and to identify risk mitigation actions.
Parthasarathy, Padmini; Dailey, Dawn E; Young, Maria-Elena D; Lam, Carrie; Pies, Cheri
In recent years, maternal and child health professionals have been seeking approaches to integrating the Life Course Perspective and social determinants of health into their work. In this article, we describe how community input, staff feedback, and evidence from the field that the connection between wealth and health should be addressed compelled the Contra Costa Family, Maternal and Child Health (FMCH) Programs Life Course Initiative to launch Building Economic Security Today (BEST). BEST utilizes innovative strategies to reduce inequities in health outcomes for low-income Contra Costa families by improving their financial security and stability. FMCH Programs' Women, Infants, and Children Program (WIC) conducted BEST financial education classes, and its Medically Vulnerable Infant Program (MVIP) instituted BEST financial assessments during public health nurse home visits. Educational and referral resources were also developed and distributed to all clients. The classes at WIC increased clients' awareness of financial issues and confidence that they could improve their financial situations. WIC clients and staff also gained knowledge about financial resources in the community. MVIP's financial assessments offered clients a new and needed perspective on their financial situations, as well as support around the financial and psychological stresses of caring for a child with special health care needs. BEST offered FMCH Programs staff opportunities to engage in non-traditional, cross-sector partnerships, and gain new knowledge and skills to address a pressing social determinant of health. We learned the value of flexible timelines, maintaining a long view for creating change, and challenging the traditional paradigm of maternal and child health.
Tao WANG; Ming Ju LIU; De Ming LI
For a proper edge coloring c of a graph G,if the sets of colors of adjacent vertices are distinct,the edge coloring c is called an adjacent strong edge coloring of G.Let ci be the number of edges colored by i.If |ci - cj| ≤ 1 for any two colors i and j,then c is an equitable edge coloring of G.The coloring c is an equitable adjacent strong edge coloring of G if it is both adjacent strong edge coloring and equitable edge coloring.The least number of colors of such a coloring c is called the equitable adjacent strong chromatic index of G.In this paper,we determine the equitable adjacent strong chromatic index of the joins of paths and cycles.Precisely,we show that the equitable adjacent strong chromatic index of the joins of paths and cycles is equal to the maximum degree plus one or two.
Full Text Available Transformational learning is the focus of 21st century global educational reforms. In India there is a need to amalgamate the skills and knowledge of medical, nursing and public health practitioners and to develop robust leadership competencies among them. This initiative proposed to identify interdisciplinary leadership competencies among Indian health practitioners, and to develop a training program for interdisciplinary leadership skills through an Innovation Collaborative. Medical, nursing and public health institutions partnered in this endeavour. An exhaustive literature search was undertaken to identify leadership competencies in these three professions. Published evidence was utilized in searching for the need for interdisciplinary training of health practitioners, including current scenarios in inter-professional health education and the key competencies required. The interdisciplinary leadership competencies identified were: self-awareness, vision, self-regulation, motivation, decisiveness, integrity, interpersonal communication skills, strategic planning, team-building, innovation and being an effective change agent. Subsequently, a training program was developed and three training sessions were piloted with 66 participants. Each cohort comprised of a mix of participants from different disciplines. The pilot training guided the development of a training model for building interdisciplinary leadership skills and organizing interdisciplinary leadership workshops. The need for interdisciplinary leadership competencies is recognized. The long-term objective of the training model is integration into the regular medical, nursing and public health curricula, with the aim of developing interdisciplinary leadership skills among them. Although challenging, formal incorporation of leadership skills into health professional education is possible within the interdisciplinary classroom setting using principles of transformative learning.
N S ePrashanth
Full Text Available Performance of local health services managers at district level is crucial to ensure that health services are of good quality and cater to the health needs of the population in the area. In many Low- and Middle-Income Countries (LMIC, health services managers are poorly equipped with public health management capacities needed for planning and managing their local health system. In the South Indian Tumkur district, a consortium of five non-governmental organisations partnered with the state government to organise a capacity-building program for health managers. The program consisted of a mix of periodic contact classes, mentoring and assignments and was spread over 30 months. In this paper, we develop a theoretical framework in the form of a refined program theory to understand how such a capacity-building program could bring about organisational change. A well-formulated program theory enables an understanding of how interventions could bring about improvements and an evaluation of the intervention. In the refined program theory of the intervention, we identified various factors at ¬individual, institutional and environmental levels that could interact with the hypothesised mechanisms of organisational change, such as staff’s perceived self-efficacy and commitment to their organisations. Based on this program theory, we formulated context-mechanism-outcome configurations that can be used to evaluate the intervention and, more specifically, to understand what worked, for whom and under what conditions. We discuss the application of program theory development in conducting a realist evaluation. Realist evaluation embraces principles of systems thinking by providing a method for understanding how elements of the system interact with one another in producing a given outcome.
Buelow, Janet R; Rathsack, Christi; Downs, David; Jorgensen, Kathy; Karges, Joy R; Nelson, Debralee
A limited, yet growing, body of research suggests that health care students educated in interdisciplinary teamwork may become more collaborative professionals in the workplace, which, in turn, may foster more productive and satisfied health care professionals. Researchers also have identified lower mortality and morbidity rates, fewer hospitalizations, decreased costs, and improved function by patients among significant health benefits of interdisciplinary teamwork, especially when it is applied to underserved and geriatric populations. Such positive outcomes have prompted medical schools and accreditation boards of many allied health professions to add interdisciplinary education into their training requirements. Meeting these requirements has challenged universities, where there are multiple allied health programs and limited time, faculty, and financial resources to coordinate interdisciplinary education. The challenges have been magnified by insufficient research on the most effective methods to educate university students about interdisciplinary teamwork. This article presents the background, evolution, and key building blocks of one such method: a simulation-based workshop designed at our university over 7 years to educate its allied health students about various health professions through shared learning, interaction, and collaboration.
Chang, Li-Chun; Huang, Song-Yuan; Wu, Fei-Lin
In the wake of the WHO's health promotion campaign health promotion schools have gained currency in Europe and the United States. The Department of Education in Taiwan has proposed a "school health promotion program" and the Department of Health a "program to build healthy schools" The goal of these programs was to create a holistic environment for school health and put the concepts of "school-family-community partnership" into practice. Although difficulties, such as school-centered perspectives, ambiguous definitions of "community" and shortage of funding, human resources and long-term planning impeded the program, this article, based on literature and practical experience, presents the "school-community model" and the strategies that it applied to organize the school-community health promotion committee to plan long-term programs and to assess the needs and resources of schools and communities on a collaborative basis. It contends, furthermore, that integrating community services into curriculums in order to enable students to appreciate the meaning of partnership, and involving the community in the planning process, can achieve the goal of effectively promoting the health of both the school and the community.
Guest, M Aaron; Freedman, Darcy; Alia, Kassandra A; Brandt, Heather M; Friedman, Daniela B
Community-university partnerships can lend themselves to the development of tools that encourage and promote future community health development. The electronic manual, "Building Farmacies," describes an approach for developing capacity and sustaining a community health center-based farmers' market that emerged through a community-university partnership. Manual development was guided by the Knowledge to Action Framework and experiences developing a multivendor, produce-only farmers' market at a community health center in rural South Carolina. The manual was created to illustrate an innovative solution for community health development. The manual was disseminated electronically through 25 listservs and interested individuals voluntarily completed a Web-based survey to access the free manual. During the 6-month dissemination period, 271 individuals downloaded the manual. Findings highlighted the value of translating community-based participatory research into user-friendly manuals to guide future intervention development and dissemination approaches, and demonstrate the need to include capacity building opportunities to support translation and adoption of interventions.
He, Jia; Xu, You-Lin; Zhan, Sheng; Huang, Qin
When health monitoring system and vibration control system both are required for a building structure, it will be beneficial and cost-effective to integrate these two systems together for creating a smart building structure. Recently, on the basis of extended Kalman filter (EKF), a time-domain integrated approach was proposed for the identification of structural parameters of the controlled buildings with unknown ground excitations. The identified physical parameters and structural state vectors were then utilized to determine the control force for vibration suppression. In this paper, the possibility of establishing such a smart building structure with the function of simultaneous damage detection and vibration suppression was explored experimentally. A five-story shear building structure equipped with three magneto-rheological (MR) dampers was built. Four additional columns were added to the building model, and several damage scenarios were then simulated by symmetrically cutting off these columns in certain stories. Two sets of earthquakes, i.e. Kobe earthquake and Northridge earthquake, were considered as seismic input and assumed to be unknown during the tests. The structural parameters and the unknown ground excitations were identified during the tests by using the proposed identification method with the measured control forces. Based on the identified structural parameters and system states, a switching control law was employed to adjust the current applied to the MR dampers for the purpose of vibration attenuation. The experimental results show that the presented approach is capable of satisfactorily identifying structural damages and unknown excitations on one hand and significantly mitigating the structural vibration on the other hand.
Yusif, Hadrat; Yussof, Ishak; Osman, Zulkifly
Public universities in Ghana are highly subsidised by the central government and account for about 80 per cent of university students in the country. Yet issues of fairness in terms of entry into the public university system have so far hardly been addressed. To find out whether participation in public university education is equitable, the authors of this paper carried out a binary logistic regression analysis. Individual data were collected from 1,129 (614 male and 515 female) final year senior high school (SHS) students for the 2009 cohort. The authors measured student, father and mother characteristics likely to influence admission to a public university. The results show that the major predictors of public university entry are students' academic ability, quality of SHS attended and number of siblings. This seems to suggest that there is a significant bias in the selection of students from different socio-economic groups for admission to highly subsidised public universities. The implication is that public financing of university education in Ghana may not be equitable.
Airhihenbuwa, Collins O.; Ogedegbe, Gbenga; Iwelunmor, Juliet; Jean-Louis, Girardin; Williams, Natasha; Zizi, Freddy; Okuyemi, Kolawole
As the burden of noncommunicable diseases (NCDs) rises in settings with an equally high burden of infectious diseases in the Global South, a new sense of urgency has developed around research capacity building to promote more effective and sustainable public health and health care systems. In 2010, NCDs accounted for more than 2.06 million deaths in sub-Saharan Africa. Available evidence suggests that the number of people in sub-Saharan Africa with hypertension, a major risk factor for cardiovascular diseases, will increase by 68% from 75 million in 2008 to 126 million in 2025. Furthermore, about 27.5 million people currently live with diabetes in Africa, and it is estimated that 49.7 million people living with diabetes will reside in Africa by 2030. It is therefore necessary to centralize leadership as a key aspect of research capacity building and strengthening in the Global South in ways that enables researchers to claim their spaces in their own locations. We believe that building capacity for transformative leadership in research will lead to the development of effective and appropriate responses to the multiple burdens of NCDs that coexist with infectious diseases in Africa and the rest of the Global South. PMID:27037144
Full Text Available Despite a growing number of collaborative partnerships between schools and community-based organizations to expand school mental health (SMH service capacity in the United States, there have been relatively few systematic initiatives focused on key strategies for large-scale SMH capacity building with state and local education systems. Based on a framework of ten critical factors for capacity building, as well as existing best practices, two case studies were utilized to develop a replicable capacity-building model to advance interagency SMH development. Seventy education and mental health stakeholders from two selected states participated in baseline assessments of skill com-petency and critical factor implementation followed by two-day trainings (one in each state; 29 (41% of the participants also completed a six month follow-up assessment. Targeted competencies increased significantly for participants from both states, with large effect sizes (d = 2.05 and 2.56, from pre- to post-training. Participant reports of critical factor implementation increased significantly for one of the two states (t = -6.40, p < .001, d = 1.77. Results inform specific training recommendations for stakeholders and collaborative teams, as well as policy implications to support future development of SMH service capacity.
Were, Martin C; Siika, Abraham; Ayuo, Paul O; Atwoli, Lukoye; Esamai, Fabian
Current approaches for capacity building in Health Informatics (HI) in developing countries mostly focus on training, and often rely on support from foreign entities. In this paper, we describe a comprehensive and multidimensional capacity-building framework by Lansang & Dennis, and its application for HI capacity building as implemented in a higher-education institution in Kenya. This framework incorporates training, learning-by-doing, partnerships, and centers of excellence. At Moi University (Kenya), the training dimensions include an accredited Masters in HI Program, PhD in HI, and HI short courses. Learning-by-doing occurs through work within MOH facilities at the AMPATH care and treatment program serving 3 million people. Moi University has formed strategic HI partnerships with Regenstrief Institute, Inc. (USA), University of Bergen (Norway), and Makerere University (Uganda), among others. The University has also created an Institute of Biomedical Informatics to serve as an HI Center of Excellence in the region. This Institute has divisions in Training, Research, Service and Administration. The HI capacity-building approach by Moi provides a model for adoption by other institutions in resource-limited settings.
Soellner, Renate; Lenartz, Norbert; Rudinger, Georg
Concept mapping served as the starting point for the aim of capturing the comprehensive structure of the construct of 'health literacy.' Ideas about health literacy were generated by 99 experts and resulted in 105 statements that were subsequently organized by 27 experts in an unstructured card sorting. Multidimensional scaling was applied to the sorting data and a two and three-dimensional solution was computed. The three dimensional solution was used in subsequent cluster analysis and resulted in a concept map of nine "clusters": (1) self-regulation, (2) self-perception, (3) proactive approach to health, (4) basic literacy and numeracy skills, (5) information appraisal, (6) information search, (7) health care system knowledge and acting, (8) communication and cooperation, and (9) beneficial personality traits. Subsequently, this concept map served as a starting point for developing a "qualitative" structural model of health literacy and a questionnaire for the measurement of health literacy. On the basis of questionnaire data, a "quantitative" structural model was created by first applying exploratory factor analyses (EFA) and then cross-validating the model with confirmatory factor analyses (CFA). Concept mapping proved to be a highly valuable tool for the process of model building up to translational research in the "real world".
Trowbridge, Matthew J; Pickell, Sarah Gauche; Pyke, Christopher R; Jutte, Douglas P
It is increasingly well recognized that the design and operation of the communities in which people live, work, learn, and play significantly influence their health. However, within the real estate industry, the health impacts of transportation, community development, and other construction projects, both positive and negative, continue to operate largely as economic externalities: unmeasured, unregulated, and for the most part unconsidered. This lack of transparency limits communities' ability to efficiently advocate for real estate investment that best promotes their health and well-being. It also limits market incentives for innovation within the real estate industry by making it more difficult for developers that successfully target health behaviors and outcomes in their projects to differentiate themselves competitively. In this article we outline the need for actionable, community-relevant, practical, and valuable metrics jointly developed by the health care and real estate sectors to better evaluate and optimize the "performance" of real estate development projects from a population health perspective. Potential templates for implementation, including the successful introduction of sustainability metrics by the green building movement, and preliminary data from selected case-study projects are also discussed.
Full Text Available An important objective of health monitoring systems for tall buildings is to diagnose the state of the building and to evaluate its possible damage. In this paper, we use our prototype to evaluate our data-mining approach for the fault monitoring. The offset cancellation and high-pass filtering techniques are combined effectively to solve common problems in numerical integration of acceleration signals in real-time applications. The integration accuracy is improved compared with other numerical integrators. Then we introduce a novel method for support vector machine (SVM classification, called convex-concave hull. We use the Jarvis march method to decide the concave (nonconvex hull for the inseparable points. Finally the vertices of the convex-concave hull are applied for SVM training.
Chambers, David A; Rupp, Agnes
With the rise of "big data," the opportunities to use administrative and clinical data to evaluate impact of state level program initiatives are greatly expanded. The National Institute of Mental Health has in recent years supported research studies pooling data across states to address state-relevant questions. This commentary summarizes these activities and describes future platforms that may enhance ongoing work in this area.
Robertson, A. W.; Ceccato, P.
In order to fill the gaps existing in climate and public health, agriculture, natural disasters knowledge and practices, the International Research Institute for Climate and Society (IRI) has developed a Curriculum for Best Practices in Climate Information. This Curriculum builds on the experience of 10 years courses on 'Climate Information' and captures lessons and experiences from different tailored trainings that have been implemented in many countries in Africa, Asia and Latin America. In this presentation, we will provide examples of training activities we have developed to bring remote sensing products to monitor climatic and environmental information into decision processes that benefited users such as the World Health Organization, Ministries of Health, Ministries of Agriculture, Universities, Research Centers such as CIFOR and FIOCRUZ. The framework developed by IRI to provide capacity building is based on the IDEAS framework: Innovation (research) Around climate impacts, evaluation of interventions, and the value of climate information in reducing risks and maximizing opportunities Demonstration E.g. in-country GFCS projects in Tanzania and Malawi - or El Nino work in Ethiopia Education Academic and professional training efforts Advocacy This might focus on communication of variability and change? We are WHO collaborating center so are engaged through RBM/Global Malaria Programme Service ENACTS and Data library key to this. Country data better quality than NASA as incorporates all relevant station data and NASA products. This presentation will demonstrate how the IDEAS framework has been implemented and lessons learned.
Full Text Available This paper examines theoretical, pedagogical, and technological differences between two technologies that have been used in undergraduate interprofessional health sciences at the University of Toronto. One, a learning management system, WebCT 2.0, supports online coursework. The other, a Knowledge Building environment, Knowledge Forum 2.0, supports the collaborative work of knowledge-creating communities. Seventy students from six health science programs (Dentistry, Medicine, Nursing, Occupational Therapy, Pharmacy and Physical Therapy participated online in a 5-day initiative to advance understanding of core principles and professional roles in pain assessment and management. Knowledge Forum functioned well as a learning management system but to preserve comparability between the two technologies its full resources were not brought into play. In this paper we examine three distinctive affordances of Knowledge Forum that have implications for health sciences education: (1 supports for Knowledge Building discourse as distinct from standard threaded discourse; (2 integration of sociocognitive functions as distinct from an assortment of separate tools; and (3 resources for multidimensional social and cognitive assessment that go beyond common participation indicators and instructor-designed quizzes and analyses. We argue that these design characteristics have the potential to open educational pathways that traditional learning management systems leave closed.
Full Text Available Introduction: Current building ventilation standards are based on acceptable minimums. Three decades of research demonstrates the human health benefits of increased ventilation above these minimums. Recent research also shows the benefits on human decision-making performance in office workers, which translates to increased productivity. However, adoption of enhanced ventilation strategies is lagging. We sought to evaluate two of the perceived potential barriers to more widespread adoption—Economic and environmental costs. Methods: We estimated the energy consumption and associated per building occupant costs for office buildings in seven U.S. cities, representing different climate zones for three ventilation scenarios (standard practice (20 cfm/person, 30% enhanced ventilation, and 40 cfm/person and four different heating, ventilation and air conditioning (HVAC system strategies (Variable Air Volume (VAV with reheat and a Fan Coil Unit (FCU, both with and without an energy recovery ventilator. We also estimated emissions of greenhouse gases associated with this increased energy usage, and, for comparison, converted this to the equivalent number of vehicles using greenhouse gas equivalencies. Lastly, we paired results from our previous research on cognitive function and ventilation with labor statistics to estimate the economic benefit of increased productivity associated with increasing ventilation rates. Results: Doubling the ventilation rate from the American Society of Heating, Refrigeration and Air-Conditioning Engineers minimum cost less than $40 per person per year in all climate zones investigated. Using an energy recovery ventilation system significantly reduced energy costs, and in some scenarios led to a net savings. At the highest ventilation rate, adding an ERV essentially neutralized the environmental impact of enhanced ventilation (0.03 additional cars on the road per building across all cities. The same change in ventilation
Full Text Available Abstract Background The purpose of this study was to examine the relationship between men who engage in carework and commitment to gender equity. The context of the study was that gender inequitable masculinities create vulnerability for men and women to HIV and other health concerns. Interventions are being developed to work with masculinity and to 'change men'. Researchers now face a challenge of identifying change in men, especially in domains of their lives beyond relations with women. Engagement in carework is one suggested indicator of more gender equitable practice. Methods A qualitative approach was used. 20 men in three South African locations (Durban, Pretoria/Johannesburg, Mthatha who were identified as engaging in carework were interviewed. The men came from different backgrounds and varied in terms of age, race and socio-economic status. A semi-structured approach was used in the interviews. Results Men were engaged in different forms of carework and their motivations to be involved differed. Some men did carework out of necessity. Poverty, associated with illness in the family and a lack of resources propelled some men into carework. Other men saw carework as part of a commitment to making a better world. 'Care' interpreted as a functional activity was not enough to either create or signify support for gender equity. Only when care had an emotional resonance did it relate to gender equity commitment. Conclusions Engagement in carework precipitated a process of identity and value transformation in some men suggesting that support for carework still deserves to be a goal of interventions to 'change men'. Changing the gender of carework contributes to a more equitable gender division of labour and challenges gender stereotypes. Interventions that promote caring also advance gender equity.
... Withdrawal of the Commission Policy Statement on Monetary Equitable Remedies in Competition Cases AGENCY... the Federal Trade Commission issued a Policy Statement on Monetary Remedies in Competition Cases. The..., Effecting the Withdrawal of the Commission's Policy Statement on Monetary Equitable Remedies in...
In this essay, the author describes principles for equitable mathematics teaching practices for English Language Learners (ELLs) and outlines guidelines for materials to support such practices. Although research cannot provide a recipe for equitable teaching practices for ELLs, teachers, educators, and administrators can use this set of…
Siegel, Marcelle A.; Menon, Deepika; Sinha, Somnath; Promyod, Nattida; Wissehr, Cathy; Halverson, Kristy L.
This study investigated the effects of the use of scaffolds in written classroom assessments through the voices of both native English speakers and English language learners from two middle schools. Students responded to assessment tasks in writing, by speaking aloud using think aloud protocols, and by reflecting in a post-assessment interview. The classroom assessment tasks were designed to engage students in scientific sense making and multifaceted language use, as recommended by the Next Generation Science Standards. Data analyses showed that both groups benefitted from the use of scaffolds. The findings revealed specific ways that modifications were supportive in helping students to comprehend, visualize and organize thinking, and elicit responses. This study offers a model for both sensitizing teachers and strengthening their strategies for scaffolding assessments equitably.
Full Text Available This paper discusses the first phase of a longitudinal study underway in Australia to ascertain the broad health benefits of specific types of biophilic design for workers in a building site office. A bespoke site design was formulated to include open plan workspace, natural lighting, ventilation, significant plants, prospect and views, recycled materials and use of non-synthetic materials. Initial data in the first three months was gathered from a series of demographic questions and from interviews and observations of site workers. Preliminary data indicates a strong positive effect from incorporating aspects of biophilic design to boost productivity, ameliorate stress, enhance well-being, foster a collaborative work environment and promote workplace satisfaction, thus contributing towards a high performance workspace. The longitudinal study spanning over two years will track human-plant interactions in a biophilic influenced space, whilst also assessing the concomitant cognitive, social, psychological and physical health benefits for workers.
Gray, Tonia; Birrell, Carol
This paper discusses the first phase of a longitudinal study underway in Australia to ascertain the broad health benefits of specific types of biophilic design for workers in a building site office. A bespoke site design was formulated to include open plan workspace, natural lighting, ventilation, significant plants, prospect and views, recycled materials and use of non-synthetic materials. Initial data in the first three months was gathered from a series of demographic questions and from interviews and observations of site workers. Preliminary data indicates a strong positive effect from incorporating aspects of biophilic design to boost productivity, ameliorate stress, enhance well-being, foster a collaborative work environment and promote workplace satisfaction, thus contributing towards a high performance workspace. The longitudinal study spanning over two years will track human-plant interactions in a biophilic influenced space, whilst also assessing the concomitant cognitive, social, psychological and physical health benefits for workers.
This paper proposes a basic approach to ensuring that knowledge from research studies is translated for use in health services management with a view towards building a "learning organization". (A learning organization is one in which the environment is structured in such a way as to facilitate learning as well as the sharing of knowledge among members or employees.) This paper highlights various dimensions that determine the complexity of knowledge translation, using the problem-solving cycle as the backbone for gaining a better understanding of how different types of knowledge interact in health services management. It is essential to use an integrated and interactive approach to ensure that knowledge from research is translated in a way that allows a learning organization to be built and that knowledge is not used merely to influence a single decision in isolation from the overall services and management of an organization.
Gens, Alexandra; Hurley, J. Fintan; Tuomisto, Jouni T.; Friedrich, Rainer
The insulation of residential buildings affects human exposure to fine particles. According to current EU guidelines, insulation is regulated for energy saving reasons. As buildings become tighter, the air exchange rate is reduced and, thus, the indoor concentration of pollutants is increased if there are significant indoor sources. While usually the effects of heat insulation and increase of the air-tightness of buildings on greenhouse gas emissions are highlighted, the negative impacts on human health due to higher indoor concentrations are not addressed. Thus, we investigated these impacts using scenarios in three European countries, i. e. Czech Republic, Switzerland and Greece. The assessment was based on modelling the human exposure to fine particles originating from sources of particles within outdoor and indoor air, including environmental tobacco smoke. Exposure response relationships were derived to link (adverse) health effects to the exposure. Furthermore, probable values for the parameters influencing the infiltration of fine particles into residential buildings were modelled. Results show that the insulation and increase of the air-tightness of residential buildings leads to an overall increase of the mean population exposure - and consequently adverse health effects - in all considered countries (ranging for health effects from 0.4% in Czech Republic to 11.8% in Greece for 100% insulated buildings) due to an accumulation of particles indoors, especially from environmental tobacco smoke. Considering only the emission reductions in outdoor air (omitting changes in infiltration parameters) leads to a decrease of adverse health effects. This study highlights the importance of ensuring a sufficient air exchange rate when insulating buildings, e. g. by prescribing heat ventilation and air conditioning systems in new buildings and information campaigns on good airing practice in renovated buildings. It also shows that assessing policy measures based on the
Starling, Melissa; McLean, Andrew; McGreevy, Paul
Equitation science is an evidence-based approach to horse training and riding that focuses on a thorough understanding of both equine ethology and learning theory. This combination leads to more effective horse training, but also plays a role in keeping horse riders and trainers safe around horses. Equitation science underpins ethical equitation, and recognises the limits of the horse's cognitive and physical abilities. Equitation is an ancient practice that has benefited from a rich tradition that sees it flourishing in contemporary sporting pursuits. Despite its history, horse-riding is an activity for which neither horses nor humans evolved, and it brings with it significant risks to the safety of both species. This review outlines the reasons horses may behave in ways that endanger humans and how training choices can exacerbate this. It then discusses the recently introduced 10 Principles of Equitation Science and explains how following these principles can minimise horse-related risk to humans and enhance horse welfare.
Hodgins, Margaret; Battel-Kirk, Barbara; Asgeirsdottir, Asa G
The current global economic crisis poses major challenges for workplace health promotion (WHP). Activities that are not perceived to obviously and directly contribute to profits could be sacrificed. This paper argues that WHP must remain centre-stage because of the rights of workers to a healthy, safe working environment but also because of WHP's beneficial financial implications for enterprises. Capacity building for WHP can be developed even within a recessionary environment, particularly if the focus is on the wider workforce, described here as people for whom workplace health promotion may not be their primary function but who have an important role to play in health improvement in workplaces. There is a strong case for the development of the wider workforce based both on the lack of suitably qualified specialists and on the practicalities of having WHP implemented within organizations, particularly for small and medium-sized enterprises (SMEs). SMEs make up a very significant proportion of the global economy and are identified as a priority area for action internationally. An example of an e-learning course, the Healthy Together programme, developed by a partnership of three countries, is discussed as an approach that has potential to develop capacity for WHP in the current climate. The findings of the evaluation of the Healthy Together programme indicate that there is a real potential in developing e-learning materials for training those with a brief for promoting workplace health and safety in SMEs. Although modifications in some aspects of delivery identified in the evaluation of the pilot course need to be considered, the course was well received, and was reported to be relevant to the learning needs of students, to their workplaces and specifically to small businesses in rural areas. Specific features of the e-learning approach increase its potential to address capacity building for WHP.
Full Text Available Abstract Background Trust is critical to generate and maintain demand for vaccines in low and middle income countries. However, there is little documentation on how health system insufficiencies affect trust in vaccination and the process of re-building trust once it has been compromised. We reflect on how disruptions to immunizations systems can affect trust in vaccination and can compromise vaccine utilization. We then explore key pathways for overcoming system vulnerabilities in order to restore trust, to strengthen the resilience of health systems and communities, and to promote vaccine utilization. Methods Utilizing secondary data and a review of the literature, we developed a causal loop diagram (CLD to map the determinants of building trust in immunizations. Using the CLD, we devised three scenarios to illustrate common vulnerabilities that compromise trust and pathways to strengthen trust and utilization of vaccines, specifically looking at weak health systems, harmful communication channels, and role of social capital. Spill-over effects, interactions and other dynamics in the CLD were then examined to assess leverage points to counter these vulnerabilities. Results Trust in vaccination arises from the interactions among experiences with the health system, the various forms of communication and social capital – both external and internal to communities. When experiencing system-wide shocks such as the case in Ebola-affected countries, distrust is reinforced by feedback between the health and immunization systems where distrust often lingers even after systems are restored and spills over beyond vaccination in the broader health system. Vaccine myths or anti-vaccine movements reinforce distrust. Social capital – the collective value of social networks of community members – plays a central role in increasing levels of trust. Conclusions Trust is important, yet underexplored, in the context of vaccine utilization. Using a CLD to
Schuchter, Joseph [Berkeley, CA (United States); Rutt, Candace, E-mail: email@example.com [Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity and Obesity, 4770 Buford Highway MS/F-77, Atlanta, GA 30341 (United States); Satariano, William A. [University of California Berkeley, School of Public Health, Division of Community Health and Human Development, Berkeley, CA (United States); Seto, Edmund [University of Washington, Department of Environmental and Occupational Health Sciences, Seattle, WA (United States)
Background: Despite the continued growth of Health Impact Assessment (HIA) in the US, there is little research on HIA capacity-building. A comprehensive study of longer-term training outcomes may reveal opportunities for improving capacity building activities and HIA practice. Methods: We conducted in-depth interviews with HIA trainees in the United States to assess their outcomes and needs. Using a training evaluation framework, we measured outcomes across a spectrum of reaction, learning, behavior and results. Results: From 2006 to 2012, four organizations trained over 2200 people in at least 75 in-person HIA trainings in 29 states. We interviewed 48 trainees, selected both randomly and purposefully. The mean duration between training and interview was 3.4 years. Trainees reported that their training objectives were met, especially when relevant case-studies were used. They established new collaborations at the trainings and maintained them. Training appeared to catalyze more holistic thinking and practice, including a range of HIA-related activities. Many trainees disseminated what they learned and engaged in components of HIA, even without dedicated funding. Going forward, trainees need assistance with quantitative methods, project management, community engagement, framing recommendations, and evaluation. Conclusions: The research revealed opportunities for a range of HIA stakeholders to refine and coordinate training resources, apply a competency framework and leverage complimentary workforce development efforts, and sensitize and build the capacity of communities. - Highlights: • We interviewed HIA trainees in the United States to assess longer-term outcomes. • Training appeared to catalyze a range of beneficial partnerships and activities. • Trainees reported outstanding needs for specific skills and competencies. • There are various opportunities to improve training and capacity-building.
Bornehag, Carl-Gustaf; Sundell, Jan
The scientific literature on health effects associated with "dampness" in buildings including literature between 1998 and 2000 has been reviewed by a European group (EUROEXPO). The group consisted of scientists with experience from medicine, epidemiology, toxicology and engineering. Of the 104...... reviewed articles 52 were excluded as they were judged as background papers or "non-informative" or "inconclusive" or the study did not present data on exposure, health effects or analysis of the association between exposure and health. The review group concluded that "dampness" in buildings is a risk...
Kahn, Michael G; Bailey, L Charles; Forrest, Christopher B; Padula, Michael A; Hirschfeld, Steven
Longitudinal observational clinical data on pediatric patients in electronic format is becoming widely available. A new era of multi-institutional data networks that study pediatric diseases and outcomes across disparate health delivery models and care settings are also enabling an innovative collaborative rapid improvement paradigm called the Learning Health System. However, the potential alignment of routine clinical care, observational clinical research, pragmatic clinical trials, and health systems improvement requires a data infrastructure capable of combining information from systems and workflows that historically have been isolated from each other. Removing barriers to integrating and reusing data collected in different settings will permit new opportunities to develop a more complete picture of a patient's care and to leverage data from related research studies. One key barrier is the lack of a common terminology that provides uniform definitions and descriptions of clinical observations and data. A well-characterized terminology ensures a common meaning and supports data reuse and integration. A common terminology allows studies to build upon previous findings and to reuse data collection tools and data management processes. We present the current state of terminology harmonization and describe a governance structure and mechanism for coordinating the development of a common pediatric research terminology that links to clinical terminologies and can be used to align existing terminologies. By reducing the barriers between clinical care and clinical research, a Learning Health System can leverage and reuse not only its own data resources but also broader extant data resources.
Thriene, B; Sobottka, A; Willer, H; Weidhase, J
The Institute of Hygiene was requested to determine causes and scope of health complaints made by the employees of Haldensleben district administration after sound absorbing mineral fibre boards had been installed as suspended ceilings. The boards were coated with a lean water-carried paint; however, the edges, which were partially frayed, were not coated. The air inside the rooms was measured on all four storeys of the building, followed by scanning electron microscopy in compliance with VDI Code 3492. In addition, measurements showed fibres with diameters of > 3 microns which are not subject to the regulations for carcinogenic substances, but, in contrast to the thinner fibres, they may cause irritations of skin and mucosa. The employees were questioned about their health problems. At the beginning of 1994, a total of 79 of the 133 employees complained about itching, reddening and burning of their eyes as well as irritations of the upper respiratory tract. More than 50% had consulted a doctor. Late in 1994, another questionnaire survey was completed. The fibre content of the office air was determined to vary from 1000 to 3500 fibres/m3 and, in addition, 100-200 fibres with diameters of > 3 microns. Our investigations showed that there is an interrelationship between the degree of dust accumulation in the offices and health complaints. Independently of the current discussion of the cancer causing potential of thin man-made mineral fibres, the very long and thick mineral fibres (> 3 microns in diameter) are of topical importance to health.
Maragkidou, Androniki; Arar, Sharif; Al-Hunaiti, Afnan; Ma, Yuning; Harrad, Stuart; Jaghbeir, Omar; Faouri, Dina; Hämeri, Kaarle; Hussein, Tareq
Polycyclic aromatic hydrocarbons (PAHs) settled in floor dust play an important role in human health. Although many studies investigated occupational exposure to PAHs, no attempts have been made to report PAHs concentrations as well as their health risk assessment inside an educational building in Jordan. Therefore, the main objective of this study is to report the PAHs concentrations in floor dust and evaluate their exposure and health risk inside the Department of Physics of the University of Jordan. The total PAHs concentrations ranged from 714 to 5246ng/g. The high concentrations were observed inside some offices, where tobacco smoking took place. One of those offices was previously renovated and some petrochemical liquids were used to remove the remaining glue from a previous carpet. Interestingly, the PAHs inside these offices were higher than those reported inside lecture rooms and the workshop area, where extensive activates of heavy machinery and use of petroleum products (such as lubricating oils). This implies that the health effects of exposure to tobacco smoking inside small micro-environmental places that are poorly ventilated can be very harmful. We also made a simple exposure and health risk assessment for the ingested dust (hand-to-mouth) by calculating the Estimated Daily Intake (EDI) and benzo(a)pyrene equivalent carcinogenic power (BaPE). The total EDI was less than 3.75ng/kg-bw/day whereas the BaPE was less than 385ng/g. These values are lower than what was reported in some previous studies in Europe and Asia.
Dahn Bernice T
Full Text Available Abstract Background Management training is fundamental to developing human resources for health. Particularly as Liberia revives its health delivery system, facility and county health team managers are central to progress. Nevertheless, such management skills are rarely prioritized in health training, and sustained capacity building in this area is limited. We describe a health management delivery program in which a north and south institution collaborated to integrate classroom and field-based training in health management and to transfer the capacity for sustained management development in Liberia. Methods We developed and implemented a 6-month training program in health management skills (i.e. strategic problem solving, financial management, human resource management and leadership delivered by Yale University and Mother Patern College from Liberia, with support from the Clinton HIV/AIDS Initiative. Over three 6-month cycles, responsibility for course instruction was transferred from the north institution to the south institution. A self-administered survey was conducted of all participants completing the course to measure changes in self-rated management skills, the degree to which the course was helpful and met its stated objectives, and faculty members' responsiveness to participant needs as the transfer process occurred. Results Respondents (n = 93, response rate 95.9% reported substantial improvement in self-reported management skills, and rated the helpfulness of the course and the degree to which the course met its objectives highly. Levels of improvement and course ratings were similar over the three cohorts as the course was transferred to the south institution. We suggest a framework of five elements for implementing successful management training programs that can be transferred and sustained in resource-limited settings, including: 1 use a short-course format focusing on four key skill areas with practical tools; 2 include
Ashok Kumar Bhardwaj
Full Text Available Research is a cornerstone for knowledge generation, which in turns requires capacity building for its tools and techniques. Despite having a vast infrastructure in India the research in medical science has been carried out in limited and focused institutions. In order to build the capacity in carrying out research activities a five-day planning workshop was conducted at state run medical college. Total 22 medical faculty members participated in the workshop with average public health experience of 12 years (range: 5–25 years. The knowledge was assessed objectively by multiple-choice questionnaire. The mean score increased from 6.7 to 7.9 from pre- to posttest. About seventy-percent participants showed improvement, whereas 21.0% showed deterioration in the knowledge and the rest showed the same score. Apart from knowledge skills also showed improvement as total 12 research projects were generated and eight were approved for funding by the Indian Council of Medical Research (ICMR, New Delhi. It can be concluded that a supportive environment for research can be built with the technical assistance.
Siegel, Marcelle A.
This study illustrated a pathway of growth that a preservice teacher might traverse when learning to use and develop equitable assessments (EA). The study is rare in that it looks at the development of preservice teachers' understanding and ability to design EA. I examined the understanding and implementation of EA of 23 secondary preservice teachers within two classes. The methods classes focused on the academic content area of science. Participants' journals, teaching philosophies, and inquiry-based science units served as data sources. Participants progressed from a simple view of EA as "fairness" to a more sophisticated view of EA, including: ways to increase fairness, the importance of challenging students, and using assessments for learning. Results also showed changes in preservice teachers' views of learners and the purpose of assessment. While understanding developed robustly, teachers' assessment plans in their units were not as strong. Teacher education programs need to place more emphasis on developing critical understanding of EA practices to meet the needs of diverse learners.
Full Text Available Abstract Background In many developing countries, including Ethiopia, few have the skills to use data for effective decision making in public health. To address this need, the U.S. Centers for Disease Control and Prevention (CDC, in collaboration with two local Ethiopian organizations, developed a year long Leadership in Strategic Information (LSI course to train government employees working in HIV to use data from strategic information sources. A process evaluation of the LSI course examined the impact of the training on trainees' skills and the strengths and weaknesses of the course. The evaluation consisted of surveys and focus groups. Findings Trainees' skill sets increased in descriptive and analytic epidemiology, surveillance, and monitoring and evaluation (M and E. Data from the evaluation indicated that the course structure and the M and E module required revision in order to improve outcomes. Additionally, the first cohort had a high attrition rate. Overall, trainees and key stakeholders viewed LSI as important in building skilled capacity in public health in Ethiopia. Conclusion The evaluation provided constructive insight in modifying the course to improve retention and better address trainees' learning needs. Subsequent course attrition rates decreased as a result of changes made based on evaluation findings.
Midboe, Amanda M; Elwy, A Rani; Durfee, Janet M; Gifford, Allen L; Yakovchenko, Vera; Martinello, Richard A; Ross, David; Czarnogorski, Maggie; Goetz, Matthew B; Asch, Steven M
We are in a new era of partner-based implementation research, and we need clear strategies for how to navigate this new era. Drawing on principles from community-based participatory research, the Clinical Public Health group of the Department of Veterans Affairs and the HIV/Hepatitis Quality Enhancement Research Initiative (HHQUERI) forged a longstanding partnership that has improved the care of Veterans with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus. An exemplar HIV testing project epitomizes this partnership and is discussed in terms of the lessons learned as a result of our high level of collaboration around design, analysis, implementation, and dissemination across projects over the past several years. Lessons learned through this partnered testing program involve respecting different time horizons among the partners, identifying relevant research questions for both parties, designing flexible studies, engaging all partners throughout the research, and placing an emphasis on relationship building at all times. These lessons and strategies can benefit others conducting partner-based research both within the Veterans Health Administration (VA) and in other integrated healthcare systems.
Salles, Mariana Moraes; Barros, Sônia
The support of social networks is a fundamental aspect for the social inclusion of people with mental health problems. This study seeks to identify and analyze the difficulties and possibilities of users of a Psychosocial Care Center (CAPS) in building their extended social network. The qualitative approach was used as the research methodology and Ágnes Heller's concept about everyday life was used as a philosophical benchmark. The subjects in this investigation were frequenters of Psychosocial Care Centers with people from their social network. Semi-structured interviews were conducted for the data gathering and discourse analysis was used for examining the data. It was seen that although this population is living in the community it is frequently segregated and isolated from living together with other people, thereby leading to social exclusion. Nevertheless, CAPS are a space of belonging and welcoming that undeniably produce favorable changes in the users' lives. People with mental health problems have also been able to relate to others in CAPS. By using the available opportunities, they make new friends and maintain friendships they already had. Living with others in the community is highly conducive to the formation of relationships.
Cohen, Alison Klebanoff; Schuchter, Joseph W
Inequities in education, the urban environment, and health co-exist and mutually reinforce each other. Educators, planners, and public health practitioners share commitments to place-based, participatory, youth-focused, and equitable work. They also have shared goals of building community resilience, social capital, and civic engagement. Interdisciplinary programs that embody these shared values and work towards these shared goals are emerging, including school-based health centers, full-service community schools, community health centers, Promise Neighborhoods, and Choice Neighborhoods. The intersection of these three fields represents an opportunity to intervene on social determinants of health. More collaborative research and practice across public health, education, and planning should build from the shared values identified to continue to address these common goals.
Bønløkke, Jakob Hjort; Holst, Gitte Juel; Sigsgaard, Torben
and the resulting effects on health and economy. Methods: Projected energy savings between 2005 and 2020 were calculated for an improved building insulation scenario and a business as usual scenario. The resulting changes in emissions (e.g. from power plants) were used in the Comprehensive Air-Quality Model...... with extensions. Mean annual changes in the main air pollutants were derived for each country. World Health Organization (WHO) and European Union (EU) data on populations and on impacts of pollutants were used to derive health effects and costs. Effects on indoor air quality were not assessed. Results: Projected...... 78678 LY in Europe. A total of 7173 cases of persistent chronic bronchitis could be avoided annually. Several other health outcomes improved similarly. The saved societal costs totaled 6.64 billion € annually. Conclusions: In addition to carbon emission reductions, an improved building insulation...
Stieda, Vivian; Colvin, Barb
In an effort to understand the extent of the inequalities in health information resources across Alberta, SEARCH Custom, HKN (Health Knowledge Network) and IRREN (Inter-Regional Research and Evaluation Network) conducted a survey in December 2007 to determine what library resources currently existed in Alberta's seven rural health regions and the two urban health regions. Although anecdotal evidence indicated that these gaps existed, the analysis was undertaken to provide empirical evidence of the exact nature of these gaps. The results, coupled with the published literature on the impact, effectiveness and value of information on clinical practice and administrative decisions in healthcare management, will be used to build momentum among relevant stakeholders to support a vision of equitably funded health information for all healthcare practitioners across the province of Alberta.
Pariyo George W
Full Text Available Abstract Background Partnerships and networking are important for an institution of higher learning like Makerere University College of Health Sciences (MakCHS to be competitive and sustainable. Methods A stakeholder and sustainability analysis of 25 key informant interviews was conducted among past, current and potential stakeholders of MakCHS to obtain their perspectives and contributions to sustainability of the College in its role to improve health outcomes. Results The College has multiple internal and external stakeholders. Stakeholders from Uganda wanted the College to use its enormous academic capacity to fulfil its vision, take initiative, and be innovative in conducting more research and training relevant to the country’s health needs. Many stakeholders felt that the initiative for collaboration currently came more from the stakeholders than the College. External stakeholders felt that MakCHS was insufficiently marketing itself and not directly engaging the private sector or Parliament. Stakeholders also identified the opportunity for MakCHS to embrace information technology in research, learning and training, and many also wanted MakCHS to start leadership and management training programmes in health systems. The need for MakCHS to be more vigorous in training to enhance professionalism and ethical conduct was also identified. Discussion As a constituent of a public university, MakCHS has relied on public funding, which has been inadequate to fulfill its mission. Broader networking, marketing to mobilize resources, and providing strong leadership and management support to inspire confidence among its current and potential stakeholders will be essential to MakCHS’ further growth. MakCHS’ relevance is hinged on generating research knowledge for solving the country’s contemporary health problems and starting relevant programs and embracing technologies. It should share new knowledge widely through publications and other forms of
Dean, Hazel D; Myles, Ranell L; Spears-Jones, Crystal; Bishop-Cline, Audriene; Fenton, Kevin A
In February 2010, CDC's National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease (STD), and Tuberculosis (TB) Prevention (NCHHSTP) formally institutionalized workforce development and capacity building (WDCB) as one of six overarching goals in its 2010-2015 Strategic Plan. Annually, workforce team members finalize an action plan that lays the foundation for programs to be implemented for NCHHSTP's workforce that year. This paper describes selected WDCB programs implemented by NCHHSTP during the last 4 years in the three strategic goal areas: (1) attracting, recruiting, and retaining a diverse and sustainable workforce; (2) providing staff with development opportunities to ensure the effective and innovative delivery of NCHHSTP programs; and (3) continuously recognizing performance and achievements of staff and creating an atmosphere that promotes a healthy work-life balance. Programs have included but are not limited to an Ambassador Program for new hires, career development training for all staff, leadership and coaching for mid-level managers, and a Laboratory Workforce Development Initiative for laboratory scientists. Additionally, the paper discusses three overarching areas-employee communication, evaluation and continuous review to guide program development, and the implementation of key organizational and leadership structures to ensure accountability and continuity of programs. Since 2010, many lessons have been learned regarding strategic approaches to scaling up organization-wide public health workforce development and capacity building. Perhaps the most important is the value of ensuring the high-level strategic prioritization of this issue, demonstrating to staff and partners the importance of this imperative in achieving NCHHSTP's mission.
Bazyk, Susan; Demirjian, Louise; LaGuardia, Teri; Thompson-Repas, Karen; Conway, Carol; Michaud, Paula
A 6-mo building capacity process designed to promote knowledge translation of a public health approach to mental health among pediatric occupational therapy practitioners empowered change leaders to articulate, advocate for, and implement practice changes.
Chodzko-Zajko, Wojtek; Schwingel, Andiara
In this paper we focus our attention on an examination of the four-step process adopted by the World Health Organization (WHO) in its systematic campaign to promote physically active lifestyles by older adults across the 193 WHO member states. The four steps adopted by the WHO include (1) Building Consensus Among Professionals; (2) Educating the…
Sergio Miranda Freire
Full Text Available AbstractIntroductionThis paper's aim is to develop a data warehouse from the integration of the files of three Brazilian health information systems concerned with the production of ambulatory and hospital procedures for cancer care, and cancer mortality. These systems do not have a unique patient identification, which makes their integration difficult even within a single system.MethodsData from the Brazilian Public Hospital Information System (SIH-SUS, the Oncology Module for the Outpatient Information System (APAC-ONCO and the Mortality Information System (SIM for the State of Rio de Janeiro, in the period from January 2000 to December 2004 were used. Each of the systems has the monthly data production compiled in dbase files (dbf. All the files pertaining to the same system were then read into a corresponding table in a MySQL Server 5.1. The SIH-SUS and APAC-ONCO tables were linked internally and with one another through record linkage methods. The APAC-ONCO table was linked to the SIM table. Afterwards a data warehouse was built using Pentaho and the MySQL database management system.ResultsThe sensitivities and specificities of the linkage processes were above 95% and close to 100% respectively. The data warehouse provided several analytical views that are accessed through the Pentaho Schema Workbench.ConclusionThis study presented a proposal for the integration of Brazilian Health Systems to support the building of data warehouses and provide information beyond those currently available with the individual systems.
Guard, J Roger; Brueggemann, Ralph F; Highsmith, Robert F; Marine, Stephen A; Riep, Josette R; Schick, Leslie C
The academic health center information environment is saturated with information of varying quality and overwhelming quantity. The most significant challenge is transforming data and information into knowledge. The University of Cincinnati Medical Center's (UCMC) focus is to develop an information architecture comprising data structures, Web services, and user interfaces that enable individuals to manage the information overload so that they can create new knowledge. UCMC has accomplished much of what is reported in this article with the help of a four-year Integrated Advanced Information Management Systems (IAIMS) operation grant awarded by the National Library of Medicine in 2003. In the UCMC vision for knowledge management, individuals have reliable, secure access to information that is filtered, organized, and highly relevant for specific tasks and personal needs. Current applications and tool sets will evolve to become the next generation knowledge management applications or smart digital services. When smart digital services are implemented, silo applications will disappear. A major focus of UCMC's IAIMS grant is research administration. Testing and building out existing and new research administration applications and digital services is underway. The authors review UCMC's progress and results in developing a software architecture, tools, and services for research administration. Included are sections on the evolution to full integration, the impact of the work at UCMC to date, lessons learned during this research and development process, and future plans and needs.
Matsuya, Iwao; Matsumoto, Fumiya; Ihara, Ikuo
An ultrasonic lateral displacement sensor utilizing air-coupled ultrasound transducers is proposed. The normally-distributed far field of an ultrasound transducer in a lateral direction is taken advantage of for measuring lateral displacement. The measurement system is composed of several air-coupled ultrasound transducers as a receiver and several transmitters. The transmitters are immobilized at a fixed point, whereas the receiver set-up is separately arranged on the opposite side. In order to improve measurement accuracy, a correction method that utilizes polynomial approximation is introduced. The difference between the corrected lateral displacement and the reference displacement is estimated to be 0.2 mm at maximum for the two transmitters system. A good responsiveness is demonstrated by conducting a dynamic response experiment. When five transmitters are arranged, their measurement range is easily extended up to ±60 mm with an accuracy of 0.7 mm. In both cases, the fluctuations to the measurement ranges show less than 1%. These results indicate that the developed sensor system is useful for measuring relative lateral displacement of a seismically isolated building in the field of structural health monitoring.
Negandhi, Preeti; Negandhi, Himanshu; Tiwari, Ritika; Sharma, Kavya; Zodpey, Sanjay P; Quazi, Zahiruddin; Gaidhane, Abhay; Jayalakshmi N; Gijare, Meenakshi; Yeravdekar, Rajiv
Transformational learning is the focus of twenty-first century global educational reforms. In India, there is a need to amalgamate the skills and knowledge of medical, nursing, and public health practitioners and to develop robust leadership competencies among them. This initiative proposed to identify interdisciplinary leadership competencies among Indian health practitioners and to develop a training program for interdisciplinary leadership skills through an Innovation Collaborative. Medical, nursing, and public health institutions partnered in this endeavor. An exhaustive literature search was undertaken to identify leadership competencies in these three professions. Published evidence was utilized in searching for the need for interdisciplinary training of health practitioners, including current scenarios in interprofessional health education and the key competencies required. The interdisciplinary leadership competencies identified were self-awareness, vision, self-regulation, motivation, decisiveness, integrity, interpersonal communication skills, strategic planning, team building, innovation, and being an effective change agent. Subsequently, a training program was developed, and three training sessions were piloted with 66 participants. Each cohort comprised a mix of participants from different disciplines. The pilot training guided the development of a training model for building interdisciplinary leadership skills and organizing interdisciplinary leadership workshops. The need for interdisciplinary leadership competencies is recognized. The long-term objective of the training model is integration into the regular medical, nursing, and public health curricula, with the aim of developing interdisciplinary leadership skills among them. Although challenging, formal incorporation of leadership skills into health professional education is possible within the interdisciplinary classroom setting using principles of transformative learning.
Snyder, Ilana; Angus, Lawrence; Sutherland-Smith, Wendy
Examines the complex connections among literacy practices, the use of information, and communication technologies (ICTs) and disadvantage. Reports findings of a year-long Australian study, which investigated ways that four families use ICTs to engage in formal and informal literacy learning in home and school settings. (BT)
Barton, Angela Calabrese
Dr. Sreyashi Jhumki Basu was a scholar committed to equity and social justice in science education who passed away in December 2008. In this essay, I describe Jhumki's research and the call to action her life's work has laid out for the science education community. In particular, I draw attention to the role of critical science agency in learning…
Dawson-Rose, Carol; Cuca, Yvette P; Webel, Allison R; Solís Báez, Solymar S; Holzemer, William L; Rivero-Méndez, Marta; Sanzero Eller, Lucille; Reid, Paula; Johnson, Mallory O; Kemppainen, Jeanne; Reyes, Darcel; Nokes, Kathleen; Nicholas, Patrice K; Matshediso, Ellah; Mogobe, Keitshokile Dintle; Sabone, Motshedisi B; Ntsayagae, Esther I; Shaibu, Sheila; Corless, Inge B; Wantland, Dean; Lindgren, Teri
Health literacy is important for access to and quality of HIV care. While most models of health literacy acknowledge the importance of the patient-provider relationship to disease management, a more nuanced understanding of this relationship is needed. Thematic analysis from 28 focus groups with HIV-experienced patients (n = 135) and providers (n = 71) identified a long-term and trusting relationship as an essential part of HIV treatment over the continuum of HIV care. We found that trust and relationship building over time were important for patients with HIV as well as for their providers. An expanded definition of health literacy that includes gaining a patient's trust and engaging in a process of health education and information sharing over time could improve HIV care. Expanding clinical perspectives to include trust and the importance of the patient-provider relationship to a shared understanding of health literacy may improve patient experiences and engagement in care.
Full Text Available Equitation science is an evidence-based approach to horse training and riding that focuses on a thorough understanding of both equine ethology and learning theory. This combination leads to more effective horse training, but also plays a role in keeping horse riders and trainers safe around horses. Equitation science underpins ethical equitation, and recognises the limits of the horse’s cognitive and physical abilities. Equitation is an ancient practice that has benefited from a rich tradition that sees it flourishing in contemporary sporting pursuits. Despite its history, horse-riding is an activity for which neither horses nor humans evolved, and it brings with it significant risks to the safety of both species. This review outlines the reasons horses may behave in ways that endanger humans and how training choices can exacerbate this. It then discusses the recently introduced 10 Principles of Equitation Science and explains how following these principles can minimise horse-related risk to humans and enhance horse welfare.
Josée G. Lavoie
Full Text Available Over the past three decades, policy reforms have been geared towards improving quality of care, responsiveness, and equitable access to healthcare services for all social groups in general, and individuals living in marginalizing circumstances in particular. The purpose of this study was to document how primary healthcare services (PHC services are provided in Norway and British Columbia to meet the needs of Indigenous peoples and use this knowledge to critically explore policy alternatives that inform the delivery of PHC for vulnerable populations. Findings show that in British Columbia, Indigenous-specific PHC services have been the preferred mechanism to ensure better care. This is not the case in Norway, where Sámi-centric services exist only in mental health and only in Finnmark.
Sultan, Zuraimi M
Although many studies have reported calculations of outdoor particulate matter (PM) associated externalities using ambient data, there is little information on the role buildings, their ventilation and filtration play. This study provides the framework to evaluate the health risk and cost reduction of building, ventilation and filtration strategies from outdoor PM pollution on a nationwide level and applied it to a case study in Singapore. Combining Indoor Air Quality (IAQ) and time weighted exposure models, with established concentration-response functions and monetary valuation methods, mortality and morbidity effects of outdoor PM on the population of Singapore under different building, ventilation and filtration strategies were estimated. Different interventions were made to compare the effects from the current building conditions. The findings demonstrate that building protection effect reduced approximately half the attributable health cases amounting to US$17.7 billion due to PM pollution when compared to levels computed using outdoor data alone. For residential buildings, nationwide adoption of natural ventilation from current state is associated with 28% higher cases of mortality and 13 to 38% higher cases for different morbidities, amounting to US$6.7 billion. The incurred cost is negligible compared to energy costs of air-conditioning. However, nationwide adoption of closed residence and air-conditioning are associated with outcomes including fewer mortality (10 and 6% respectively), fewer morbidities (8 and 4% respectively) and economic savings of US$1.5 and 0.9 billion respectively. The related savings were about a factor of 9 the energy cost for air-conditioning. Nationwide adoption of mechanical ventilation and filtration from current natural ventilation in schools is associated with fewer asthma hospital admissions and exacerbations; although the economic impact is not substantial. Enhanced workplace filtration reduces the mortality and morbidity
Lorenzoni, Filippo; Casarin, Filippo; Caldon, Mauro; Islami, Kleidi; Modena, Claudio
In the last decades the need for an effective seismic protection and vulnerability reduction of cultural heritage buildings and sites determined a growing interest in structural health monitoring (SHM) as a knowledge-based assessment tool to quantify and reduce uncertainties regarding their structural performance. Monitoring can be successfully implemented in some cases as an alternative to interventions or to control the medium- and long-term effectiveness of already applied strengthening solutions. The research group at the University of Padua, in collaboration with public administrations, has recently installed several SHM systems on heritage structures. The paper reports the application of monitoring strategies implemented to avoid (or at least minimize) the execution of strengthening interventions/repairs and control the response as long as a clear worsening or damaging process is detected. Two emblematic case studies are presented and discussed: the Roman Amphitheatre (Arena) of Verona and the Conegliano Cathedral. Both are excellent examples of on-going monitoring activities, performed through static and dynamic approaches in combination with automated procedures to extract meaningful structural features from collected data. In parallel to the application of innovative monitoring techniques, statistical models and data processing algorithms have been developed and applied in order to reduce uncertainties and exploit monitoring results for an effective assessment and protection of historical constructions. Processing software for SHM was implemented to perform the continuous real time treatment of static data and the identification of modal parameters based on the structural response to ambient vibrations. Statistical models were also developed to filter out the environmental effects and thermal cycles from the extracted features.
Obaid, Jannah M; Bailey, Ginger; Wheeler, Heidi; Meyers, Laura; Medcalf, Sharon J; Hansen, Keith F; Sanger, Kristine K; Lowe, John J
Rural communities face barriers to disaster preparedness and considerable risk of disasters. Emergency preparedness among rural communities has improved with funding from federal programs and implementation of a National Incident Management System. The objective of this project was to design and implement disaster exercises to test decision making by rural response partners to improve regional planning, collaboration, and readiness. Six functional exercises were developed and conducted among three rural Nebraska (USA) regions by the Center for Preparedness Education (CPE) at the University of Nebraska Medical Center (Omaha, Nebraska USA). A total of 83 command centers participated. Six functional exercises were designed to test regional response and command-level decision making, and each 3-hour exercise was followed by a 3-hour regional after action conference. Participant feedback, single agency debriefing feedback, and regional After Action Reports were analyzed. Functional exercises were able to test command-level decision making and operations at multiple agencies simultaneously with limited funding. Observations included emergency management jurisdiction barriers to utilization of unified command and establishment of joint information centers, limited utilization of documentation necessary for reimbursement, and the need to develop coordinated public messaging. Functional exercises are a key tool for testing command-level decision making and response at a higher level than what is typically achieved in tabletop or short, full-scale exercises. Functional exercises enable evaluation of command staff, identification of areas for improvement, and advancing regional collaboration among diverse response partners. Obaid JM , Bailey G , Wheeler H , Meyers L , Medcalf SJ , Hansen KF , Sanger KK , Lowe JJ . Utilization of functional exercises to build regional emergency preparedness among rural health organizations in the US. Prehosp Disaster Med. 2017;32(2):1-7.
Summers, Michael P; Verikios, George
Objective To examine available systematically collected evidence regarding prices for assistive technology (AT; e.g. disability aids and equipment) in Australia with other comparable countries. Issues of appropriate AT pricing are coming to the fore as a consequence of efforts to move to consumer-centric purchasing decisions with the National Disability Insurance Scheme (NDIS) and also in the recent aged care reforms.Methods We identified and present three sets of AT price comparisons. Two comparisons were based solely on the lowest prices advertised on the internet, and one comparison examined recommended retail prices. Variables essential to ensuring accurate comparisons, as well as significant supply-chain issues were also examined and considered in the analyses.Results The first internet-only price comparison found that overall AT prices were 38% higher in Australia compared to other countries, but did not factor in shipping and other related costs that are essential to include given that most AT is imported. The second internet-only price comparison found that overall Australian prices were 24% lower when shipping and related costs were included. The recommended retail price comparisons found that Australian prices were between 14% and 27% lower. Prices for internet-only retailers (those with no bricks-and-mortar presence) are consistently lower for all products than those sold by retailers with actual shop-fronts. Further, there is no evidence of suppliers earning supranormal profits in Australia.Conclusions The results indicate that AT prices in Australia are efficient and equitable, with no significant indicators of market failure which would require government intervention. Efforts to reduce prices through the excessive use of large-scale government procurement programs are likely to reduce diversity and innovation in AT and raise AT prices over time. Open markets and competition with centralised tracking of purchases and providers to minimise possible
Thomas, Elizabeth; Mulvey, Anne
Perspectives have emerged within health psychology that focus on the social constitution of health and emphasize community development and social change strategies to reduce human suffering and improve quality of life. Education and training are needed to build student capacity in these areas. Our analysis, grounded in theoretical, empirical, and experiential evidences, suggests that the arts may play a leading role in building this student capacity for community research and action. Major themes are that the arts promote student understandings of the values, goals, and practices of community-based work and enable meaningful student roles in community-based partnerships. Narrative accounts of our use of creative writing, visual arts, poetry, film, and theater in classroom and community-based practice with students illustrate these themes.
The importance of the structural health monitoring system for tall buildings is now widely recognized by at least structural engineers and managers at large real estate companies to ensure the structural safety immediately after a large earthquake and appeal the quantitative safety of buildings to potential tenants. Some leading real estate companies decided to install the system into all tall buildings. Considering this tendency, a pilot project for the west area of Shinjuku Station supported by the Japan Science and Technology Agency was started by the author team to explore a possibility of using the system to provide safe spaces for commuters and residents. The system was installed into six tall buildings. From our experience, it turned out that viewing only from technological aspects was not sufficient for the system to be accepted and to be really useful. Safe spaces require not only the structural safety but also the soundness of key functions of the building. We need help from social scientists, medical doctors, city planners etc. to further improve the integrity of the system.
Sánchez, Jesús; Silva-Suarez, Georgina; Serna, Claudia A; De La Rosa, Mario
There is limited information on the impact of the HIV/AIDS epidemic on Latino migrant workers (LMWs), although available data indicate that this community is being disproportionally affected. The need for prevention programs that address the specific needs of LMWs is becoming well recognized. HIV prevention interventions that train and employ community health workers are a culturally appropriate way to address the issues of community trust and capacity building in this community. This article describes the Latino Migrant Worker HIV Prevention Program and its efforts to train and engage community health workers in the prevention of HIV among LMWs in South Florida.
Now, more than ever, health care organizations are desperately trying to reach out to customers and establish stronger relationships that will generate increased loyalty and repeat business. As technology, like the Internet and related mediums, allow us to do a better job of managing information and communication, health care executives must invest the time and resources necessary to bring these new advances into the day-to-day operations of their businesses. Those that do will have a head start in building their brand and their customer loyalty.
Full Text Available Inequity and poverty are the root causes of ill health. Access to quality health services on an affordable and equitable basis in many parts of the country remains an unfulfilled aspiration. Disparity in health care is interpreted as compromise in ′Right to Life.′ It is imperative to define ′essential health care,′ which should be made available to all citizens to facilitate inclusivity in health care. The suggested methods for this include optimal utilization of public resources and increasing public spending on health care. Capacity building through training, especially training of paramedical personnel, is proposed as an essential ingredient, to reduce cost, especially in tertiary care. Another aspect which is considered very important is improvement in delivery system of health care. Increasing the role of ′family physician′ in health care delivery system will improve preventive care and reduce cost of tertiary care. These observations underlie the relevance and role of Primary health care as a key to deliver inclusive health care. The advantages of a primary health care model for health service delivery are greater access to needed services; better quality of care; a greater focus on prevention; early management of health problems; and cumulative improvements in health and lower morbidity as a result of primary health care delivery.
Martineau, Fred P
The 2014-2016 West African Ebola outbreak demonstrated the extent to which local social and political dynamics shape health system responses to crises such as epidemics. Many post-Ebola health system strengthening programmes are framed around a notion of health system 'resilience' that focuses on global rather than local priorities and fails to account for key local social dynamics that shape crisis responses. Post-crisis health system strengthening efforts require a shift towards a more 'people-centred' understanding of resilience that attends to the people, relationships and local contexts that constitute health systems and the practices that produce crisis responses.
Mulley, Albert G
This paper addresses the fourth theme of the Indiana Global Health Research Working Conference, Clinical Effectiveness and Health Systems Research. It explores geographic variation in health care delivery and health outcomes as a source of learning how to achieve better health outcomes at lower cost. It focuses particularly on the relationship between investments made in capacities to deliver different health care services to a population and the value thereby created by that care for individual patients. The framing begins with the dramatic variation in per capita health care expenditures across the nations of the world, which is largely explained by variations in national wealth. The 1978 Declaration of Alma Ata is briefly noted as a response to such inequities with great promise that has not as yet been realized. This failure to realize the promise of Alma Ata grows in significance with the increasing momentum for universal health coverage that is emerging in the current global debate about post-2015 development goals. Drawing upon work done at Dartmouth over more than three decades, the framing then turns to within-country variations in per capita expenditures, utilization of different services, and health outcomes. A case is made for greater attention to the question of value by bringing better information to bear at both the population and individual levels. Specific opportunities to identify and reduce waste in health care, and the harm that is so often associated with it, are identified by learning from outcome variations and practice variations.
Oberle Mark W
Full Text Available Abstract Effective public health practice relies on the availability of public health data sources and assessment tools to convey information to investigators, practitioners, policy makers, and the general public. Emerging communication technologies on the Internet can deliver all components of the "who, what, when, and where" quartet more quickly than ever with a potentially higher level of quality and assurance, using new analysis and visualization tools. Open-source software provides the opportunity to build low-cost information systems allowing health departments with modest resources access to modern data analysis and visualization tools. In this paper, we integrate open-source technologies and public health data to create a web information system which is accessible to a wide audience through the Internet. Our web application, "EpiVue," was tested using two public health datasets from the Washington State Cancer Registry and Washington State Center for Health Statistics. A third dataset shows the extensibility and scalability of EpiVue in displaying gender-based longevity statistics over a twenty-year interval for 3,143 United States counties. In addition to providing an integrated visualization framework, EpiVue's highly interactive web environment empowers users by allowing them to upload their own geospatial public health data in either comma-separated text files or MS Excel™ spreadsheet files and visualize the geospatial datasets with Google Maps™.
Kalita, Anuska; Zaidi, Sarover; Prasad, Vandana; Raman, V R
The Public Health Resource Network is an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level, to improve accountability of health systems, elicit community participation for health, ensure equitable and accessible health facilities and to bring about convergence in programmes and services. The question confronting health systems in India is how best to reform, revitalize and resource primary health systems to deliver different levels of service aligned to local realities, ensuring universal coverage, equitable access, efficiency and effectiveness, through an empowered cadre of health personnel. To achieve these outcomes it is essential that health planning be decentralized. Districts vary widely according to the specific needs of their population, and even more so in terms of existing interventions and available resources. Strategies, therefore, have to be district-specific, not only because health needs vary, but also because people's perceptions and capacities to intervene and implement programmes vary. In centrally designed plans there is little scope for such adaptation and contextualization, and hence decentralized planning becomes crucial. To undertake these initiatives, there is a strong need for trained, motivated, empowered and networked health personnel. It is precisely at this level that a lack of technical knowledge and skills and the absence of a supportive network or adequate educational opportunities impede personnel from making improvements. The absence of in-service training and of training curricula that reflect field realities also adds to this, discouraging health workers from pursuing effective strategies. The Public Health Resource Network is thus an attempt to reach out to motivated though often isolated health
Full Text Available Abstract The Public Health Resource Network is an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level, to improve accountability of health systems, elicit community participation for health, ensure equitable and accessible health facilities and to bring about convergence in programmes and services. The question confronting health systems in India is how best to reform, revitalize and resource primary health systems to deliver different levels of service aligned to local realities, ensuring universal coverage, equitable access, efficiency and effectiveness, through an empowered cadre of health personnel. To achieve these outcomes it is essential that health planning be decentralized. Districts vary widely according to the specific needs of their population, and even more so in terms of existing interventions and available resources. Strategies, therefore, have to be district-specific, not only because health needs vary, but also because people's perceptions and capacities to intervene and implement programmes vary. In centrally designed plans there is little scope for such adaptation and contextualization, and hence decentralized planning becomes crucial. To undertake these initiatives, there is a strong need for trained, motivated, empowered and networked health personnel. It is precisely at this level that a lack of technical knowledge and skills and the absence of a supportive network or adequate educational opportunities impede personnel from making improvements. The absence of in-service training and of training curricula that reflect field realities also adds to this, discouraging health workers from pursuing effective strategies. The Public Health Resource Network is thus an attempt to reach out to motivated
Hinman, Alan R; Ross, David A
Electronic health records and health information exchanges are necessary components of the information infrastructure to support a reformed health care system. However, they are not sufficient by themselves. Merely summing data from electronic health records together will not provide a comprehensive picture of the population, which is essential for tracking disease trends and treatment outcomes. Public health information systems such as immunization registries are an essential component of the information infrastructure and will allow assessment of the impact of changes in health care on the population as a whole.
Rapado-Castro, Marta; Pazos, Ángel; Fañanás, Lourdes; Bernardo, Miquel; Ayuso-Mateos, Jose Luis; Leza, Juan Carlos; Berrocoso, Esther; de Arriba, Jose; Roldán, Laura; Sanjuán, Julio; Pérez, Victor; Haro, Josep M; Palomo, Tomás; Valdizan, Elsa M; Micó, Juan Antonio; Sánchez, Manuel; Arango, Celso
The number of large collaborative research networks in mental health is increasing. Training programs are an essential part of them. We critically review the specific implementation of a research training program in a translational Centre for Biomedical Research in Mental Health in order to inform the strategic integration of basic research into clinical practice to have a positive impact in the mental health system and society. Description of training activities, specific educational programs developed by the research network, and challenges on its implementation are examined. The Centre for Biomedical Research in Mental Health has focused on training through different activities which have led to the development of an interuniversity master's degree postgraduate program in mental health research, certified by the National Spanish Agency for Quality Evaluation and Accreditation. Consolidation of training programs within the Centre for Biomedical Research in Mental Health has considerably advanced the training of researchers to meet competency standards on research. The master's degree constitutes a unique opportunity to accomplish neuroscience and mental health research career-building within the official framework of university programs in Spain.
Mookherji, Sangeeta; Mehl, Garrett; Kaonga, Nadi; Mechael, Patricia
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.
The United States spends $2.7 trillion a year on health care, more than any other country by far, and yet the U.S. population is not healthy. In fact, the United States loses $227 billion in productivity each year because of poor health. This is not sustainable-and it is the reason behind the Robert Wood Johnson Foundation's Culture of Health initiative. Culture of Health means so much more than simply not being sick. It means embracing a definition of health as outlined by the World Health Organization-a state of complete physical, mental, and social well-being. And it means shifting the values-and the actions-in the United States so that health becomes a part of everything we do. Health is the bedrock of personal fulfillment. It is the backbone of prosperity and the key to creating a strong and competitive nation. With health, children can grow up making the most of life's opportunities. Businesses can rely on the vitality of workers to stay competitive, and the military can perform at its highest level. But there is no single way to cultivate health. This Commentary explores the principles behind the Culture of Health initiative and examines the role of academic medicine in achieving this vision. Different communities must come up with the approaches that serve them best. Only by working toward a common goal in unique ways will a true Culture of Health be attainable in the United States.
Goodman, Robert Mark
The unification of the American Association for Health Education (AAHE) and the Society for Public Health Education (SOPHE) generates a long-desired synergy, a ramping up of our leadership influence in promoting health. It also serves as an ongoing opportunity to reflect on how we synergize the distinct philosophic, scientific, and practical…
The purpose of this position paper was to explore the challenges faced by principals in creating equitable opportunities for English language learners (ELLs) in the United States. We questioned "To what extent are educational leaders encouraged to create environments that value cultural diversity and the promotion of English language learners?"…
Sinagatullin, Ilghiz M.
Russia's secondary school populations are becoming increasingly diverse in terms of ethnicity, culture, language, and religion. The growing diversity makes a considerable impact on the functions and goals of schools, the realization of which requires the implementation of an equitable language policy. In this article, I briefly represent Russia as…
... differences in credit risk and administrative costs to the Farm Credit Bank or agricultural credit bank. (c... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Equitable treatment of OFIs and Farm Credit System associations. 614.4590 Section 614.4590 Banks and Banking FARM CREDIT ADMINISTRATION FARM...
This paper is centered on creating equitable opportunities for learners in mathematics education. Through observations of teacher practice, the paper seeks to theorize how teachers enact their dispositions toward mathematics instruction. These observed propensities, in relation to teachers' aims for students to "take up their space" in and beyond…
Kofoed, Jens Peter; Pecher, Arthur; Margheritini, Lucia
This paper provides a methodology for the analysis and presentation of data obtained from sea trials of wave energy converters (WEC). The equitable aspect of this methodology lies in its wide application, as any WEC at any scale or stage of development can be considered as long as the tests are p...
Yow, Jan A.
This article reports findings from a study conducted within a teacher education program to help highlight the importance of equitable instruction of mathematics for all students. The researcher developed four scenarios of her oppressive and liberative teaching practices. Prospective teachers were then asked to write scenarios describing their…
Bottermann, H; Vogel, M
Recent changes in equitation, tournament disciplines and teaching methods, which did not play a significant role in Germany so far, have to be reflected critically. Several examples such as hyperflexion of the neck, western riding, endurance riding and eventing are given to explain the requirements for teaching methods and different disciplines in terms of animal welfare and the role of the competent authorities.
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Evidence you are an equitably adopted child. 404.734 Section 404.734 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS... another if he or she agreed to adopt the child, the natural parents or the person caring for the...
Robert Wood Johnson Foundation, 2012
The nation faces an obesity crisis, especially among low-income children and children of color. Today, nearly one-third of children and adolescents are overweight or obese, and physical inactivity is a leading cause of this epidemic. Equitable transportation policy that fosters healthy, opportunity-rich communities has a critical role to play in…
Lyon, Edward G.
The three case studies, drawing on qualitative analysis of surveys, interviews, program artifacts, and classroom observation, describe secondary science preservice teachers' evolving expertise at providing opportunities for linguistically diverse students to learn and demonstrate what they have learned (i.e., equitable assessment). The teachers…
... proportionate to the number of private school children from low-income families residing in participating public... families of participating private school children. 200.65 Section 200.65 Education Regulations of the... Determining equitable participation of teachers and families of participating private school children....
Peercy, Chavanne; Svenson, Nanette
As developing countries continue to battle poverty despite strong economic growth, understanding the relationship between equity and human development becomes increasingly important. In this context, equity is not equivalent to equality for any specific outcome such as health status, education or income. It is an objective ideal whereby people's…
Kohn, Sivan; Barnett, Daniel J; Galastri, Costanza; Semon, Natalie L; Links, Jonathan M
Local health departments (LHDs) are at the hub of the public health emergency preparedness system. Since the 2003 issuance of Homeland Security Presidential Directive-5, LHDs have faced challenges to comply with a new set of all-hazards, 24/7 organizational response expectations, as well as the National Incident Management System (NIMS). To help local public health practitioners address these challenges, the Centers for Disease Control and Prevention-funded Johns Hopkins Center for Public Health Preparedness (JH-CPHP) created and implemented a face-to-face, public health-specific NIMS training series for LHDs. This article presents the development, evolution, and delivery of the JH-CPHP NIMS training program. In this context, the article also describes a case example of practice-academic collaboration between the National Association of County and City Health Officials and JH-CPHP to develop public health-oriented NIMS course content.
Rudolphi, Josie M; Donham, Kelley J
ABSTRACT The agricultural industry poses specific hazards and risks to its workers. Since the 1970s, the University of Iowa has been establishing programs to educate rural health care and safety professionals who in turn provide education and occupational health and safety services to farm families and farm workers. This program has been well established in the state of Iowa as a program of Iowa's Center for Agricultural Safety and Health (I-CASH). However, the National 1989 Agriculture at Risk Report indicated there was a great need for agricultural medicine training beyond Iowa's borders. In order to help meet this need, Building Capacity: A National Resource of Agricultural Medicine Professionals was initiated as a project of the National Institute for Occupational Safety and Health (NIOSH)-funded Great Plains Center for Agricultural Health in 2006. Before the first phase of this project, a consensus process was conducted with a group of safety and health professionals to determine topics and learning objectives for the course. Over 300 students attended and matriculated the agricultural medicine course during first phase of the project (2007-2010). Beginning the second phase of the project (2012-2016), an expanded advisory committee (38 internationally recognized health and safety professionals) was convened to review the progress of the first phase, make recommendations for revisions to the required topics and competencies, and discuss updates to the second edition of the course textbook (Agricultural Medicine: Occupational and Environmental Health for the Health Professions). A formal consensus process was held and included an online survey and also a face-to-face meeting. The group was charged with the responsibility of developing the next version of this course by establishing best practices and setting an agenda with the long-term goal of developing a national course in agricultural medicine.
Rigon, Silvia do Amaral; Schmidt, Suely Teresinha; Bógus, Cláudia Maria
This article discusses the establishment of inter-sector action between health and food and nutritional security in Brazil from 2003 to 2010, when this issue was launched as a priority on the government's agenda. A qualitative study was developed according to constructivist epistemology, using key-informant interviews in the field's nationwide social oversight body. Advances and challenges in this process are addressed as analytical categories. The National Food and Nutrition Policy (PNAN) was mentioned as the link between the two fields, decentralized through a network with activity in the states and municipalities. However, the study found political, institutional, and operational obstacles to the effective implementation of the PNAN in the Brazilian Unified National Health System and consequently to a contribution to the advancement of Health and Food and Nutritional Security in the country. The predominance of the biomedical, curative, and high-complexity model was cited as the principal impediment, while health promotion policies like the PNAN were assigned secondary priority.
Househ, Mowafa; Alshammari, Riyad; Almutairi, Mariam; Jamal, Amr; Alshoaib, Saleh
Entrepreneurship and innovation within the health informatics (HI) scientific community are relatively sluggish when compared to other disciplines such as computer science and engineering. Healthcare in general, and specifically, the health informatics scientific community needs to embrace more innovative and entrepreneurial practices. In this paper, we explore the concepts of innovation and entrepreneurship as they apply to the health informatics scientific community. We also outline several strategies to improve the culture of innovation and entrepreneurship within the health informatics scientific community such as: (I) incorporating innovation and entrepreneurship in health informatics education; (II) creating strong linkages with industry and healthcare organizations; (III) supporting national health innovation and entrepreneurship competitions; (IV) creating a culture of innovation and entrepreneurship within healthcare organizations; (V) developing health informatics policies that support innovation and entrepreneurship based on internationally recognized standards; and (VI) develop an health informatics entrepreneurship ecosystem. With these changes, we conclude that embracing health innovation and entrepreneurship may be more readily accepted over the long-term within the health informatics scientific community.
Pottie, Kevin; Hui, Charles; Rahman, Prinon; Ingleby, David; Akl, Elie A.; Russell, Grant; Ling, Li; Wickramage, Kolitha; Mosca, Davide; Brindis, Claire D.
Persons affected by migration require health systems that are responsive and adaptable to the needs of both disadvantaged migrants and non-migrant populations. The objective of this study is to support health systems for populations affected by migration. Materials and Methods: An international Delphi consensus process was used to identify policy approaches to improve health systems for populations affected by migration. Participants were leading migrant health experts from Americas, Europe, Middle East, Asia, and Australasia. We calculated average ranking scores and qualitatively analyzed open-ended questions. Results: Participants identified the following key areas as priorities for policy development: health inequities, system discrimination, migrant related health data, disadvantaged migrant sub-groups, and considerations for disadvantaged non-migrant populations. Highly ranked items to improve health systems were: Health Equity Impact Assessment, evidence based guidelines, and the International Organization for Migration annual reports. Discussion: Policy makers need tools, data and resources to address health systems challenges. Policies need to avoid preventable deaths of migrants and barriers to basic health services. PMID:28165380
Hayfaa A. Wahabi
Full Text Available Translation of research evidence into public health programs is lagging in Eastern Mediterranean Region. Graduate level public health curriculum at King Saud University (KSU, College of Medicine, Riyadh, is designed to equip students to integrate best available evidence in public health decision making. The objectives of study were to explore students’ opinion about the evidence based public health (EBPH courses and to survey the knowledge, opinion, and attitude of the students towards EBPH and perceived barriers for implementation of EBPH in decision making in public health. EBPH courses are designed based on a sequential framework. A survey was conducted at the completion of EBPH courses. Forty-five graduate students were invited to complete a validated self-administered questionnaire. It included questions about demography, opinion, and attitude towards EBPH and perceived barriers towards implementation of EBPH in the work environment. The response rate was 73%. Mean age of students was 30.1 (SD 2.3 years, and 51% were males. More than 80% had sound knowledge and could appreciate the importance of EBPH. The main perceived barriers to incorporate EBPH in decision making were lack of system of communication between researchers and policy makers and scarcity of research publications related to the public health problems.
Tvrdy, C.; Walter, R. [Inst. of Environmental Medicine of the City Council of Vienna (Austria)
Urban traffic influences air quality in cities considerably. This is particularly true for the medieval parts of the big European cities, which have not been designed for today s heavy traffic. A problem closely associated with city traffic, is the lack of parking lots, particularly for residents. In Vienna, the parking problem is tackled by the building of underground car parks. In the next years more than 50 large garages (>100 sites) are being planned. The main goal is the clearing of the beautiful old places and streets of Vienna from the bulk of parking vehicles and supplying the citizens with parking spaces in the neighbourhood. According to a recent decision of the City Council of Vienna the construction of `large garages` (>100 parking spaces) requires an official approval by various local authorities. Among them are those responsible for town design and architecture, for fire precaution and fire fighting, for city traffic, for planning and building and for environmental health. In this context the Institute of Environmental Medicine of the City Council of Vienna faced the task of establishing criteria for a health risk assessment linked with `large garages`. Health-risks may be caused by air pollution and noise. This presentation deals with the air pollution problem. Air pollution problems may occur due to traffic in and out of the garage, by insufficient ventilation systems and by construction failures. In the garage programme the health officers have to bring evidence that residents of the houses with underground car parks and residents in the close neighbourhood are not exposed to any health risk due to air pollution
Pejtersen, Jan; Brohus, H.; Hyldgaard, C. E.
. Before the floor material was installed in the office building, a full-scale exposure experiment was performed in the laboratory. The new ventilation strategy and renovation of the HVAC system were selected on the basis of laboratory experiments on a full-scale mock-up of a cellular office. The severity...
Full Text Available Abstract Background While South Africa spends approximately 7.4% of GDP on healthcare, only 43% of these funds are spent in the public system, which is tasked with the provision of care to the majority of the population including a large proportion of those in need of antiretroviral treatment (ART. South Africa is currently debating the introduction of a National Health Insurance (NHI system. Because such a universal health system could mean increased public healthcare funding and improved access to human resources, it could improve the sustainability of ART provision. This paper considers the minimum resources that would be required to achieve the proposed universal health system and contrasts these with the costs of scaled up access to ART between 2010 and 2020. Methods The costs of ART and universal coverage (UC are assessed through multiplying unit costs, utilization and estimates of the population in need during each year of the planning cycle. Costs are from the provider’s perspective reflected in real 2007 prices. Results The annual costs of providing ART increase from US$1 billion in 2010 to US$3.6 billion in 2020. If increases in funding to public healthcare only keep pace with projected real GDP growth, then close to 30% of these resources would be required for ART by 2020. However, an increase in the public healthcare resource envelope from 3.2% to 5%-6% of GDP would be sufficient to finance both ART and other services under a universal system (if based on a largely public sector model and the annual costs of ART would not exceed 15% of the universal health system budget. Conclusions Responding to the HIV-epidemic is one of the many challenges currently facing South Africa. Whether this response becomes a “resource for democracy” or whether it undermines social cohesiveness within poor communities and between rich and poor communities will be partially determined by the steps that are taken during the next ten years. While the
Li, Xiang; Hu, Gang; Teng, Xiaofei; Xie, Guotong
Personal health records (PHRs) provide patient-centric healthcare by making health records accessible to patients. In China, it is very difficult for individuals to access electronic health records. Instead, individuals can easily obtain the printed copies of their own medical records, such as prescriptions and lab test reports, from hospitals. In this paper, we propose a practical approach to extract structured data from printed medical records photographed by mobile phones. An optical chara...
Wiesner, Martin; Pfeifer, Daniel
Many developing countries struggle to move their health care system into the information age. Millions of people in Africa do not have any access to online resources to satisfy their need for adequate individual health information. Access to high quality content available in public spots could have an immense impact on people's daily life. Our browser-based health education application might help to provide a better understanding of diseases for people in developing countries. We encourage other researchers to adopt our vision for a widespread public health education system in Africa.
Eggert, Lynne K; Blood-Siegfried, Jane; Champagne, Mary; Al-Jumaily, Maha; Biederman, Donna J
Refugees often experience compromised health from both pre- and post-migration stressors. Coalition theory has helped guide the development of targeted programs to address the health care needs of vulnerable populations. Using the Community Coalition Action Theory as a framework, a coalition was formed to implement a community garden with apartment-dwelling refugees. Outcomes included successful coalition formation, a community garden, reported satisfaction from all gardeners with increased vegetable intake, access to culturally meaningful foods, and evidence of increased community engagement. The opportunity for community health nurses to convene a coalition to affect positive health for refugees is demonstrated.
Full Text Available There is a growing concern about human factors in green building, which is imperative in high-rise high-density urban environments. This paper describes our attempts to explore the influence of workplace green features (such as green certification, ventilation mode, and building morphology on health perceptions (personal sensation, sensorial assumptions, healing performance based on a survey in Hong Kong and Singapore. The results validated the relationship between green features and health perceptions in the workplace environment. Remarkably, participants from the air-conditioned offices revealed significant higher concerns about health issues than those participants from the mixed-ventilated offices. The mixed-ventilation design performs as a bridge to connect the indoor environment and outdoor space, which enables people to have contact with nature. Additionally, the preferred building morphology of the workplace is the pattern of a building complex instead of a single building. The complex form integrates the configuration of courtyards, podium gardens, green terrace, public plaza, and other types of open spaces with the building clusters, which contributes to better health perceptions. This research contributes to the rationalization and optimization of passive climate-adaptive design strategies for green buildings in high-density tropical or subtropical cities.
Matacz, Rochelle; Priddis, Lynn
This article describes a unique Australian infant mental health (IMH) service for families from pregnancy through to early parenthood (0-3 years) and training center for postgraduate clinical psychology students. The Australian Association for Infant Mental Health Incorporated, West Australia Branch (AAIMHI WA) "Competency Guidelines"®…
Hannan, T J; Celia, C
Progressive evaluations by the Organization for Economic Co-operation and Development (OECD) demonstrate that health care is now or becoming unaffordable. This means nations must change the way they manage health care. The costly nature of health care in most nations, as a percentage of Gross Domestic Product (GDP) seems independent of the national funding models. Increasing evidence is demonstrating that the lack of involvement by clinicians (doctors, nurses, pharmacists, ancillary care and patients) in e-health projects is a major factor for the costly failures of many of these projects. The essential change in focus required to improve healthcare delivery using e-health technologies has to be on clinical care. To achieve this change clinicians must be involved at all stages of e-health implementations. From a clinicians perspective medicine is not a business. Our business is clinical medicine and e-health must be focussed on clinical decision making. This paper views the roles of physicians in e-health structural reforms.
Simon de Lusignan
Full Text Available After 20-years as Informatics in Primary Care the journal is renamed Journal of Innovation in Health Informatics. The title was carefully selected to reflect that:(1 informatics provides the opportunity to innovate rather than simply automates;(2 implementing informatics solutions often results in unintended consequences, and many implementations fail and benefits and innovations may go unrecognised;(3 health informatics is a boundary spanning discipline and is by its very nature likely to give rise to innovation.Informatics is an innovative science, and informaticians need to innovate across professional and discipline boundaries.
Grover, Atul; Niecko-Najjum, Lidia M
Traditionally, projections of US health care demand have been based upon a combination of existing trends in usage and idealized or expected delivery system changes. For example, 1990s health care demand projections were based upon an expectation that delivery models would move toward closed, tightly managed care networks and would greatly decrease the demand for subspecialty care. Today, however, a different equation is needed on which to base such projections. Realistic workforce planning must take into account the fact that expanded access to health care, a growing and aging population, increased comorbidity, and longer life expectancy will all increase the use of health care services per capita over the next few decades--at a time when the number of physicians per capita will begin to drop. New technologies and more aggressive screening may also change the equation. Strategies to address these increasing demands on the health system must include expanded physician training.
Hirai, Kenta; Mita, Akira
Because of social background, such as repeated large earthquakes and cheating in design and construction, structural health monitoring (SHM) systems are getting strong attention. The SHM systems are in a practical phase. An SHM system consisting of small number of sensors has been introduced to 6 tall buildings in Shinjuku area. Including them, there are 2 major issues in the SHM systems consisting of small number of sensors. First, optimal system number of sensors and the location are not well-defined. In the practice, system placement is determined based on rough prediction and experience. Second, there are some uncertainties in estimation results by the SHM systems. Thus, the purpose of this research is to provide useful information for increasing reliability of SHM system and to improve estimation results based on uncertainty analysis of the SHM systems. The important damage index used here is the inter-story drift angle. The uncertainty considered here are number of sensors, earthquake motion characteristics, noise in data, error between numerical model and real building, nonlinearity of parameter. Then I have analyzed influence of each factor to estimation accuracy. The analysis conducted here will help to decide sensor system design considering valance of cost and accuracy. Because of constraint on the number of sensors, estimation results by the SHM system has tendency to provide smaller values. To overcome this problem, a compensation algorithm was discussed and presented. The usefulness of this compensation method was demonstrated for 40 story S and RC building models with nonlinear response.
Kosseim, Patricia; Pullman, Daryl; Perrot-Daley, Astrid; Hodgkinson, Kathy; Street, Catherine; Rahman, Proton
Objective To provide a legal and ethical analysis of some of the implementation challenges faced by the Population Therapeutics Research Group (PTRG) at Memorial University (Canada), in using genealogical information offered by individuals for its genetics research database. Materials and methods This paper describes the unique historical and genetic characteristics of the Newfoundland and Labrador founder population, which gave rise to the opportunity for PTRG to build the Newfoundland Genea...
Vuori, Jukka; Toppinen-Tanner, Salla; Mutanen, Pertti
A resource-building group intervention was developed to enhance career management, mental health, and job retention in work organizations. The in-company training program provided employees with better preparedness to manage their own careers. The program activities were universally implemented using an organization-level, 2-trainer model with trainers from the human resources management and occupational health services. The study was a within-organizations, randomly assigned field experimental study; it investigated the impacts of the intervention on immediate career management preparedness and later mental health and intentions to retire early. A total of 718 eligible individuals returned a questionnaire in 17 organizations and became voluntary participants. The respondents were randomly assigned to either an intervention (N = 369) or a comparison group (N = 349). Those in the intervention group were invited to group intervention workshops, whereas those in the comparison group received printed information about career and health-related issues. The 7-month follow-up results showed that the program significantly decreased depressive symptoms and intentions to retire early and increased mental resources among the group participants compared to the others. The mediation analyses demonstrated that the increase in career management preparedness as a proximal impact of the intervention mediated the longer term mental health effects. Those who benefited most from the intervention as regards their mental health were employees with elevated levels of depression or exhaustion and younger employees, implying additional benefits of a more targeted use of the intervention. The results demonstrated the benefits of the enhancement of individual-level career management and resilience resources as career and health promotion practice in work organizations.
Bunger, Alicia C.; Doogan, Nathan J.; Cao, Yiwen
Meeting the complex needs of youth with behavioral health problems requires a coordinated network of community-based agencies. Although fiscal scarcity or retrenchment can limit coordinated services, munificence can stimulate service delivery partnerships as agencies expand programs, hire staff, and spend more time coordinating services. This study examines the 2-year evolution of referral and staff expertise sharing networks in response to substantial new funding for services within a regional network of children’s mental health organizations. Quantitative network survey data were collected from directors of 22 nonprofit organizations that receive funding from a county government-based behavioral health service fund. Both referral and staff expertise sharing networks changed over time, but results of a stochastic actor-oriented model of network dynamics suggest the nature of this change varies for these networks. Agencies with higher numbers of referral and staff expertise sharing partners tend to maintain these ties and/or develop new relationships over the 2 years. Agencies tend to refer to agencies they trust, but trust was not associated with staff expertise sharing ties. However, agencies maintain or form staff expertise sharing ties with referral partners, or with organizations that provide similar services. In addition, agencies tend to reciprocate staff expertise sharing, but not referrals. Findings suggest that during periods of resource munificence and service expansion, behavioral health organizations build service delivery partnerships in complex ways that build upon prior collaborative history and coordinate services among similar types of providers. Referral partnerships can pave the way for future information sharing relationships. PMID:25574359
Chandra, Anita; Miller, Carolyn E; Acosta, Joie D; Weilant, Sarah; Trujillo, Matthew; Plough, Alonzo
Making health a shared value is central to building a culture of health, a new action framework intended to spur faster progress toward equitable health outcomes in the United States. Unlike in other US social movements, such as the environmental and civil rights movements, the necessary understanding of shared values has not yet been achieved for health. Discussions about values regarding health have primarily focused on health care instead of health or well-being. These discussions have not progressed to a clear focus on prioritizing values on health instead of simply health care. The evidence base for understanding health as a shared value is only now emerging. Making health a shared value is the first of four Action Areas in the Robert Wood Johnson Foundation's Culture of Health Action Framework. We assert that the achievement of this shared understanding of health as a cultural value will be enhanced through action in specific drivers: mindset and expectations, sense of community, and civic engagement. Building on a literature review and stakeholder engagement, this article examines the evidence base for these drivers and identifies where policy and research actions are needed to advance positive change on population health and well-being outcomes.
Our society is faced with an epidemic of partner violence that has far-reaching consequences. As viewed through a public health lens, prevention of teen dating violence can thwart this epidemic from starting and spreading. The Robert Wood Johnson Foundation's Culture of Health strategy aims to reduce negative outcomes and promotes overall well-being. This supplement affirms our dedication to a Culture of Health by generating an evidence base to prevent teen dating violence and promote healthy relationships across the life span.
Tremblay, Monica Chiarini; Deckard, Gloria J; Klein, Richard
Health care organizations must develop integrated health information systems to respond to the numerous government mandates driving the movement toward reimbursement models emphasizing value-based and accountable care. Success in this transition requires integrated data analytics, supported by the combination of health informatics, interoperability, business process design, and advanced decision support tools. This case study presents the development of a master's level cross- and multidisciplinary informatics program offered through a business school. The program provides students from diverse backgrounds with the knowledge, leadership, and practical application skills of health informatics, information systems, and data analytics that bridge the interests of clinical and nonclinical professionals. This case presents the actions taken and challenges encountered in navigating intra-university politics, specifying curriculum, recruiting the requisite interdisciplinary faculty, innovating the educational format, managing students with diverse educational and professional backgrounds, and balancing multiple accreditation agencies.
Montoya, Jaime C; Rebulanan, Carina L; Parungao, Nico Angelo C; Ramirez, Bernadette
Globally, there are growing efforts to address diseases through the advancement in health research and development (R&D), strengthening of regional cooperation in science and technology (particularly on product discovery and development), and implementation of the World Health Assembly Resolution 61.21 (WHA61.21) on the Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property (GSPA-PHI). As such, the Association of Southeast Asian Nations (ASEAN) is responding to this through the establishment of the ASEAN-Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation (ASEAN-NDI). This is important in the ASEAN considering that infectious tropical diseases remain prevalent, emerging, and reemerging in the region. This paper looks into the evolution of the ASEAN-NDI from its inception in 2009, to how it is at present, and its plans to mitigate public health problems regionally and even globally.
It is a great time for prevention. As the United States explores what health in our country should look like, it is an extraordinary time to highlight the role of prevention in improving health, saving lives, and saving money. The Affordable Care Act's investment in prevention has spurred innovation by communities and states to keep people healthy and safein the first place This includes growing awareness that community conditions are critical in determining health and that there is now a strong track record of prevention success. Community prevention strategies create lasting changes by addressing specific policies and practices in the environments and institutions that shape our lives and our health-from schools and workplaces to neighborhoods and government. Action at the community level also fosters health equity-the opportunity for every person to achieve optimal health regardless of identity, neighborhood, ability, or social status-and is often the impetus for national-level decisions that vitally shape the well-being of individuals and populations.
VanLare, Jordan M; Conway, Patrick H; Rowe, John W
In recent years, the focus on comparative effectiveness research (CER), the funding available to support it, and the range of possible effects of CER policy on academic health centers (AHCs) have increased substantially. CER has implications for the research, education, and clinical care components of AHCs' missions. The current funding and policy environment have created specific opportunities for AHCs to shape and respond to CER policies across the four dimensions of the CER enterprise: research, human and scientific capital, data infrastructure, and translation and dissemination. Characteristics such as the degree of physician-hospital integration, the status of a health information technology infrastructure, and the presence of a well-developed cross-functional health services research capacity linked to the care delivery enterprise could help AHCs respond to these opportunities and influence future policies. AHCs are also essential to the development of methodologies and the training of the next cadre of researchers. Further, a focus on understanding what works in health care and increasing adoption of evidence-based practice must become embedded in the fabric of AHCs. Those AHCs most successful in responding to the CER challenge may leverage it as a point of differentiation in the marketplace for health care and lead transformational improvements in health.
Priddis, Lynn E; Matacz, Rochelle; Weatherston, Deborah
This article describes findings from a project conducted in Western Australia (Mental Health Commission WA, 2015) that investigated the education and training needs of the Infant/Early Childhood Mental Health (I/ECMH) workforce. We examined international training programs and models of delivery in infant mental health, including a review of the current training available in Australia. Data collected from over 60 interviews were analyzed, and a staged delivery model for I/ECMH training and supervision that aligned with the Michigan Association for Infant Mental Health (2014) Competency Guidelines was recommended. These findings led to the purchase of the Michigan Association for Infant Mental Health (2014) for use in Western Australia. In a very short time, use of the Michigan Competency Framework by the Australian Association for Infant Mental Health West Australian Branch Incorporated has begun to change the training and education opportunities for upskilling the infant and early childhood workforce in Western Australia. It has resulted in a map to guide and develop training in the I/ECMH field for individual practitioners and professionals as well as for workplaces that will ultimately benefit Western Australian infants, young children, and their families during the perinatal period and in the early years.
There is a health care crisis in the United States and women, particularly low-income women and women of colour, are paying the price. The politicisation of pregnancy, sexuality and women's reproductive rights has created a uniquely contradictory situation in many states. Policymakers are working to control women's reproductive choices and sexuality, and restricting sex education, but doing little to address the overall lack of access to quality reproductive health care. This article describes a new reproductive rights advocacy model that was implemented starting in 2003 in two US states, South Carolina and Florida. In-depth research on the status of reproductive health and rights in each state, analysed by race, economic status, county and state policy initiatives relevant to women's health, showed that in both states access to contraception and abortion, cervical and breast cancer screening and treatment, HIV/AIDS-related care and pregnancy care were poor, with African American and Hispanic women faring even worse than white women. Implementing the advocacy model involved identifying and bringing together a diverse set of health care professionals, academics and activists who formed coalitions and are now working together and developing advocacy strategies in support of policies to improve access to reproductive health care and protect reproductive rights in both states.
Chenven, Laura; Copeland, Danielle
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.
Full Text Available AI Syazwan,1 B Mohd Rafee,1 Hafizan Juahir,2 AZF Azman,1 AM Nizar,3 Z Izwyn,4 K Syahidatussyakirah,1 AA Muhaimin,5 MA Syafiq Yunos,6 AR Anita,1 J Muhamad Hanafiah,1 MS Shaharuddin,7 A Mohd Ibthisham,8 I Mohd Hasmadi,9 MN Mohamad Azhar,1 HS Azizan,1 I Zulfadhli,10 J Othman,11 M Rozalini,12 FT Kamarul131Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, 2Department of Environmental Science/ Environmental Forensics Research Center (ENFORCE, Universiti Putra Malaysia, Selangor, 3Pharmacology Unit, Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, 4Department of Therapy and Rehabilitation, Faculty of Health Science and Biomedical Engineering, Universiti Teknologi Malaysia, Johor, 5Department of Environmental Management, Faculty of Environmental Studies, Universiti Putra Malaysia, Selangor, 6Plant Assessment Technology (PAT, Industrial Technology Division, Malaysian Nuclear Agency, Bangi, 7Department of Environmental and Occupational Health Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, 8Department of Mechanical Engineering, Faculty of Mechanical Engineering, Universiti Teknologi Malaysia, Johor, 9Department of Forest Production, Faculty of Forestry, Universiti Putra Malaysia, Selangor, 10Faculty of Built Environment and Architect, Universiti Teknologi Malaysia, Johor, 11Department of Counselor Education and Psychology Counseling, Faculty of Educational Studies, Universiti Putra Malaysia, Selangor, 12Occupational Safety, Health and Environment Unit, Multimedia University, Jalan Multimedia 63100 Cyberjaya, Selangor, 13ERALAB SDN. BHD. (Environmental Research and Analytical Laboratory Sdn. Bhd., Selangor, MALAYSIAPurpose: To analyze and characterize a multidisciplinary, integrated indoor air quality checklist for evaluating the health risk of building occupants in a nonindustrial
Full Text Available Abstract Background Evidence-based practice aims to achieve better health outcomes in the community. It relies on high quality research to inform policy and practice; however research in primary health care continues to lag behind that of other medical professions. The literature suggests that research capacity building (RCB functions across four levels; individual, team, organisation and external environment. Many RCB interventions are aimed at an individual or team level, yet evidence indicates that many barriers to RCB occur at an organisational or external environment level. This study asks senior managers from a large healthcare organisation to identify the barriers and enablers to RCB. The paper then describes strategies for building allied health (AH research capacity at an organisational level from a senior managers’ perspective. Methods This qualitative study is part of a larger collaborative RCB project. Semi-structured in-depth interviews were conducted with nine allied health senior managers. Recorded interviews were transcribed and NVivo was used to analyse findings and emergent themes were defined. Results The dominant themes indicate that the organisation plays an integral role in building AH research capacity and is the critical link in creating synergy across the four levels of RCB. The organisation can achieve this by incorporating research into its core business with a whole of organisation approach including its mission, vision and strategic planning. Critical success factors include: developing a co-ordinated and multidisciplinary approach to attain critical mass of research-active AH and enhance learning and development; support from senior managers demonstrated through structures, processes and systems designed to facilitate research; forming partnerships to increase collaboration and sharing of resources and knowledge; and establishing in internal framework to promote recognition for research and career path
Weschler, C J; Shields, H C; Rainer, D
For four separate periods over a 1-yr span, the concentrations of volatile organic compounds (VOCs) have been measured at a facility with a history of occupant complaints. The reported symptoms were characteristic of "sick building syndrome." This study was initiated to determine if VOC levels were higher than those measured in "complaint-free" buildings and, if so, to identify sources and other factors that might contribute to the elevated concentrations. VOCs were collected with passive samplers, using a sampling interval that lasted from 3 to 4 weeks. Following collection, the samplers were extracted, and the compounds in the extract were separated and identified using standard gas chromatographic-mass spectrometric procedures. Over 40 different organic compounds with concentrations in excess of 1 microgram/m3 were identified; several species had values greater than 100 micrograms/m3. For each of the first three sampling periods, the total concentration of VOCs detected using this methodology was in excess of 3 mg/m3. Sources of the identified compounds included cleaning products, floor wax, latex paints, and reentrained motor vehicle exhaust. However, the dominant source was the hydraulic system for the buildings' elevators. Compounds were volatilizing from the hydraulic fluid used in this system. Neither the elevator shafts nor the mechanical room housing the fluid reservoirs were vented to the outside. The problem was compounded by the relatively small amount of outside air used for ventilation at this facility (less than 6 L/sec [12 cfm]/occupant or about 1/4 air change/hr). At such low ventilation rates, compounds with strong sources can achieve high steady-state concentrations within the facility. Recommendations have been made to reduce the VOC levels at this site. Although implementing the recommendations will be costly, even a slight improvement in employee productivity will offset these costs.
Deepti Moyi Sahoo
Full Text Available The present study intends to propose identification methodologies for multistorey shear buildings using the powerful technique of Artificial Neural Network (ANN models which can handle fuzzified data. Identification with crisp data is known, and also neural network method has already been used by various researchers for this case. Here, the input and output data may be in fuzzified form. This is because in general we may not get the corresponding input and output values exactly (in crisp form, but we have only the uncertain information of the data. This uncertain data is assumed in terms of fuzzy number, and the corresponding problem of system identification is investigated.
This research focuses on identifying the information needs of health professionals, social workers and staff from voluntary agencies, who work together in the provision of services for people with a mental illness. The aim is to provide a fully integrated library and information service for mental health and social care. A number of recent government reports have prompted this research. These have culminated in the publication of the National Service Framework for Mental Health. It was decided to conduct a qualitative study using 17 semistructured interviews with individuals and multi-professional groups. A thematic analysis highlighted a number of key themes including: information need, information seeking behaviour and information flows. Results have indicated that because of the dispersed nature of mental health services, across primary and secondary care, and from statutory and non-statutory organisations, information technology is viewed as the only realistic vehicle to provide the required information. As specialist mental health trusts are configured, covering wider geographical areas, this can only increase the reliance on information technology, for information access and information sharing.
Yancey, Antronette; Winfield, David; Larsen, Judi; Anderson, Michele; Jackson, Portia; Overton, Jeff; Wilson, Shawn; Rossum, Allen; Kumanyika, Shiriki
Public-private partnerships allow communities and corporate entities to pool resources to address a mission of relevance to their common constituency or consumer base. Collaborations between public health and professional sports may present unique opportunities to improve health outcomes related to physical activity since athletes are fitness icons, both for adults and children. There are many "win-win" opportunities, as sports venues regularly host huge numbers of spectators, offering food and entertainment, providing hours of exposure, and introducing new ideas for engaging fans in order to remain a competitive draw. In 2008, the San Diego Padres embarked on a communitywide fitness initiative, FriarFit, including incorporating 10-minute Instant Recess breaks during their Sunday homestand pre-game shows. Many lessons have been learned that may be useful to others mounting such initiatives, such as: there is more at stake in cost-benefit and risk-benefit assessment for sports executives, requiring greater caution and circumspection than is typical for public health projects; the core business of the corporate entity must be accommodated without undermining the health objectives; and health aims must be addressed in a way that is financially viable and delivers tangible value for profit-making concerns, in terms of marketing, revenues or brand enhancement.
The aim of the study is to reveal employees’ attitudes to management style in International equitable association Limited, Aba, Nigeria (IEA). IEA is a soap and detergent manufacturing company. The company uses modern management styles to drive employee performance. This study set out to investigate employee attitudes to the various management styles in use at IEA. The study used a framework which shows that employee attitude is driven by the employee’s awareness, the employee’s application o...
Ridderhof, John C; Moulton, Anthony D; Ned, Renée M; Nicholson, Janet K A; Chu, May C; Becker, Scott J; Blank, Eric C; Breckenridge, Karen J; Waddell, Victor; Brokopp, Charles
Beginning in early 2011, the Centers for Disease Control and Prevention and the Association of Public Health Laboratories launched the Laboratory Efficiencies Initiative (LEI) to help public health laboratories (PHLs) and the nation's entire PHL system achieve and maintain sustainability to continue to conduct vital services in the face of unprecedented financial and other pressures. The LEI focuses on stimulating substantial gains in laboratories' operating efficiency and cost efficiency through the adoption of proven and promising management practices. In its first year, the LEI generated a strategic plan and a number of resources that PHL directors can use toward achieving LEI goals. Additionally, the first year saw the formation of a dynamic community of practitioners committed to implementing the LEI strategic plan in coordination with state and local public health executives, program officials, foundations, and other key partners.
Elliot, Diane L; Lindemulder, Susan J; Goldberg, Linn; Stadler, Diane D; Smith, Jennifer
Teenage survivors of childhood acute lymphoblastic leukemia (ALL) have increased morbidity likely due to their prior multicomponent treatment. Habits established in adolescence can impact individuals' subsequent adult behaviors. Accordingly, healthy lifestyles, avoiding harmful actions, and appropriate disease surveillance are of heightened importance among teenage survivors. We review the findings from prevention science and their relevance to heath promotion. The capabilities and current uses of eHealth components including e-learning, serious video games, exergaming, behavior tracking, individual messaging, and social networking are briefly presented. The health promotion needs of adolescent survivors are aligned with those eHealth aspects to propose a new paradigm to enhance the wellbeing of adolescent ALL survivors.
Li, Xiang; Hu, Gang; Teng, Xiaofei; Xie, Guotong
Personal health records (PHRs) provide patient-centric healthcare by making health records accessible to patients. In China, it is very difficult for individuals to access electronic health records. Instead, individuals can easily obtain the printed copies of their own medical records, such as prescriptions and lab test reports, from hospitals. In this paper, we propose a practical approach to extract structured data from printed medical records photographed by mobile phones. An optical character recognition (OCR) pipeline is performed to recognize text in a document photo, which addresses the problems of low image quality and content complexity by image pre-processing and multiple OCR engine synthesis. A series of annotation algorithms that support flexible layouts are then used to identify the document type, entities of interest, and entity correlations, from which a structured PHR document is built. The proposed approach was applied to real world medical records to demonstrate the effectiveness and applicability.
Ellen, Jonathan M
In 2011, All Children's Hospital (ACH) joined the Johns Hopkins Health System (JHHS) and in so doing became a member of Johns Hopkins Medicine (JHM). The value proposition for the joining of ACH and JHHS/JHM was to transform ACH into an academic pediatric health system. This case study of the transformation provides evidence for the usefulness of a precision medicine framework to organize investments in programs and practices that further the tripartite mission of academic medical centers and may increase the value of the care they deliver.
Casillas, Alejandra; Paroz, Sophie; Dory, Elody; Green, Alexander; Vu, Francis; Bodenmann, Patrick
Introduction: Although the United States has been central in bringing cultural competency into the discussion of high-quality care, health systems all over the world are faced with the effects of global immigration and the widening disparities gap between socioeconomic classes. Lausanne University Hospital is one of five Swiss academic medical…
Urowitz, Sara; Chiu, Winnie; Cockburn, Moira; Dunlop, Barbara; Fierini, Daniela; Himel, Danielle; Jones, Erin; Pulandiran, Menaka; Smith, James; Wiljer, David
A multidisciplinary team from the health and culinary sectors developed and evaluated nutritious recipes for cancer-survivors to inform and support healthy eating post-cancer. Participants in the study indicated that they were likely to incorporate the recipes into their diets, and that it would help them change their eating habits. (Contains 1…
Pejtersen, Jan; Brohus, H.; Hyldgaard, C. E.;
and health. Physiological examinations of eyes, nose and lungs were performed on each occupant. Physical, chemical and sensory measurements were performed before and after the intervention. The renewal of the flooring material was performed after a sensory test of alternative solutions in the laboratory...
Super, S; Wagemakers, M A E; Picavet, H S J; Verkooijen, K T; Koelen, M A
Sense of coherence (SOC) reflects a coping capacity of people to deal with everyday life stressors and consists of three elements: comprehensibility, manageability and meaningfulness. SOC is often considered to be a stable entity that is developed in young adulthood and stabilizes around the age of 30. Recent studies have questioned this stability of SOC and some studies report on interventions that have been successful in strengthening SOC in adult populations. Currently, however, there is no clear understanding of the mechanisms underlying SOC. As a consequence, it is a challenge to determine what is needed in health promotion activities to strengthen SOC. This article aims to explore the mechanisms underlying SOC as these insights may underpin future health promotion efforts. An exploration of the salutogenic model suggests two important mechanisms: the behavioural and the perceptual. The behavioural mechanism highlights the possibility to empower people to use their resources in stressful situations. The perceptual mechanism suggests that, in order for people to deal with life stressors, it is essential that they are able to reflect on their understanding of the stressful situation and the resources that are available. Based on these mechanisms, we suggest that both empowerment and reflection processes, which are interdependent, may be relevant for health promotion activities that aim to strengthen SOC. The successful application of resources to deal with stressors is not only likely to have a positive influence on health, but also creates consistent and meaningful life experiences that can positively reinforce SOC levels.
Ipsen, Catherine; Seekins, Tom; Ravesloot, Craig
Research studies report a negative relationship between employment and secondary conditions. Access to health promotion programs to manage secondary conditions, however, is limited for people with disabilities due to employment, financial, and insurance barriers. Vocational rehabilitation (VR) is one possible delivery point to overcome these…
Jong, Kim de
The principal aim of this thesis was to develop an outcome monitoring feedback model for Dutch outpatient mental health care in the Netherlands and to test whether providing feedback to therapists and patients can improve treatment outcomes. Data on patient progress collected in outpatient centers i
M. Mahdavi (Mahdi)
markdownabstract__Abstract__ The PhD research has two objectives: - To develop generally applicable operational models which allow developing the evidence base for health service operations in provider networks. - To contribute to the evidence base by validating the model through application to hea
Alessandra Aniceto Ferreira de Figueirêdo
Full Text Available This paper aims to describe educational activities, developed with a group of the elderly in the city of Itaporanga-PB. These activities relate to the practice of health education for discussion of hypertension and diabetes, constituted by professionals in primary care of psychology, pharmacy, physiotherapy and social service core to support family health (NASF, along with the health teams family (FHS of the city. The groups were built by elderly between 68 and 75 years of both sexes, these being conducted in community centers, health facilities close to family. To implement these activities, were used: data projector, computer, stereo and CD player, blowing balls, sheets of paper, projection screen, speaker , microphone, chairs and tables. It was considered that were discussed pathologies that afflict this group, this action caused the service users could reflect not only on hypertension and diabetes, but also about themselves, about their daily lives through knowledge and practices shared that enabled their involvement with the care of the self and the production of life through a conscious and autonomous attitude .
Estapé-Garrastazu, Estela S; Noboa-Ramos, Carlamarie; De Jesús-Ojeda, Lizbelle; De Pedro-Serbiá, Zulmarie; Acosta-Pérez, Edna; Camacho-Feliciano, Delia M
A preliminary needs assessment was conducted among faculty and students of three minority medical and health science institutions comprising the Puerto Rico Clinical and Translational Research Consortium (PRCTRC). The Web-based survey was focused on evaluating the training interests in the clinical and translational research core areas and competencies developed by the National Institutes of Health-Clinical and Translational Sciences Award. The survey was the result of a team effort of three PRCTRC key function's leaderships: Multidisciplinary Training and Career Development, Tracking and Evaluation and Community Research and Engagement. The questionnaire included 45 items distributed across five content areas including demographics, research training needs, training activities coordination and knowledge about the services offered by the PRCTRC. Analysis of research needs includes a sample distribution according to professor, assistant/associate professor and graduate students. The thematic area with highest response rate among the three groups was: "Identify major clinical/public health problems and relevant translational research questions," with the competency "Identify basic and preclinical studies that are potential testable clinical research hypothesis." These preliminary results will guide the training and professional development of the new generation of clinical and translational researchers needed to eliminate health disparities.
This article reviews the personal and professional processes of developing an interdisciplinary approach to understanding the complex issues of environmental health in their community, political-economic, social science, and scientific contexts. This interdisciplinary approach includes a synthesis of research, policy work, and advocacy. To examine…
... animal antimicrobials to be reviewed by WHO; and FDA's resources could be used in support of AGISAR's.... Promote development of standardized methods for monitoring antimicrobial use and work with member states... Health Organization (WHO) Advisory Group on Integrated Surveillance of Antimicrobial Resistance...
Syazwan, AI; Rafee, B Mohd; Juahir, Hafizan; Azman, AZF; Nizar, AM; Izwyn, Z; Syahidatussyakirah, K; Muhaimin, AA; Yunos, MA Syafiq; Anita, AR; Hanafiah, J Muhamad; Shaharuddin, MS; Ibthisham, A Mohd; Hasmadi, I Mohd; Azhar, MN Mohamad; Azizan, HS; Zulfadhli, I; Othman, J; Rozalini, M; Kamarul, FT
Purpose To analyze and characterize a multidisciplinary, integrated indoor air quality checklist for evaluating the health risk of building occupants in a nonindustrial workplace setting. Design A cross-sectional study based on a participatory occupational health program conducted by the National Institute of Occupational Safety and Health (Malaysia) and Universiti Putra Malaysia. Method A modified version of the indoor environmental checklist published by the Department of Occupational Health and Safety, based on the literature and discussion with occupational health and safety professionals, was used in the evaluation process. Summated scores were given according to the cluster analysis and principal component analysis in the characterization of risk. Environmetric techniques was used to classify the risk of variables in the checklist. Identification of the possible source of item pollutants was also evaluated from a semiquantitative approach. Result Hierarchical agglomerative cluster analysis resulted in the grouping of factorial components into three clusters (high complaint, moderate-high complaint, moderate complaint), which were further analyzed by discriminant analysis. From this, 15 major variables that influence indoor air quality were determined. Principal component analysis of each cluster revealed that the main factors influencing the high complaint group were fungal-related problems, chemical indoor dispersion, detergent, renovation, thermal comfort, and location of fresh air intake. The moderate-high complaint group showed significant high loading on ventilation, air filters, and smoking-related activities. The moderate complaint group showed high loading on dampness, odor, and thermal comfort. Conclusion This semiquantitative assessment, which graded risk from low to high based on the intensity of the problem, shows promising and reliable results. It should be used as an important tool in the preliminary assessment of indoor air quality and as a
Stansbury, P. S.
The facility in the east end of Building 2008, ORNL, consists of an x-ray machine and a shielded enclosure. The x-ray machine is of the constant potential type and can be operated continuously at generating potentials up to 125 kVcp with tube currents ranging from 0.1 ..mu..A to 10 mA. Both the generating potential and the tube current are highly regulated and stabilized. The machine is installed and operated within a large shielded enclosure. In addition to the x-ray machine and its ancillary equipment, the shielded enclosure contains many of the features of a general chemistry and physics laboratory including work benches, sinks, storage space, and electrical and gas service. This manual contains instructions for the safe operation of the x-ray machine.
Gaughan, Monica; Gillman, Laura B; Boumbulian, Paul; Davis, Marsha; Galen, Robert S
We describe and assess how the College of Public Health at the University of Georgia, established in 2005, has developed formal institutional mechanisms to facilitate community-university partnerships that serve the needs of communities and the university. The College developed these partnerships as part of its founding; therefore, the University of Georgia model may serve as an important model for other new public health programs. One important lesson is the need to develop financial and organizational mechanisms that ensure stability over time. Equally important is attention to how community needs can be addressed by faculty and students in academically appropriate ways. The integration of these 2 lessons ensures that the academic mission is fulfilled at the same time that community needs are addressed. Together, these lessons suggest that multiple formal strategies are warranted in the development of academically appropriate and sustainable university-community partnerships.
Eaves, S; Gyi, D E; Gibb, A G F
Construction is a heavy manual industry where working into later life can be a challenge. An interview study was conducted to explore workers' understanding of their health at work and ways of making their jobs easier, safer or more comfortable. Using purposive sampling, 80 trades' workers were selected from construction sites in the UK. The Nordic Musculoskeletal Questionnaire and Work Ability Index were used to explore aches and pains and reducing strain on the body. A high prevalence of symptoms was reported and ratings of work ability were high. Workers were aware of the physical demands of their work and had over 250 ideas around health and wellbeing e.g. rucksacks for tools, bespoke benches, adapting PPE, and higher cost solutions e.g. mechanical lifting aids. Engagement of the workforce should be encouraged and feed into change processes in the industry to enable all workers stay fit for work for longer.
In this study, a mixed methods approach was used to gather descriptive exploratory information regarding the teaching of science to middle grades students with learning disabilities within a general education classroom. The purpose of this study was to examine teachers' beliefs and their practices concerning providing equitable opportunities for students with learning disabilities in a general education science classroom. Equitable science teaching practices take into account each student's differences and uses those differences to inform instructional decisions and tailor teaching practices based on the student's individualized learning needs. Students with learning disabilities are similar to their non-disabled peers; however, they need some differentiation in instruction to perform to their highest potential achievement levels (Finson, Ormsbee, & Jensen, 2011). In the quantitative phase, the purpose of the study was to identify patterns in the beliefs of middle grades science teachers about the inclusion of students with learning disabilities in the general education classroom. In the qualitative phase, the purpose of the study was to present examples of instruction in the classrooms of science education reform-oriented middle grades science teachers. The quantitative phase of the study collected data from 274 sixth through eighth grade teachers in the State of Florida during the 2007--2008 school year using The Teaching Science to Students with Learning Disabilities Inventory. Overall, the quantitative findings revealed that middle grades science teachers held positive beliefs about the inclusion of students with learning disabilities in the general education science classroom. The qualitative phase collected data from multiple sources (interviews, classroom observations, and artifacts) to develop two case studies of reform-oriented middle grades science teachers who were expected to provide equitable science teaching practices. Based on their responses to The
Objectives The aim of this paper is to summarize concerns with the de-identification standard and methodologies established under the Health Insurance Portability and Accountability Act (HIPAA) regulations, and report some potential policies to address those concerns that were discussed at a recent workshop attended by industry, consumer, academic and research stakeholders. Target audience The target audience includes researchers, industry stakeholders, policy makers and consumer advocates co...
Harris, D.A.; Paulson, G.; Perry, E. [New Jersey Univ. of Medicine and Dentistry, New Brunswick, NJ (United States). School of Public Health
The network of Centers for Public Health Preparedness (CPHP) was created by the United States Centers for Disease Control and Prevention in response to the perception that public health professionals were inadequately prepared to respond to terrorism incidents, natural disasters and similar major events. The events of September 11, 2001 and the subsequent anthrax attacks confirmed the wisdom of a concerted approach to emergency preparedness. This paper provides an outline of the network's recent activities as well as a review of the rationale, history and progress of the network to date. In the most recent grant cycle, each center was required to allocate 20 per cent of its resources to network-wide activities, including contribution of CPHP-developed materials to a central resource center maintained by the Association of Schools of Public Health. The materials are publicly available and are to be used in the development of training programs; the establishment of 19 or more exemplar groups that focus on specific preparedness-related knowledge domains such as mental health, educational evaluation methods and field epidemiology, who are also expected to develop tool kits of validated and fully described training materials for use by any CPHP person or group. The outcome of the CPHP network activities is the development of a more comprehensive and robust core of preparedness training materials that aim to facilitate rapid and effective training, while at the same time eliminating redundancy and duplication of effort. It was concluded that the expenditure of 20 per cent of center funds on network development activities is forcing the academically based CPHPs to adopt a new collaborative paradigm in order to ensure effective nationwide preparedness. 3 refs.
Antonio S. Williams
Full Text Available The purpose of this study was to empirically examine antecedents of sport consumer-based brand equity in the fitness segment of the sport industry (i.e., participatory sport. The proposed framework consisted of market-induced (e.g. word-of-mouth, electronic word-of-mouth and organization-induced antecedents (e.g. price, place that have been theoretically proposed, but not tested. An 18-item paper-based survey was administered to a convenience sample of health club prospects (N= 213. The questionnaire consisted of items measuring price (three items, brand awareness (two items, brand association (three items, electronic word-of-mouth (eWOM (three items, word-of-mouth (WOM (three items, and place (four items. The relationship between independent (i.e., price, place, WOM, eWOM and dependent variables (i.e., brand awareness, brand association within the proposed model were tested using a multiple linear regression analysis (MLR. The results of the proposed model indicated that the four proposed antecedents accounted for a total of 30% of the variance in brand awareness and 14% of the variance in brand association. Specifically, price and WOM were significant predictors of brand awareness as well as brand association. The findings suggest that organization controlled brand strategies such as price, and organic brand communications such as WOM, help shape the perceptions potential health club members have with the health club brand.
McNally, Luke; Brown, Sam P
Microbes collectively shape their environment in remarkable ways via the products of their metabolism. The diverse environmental impacts of macro-organisms have been collated and reviewed under the banner of 'niche construction'. Here, we identify and review a series of broad and overlapping classes of bacterial niche construction, ranging from biofilm production to detoxification or release of toxins, enzymes, metabolites and viruses, and review their role in shaping microbiome composition, human health and disease. Some bacterial niche-constructing traits can be seen as extended phenotypes, where individuals actively tailor their environment to their benefit (and potentially to the benefit of others, generating social dilemmas). Other modifications can be viewed as non-adaptive by-products from a producer perspective, yet they may lead to remarkable within-host environmental changes. We illustrate how social evolution and niche construction perspectives offer complementary insights into the dynamics and consequences of these traits across distinct timescales. This review highlights that by understanding the coupled bacterial and biochemical dynamics in human health and disease we can better manage host health.
Veiga, Tatiane Bonametti; Coutinho, Silvano da Silva; Andre, Silvia Carla Silva; Mendes, Adriana Aparecida; Takayanagui, Angela Maria Magosso
ABSTRACT Objective: to prepare a list of sustainability indicators in the health dimension, for urban solid waste management. Methods: a descriptive and exploratory study performed jointly with 52 solid waste specialists, using a three-steps Delphi technique, and a scale measuring the degree of importance for agreement among the researchers in this area. Results: the subjects under study were 92,3% PhD's concentrated in the age group from 30 to 40 years old (32,7%) and 51% were men. At the end of the 3rd step of the Delphi process, the average and standard deviation of all the proposed indicators varied from 4,22 (±0,79) to 4,72 (±0,64), in a scale of scores for each indicator from 1 to 5 (from "dispensable" to "very important"). Results showed the level of correspondence among the participants ranging from 82% to 94% related to those indicators. Conclusion: the proposed indicators may be helpful not only for the identification of data that is updated in this area, but also to enlarge the field of debates of the environmental health policies, directed not only for urban solid waste but for the achievement of better health conditions for the Brazilian context. PMID:27508905
Wells, Kristen J; Lima, Diana S; Meade, Cathy D; Muñoz-Antonia, Teresita; Scarinci, Isabel; McGuire, Allison; Gwede, Clement K; Pledger, W Jack; Partridge, Edward; Lipscomb, Joseph; Matthews, Roland; Matta, Jaime; Flores, Idhaliz; Weiner, Roy; Turner, Timothy; Miele, Lucio; Wiese, Thomas E; Fouad, Mona; Moreno, Carlos S; Lacey, Michelle; Christie, Debra W; Price-Haywood, Eboni G; Quinn, Gwendolyn P; Coppola, Domenico; Sodeke, Stephen O; Green, B Lee; Lichtveld, Maureen Y
Significant cancer health disparities exist in the United States and Puerto Rico. While numerous initiatives have been implemented to reduce cancer disparities, regional coordination of these efforts between institutions is often limited. To address cancer health disparities nation-wide, a series of regional transdisciplinary networks through the Geographic Management Program (GMaP) and the Minority Biospecimen/Biobanking Geographic Management Program (BMaP) were established in six regions across the country. This paper describes the development of the Region 3 GMaP/BMaP network composed of over 100 investigators from nine institutions in five Southeastern states and Puerto Rico to develop a state-of-the-art network for cancer health disparities research and training. We describe a series of partnership activities that led to the formation of the infrastructure for this network, recount the participatory processes utilized to develop and implement a needs and assets assessment and implementation plan, and describe our approach to data collection. Completion, by all nine institutions, of the needs and assets assessment resulted in several beneficial outcomes for Region 3 GMaP/BMaP. This network entails ongoing commitment from the institutions and institutional leaders, continuous participatory and engagement activities, and effective coordination and communication centered on team science goals.
Abas, Melanie A; Nhiwatiwa, Sekai M; Mangezi, Walter; Jack, Helen; Piette, Angharad; Cowan, Frances M; Barley, Elizabeth; Chingono, Alfred; Iversen, Amy; Chibanda, Dixon
Despite the need to improve the quantity and quality of psychiatry training in sub-Saharan Africa (SSA), very little is known about the experiences of psychiatric trainees in the region. This is the first study examining psychiatric trainees in a low-income country in SSA. It was carried out as part of the needs assessment for a unique Medical Education Partnership Initiative (MEPI) programme to find African solutions for medical shortages in Africa. We approached all doctors who had trained in post-graduate psychiatry in Zimbabwe in 2010 and conducted in-depth qualitative interviews with all except one (n = 6). We analysed the data using constant comparison and thematic analysis. Trainees described the apprenticeship model as the programme's primary strength, through providing clinical exposure and role models. Programme weaknesses included shortages in information sources, trainee salaries, trainers, public health education, and in the mental health service. Most respondents were, however, eager to continue practising psychiatry in Zimbabwe, motivated by family ties, national commitment and helping vulnerable, stigmatized individuals. Respondents called for sub-speciality training and for infrastructure and training to do research. Resources need to be made available for psychiatric trainees in more SSA settings to develop public health competencies. However, investment in psychiatry training programmes must balance service provision with trainees' educational needs. Directing investment towards needs identified by trainees may be a cost-effective, context-sensitive way to increase retention and learning outcomes.
Jackson, Fleda Mask; Saran, Ama R; Ricks, Sharon; Essien, Joyce; Klein, Kevin; Roberts, Darryl; Worthy, Natasha
This paper presents a community engagement model designed to advance social justice and equity for African American birth outcomes through the combined techniques of Photovoice and Appreciative Inquiry. In response to the persistent racial disparities in birth outcomes, Save 100 Babies© was constructed as a 2-day summit where the emphasis was placed on individual and community assets rather than deficits. The engagement was designed to create a level of readiness among individuals working within and outside the field of Maternal and Child Health to envision strategies to attain equitable birth outcomes. The goal of the conference was to facilitate higher level consciousness by guiding the participants though a process aimed at articulating assets, possibilities and the potential for co-creating the desired futures where racial disparities in birth outcome are eliminated [corrected]. As the result of the guided discourse that began with photographs of the lives of African American women, participants articulated the strengths they detected from the pictures, their recommendations for multifaceted changes in policies and practices, and their individual and organizational commitments for a changed future. Since the summit, participants have indicated ways they have fulfilled their vows that include informing families and communities about pregnancy risks, working with youth programs, supporting fatherhood involvement in pregnancy and birth, and advancing case management that is more attuned to women's strengths. Save 100 Babies© is evolving into a network and clearinghouse for sharing and disseminating information and resources for collaboration.
Williams, Antonio S.; Isabell Rhenwrick; Ben Wright; Wanyong Choi; Dae Yeon Kim; Theodore Vickey
The purpose of this study was to empirically examine antecedents of sport consumer-based brand equity in the fitness segment of the sport industry (i.e., participatory sport). The proposed framework consisted of market-induced (e.g. word-of-mouth, electronic word-of-mouth) and organization-induced antecedents (e.g. price, place) that have been theoretically proposed, but not tested. An 18-item paper-based survey was administered to a convenience sample of health club prospects (N= 213). The q...
Geelen-Baass, Briana N L; Johnstone, Jade M K
In light of recent disasters and terrorist attacks, private and public organisations alike are becoming increasingly concerned with their ability to continue operating in spite of unforeseen events. This paper describes a project conducted at the Royal Victorian Eye and Ear Hospital to develop a Business Continuity Management (BCM) Framework, and outlines the learning experience. It provides a Framework and describes the key issues to be considered when initiating BCM in a health organisation, concluding that a project management approach can be used to establish a framework for BCM.
Festervand, T A; Lumpkin, J R
With the increasing competitiveness of the health care marketplace, the need for information by service providers has increased concomitantly. In response to this need, strategic and competitive intelligence systems have emerged as a vital source of information. This article establishes a basis for the development and operation of a competitive intelligence system. Initially, strategic and competitive intelligence systems are conceptualized, then followed by a discussion of the areas which are candidates for inclusion in the intelligence system. The remainder of the article focuses on system development and operation. Attention also is directed toward information utilization and integration.
Full Text Available Introduction: Public healthcare system in India suffers from poor performance mainly due to the severe shortage and high absenteeism of healthcare providers. The performance is further affected due to low productivity and competencies of the already existing healthcare providers. While management training (with a special focus on human resource issues to address the shortage to healthcare providers has gained some importance in recent past, there has been a very limited focus on how to use the exiting workforce effectively. With this backdrop, training health providers in issues pertaining to team effectiveness becomes very crucial. The case study discusses some of the dimensions of team building, as well as processes involved in performance improvement including problem identification, prioritization, and problem-solving process as demonstrated by health system improvement teams (HSIT′s. Materials and Methods: HSIT′s have been constituted and are functional at 238 secondary level facilities in Rajasthani. The case writer interacted with five HSIT′s from two districts in Rajasthan. We were able to speak to about four to five members from each team for all the five facilities. The information for the case was gathered in two ways. The first was use of an instrument on team building that was given to each member of the team to gauge their individual perception about various team building aspects. The second was with the help of group discussions that were done with all the team members for each all the five teams. All those who were present and willing to be part of the discussion were given instruments and were included in group discussions. As this was an exploratory case study, the sample size was small and, therefore, the findings from group discussion and instruments have been presented together without any quantification of the data. Results: The findings of the case study indicate moderate team empowerment. While HSIT′s were clear
Full Text Available The existing data at European level situate Romania on the last places regarding the rate of organ donation. This fact is also an indicator of the effect of the health policies in Romania in the field of transplant. The research carried out (the study on the population’s attitudes towards the organ donation, the study on the theme of organ transplantation as presented in the Romanian media, and the study on the opinions of the ER doctors, neurologists and neurosurgeons regarding the organ donation and transplantation show different models of approaching the issue of transplant in the European area. The investigations carried out among doctors identify a series of issues which relate, on the one hand, to the cultural component, and, on the other hand, to the structure and functioning of the Romanian health system. The survey carried out in Iași in 2012 shows favorable attitudes towards organ donations in the conditions of a lack of information and of a less effective policy regarding organ donation.
Rowe, Sylvia; Alexander, Nick; Kretser, Alison; Steele, Robert; Kretsch, Molly; Applebaum, Rhona; Clydesdale, Fergus; Cummins, Deborah; Hentges, Eric; Navia, Juan; Jarvis, Ashley; Falci, Ken
The present article articulates principles for effective public-private partnerships (PPPs) in scientific research. Recognizing that PPPs represent one approach for creating research collaborations and that there are other methods outside the scope of this article, PPPs can be useful in leveraging diverse expertise among government, academic, and industry researchers to address public health needs and questions concerned with nutrition, health, food science, and food and ingredient safety. A three-step process was used to identify the principles proposed herein: step 1) review of existing PPP guidelines, both in the peer-reviewed literature and at 16 disparate non-industry organizations; step 2) analysis of relevant successful or promising PPPs; and step 3) formal background interviews of 27 experienced, senior-level individuals from academia, government, industry, foundations, and non-governmental organizations. This process resulted in the articulation of 12 potential principles for establishing and managing successful research PPPs. The review of existing guidelines showed that guidelines for research partnerships currently reside largely within institutions rather than in the peer-reviewed literature. This article aims to introduce these principles into the literature to serve as a framework for dialogue and for future PPPs.
Ravindran, T K Sundari
Privatisation in Pakistan's health sector was part of the Structural Adjustment Programme that started in 1998 following the country's acute foreign exchange crisis. This paper examines three examples of privatisation which have taken place in service delivery, management and capacity-building functions in the health sector: 1) large-scale contracting out of publicly-funded health services to private, not-for-profit organisations; 2) social marketing/franchising networks providing reproductive health services; and 3) a public-private partnership involving a consortium of private players and the government of Pakistan. It assesses the extent to which these initiatives have contributed to promoting equitable access to good quality, comprehensive reproductive health services. The paper concludes that these forms of privatisation in Pakistan's health sector have at best made available a limited range of fragmented reproductive health services, often of sub-optimal quality, to a fraction of the population, with poor returns in terms of health and survival, especially for women. This analysis has exposed a deep-rooted malaise within the health system as an important contributor to this situation. Sustained investment in health system strengthening is called for, where resources from both public and private sectors are channelled towards achieving health equity, under the stewardship of the state and with active participation by and accountability to members of civil society.
Blue, Christine M; Lopez, Naty
In 2009, Minnesota Governor Pawlenty signed into law a bill approving the creation of a new dental team member: the dental therapist. The intent of this legislation was to address oral health disparities by creating a dental professional who would expand access to dental care in Minnesota. This study aimed to describe the characteristics of the first class of dental therapy students at the University of Minnesota and to ascertain the values and motivations that led them to choose a career in dental therapy. Four surveys were used to create the composite profile of the ten students in this first dental therapy class: 1) the California Critical Thinking Skills Test, 2) the Learning Type Measure, 3) the Attitudes Toward Healthcare Survey, and 4) a values and motivation survey that included demographic data. The results of the surveys revealed interacting influences of the students' background, personal self-concept, and environment leading to a career decision to pursue dental therapy.
Lucier, R E
In 1990, the University of California, San Francisco, dedicated a new library to serve the faculty, staff, and students and to meet their academic information needs for several decades to come. Major environmental changes present new and additional information management challenges, which can effectively be handled only through the widespread use of computing and computing technologies. Over the next five years, a three-pronged strategy will be followed. We are refining the current physical, paper-based library through the continuous application of technology for modernization and functional improvement. At the same time, we have begun the planning, design, and implementation of a "free-standing" Digital Library of the Health Sciences, focusing on the innovative application of technology. To ensure complementarity and product integrity where the two libraries interface, we will look to technology to transform these separate entities into an eventual, integral whole.
Detmer, D E
Substantial global and national commitment will be required for current healthcare systems and health professional practices to become learning care systems utilizing information and communications technology (ICT) empowered by informatics. To engage this multifaceted challenge, a vision is required that shifts the emphasis from silos of activities toward integrated systems. Successful systems will include a set of essential elements, e.g., a sufficient ICT infrastructure, evolving health care processes based on evidence and harmonized to local cultures, a fresh view toward educational preparation, sound and sustained policy support, and ongoing applied research and development. Increasingly, leaders are aware that ICT empowered by informatics must be an integral part of their national and regional visions. This paper sketches out the elements of what is needed in terms of objectives and some steps toward achieving them. It summarizes some of the progress that has been made to date by the American and International Medical Informatics Associations working separately as well as collaborating to conceptualize informatics capacity building in order to bring this vision to reality in low resource nations in particular.
Shoemaker, Paul A; Skogstrom, Tiffany; Shea, John; Bethune, Leon
Boston's more than 500 automotive shops, located primarily in low-income communities of color, are a source both of well-paying jobs and of potential hazardous exposures to employees and residents. The Safe Shops Project works to reduce occupational and environmental health hazards without having to close these businesses. Combining inspections, in-shop trainings, outreach, and technical/financial assistance, it brings shops into compliance with laws and promotes use of safer practices and alternative products. After 18 months, 254 workers at 61 of 124 participating shops had received training. Surveys showed improved worker knowledge: Pre-training, 24.2 percent of the worker survey respondents stated that they knew what an MSDS was, and post-training, 75 percent stated that they knew. The surveys also found improvement in work practices: Pre-training, 48 percent of workers indicated that they used safety goggles in their work, while post-training, 70 percent indicated proper use of safety goggles. The results also showed shops investing in capital improvements such as replacement of PCE-based brake cleaners with aqueous cleaners. The Safe Shops Project has a successfully modeled application of the 10-essential-services framework to the building of public health capacity and community collaboration, and this model can be adapted to other locations and industries.
Ponzin, Diego; Fasolo, Adriano; Vidale, Enrico; Pozzi, Annalaura; Bottignolo, Elisa; Calabrò, Francesco; Rupolo, Giampietro
The aim of this study was to evaluate the effects of a team-building learning project on job satisfaction, psychological wellbeing, and performance of health care workers involved in the process of organ and tissue donation. The project was conducted between June and September 2011 and consisted of two one-day meetings and a one week sailing, involving 20 staff members. GHQ-12, MBI-HSS, and 25 items taken from the Multidimensional Organizational Health Questionnaire (MOHQ) were used to assess health status, burnout, and job satisfaction. Results of the descriptive analyses were expressed as mean ± SD and as counts and percentages; Chi-square test was used to evaluate statistical significance of differences before and after the initiative. 6 (30,0%) participants showed the likelihood to suffering from anxiety and depression (i.e. recognized as 'cases' by the GHQ-12), 3 (15.0%) of them at baseline and 3 (15.0%), different from the previous ones, in the post-intervention. The presence of stress was revealed in 9 (45.0%) and 12 subjects (60.0%) before and after the experience, respectively (6 subjects showed the presence of stress in both circumstances). We documented 4 burnout cases, 3 (15.0%) at baseline and 1 (5.0%) after the experience. Nevertheless, about 80% of the participants showed a high degree ofjob satisfaction, in terms of positive influence of job in the professional satisfaction and of clear satisfaction for the organization, during both evaluation. In respect to 2010, the number of organ donors and that of ocular tissue donors improved of about 16% and 10%, respectively, during the year of the project and in the following year (mean value). We recognize that our team-building project for personnel involved in the stressful and demanding setting of organ and tissue donation, worthwhile and recompensing at the same time, possibly influenced the personal commitment and the quality of job provided. The high level of stress showed by participants should be
Abas Nor Haslinda
Full Text Available Malaysia’s construction industry has been long considered hazardous, owing to its poor health and safety record. It is proposed that one of the ways to improve safety and health in the construction industry is through the implementation of ‘off-site’ systems, commonly termed ‘industrialised building systems (IBS’ in Malaysia. This is deemed safer based on the risk concept of reduced exposure, brought about by the reduction in onsite workers; however, no method yet exists for determining the relative safety of various construction methods, including IBS. This study presents a comparative evaluation of the occupational health and safety (OHS risk presented by different construction approaches, namely IBS and traditional methods. The evaluation involved developing a model based on the concept of ‘argumentation theory’, which helps construction designers integrate the management of OHS risk into the design process. In addition, an ‘energy damage model’ was used as an underpinning framework. Development of the model was achieved through three phases, namely Phase I – knowledge acquisitaion, Phase II – argument trees mapping, and Phase III – validation of the model. The research revealed that different approaches/methods of construction projects carried a different level of energy damage, depending on how the activities were carried out. A study of the way in which the risks change from one construction process to another shows that there is a difference in the profile of OHS risk between IBS construction and traditional methods.Therefore, whether the option is an IBS or traditional approach, the fundamental idea of the model is to motivate construction designers or decision-makers to address safety in the design process and encourage them to examine carefully the probable OHS risk variables surrounding an action, thus preventing accidents in construction.
Karine de Mello Freire
Full Text Available It has been identified a latent need for developing efficient communication strategies for prevention of diseases and also, design as a potential agent to create communications artifacts that are able to promote self-care. In order to analyze a design process that develops this kind of artifact, an action research in IAPI Health Center in Porto Alegre was done. The action’s goal was to design a strategy to promote self-care to prevent cervical cancer. The process was conducted from the human centered design approach - HCD, which seeks to create solutions desirable for people and feasible for organizations from three main phases: a Hear, in which inspirations are originated from stories collected from people; b Create, which aims to translate these knowledge into prototypes; and, c Deliver, where the prototypes are tested and developed with users. Communication strategies were supported by design studies about visual-verbal rhetoric. As results, this design approach has shown adequate to create communication strategies targeted at self-care behaviors, aiming to empower users to change their behavior.
Full Text Available In this article, Ciarán J. Burke argues that the ‘Responsibility to Protect’ initiative has failed. Burke presents a series of fundamental flaws, both with the doctrine advanced by the ICISS, and with the subsequent attempts to incorporate it into the international legal framework. Burke opines that equity, as a source of international law, should instead be used to shed fresh light on the debate, keeping the discourse within the law and away from subjective ethics, and drafting a novel framework which he dubs ‘equitable humanitarian intervention’.
Wallach Kildemoes, Helle; Diderichsen, Finn; Krasnik, Allan
ABSTRACT: BACKGROUND: Statins are increasingly prescribed to prevent cardiovascular disease (CVD) in asymptomatic individuals. Yet, it is unknown whether those at higher CVD risk - i.e. individuals in lower socio-economic position (SEP) - are adequately reached by this high-risk strategy. Aim......: To examine whether the Danish implementation of the strategy to prevent cardiovascular disease (CVD) by initiating statin (HMG-CoA reductase inhibitor) therapy in high-risk individuals is equitable across socioeconomic groups. METHODS: Design: Cohort study. Setting and participants: Applying individual...
Golden, Shelley D; McLeroy, Kenneth R; Green, Lawrence W; Earp, Jo Anne L; Lieberman, Lisa D
Efforts to change policies and the environments in which people live, work, and play have gained increasing attention over the past several decades. Yet health promotion frameworks that illustrate the complex processes that produce health-enhancing structural changes are limited. Building on the experiences of health educators, community activists, and community-based researchers described in this supplement and elsewhere, as well as several political, social, and behavioral science theories, we propose a new framework to organize our thinking about producing policy, environmental, and other structural changes. We build on the social ecological model, a framework widely employed in public health research and practice, by turning it inside out, placing health-related and other social policies and environments at the center, and conceptualizing the ways in which individuals, their social networks, and organized groups produce a community context that fosters healthy policy and environmental development. We conclude by describing how health promotion practitioners and researchers can foster structural change by (1) conveying the health and social relevance of policy and environmental change initiatives, (2) building partnerships to support them, and (3) promoting more equitable distributions of the resources necessary for people to meet their daily needs, control their lives, and freely participate in the public sphere.
Norbäck, D; Zock, J-P; Plana, E; Heinrich, J; Tischer, C; Jacobsen Bertelsen, R; Sunyer, J; Künzli, N; Villani, S; Olivieri, M; Verlato, G; Soon, A; Schlünssen, V; Gunnbjörnsdottir, M I; Jarvis, D
We studied dampness and mold in homes in relation to climate, building characteristics and socio-economic status (SES) across Europe, for 7127 homes in 22 centers. A subsample of 3118 homes was inspected. Multilevel analysis was applied, including age, gender, center, SES, climate, and building factors. Self-reported water damage (10%), damp spots (21%), and mold (16%) in past year were similar as observed data (19% dampness and 14% mold). Ambient temperature was associated with self-reported water damage (OR=1.63 per 10°C; 95% CI 1.02-2.63), damp spots (OR=2.95; 95% CI 1.98-4.39), and mold (OR=2.28; 95% CI 1.04-4.67). Precipitation was associated with water damage (OR=1.12 per 100 mm; 95% CI 1.02-1.23) and damp spots (OR=1.11; 95% CI 1.02-1.20). Ambient relative air humidity was not associated with indoor dampness and mold. Older buildings had more dampness and mold (Pmanagerial/professional workers. There were correlations between reported and observed data at center level (Spearman rho 0.61 for dampness and 0.73 for mold). In conclusion, high ambient temperature and precipitation and high building age can be risk factors for dampness and mold in homes in Europe.
Costello, Anthony; Maslin, Mark; Montgomery, Hugh; Johnson, Anne M; Ekins, Paul
The health effects of climate change have had relatively little attention from climate scientists and governments. Climate change will be a major threat to population health in the current century through its potential effects on communicable disease, heat stress, food and water security, extreme weather events, vulnerable shelter and population migration. This paper addresses three health-sector strategies to manage the health effects of climate change-promotion of mitigation, tackling the pathways that lead to ill-health and strengthening health systems. Mitigation of greenhouse gas (GHG) emissions is affordable, and low-carbon technologies are available now or will be in the near future. Pathways to ill-health can be managed through better information, poverty reduction, technological innovation, social and cultural change and greater coordination of national and international institutions. Strengthening health systems requires increased investment in order to provide effective public health responses to climate-induced threats to health, equitable treatment of illness, promotion of low-carbon lifestyles and renewable energy solutions within health facilities. Mitigation and adaptation strategies will produce substantial benefits for health, such as reductions in obesity and heart disease, diabetes, stress and depression, pneumonia and asthma, as well as potential cost savings within the health sector. The case for mitigating climate change by reducing GHGs is overwhelming. The need to build population resilience to the global health threat from already unavoidable climate change is real and urgent. Action must not be delayed by contrarians, nor by catastrophic fatalists who say it is all too late.
Is a Health Care Ethics possible? Against sceptical and relativist doubts Kantian deontology may advance a challenging alternative affirming the possibility of such an ethics on the condition that deontology be adopted as a total programme or complete vision. Kantian deontology is enlisted to move us from an ethics of two-person informal care to one of institutions. It justifies this affirmative answer by occupying a commanding meta-ethical stand. Such a total programme comprises, on the one hand, a dual-aspect strategy incorporating the macro- (institutional) and micro- (person-to-person) levels while, on the other, it integrates consistently within moral epistemology a meta-ethics with lower-ground moral theories. The article describes the issues to be dealt with and the problems which have to be solved on the way to a unifying theory of that kind (Sections I-III) and indicates elements of Kantian moral philosophy which may serve as building blocks (Section IV). Among these are not only Kant's ideas concerning the moral acting of persons and his ideas concerning civil society and state but also his ideas concerning morality, schematism and religion.
Cominetti, Laura; Dimonte, Valerio
It is always difficult to measure the quality and efficacy of a formative event. The event assessed in this study was an outdoor course and the aspects considered were the degree of satisfaction, the increase of knowledge, modifications in behavior and working actions and organized change (4 levels according to Kirkpatrick). Data were collected by means of a questionnaire which the 28 course participants were asked to fill in. Some aspects were statistically tested to evaluate eventual associations between the role of the participant and the answer given but these were not found to be significant. Results showed a good levels of satisfaction and knowledge increase which, in terms of working procedures and individual behavior, resulted in better team-building and mutual appreciation, whereas organizational changes were rather limited and sometimes reflected disappointment. The study made the Health Authority aware of the value of human resources and of the fact that a formative event which acts on feelings and behavior may be the key to success in bringing about deep and lasting changes.
Burman, S.N.; Brown, K.S.; Landguth, D.C.
As part of the Underground Storage Tank Program at the Department of Energy's Oak Ridge National Laboratory (ORNL) in Oak Ridge, Tennessee, this Health and Safety Plan has been developed for removal of the 110-gal leaded fuel underground storage tank (UST) located in the Building 3019B area at ORNL This Health and Safety Plan was developed by the Measurement Applications and Development Group of the Health and Safety Research Division at ORNL The major components of the plan follow: (1) A project description that gives the scope and objectives of the 110-gal tank removal project and assigns responsibilities, in addition to providing emergency information for situations occurring during field operations; (2) a health and safety plan in Sect. 15 for the Building 3019B UST activities, which describes general site hazards and particular hazards associated with specific tasks, personnel protection requirements and mandatory safety procedures; and (3) discussion of the proper form completion and reporting requirements during removal of the UST. This document addresses Occupational Safety and Health Administration (OSHA) requirements in 29 CFR 1910.120 with respect to all aspects of health and safety involved in a UST removal. In addition, the plan follows the Environmental Protection Agency (EPA) QAMS 005/80 (1980) format with the inclusion of the health and safety section (Sect. 15).
Burman, S.N.; Brown, K.S.; Landguth, D.C.
As part of the Underground Storage Tank Program at the Department of Energy`s Oak Ridge National Laboratory (ORNL) in Oak Ridge, Tennessee, this Health and Safety Plan has been developed for removal of the 110-gal leaded fuel underground storage tank (UST) located in the Building 3019B area at ORNL This Health and Safety Plan was developed by the Measurement Applications and Development Group of the Health and Safety Research Division at ORNL The major components of the plan follow: (1) A project description that gives the scope and objectives of the 110-gal tank removal project and assigns responsibilities, in addition to providing emergency information for situations occurring during field operations; (2) a health and safety plan in Sect. 15 for the Building 3019B UST activities, which describes general site hazards and particular hazards associated with specific tasks, personnel protection requirements and mandatory safety procedures; and (3) discussion of the proper form completion and reporting requirements during removal of the UST. This document addresses Occupational Safety and Health Administration (OSHA) requirements in 29 CFR 1910.120 with respect to all aspects of health and safety involved in a UST removal. In addition, the plan follows the Environmental Protection Agency (EPA) QAMS 005/80 (1980) format with the inclusion of the health and safety section (Sect. 15).
Christensen, Cathryn; Edward, Anbrasi
While demonstrating causality remains challenging, several 'health-peace' mechanisms have been proposed to describe how health systems contribute to peace-building and stability in post-conflict settings. A qualitative study was undertaken in southern Burundi to identify drivers of social tension and reconciliation in the catchment area of Village Health Works, a health services organisation. Key informant interviews and focus group discussions were conducted in early 2014 with a total of one hundred and twenty community members and staff representing a range of conflict and recovery experience. Themes emerging from these interviews indicated mechanisms at the individual, household, community, and regional levels through which health provision mitigates tensions and promotes social cohesion. This peace dividend was amplified by the clinic's integrated model, which facilitates further community interaction through economic, agricultural and education programmes. Land pressure and the marginalisation of repatriated refugees were cited as drivers of local tension.
Paul D. Juarez
Full Text Available The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training.
Karkee, R; Jha, N
The year 2008 has witnessed the global conversation to return to tenets of Alma-Ata and to review its 30 years of journey. We reviewed Nepal's journey on Primary Health Care development: policy formulation, structure development, progress and constraints. Though Nepal has institutionalised the PHC approach in health policy, strategy and health care delivery system, this has not been effectively translated into actions, and the results are mixed. Nepal has gained impressive achievements in selective primary health care markers: 45.43% maternal mortality and 62.34% child mortality reduction during 1990-2005. But gain in comprehensive health care markers is not impressive: 18.7% Skilled Birth Attendant (4% in poorest quintile and 45% in richest quintile), 39% having access to improved sanitation and 55.7% of females are literate as compared to males. Socio-political environment until recently was not favourable for comprehensive primary health care, allowing limited health sector decentralisation and community empowerment. Health activities were focussed more on selective health care strategy in the form of disease control, immunisation, vitamin A supplementation, oral rehydration solution use and contraceptive use. Nepal's rural hilly geography posed great challenge on logistic supply, communication and retention of health workers rendering public health centres of low quality with negative perceptions of consumers. Nepal is on the pathway to build equitable comprehensive primary health care.
Full Text Available Sport mega-events (SMEs involve struggles to determine the definition of legacy and the outcome priorities that guide legacy planning, funding, and implementation processes. History shows that legacies reflect the interests of capital, and legacy benefits are enjoyed primarily, if not exclusively, by powerful business interests, a few political leaders, and organizations that govern high performance sports. This paper addresses challenges faced by cities and countries that host SMEs, and shows that fair and equitable legacies and developmental outcomes are achieved only when the voices and interests of the general population are taken into account and given priority during the process of planning, funding and implementation. It also explains how full representation in the process of defining and achieving legacies and developmental outcomes may be undermined by populist beliefs about the power of sport.
Delnoij, D.M.J.; Klazinga, N.S.; Velden, K. van der
Background: Two questions are addressed.1): What are the views on health and health systems as expressed in the World Development Report 2000/2001 of the WB and the World Health Report 2000 and Health 21 of the World Health Organization, and how compatible are those views? 2): To what extent will co
Misra-Hebert, Anita D; Isaacson, J Harry
Health care disparities have multiple causes; the dynamics of the physician-patient encounter is one of the causes that can be modified. Here, we discuss specific recommendations related to cross-cultural communication and health literacy as practical steps to providing more equitable health care to all patients.
Van der Zwaan, B.; Petersen, A. (eds.)
The world is going through the profound changes of a demographic transition. Population growth is best taken care of when women and men are able to choose freely and responsibly their number of children. The most important aspects are the availability of reliable and safe means and the access women have to knowledge, resources and decision power. General education is a prerequisite. (Groningen Manifesto, statement no. 7). The current international, political, economic and financial order still primarily reflects the claims of international trade. There is a lack of public awareness as to the inescapable limits of the planet's resources and we hardly seem to be moving towards a sustainable and equitable world. The contributors to this volume provide an up-to-date and forceful exposition of this problematique. In the aftermath of the World Summit on Sustainable Development held in Johannesburg, they suggest topical ways to alter the world's course. The keys to reaching a sustainable world, in which the planet is equitably shared among humans and other species, are to consider the impact of our collective actions at longer timescales and to deal head-on with the interconnected issues of population pressure, consumption volume and species loss. The volume displays a multidisciplinary and multicultural approach involving both scientific and ethical arguments. It is of interest to a wide audience of scholars and concerned citizens. With contributions by: Ernst Ulrich von Weizsaecker, Friedrich Schmidt-Bleek, Johan van Klinken, Anne Ehrlich, Sergey Kapitza, Roefie Hueting, Jan van Hooff, Lucas Reijnders, Arthur Petersen, Bob van der Zwaan, Vandana Shiva, Radha Holla, Koo van der Wal, Bas de Gaay Fortman, Atiq Rahman and Jane Goodall.
Shah, Gulzar H.
Objective and Methods: The objective of this case study was to describe the process and outcomes of a small local health department's (LHD's) strategy to build and use information systems. The case study is based on a review of documents and semi-structured interviews with key informants in the Pomperaug District Health Department. Interviews were recorded, transcribed, coded, and analyzed. Results and Conclusions: The case study here suggests that small LHDs can use a low-resource, incremental strategy to build information systems for improving departmental effectiveness and efficiency. Specifically, we suggest that the elements for this department's success were simple information systems, clear vision, consistent leadership, and the involvement, training, and support of staff. PMID:27684628
... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Fair and equitable representation of members (section 17(b)(5) of the Act). 170.3 Section 170.3 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION REGISTERED FUTURES ASSOCIATIONS Standards Governing Commission Review of Applications for Registration as...
... participation of children and teachers in private schools? 299.7 Section 299.7 Education Regulations of the... EDUCATION GENERAL PROVISIONS Services to Private School Students and Teachers § 299.7 What are the factors for determining equitable participation of children and teachers in private schools? (a)...
Green, Terrance L.
Purpose: To equitably transform urban schools of color and the neighborhoods where they are nested requires approaches that promote community equity and foster solidarity among a range of stakeholders. However, most school-community approaches solely focus on improving school-based outcomes and leave educational leaders with little guidance for…
Smetana, Lara K.; Wenner, Julianne; Settlage, John; McCoach, D. Betsy
Science education reform may fall short of its potential to reduce educational disparities if the challenges are interpreted using strictly reductionist approaches. Taking a cue from school effectiveness research and reframing our approach using systems thinking, this study examined school-level variables associated with equitable science…
Hindhede, Anette Lykke
In empowerment and asset-based approaches to community development, the ability to change local residents’ perception of themselves and their neighbours from that of persons with needs that can only be met with the help of professionals to that of a more self-reliant group with assets......-building project aiming at increasing upward mobility and social capital within the area and increase equity in health. This presentation will outline the tensions and contradictions which accompany policies and interventions that seek to strengthen local communities as a means of promoting health. Emerging...
Full Text Available A building code, or building control, is a set of rules that specify the minimum standards for constructed objects such as buildings and non building structures. The main purpose of building codes are to protect public health, safety and general welfare as they relate to the construction and occupancy of buildings and structures. The building code becomes law of a particular jurisdiction when formally enacted by the appropriate governmental or private authority. Building codes are generally intended to be applied by architects, engineers, constructors and regulators but are also used for various purposes by safety inspectors, environmental scientists, real estate developers, subcontractors, manufacturers of building products and materials, insurance companies, facility managers, tenants and others.
Damp building-related illnesses (DBRI) include a myriad of respiratory, immunologic, and neurologic symptoms that are sometimes etiologically linked to aberrant indoor growth of the toxic black mold, Stachybotrys chartarum. Although supportive evidence for such linkages is limite...
Full Text Available The Chinese health system was once held up as a model for providing universal health care in the developing world in the 1970s, only to have what is now considered one of the least equitable systems in the world according to the World Health Organization. This article begins with a brief look at what equity in health services entails, and considers the inequities in access to health services in China among different segments of the population. This article will consider challenges the current inequities may present to China in the near future if reforms are not implemented. Finally, it will take a look at reforms made by China’s neighbors, Singapore and Thailand, which made their health care more equitable, affordable, and sustainable.
Bush, Paula Louise; García Bengoechea, Enrique
School-based physical activity programs are only effective for increasing adolescents' school-based physical activity. To increase out-of-school-time physical activity, complementary community programs are warranted. Partnerships between universities and community organizations may help build the capacity of these organizations to provide sustainable programs. To understand capacity building processes and outcomes, we partnered with a YMCA to build on their adolescent physical activity promotion capacity. Together, we designed and implemented means to evaluate the YMCA teen program to inform program planning. For this qualitative case study, emails and interviews and meetings transcripts were collected over 2.5 years and analyzed using inductive and deductive thematic analysis. Findings illustrate that the YMCA's workforce and organizational development capacities (e.g., evaluation and health promotion capacity and competence) were increased through our partnership, resource allocation, and leadership. We responded to YMCA partners' perceived needs, yet guided them beyond those needs, successfully combining our complementary objectives, knowledge, and skills to generate an integrated program vision, rationale, and evaluation results. This provided YMCA partners with validation, reminders, and awareness. In turn, this contributed to programming and evaluation practice changes. In light of extant capacity building literature, we discuss how our partnership increased the YMCA's capacity to promote healthy adolescent programs.
A growing number of community colleges are investing in new facilities and programs to train health care workers in a variety of professions, including nursing, radiology, health information technology, physical therapy, dentistry, and surgical technology. Community colleges have historically offered job training programs in health care, but with…
Coles, Emma; Watt, Celia; Freeman, Ruth
Objective: To use a qualitative exploration to evaluate whether "Something to Smile About" (STSA), an oral health intervention, had increased the oral health capacity of staff working with homeless people. Setting: A National Health Service board area in Scotland. Method: A purposive sample of 14 staff members from STSA-participating organizations…
Coles, Emma; Watt, Celia; Freeman, Ruth
Objective: To use a qualitative exploration to evaluate whether "Something to Smile About" (STSA), an oral health intervention, had increased the oral health capacity of staff working with homeless people. Setting: A National Health Service board area in Scotland. Method: A purposive sample of 14 staff members from STSA-participating…
[目的]通过对楼宇员工健康现况的调查、健康干预,评价在楼宇开展办公人员健康管理方法的有效性. [方法]对467名城市办公人员开展问卷调查、健康体检,将其中137名脂代谢和糖代谢障碍的办公人员分为干预组64人和对照组73人,进行综合性健康干预. [结果]经综合健康管理模式干预后的健康知识知晓率较干预前提高了11.7％,与对照组相比有明显提高. [结论] “三级医院技术指导—社区卫生服务中心实施与管理—街道相关部门协调支持—楼宇办公人员积极参与”的新型综合健康管理模式在健康促进方面有显著效果.楼宇健康管理应根据办公人员主要健康问题和需求,由社区卫生服务中心制定健康管理计划,协同楼宇工会、街道办事处等机构部门合作完成.%[Objective ] To compare health status of office workers in city buildings before and after health interventions, and to evaluate effectiveness of health management conducted in commercial buildings. [ Methods ] A total of 467 office workers participated in a questionnaire survey and physical examination, in which 137 with lipid metabolism and glucose metabolism disorders were divided into an intervention group (64) and a control group (73). The latter group received an integrated health intervention. [ R6SUltS ] After intervention, the awareness rate of health knowledge in the intervention group was significantly increased by 11.7%, compared with the control group. [ Conclusion ] The new mndel of integrated health management, which is technically directed by tertiary hospitals, implemented and managed by community health center, coordinated and supported by sub-district departments, and actively involves office workers, showed remarkable results on health promotion. Health management for office workers should be based on their major health problems and demands and be carried out with joint efforts of sectors mentioned above.
Roshi, Enver; Burazeri, Genc; Bjegovic, Vesna; Georgieva, Lidia; Donev, Doncho; Scintee, Gabriela; Hysa, Bajram; Laaser, Ulrich
The Albanian Forum of Public Health (AFPH), an umbrella organization including different public health associations operating in Albania, was established in March 2004 with the support of the European Public Health Association (EUPHA) and the Open Society Institute (OSI). Ever since its establishment the AFPH has been an open arena wherein opinions and options for rational health policies comprising all relevant issues of the New Public Health are discussed, formulated, and documented near the Albanian Ministry of Health. Notwithstanding the laudable mission of the AFPH, there is an emerging need to establish a regional Public Health Forum in south-east Europe as a basic prerequisite for sustainable development of public health in these countries. Most conveniently, this regional umbrella organization should have a supporting Secretariat based in one of the south-east European countries. Nevertheless, there is a clear call for international funding with participation of different agencies and bodies (OSI, EUPHA, Canadian International Development Agency, and the Stability Pact). A regional association in the south-east Europe would enable the organization of annual conferences in the most renowned institutions in the region. Also, a regional collaboration among public health associations would be a suitable start for the development of research in south-east Europe. Furthermore, the existence of a regional public health association would make feasible the establishment of a scientific public health journal for south-east Europe in the English language.
Miranda, J Jaime; Bernabé-Ortiz, Antonio; Diez-Canseco, Francisco; Málaga, Germán; Cardenas, María K; Carrillo-Larco, Rodrigo M; Pesantes, M Amalia; Araya, Ricardo; Boggio, Oscar; Checkley, William; García, Patricia J; León-Velarde, Fabiola; Lescano, Andrés G; Montori, Victor; Pan, William; Rivera-Chira, Maria; Sacksteder, Katherine; Smeeth, Liam; García, Héctor H; Gilman, Robert H
The CRONICAS Centre of Excellence in Chronic Diseases, based at Universidad Peruana Cayetano Heredia, was created in 2009 with support from the U.S. National Heart, Lung, and Blood Institute (NHLBI). The vision of CRONICAS is to build a globally recognized center of excellence conducting quality and innovative research and generating high-impact evidence for health. The center's identity is embedded in its core values: generosity, innovation, integrity, and quality. This review has been structured to describe the development of the CRONICAS Centre, with a focus on highlighting the ongoing translational research projects and capacity-building strategies. The CRONICAS Centre of Excellence is not a risk-averse organization: it benefits from past experiences, including past mistakes, and improves upon them and thus challenges traditional research approaches. This ethos and environment are key to fostering innovation in research.
Does the Dutch Building Decree 2012 guarantee air quality? Quality is essential for productivity and health; Bouwbesluit 2012 garantie voor luchtkwaliteit? Kwaliteit essentieel voor productiviteit en gezondheid
Poor indoor air quality in new buildings is a common problem. According to the Health Council scientific evidence is lacking that it is necessary to tighten ventilation requirements in the Building Decree . GGD Netherlands are advocates for stricter rules. Several studies show that the productivity in offices and the academic performance of children will benefit. [Dutch] Slechte kwaliteit van de binnenlucht in nieuwe gebouwen is een veel voorkomend probleem. Volgens de Gezondheidsraad ontbreken echter wetenschappelijke aanwijzingen dat het noodzakelijk is de ventilatie-eisen in het Bouwbesluit aan te scherpen. GGD Nederland pleit wel voor strengere regels. Diverse onderzoeken laten zien dat de productiviteit op kantoor en de leerprestaties van kinderen daarbij gebaat zijn.
Bekö, Gabriel; Clausen, Geo; Weschler, Charles J.
Estimates of costs and the corresponding benefits of particle filtration have been derived for a standard office building. Reduction in occupants’ exposure to particles during their workday is anticipated to reduce their morbidity and mortality. Filtration may also reduce the costs associated...... is impacted by maintenance of the building and its HVAC system; society is impacted by the employees’ health and welfare. Regardless of perspective, particle filtration is anticipated to lead to annual savings significantly exceeding the running costs for filtration. However, economic losses resulting from...... even a small decrease in productivity caused by sensory pollutants emitted from used ventilation filters have the potential to substantially exceed the annual economic benefits of filtration. Further studies are required to determine if meaningful benefits can be obtained from more frequent filter...
Bantjes, Jason; Rall, Divan; Ferreira, Suzanne; Blauwet, Cheri; Derman, Wayne
The Paralympic Movement explicitly sets out to create a more equitable society and promote participation for all and fairness in disability sport. This is primarily achieved through the use of a range of interventions with less attention given to how economic factors may hinder access and achievement in Paralympic sport. We investigated how country-level economic variables influence the level of participation and achievement in the 2015 International Paralympic Committee (IPC) Athletics Championships held in Doha. We used multiple regression analysis to show how levels of participation and achievement in the Championships were significantly determined by economic factors independent of population size. Our data show that in spite of the ideals of inclusion and fairness within the Paralympic Movement and the considerable effort expended on the use of technologies to achieve this, economic factors continue to exert a statistically significant influence on both the level of participation and achievement of Paralympic athletes. LMICs participate at lower levels and achieve fewer medals when compared to HICs. These differences are particularly marked in events that have a high cost of participation. Our findings raise questions regarding the use of current technologies and the level to which they are able to truly disrupt the politics of global inequality in sport. PMID:27941981
Shimada, M; Akazawa, K; Moriguchi, S; Odaka, T; Nose, Y
We developed a personal computer network system for the equitable allocation of cadaveric organs. This network consists of a host computer (IBM PS55 model 5570 T) and various kinds of personal computers manufactured by many different computer makers in Japan. The merits of our personal computer network include lower cost and an easy access to the host computer from all the centres participating in this network while using their own favourite personal computers. Among the programs made for allocating cadaveric organs, we present in this paper the program for livers. This program was developed with a modified version of the logic developed by Starzl et al. The grade modification for the United Network for Organ Sharing (UNOS) in the United States was used as the basis for classification of medical urgency. Our program weighed the factors of medical urgency, compatibility of blood group and waiting time. Distance factors were omitted because of the smaller area of the network compared to that of UNOS. This computer network would be linked to other computer networks in creating a national organ procurement and transplant network in Japan, in order to help them to catch up with other advanced transplant countries. Such an equal and objective computer system should allow organ transplantation to become more widely accepted.
Western China includes 12 provincial divisions (the 7 provinces of Sichuan, Guizhou,Yunnan, Shaanxi, Gansu, Qinghai and; 5 autonomous regions of Tibet, Ningxia, Xinjiang, Inner Mongolia and Guangxi; and one city of Chongqing), which comprise 71.4% of the national land area,28.5% of the national population and produce 17.5% of the national GDP in China. There are 17countries that have riparian relationships with western China, most of which are water-short countries. All are listed by UN ESCAP as countries with potential water crisis. The co-operative development and coordinated management of international rivers in western China is an important step toward the implementation of the national Great Western Development program. Taking into account of the national strategy and object hierarchy, as well as the development demand of the western region, it is necessary to pursue the multi-disciplinary study of the equitable allocation,utilisation, and eco-environment protection of transboundary water resources in the region. Such efforts will undoubtedly provide scientific evidence and support for the decision-making of the environmental protection and ecological construction and management in the western regions, the enforcement of the sub-regional economic co-operation, mitigation of trans-boundary conflicts, and enhancing bio-diversity conservation.
I.E.J. Bonfrer (Igna); Breebaart, L. (Lyn); De Poel, E.V. (Ellen Van)
textabstractIncreasing equitable access to health care is a main challenge African policy makers are facing. The Ghanaian government implemented the National Health Insurance Scheme in 2004 and the aim of this study is to evaluate its early effects on maternal and infant healthcare use. We exploit d
Peel’s vision launched in the 1920s when Qantas Airways (founded by an- other World War I Australian pilot) leased biplanes to a nascent health...jp5_0.pdf. 16. Mexican Commission on Macroeconomics and Health, Investing in Health for Economic Develop- ment ( Puebla , Mexico: Mexican Commission...and Lt Col Peter Garretson, “A Vision for Global Aviation Enterprise Development,” DISAM Journal, April 2014, http://www.disamjournal.org/articles
In this paper, we use the word "excitability" to denote degree that two players who play a continuous game have good luck and take a risk, respectively. Different continuous games can have different excitability. The greater excitability is, the smaller equitability is, and vise versa. We shall solve the questions: (1) What are mathematical descriptions of equitability and excitability? (2) How do players guarantee that their game result is the most equitable or the most excitable? (3) Which game should be picked from some given games if the players hope their game result is the most equitable or the most excitable?%本文用刺激性(感)来描述游戏一个零和对策的两个局中人的风险性和侥幸取胜性.游戏不同的零和对策可能有不同的刺激感.刺激性越大,对策结果的公平性越小;反之亦然.本文解决了如下问题:(1)刺激性和公平性的数学描述是什么?(2)局中人如何保证他们的一局对策的对策结果是最公平的或最有刺激感的?(3)如果两个局中人希望对策结果尽量公平或尽量有刺激感,他们最好从给定的连续对策中选择哪个?
Full Text Available Background. This article outlines a program of applied research and development known as Housing for Health that, over the period 1999–2012, targeted health-related improvements in housing for Indigenous householders in communities across regional and remote Australia. In essence, the program focuses on measuring the functionality of key appliances and structures (we term this “health hardware” against clear criteria and ensuring identified faults are fixed. Methods. Detailed survey and assessment of all aspects of housing was undertaken, particularly focusing on the function of health hardware. All results were entered into a database and analyzed. Results. The results demonstrate extremely poor initial performance of the health hardware. A key finding is that attention to maintenance of existing houses can be a cost-effective means of improving health outcomes and also suggests the need to superintend the health-conferring qualities of new infrastructure. We briefly outline the early foundations of the Housing for Health program, major findings from data gathered before and after improvements to household amenities, and our efforts to translate these findings into broader policy. Conclusions. These data demonstrate that simply injecting funds into housing construction is not sufficient for gaining maximum health benefit.
Aquilante, Aline Guerra; Aciole, Geovani Gurgel
This paper is a case study on the implementation of the Brazilian National Oral Health Policy (PNSB), known as "Smiling Brazil", in the cities of the Regional Health Department of Araraquara (DRS III) in São Paulo State. A structured questionnaire was given to the municipal oral health coordinators, an interview with oral health care professionals and managers was conducted, and the official data provided by the Brazilian Ministry of Health were coded to assess the policy's scope: (i) expansion and qualification of actions; (ii) work conditions; (iii) care; (iv) access; and (v) planning and management. The quantitative and qualitative analyses were linked by methods triangulation. In terms of PNSB implementation, the majority of the cities (52.6%) were classified as "good", with 42.1% classified as "bad". Approximately 10 years after launching the PNSB, despite strides in oral health care and access to different levels of care, the cities still experience difficulties in implementing the policy's principles.
Bolam, Bruce; McLean, Carl; Pennington, Andrew; Gillies, Pamela
The present article presents an exploratory qualitative process evaluation study of 'Ambassador' participation in CityNet, an innovative information-communication technology-based (ICT) project that aims to build aspects of social capital and improve access to information and services among disadvantaged groups in Nottingham, UK. A purposive sample of 40 'Ambassadors' interviewees was gathered in three waves of data collection. The two emergent analytic themes highlighted how improvements in confidence, self-esteem and social networks produced via participation were mitigated by structural problems in devolving power within the project. This illustrates how concepts of power are important for understanding the process of health promotion interventions using new media.
Franko, Debra L.
In this paper, I report the development of a mentoring program in a College of Health Sciences comprised of schools of nursing, pharmacy, and health professions (which include physical therapy, speech pathology and audiology, applied psychology, and physician assistant programs) at a large private university. Although university-wide mentoring…
Howze, Elizabeth H.; Auld, M. Elaine; Woodhouse, Lynn D.; Gershick, Jessica; Livingood, William C.
The Galway Consensus Conference articulated key definitions, principles, values, and core domains of practice as the foundation for the diffusion of health promotion across the globe. The conference occurred in the context of an urgent need for large numbers of trained health workers in developing countries, which face multiple severe threats to…
Kaffenberger, Carol J.; O'Rorke-Trigiani, Judith
Given that 20% of students experience mental health issues that interfere with school performance and most of these students will turn first to their school for help, school counselors need to consider how they can best serve this population. This article describes how school counselors can address the mental health needs of students by providing…
Extended-stay hotels are housing solutions for some older adults on the fringe of street homelessness. Research indicates that these environments can produce negative health outcomes for older adults. Strategies for managing negative environmental conditions must be identified to help older adults manage health outcomes. This paper describes a…
Vallee, A. [Paris-12 Univ., 94 - Creteil (France)
The author discusses the definition of an equitable division rule of the global effort of greenhouse gases emissions decrease, the research of the economic efficiency, the flexibility mechanisms and the emissions trading. (A.L.B.)
Schneider, T.; Sundell, Jan; Bischof, W.
The relevance of particle mass, surface area or number concentration as risk indicators for health effects in non-industrial buildings has been assessed by a European interdisciplinary group of researchers by reviewing papers identified in Medline, Toxline, and OSH. Studies dealing with dermal...... effects or cancer or specifically addressing environmental tobacco smoke, major allergens, and pesticides were excluded. Seventy-six papers were identified for evaluation and eight of these were judged to be conclusive and included in the final review: five experimental studies, two cross-sectional office...... studies, and a longitudinal study among elderly with cardiovascular conditions. Given the limited and inconclusive scientific evidence, the group concluded that indoor particulate mass or number concentrations cannot be used as generally applicable risk indicators of health effects in non...
尹爱田; 王文华; 杨文燕
Based on public policy nature and barrier analysis of rural health workforce building, we establish a theoretical frame from WHO health workforce strategy targets. From the four aspects of idea, model, action, measure, the policy recommendations conclude management policy, regulation policy, medical education policy and health workforce supporting policy.%文章以农村卫生人才建设的公共政策属性和对农村卫生人才建设的障碍分析为基础,基于世界卫生组织卫生人力战略目标建立理论框架,从思路、模式、行动、措施4个维度,提出建立和完善农村卫生人才管理政策、规制政策、医学教育政策和卫生人才支持政策的建议.
Ramírez, Denise Moreno; Vea, Lourdes; Field, James A; Baker, Paul B; Gandolfi, A Jay; Maier, Raina M
Community health workers (promotores de salud) have the ability to empower communities to mitigate negative health outcomes. Current training efforts in environmental topics are lacking. This project addressed this gap by developing 4 transferable training modules on environmental health. By applying a series of surveys, interviews, and trainings, we evaluated their relevance. Partners provided favorable feedback for 3 of the 4 modules. It was also learned that the development method could be improved by engaging technically trained promotores de salud in the role of co-creators. This project has implications for environmental justice communities as it can lessen information disparities.
Tyagi, H.; Gosain, A. K.; Khosa, R.; Anand, J.
Rivers have no regard for human demarcated boundaries. Besides, ever increasing demand-supply gap & vested riparian interests, fuel transboundary water conflicts. For resolving such disputes, appropriation doctrines advocating equity & fairness have received endorsement in the Helsinki Rules-1966 & UN Convention-1997. Thus, current study proposes the principle of equitable apportionment for sharing Ganges waters as it balances the interests & deservedness of all stakeholders, namely, India & its 11 states, Bangladesh, Nepal, & China. The study endeavors to derive a reasonable share of each co-basin state by operationalizing the vague concepts of fairness & equity through an objective & quantitative framework encompassing proportionality & egalitarianism for distributive & procedural justice. Equal weightage factors reflecting hydrology, geography & water use potential are chosen for fair share computation, wherein each contender ranks these factors to maximize his entitlement. If cumulative claims exceed the water availability, each claimant puts forth next ranked factor & this process continues till the claims match availability. Due to inter-annual variability in few factors, scenarios for Rabi & Kharif seasons are considered apart from cases for maximum, upper quartile, median, lower quartile & minimum. Possibility of spatial homogeneity & heterogeneity in factors is also recognized. Sometimes lack of technical information hinders transboundary dispute resolution via legal mechanisms. Hence, the study also attempts to bridge this gap between law & technology through GIS-based SWAT hydrologic model by estimating the Ganges water yield, & consequent share of each riparian for range of flows incorporating e-flows as well, under present & future climate & landuse scenarios. 82% of India's territory lies within interstate rivers, & therefore this research is very pertinent as it can facilitate the decision makers in effective interstate water conflict resolution.
Issa, M.H.; Rankin, J.H.; Christian, A.J. [Department of Civil Engineering, University of New Brunswick, PO Box 4400, Fredericton, New Brunswick (Canada)
Despite evidence suggesting conflicting views between practitioners and researchers when it comes to estimating the costs and financial benefits of green buildings, there exists no research work that has attempted to investigate practitioners' perception, and in particular Canadian practitioners', of the work conducted by researchers. To fill this gap in the literature, a web-based anonymous survey was administered to 1200 LEED accredited professionals in Canada to assess, among other things, practitioners' awareness, and confidence in research work assessing the cost premiums, long-term cost benefits, and health and productivity benefits of green buildings. The statistical analysis of the data using t-tests and mixed-model ANOVA tests showed that Canadian practitioners were still uncertain about results of the literature. Despite a slow change in attitudes the longer they worked in the field, practitioners continued to identify high cost premiums as the primary barrier to investing in green practices, and energy cost savings as the most important type of savings incurred in green buildings. The majority were uncertain about the size and impact of productivity and health benefits, and about how best to measure them. First-time adopters of LEED usually found the cost and complexity of the system prohibitive. Many believed that the decision to go green rested ultimately with the owner. That is why future research work needs to focus on improving knowledge transfer between practitioners and researchers and on improving the rigour and accuracy of the literature by using more empirical data, and getting practitioners to endorse research work in the field. (author) )
Full Text Available The different approaches are considered near the estimation of the state of health of students. General description of the state of health and activity of students is resulted on its maintenance. It is marked that different rejections have 30% students in a state of health, disease of temporal or permanent character. The students of the first course of university took part in research. It is set that unsatisfactory physical preparation is observed 43% students, good - at 37,2%, excellent at 20%. On the whole there is a tendency to the decline of motive activity of students of the I course, frequent violations of the mode of sleep and feed. The system of recommendations is developed for employments by a physical culture and sport. It is marked that for maintenance and optimization of resources of organism of students of the I course the correctly organized athletic health work is needed.
Bluyssen, P.M.; Roda, C.; Mandin, C.; Fossati, S.; Carrer, P.; Kluizenaar, Y. de; Mihucz, V.G.; Oliveira Fernandes, E. de; Bartzis, J.
In the European research project OFFICAIR, a procedure was developed to determine associations between characteristics of European offices and health and comfort of office workers, through a checklist and a selfadministered questionnaire including environmental, physiological, psychological, and soc
Hospital construction is a significant event in any health system. The financial implications are great, especially at a time of shrinking capital resources. Personnel are affected, as are the processes to perform their tasks. Often, new facilities are catalysts that change organizational culture; it has been clearly shown that new facilities have a positive impact on patient satisfaction scores. The members of the C-suite of a hospital/health system play important roles in construction projects. However, no one is more critical to the success of such major endeavors than the chief executive officer (CEO). The CEO sets the tone for the project, giving direction to the design and construction process that may have implications for the rest of the organization. Palomar Pomerado Health (PPH) is the largest public health district in California. In 2002, the PPH governing board authorized the creation of a new facility master plan for the district, which included the construction of a replacement facility for its tertiary care trauma center. The new Palomar Medical Center is slated to open in August 2012. HERD had the opportunity to speak with PPH CEO Michael H. Covert on the role of the CEO in the building of this "fable hospital".
Blazes David L
Full Text Available Abstract A cornerstone of effective global health surveillance programs is the ability to build systems that identify, track and respond to public health threats in a timely manner. These functions are often difficult and require international cooperation given the rapidity with which diseases cross national borders and spread throughout the global community as a result of travel and migration by both humans and animals. As part of the U.S. Armed Forces Health Surveillance Center (AFHSC, the Department of Defense’s (DoD Globa Emerging Infections Surveillance and Response System (AFHSC-GEIS has developed a global network of surveillance sites over the past decade that engages in a wide spectrum of support activities in collaboration with host country partners. Many of these activities are in direct support of International Health Regulations (IHR. The network also supports host country military forces around the world, which are equally affected by these threats and are often in a unique position to respond in areas of conflict or during complex emergencies. With IHR(2005 as the guiding framework for action, the AFHSC-GEIS network of international partners and overseas research laboratories continues to develop into a far-reaching system for identifying, analyzing and responding to emerging disease threats.
@@ Building Materials Sub-council of CCPIT is the other sub-council in construction field. CCPIT Building Materials Sub-council (CCPITBM), as well as CCOIC Build-ing Materials Chamber of Commerce, is au-thorized by CCPIT and state administration of building materials industry in 1992. CCPITBM is a sub-organization of CCPIT and CCOIC.
Sach Tracey H; Whynes David K; Yu Chai
Abstract Background Equitable financing is a key objective of health care systems. Its importance is evidenced in policy documents, policy statements, the work of health economists and policy analysts. The conventional categorisations of finance sources for health care are taxation, social health insurance, private health insurance and out-of-pocket payments. There are nonetheless increasing variations in the finance sources used to fund health care. An understanding of the equity implication...
Helen de Pinho
Helen de Pinho focuses on the tension between market-driven health sector reform processes post-1990 and those reforms necessary to ensure sexual and reproductive health as mediated through health systems that are rights based and equitable. She argues that sexual and reproductive health services depend on progressive realization of the right to sexual and reproductive health through fundamental and systemic changes to the health system, with a focus on shifting power dynamics to ensure peopl...
Nielsen, Kristian Fog; Frisvad, Jens Christian
as in future energy efficient buildings. It brings together different disciplinary points of view on indoor mold, ranging from physics and material science to microbiology and health sciences. The contents have been outlined according to three main issues: Fundamentals, particularly addressing the crucial...... for avoiding adverse health effects is the prevention (or minimization) of persistent dampness and microbial growth on interior surfaces and in building structures. This book aims to describe the fundamentals of indoor mold growth as a prerequisite to tackle mold growth in the existing building stock as well...
Shah, Alaap; Stewart, Andrew K; Kolacevski, Andrej; Michels, Dina; Miller, Robert
The ever-increasing volume of scientific discoveries, clinical knowledge, novel diagnostic tools, and treatment options juxtaposed with rising costs in health care challenge physicians to identify, prioritize, and use new information rapidly to deliver efficient and high-quality care to a growing and aging patient population. CancerLinQ, a rapid learning health care system in oncology, is an initiative of the American Society of Clinical Oncology and its Institute for Quality that addresses these challenges by collecting information from the electronic health records of large numbers of patients with cancer. CancerLinQ is first and foremost a quality measurement and reporting system through which oncologists can harness the depth and power of their patients' clinical records and other data to assess, monitor, and improve the care they deliver. However, in light of privacy and security concerns with regard to collection, use, and disclosure of patient information, this article addresses the need to collect protected health information as defined under the Health Insurance Portability and Accountability Act of 1996 to drive rapid learning through CancerLinQ.
Balcazar, Hector; Perez-Lizaur, Ana Bertha; Izeta, Ericka Escalante; Villanueva, Maria Angeles
This article takes a historical perspective combining 3 illustrative examples of the origins of the community health worker (CHW) model in Mexico, as a community-based participatory strategy. Three examples were identified from the sparse literature about CHWs in Mexico emphasizing their key roles and functions in various community settings. The CHW models illustrate what is known of training-development and planning, implementation, and evaluation of the CHWs model in different settings addressing cardiovascular disease and risk factors. The potential exists for integrating CHW projects to expand the health promotion model with new emphasis on municipality and regional participation.
McCarthy, Katharine; Ramarao, Saumya; Taboada, Hannah
Despite notable progress in Millennium Development Goal (MDG) five, to reduce maternal deaths three-quarters by 2015, deaths due to treatable conditions during pregnancy and childbirth continue to concentrate in the developing world. Expanding access to three effective and low-cost maternal health drugs can reduce preventable maternal deaths, if available to all women. However, current failures in markets for maternal health drugs limit access to lifesaving medicines among those most in need. In effort to stimulate renewed action planning in the post-MDG era, we present three case examples from other global health initiatives to illustrate how market shaping strategies can scale-up access to essential maternal health drugs. Such strategies include: sharing intelligence among suppliers and users to better approximate and address unmet need for maternal health drugs, introducing innovative financial strategies to catalyze otherwise unattractive markets for drug manufacturers, and employing market segmentation to create a viable and sustainable market. By building on lessons learned from other market shaping interventions and capitalizing on opportunities for renewed action planning and partnership, the maternal health field can utilize market dynamics to better ensure sustainable and equitable distribution of essential maternal health drugs to all women, including the most marginalized.
Hannah B Faal
Full Text Available In September 2000, world leaders made a commitment to build a more equitable, prosperous and safer world by 2015 and launched the Millennium Development Goals (MDGs. In the previous year, the World Health Organization and the International Agency for the Prevention of Blindness in partnership launched the global initiative to eliminate avoidable blindness by the year 2020-VISION 2020 the Right to Sight. It has focused on the prevention of a disability-blindness and recognized a health issue-sight as a human right. Both global initiatives have made considerable progress with synergy especially on MDG 1-the reduction of poverty and the reduction in numbers of the blind. A review of the MDGs has identified the need to address disparities within and between countries, quality, and disability. Noncommunicable diseases are emerging as a challenge to the MDGs and Vision 2020:0 the Right to Sight. For the future, up to and beyond 2015, there will be need for both initiatives to continue to work in synergy to address present and emerging challenges.
Cometto, Giorgio; Sheikh, Mubashar
The health workforce is in many countries the weakest link in the effective and equitable delivery of quality health services, and the largest impediment to the achievement of health Millennium Development Goals. The Kampala Declaration and Agenda for Global Action, championed by the Global Health Workforce Alliance, provide an effective overarching framework for the bold, concerted and sustained action which is required at the international, national and local level.
Weel, C. van; Rosser, W.W.
An invitational conference led by the World Organization of Family Doctors (Wonca) involving selected delegates from 34 countries was held in Kingston, Ontario, Canada, March 8 to12, 2003. The conference theme was "Improving Health Globally: The Necessity of Family Medicine Research." Guiding confer
Heffron, Mary Claire; Purcell, Arlene; Schalit, Jackie
Families In Recovery Staying Together (FIRST) is a team from Children's Hospital and Research Center at Oakland that has joined in collaboration with two local perinatal residential drug treatment programs to create early childhood mental health services at those sites. The authors highlight the collaboration strategies and challenges the partners…
Carrer, Paolo; Wargocki, Pawel; Fanetti, Annaclara
Objective of this paper is to examine whether the available epidemiological evidence provides information on the link between outdoor air ventilation rates and health, and whether it can be used for regulatory purposes when setting ventilation requirements for non-industrial built environments...
U. Suresh Kumar
Full Text Available The renewable energy potential of coastal areas of Tamil Nadu, India ranks along with the utmost in the world. This study proposes optimization and cost of energy of different hybrid renewable energy system to power a health clinic in that building. The National Renewable Energy Laboratory (NREL optimization computer model for distributed power, “HOMER,” is used to estimate the optimization and its cost of energy. The implementation of RE systems to supply Rural Health Clinics will contribute to reduce both electricity generation cost and to reduce the consumption of fuel while improving health care and quality of life in these isolated coastal regions. We conclude that using the PV+Wind+Diesel+Battery system for these types of applications in justified on technical and economic grounds. The experimental results show that the least cost of energy at Rs 5.00/KWh, is obtained from above said system and also experiment result shows that the COE decreases with 0% of interest. It is noted, that the PV+Wind+Diesel+Battery hybrid system shows the lowest COE and high amount of Renewable energy.
适应大健康战略的要求，医疗保险要顺势而为，建立符合大健康要求的医保规则体系，明确规则为何人所定、依何而定、缘何来定；建立适应多样化诉求的包容性制度和管理机制，由基本医保“一家独大”到实现多层次协调发展；建立坚守与创新相统一的制度政策和管理运行机制，在“变与不变”中推进全民医保更加公平更可持续；建立多方参与相互协同的治理机制，实现多方共同发展；建立运行高效的监管体系，明确监管责任、强化内部监管、树立法治思维、推进社会监督，助推大健康战略实施，提升人民健康水平。%To response to the call for Big Health, Health Insurance should establish rules meeting the requirement of Big Health, in which to specify that for who and by what reason the rules was defined. It also need to build a harmonious system and management mechanism which can match multiple demands, and the situation of basic medical insurance dominating alone can be changed to that of multi-level coordinative development;set up a policy and operation mechanism unified with conservation and innovation to promote the policy of Insurance for All more fairly and sustainably developed;establish a management mechanism with the coordination and involvement of multi-departments to achieve the goal of co-win;and build an eﬃcient supervision system, which should define supervision responsibility, strengthen internal regulation, build legal thoughts, and promote social supervision. As a result, it will promote the achievement of Big Health, and increase people’s health level.
Barclay-Goddard, Ruth; King, Judy; Dubouloz, Claire-Jehanne; Schwartz, Carolyn E
A major goal of treatment for people living with chronic illness or disability is self-management leading to optimized health-related quality of life. This change process has been described in the adult education literature as transformative learning, while in health-related quality of life research, response shift has emerged as a key concept. Response shift and transformative learning literature were reviewed, and the theoretical frameworks of the 2 concepts were compared and contrasted. Response shift is described as a change in internal standards, values, or definition of a construct (eg, health-related quality of life) over time, commonly seen in individuals with chronic illness. In the context of chronic illness, transformative learning is described as a complex process of personal change including beliefs, feelings, knowledge, and values. Transformative learning is often triggered by the diagnosis of a chronic illness. This results in a critical reflection of taken-for-granted assumptions and leads to new ways of thinking, influencing personal changes in daily living. Comparing the models of response shift and transformative learning in chronic illness, the catalyst in response shift appears comparable with the trigger in transformational learning; mechanisms to process of changing; and perceived quality of life to outcomes. Both transformative learning and response shift have much to offer health care providers in understanding the learning process for the person living with chronic illness or disability to optimize their quality of life. Suggestions for future research in response shift and transformative learning in individuals with chronic health conditions and disability are proposed.
Sheth, Manali J.
Students of color are routinely asked to participate in science education that is less intellectually rich and self-affirming. Additionally, teachers have trouble embarking on professional growth related to issues of equity and diversity in science. The purpose of this dissertation research is to develop a multi-dimensional framework for equitable science pedagogy (ESP) through analyzing the efforts and struggles of high school science teachers. This study is grounded in a conceptual framework derived from scholarship in science education, multicultural education, critical science studies, and teacher learning. The following questions guide this research: 1) What visions and enactments emerge in teachers' practices towards equitable science pedagogy? 2) How are teachers' practice decisions towards ESP influenced by their personal theories of race/culture, science, and learning and sociocultural contexts? 3) Why are there consistencies and variances across teachers' practices? This study employs a qualitative multiple case study design with ethnographic data collection to explore the practices of three urban high school science teachers who were identified as being committed to nurturing the science learning of students of color. Data include over 120 hours of classroom observation, 60 hours of teacher interviews, and 500 teacher- and student-generated artifacts. Data analysis included coding teachers' practices using theory- and participant generated codes, construction of themes based on emergent patterns, and cross-case analysis. The affordances and limitations of the participants' pedagogical approaches inform the following framework for equitable science pedagogy: 1) Seeing race and culture and sharing responsibility for learning form foundational dimensions. Practices from the other three dimensions--- nurturing students' identities, re-centering students' epistemologies, and critiquing structural inequities---emerge from the foundation. As emergent practices
Zimmerer, L W; Zimmerer, T W; Yasin, M M
Several of the manufacturing-based philosophies, techniques and tools, such as Total Quality Management (TQM), Continuous Improvement (CI), Business Process Reengineering (BPR) and Time-based Competition (TBC) have been successfully adapted for use within the service sector. Diverse service industries including airlines, insurance, food services and hospitality have increased customer satisfaction and performance through the use of the quality driven, manufacturing-based philosophies. This article explores the reasons for the limited success of TQM/CI, BPR, TBC and benchmarking within the health care industry. Sixteen barriers to change are identified, possible counter-measures to these barriers are outlined and two conceptual frameworks are offered as possible facilitators of change for the health care industry.
Pamela Payne Foster
Full Text Available The Black Church has long been purported as being strongly influential in the lives of Blacks in America. Recent U.S. census data trends highlight a “reverse migration” pattern where Blacks are moving back to the South from larger metropolitan areas in other U.S. geographical regions. This migration pattern parallels the increasing HIV/AIDS prevalence among Blacks in the Deep South. This paper reviews both the historical and current migration patterns among Blacks, as well as the current HIV/AIDS epidemic among Blacks in the Deep South. Thereafter, the authors discuss an existing framework for increasing HIV/AIDS prevention capacity through a conceptual connection of migration, religion and sexual health. The authors use case studies to support the proposed framework. It is hoped that the framework could be used to address HIV/AIDS health disparities and other chronic diseases affecting Blacks in America.
Riley, Barbara; Harvey, Jean; Di Ruggiero, Erica; Potvin, Louise
Population health intervention research (PHIR) is a relatively new research field that studies interventions that can improve health and health equity at a population level. Competencies are one way to give legitimacy and definition to a field. An initial set of PHIR competencies was developed with leadership from a multi-sector group in Canada. This paper describes the development process for these competencies and their possible uses. Methods to develop the competencies included key informant interviews; a targeted review of scientific and gray literature; a 2-round, online adapted Delphi study with a 24-member panel; and a focus group with 9 international PHIR experts. The resulting competencies consist of 25 items grouped into 6 categories. They include principles of good science applicable though not exclusive to PHIR, and more suitable for PHIR teams rather than individuals. This initial set of competencies, released in 2013, may be used to develop graduate student curriculum, recruit trainees and faculty to academic institutions, plan non-degree professional development, and develop job descriptions for PHIR-related research and professional positions. The competencies provide some initial guideposts for the field and will need to be adapted as the PHIR field matures and to meet unique needs of different jurisdictions.
Full Text Available Abstract Laboratory is one of the core capacities that countries must develop for the implementation of the International Health Regulations (IHR since laboratory services play a major role in all the key processes of detection, assessment, response, notification, and monitoring of events. While developed countries easily adapt their well-organized routine laboratory services, resource-limited countries need considerable capacity building as many gaps still exist. In this paper, we discuss some of the efforts made by the African Field Epidemiology Network (AFENET in supporting laboratory capacity development in the Africa region. The efforts range from promoting graduate level training programs to building advanced technical, managerial and leadership skills to in-service short course training for peripheral laboratory staff. A number of specific projects focus on external quality assurance, basic laboratory information systems, strengthening laboratory management towards accreditation, equipment calibration, harmonization of training materials, networking and provision of pre-packaged laboratory kits to support outbreak investigation. Available evidence indicates a positive effect of these efforts on laboratory capacity in the region. However, many opportunities exist, especially to support the roll-out of these projects as well as attending to some additional critical areas such as biosafety and biosecuity. We conclude that AFENET’s approach of strengthening national and sub-national systems provide a model that could be adopted in resource-limited settings such as sub-Saharan Africa.
Schneider, T.; Sundell, Jan; Bischof, W.
The relevance of particle mass, surface area or number concentration as risk indicators for health effects in non-industrial buildings has been assessed by a European interdisciplinary group of researchers (called EUROPART) by reviewing papers identified in Medline, Toxline, and OSH. Studies...... dealing with dermal effects or cancer or specifically addressing environmental tobacco smoke, house dust-mite, cockroach or animal allergens, microorganisms and pesticides were excluded. A total of 70 papers were reviewed, and eight were identified for the final review: Five experimental studies involving...... mainly healthy subjects, two cross-sectional office studies and one longitudinal study among elderly on cardiovascular effects. From most studies, no definite conclusions could be drawn. Overall, the group concluded that there is inadequate scientific evidence that airborne, indoor particulate mass...
Gabriela Guerra Gonze
Full Text Available A integralidade da assistência, um dos princípios doutrinários do sistema de saúde brasileiro, constitui uma das principais metas para se alcançar uma assistência de qualidade e humanizada. O presente trabalho tem por objetivo analisar a percepção dos professores dos cursos de graduação que formam profissionais de saúde na Universidade Federal de Juiz de Fora, sobre a formação orientada pela integralidade. Trata-se de uma pesquisa qualitativa, na qual foi utilizada a técnica da entrevista semiestruturada com docentes dos referidos cursos. Como estratégia de análise dos dados, propõese a modalidade de análise temática. A categoria em torno da qual são trazidas as reflexões sobre a percepção dos docentes sobre o ensino voltado para o princípio da integralidade foi nomeada "os princípios do SUS orientando a formação". Os resultados do estudo apontam que os docentes expressam um envolvimento com os valores da Reforma Sanitária brasileira, no contexto das mudanças necessárias na formação em saúde.Integral healthcare, one of the doctrinal principles of the Brazilian health care system, is one of the main ways to reach high-quality and humanized care. This work aims to analyze the perception of teachers of undergraduate courses who train health professionals at Juiz de Fora Federal University, Brazil, when it comes to integral care-oriented training. It is a qualitative research, employing the semi-structured interview technique with teachers of the studied courses. The thematic analysis is suggested as the data analysis method. The reflections on the perception of teachers about the principle of the integral healthcare have been centered on the category "trainingorienting principles of the Unified Health System". The study results show that teachers express involvement with the Brazilian Health Reform values, in the context of necessary changes in health training.
Anderson, Ludmila; Foster, Scot; Flynn, Regina; Fitterman, Mindy
The New Hampshire Obesity Prevention Program and the 9 New Hampshire regional planning commissions assessed the state's obesity-related policies and assets by using community measures recommended by the Centers for Disease Control and Prevention. A self-administered questionnaire that focused on policies and assets that promote healthful eating, physical activity, and breast-feeding was sent to 234 municipalities; 59% responded (representing 73% of the state's population). Of the municipalities that responded, 52% had sidewalks, 22% had bicycle lanes, none had nutrition standards, and 4% had a policy supporting breastfeeding. Through collaboration, we gathered baseline information that can be used to set priorities and assess progress over time.
Full Text Available This article explores the relationship between the biological dimension of diseases and self-care practices or “healthy behaviors.” Its central question examines how a seemingly biological phenomenon creates certain “good” health practices, supporting the idea of disease as a socio-cultural issue rather than a mere biological fact. The current study is based on a research project focusing on two diseases, dengue and H1N1 influenza A, undertaken in Cali, Colombia during 2009 and 2010. An examination of the relevance that these two diseases have acquired shows how biology and self-care practices are closely related.
Kawakami, Tsuyoshi; Van, Vhu Nhu; Theu, Nguyen Van; Khai, Ton That; Kogi, Kazutaka
The government of Viet Nam places a high priority on upgrading the quality of farmers' lives. Providing adequate occupational safety and health (OSH) protection for all farmers is an important challenge. The Ministry of Labour, Invalids and Social Affairs (MOLISA) of Viet Nam trained WIND (Work Improvement in Neighbourhood Development) farmer volunteers. From 2004-2007, MOLISA in cooperation with ministries of health and agriculture trained 480 WIND farmer volunteers in selected 14 provinces. Trained farmer volunteers trained their neighbouring farmers and expanded their networks. The WIND training programme produced in Cantho, Viet Nam in 1996, was used as the core training methodology. The WIND action-checklist, good example photo-sheets, and other participatory training materials were designed for WIND farmer volunteers as practical training tools. The volunteers trained 7,922 farmers. The trained farmers implemented 28,508 improvements in materials handling, work posture, machine and electrical safety, working environments and control of hazardous chemicals, and welfare facilities. The provincial support committees organized follow-up workshops and strengthen the WIND farmer volunteer networks. The system of WIND farmer volunteers proved effective in extending practical OSH protection measures to farmers at grassroots level. The system of WIND farmer volunteers was adopted in the First National Programme on Labour Protection and OSH of Viet Nam as a practical means in OSH and is now further expanding within the framework of the National Programme.
Izenberg, Jacob M; Fullilove, Mindy Thompson
The aim of this study was to investigate the contribution of main streets to community social cohesion, a factor important to health. Prior work suggests that casual contact in public space, which we call "sociability," facilitates more sustained social bonds in the community. We appropriate the term "hospitality" to describe a main street's propensity to support a density of such social interactions. Hospitality is a result of the integrity and complex contents of the main street and surrounding area. We examine this using a typology we term "box-circle-line" to represent the streetscape (the box), the local neighborhood (the circle), and the relationship to the regional network of streets (the line). Through field visits to 50 main streets in New Jersey and elsewhere, and a systematic qualitative investigation of main streets in a densely interconnected urban region (Essex County, New Jersey), we observed significant variation in main street hospitality, which generally correlated closely with sociability. Physical elements such as street wall, neighborhood elements such as connectivity, inter-community elements such as access and perceived welcome, and socio-political elements such as investment and racial discrimination were identified as relevant to main street hospitality. We describe the box-circle-line as a theoretical model for main street hospitality that links these various factors and provides a viable framework for further research into main street hospitality, particularly with regard to geographic health disparities.
Kobeissi, M A; El-Samad, O; Rachidi, I
Measurements of specific activities (Bq kg(-1)) of gamma-emissions from radioactive nuclides, (238)U, (226)Ra, (214)Bi, (232)Th, (212)Pb and (40)K, contained in 28 granite types, used as building materials in indoors in Lebanon, were performed on the powdered granites. The concentration of the nuclides, (226)Ra, (232)Th and (40)K, in the granites varied from below detection level (BDL) to 494 Bq kg(-1), BDL to 157.2 Bq kg(-1) and BDL to 1776 Bq kg(-1), respectively. (226)Ra concentration equivalents, C(Raeq), were obtained and ranged between 37 and 591 Bq kg(-1), with certain values above the allowed limit of 370 Bq kg(-1). Calculated annual gamma-absorbed dose in air, D(aR), varied from 17.7 to 274.5 (nGy h(-1)). Annual effective dose, E (mSv y(-1)), of gamma radiations related to the studied granites and absorbed by the inhabitants was evaluated. E (mSv y(-1)) ranged from 0.09 to 1.35 mSv y(-1). Some granite types produced E above the allowed limit of 1 mSv y(-1) set by ICRP. Values of (222)Rn mass exhalation rate, E(M) (mBq kg(-1)h(-1))(,) in granite powder were obtained using the CR-39 detector technique. Diffusion factors, f, in 23 granite types were calculated with f ranging between (0.1 ± 0.02)×10(-2) and (6.6 ± 1.01)×10(-2).
Lin, E.; Balogh, R.; Cobigo, V.; Ouellette-Kuntz, H.; Wilton, A. S.; Lunsky, Y.
Background: Individuals with intellectual and developmental disabilities (IDD) experience high rates of physical and mental health problems; yet their health care is often inadequate. Information about their characteristics and health services needs is critical for planning efficient and equitable services. A logical source of such information is…
Health Law is a legal science that study the health law (normative law ),and the phenomenon of the law (law of life )and its related issues. Through the phenomenon of the health law ,we can find that pursuing human health is the best interest of the health law, the essence of the health law views social welfare as the legal interest, and its essence is to make health service more equitable. Building the basic law that regards the health right as the core is the top priority of health law.%卫生法学是研究卫生法、卫生法的现象及其与卫生法相关问题的一门法律科学.透过卫生法现象不难发现,卫生法以追求人的生命健康为最大利益,卫生法的本质是以社会公益为法益的法律,其实质就是让卫生服务更加公平.制定以健康权为核心的卫生基本法是卫生法学的重中之重.
Novillo-Ortiz, David; D'Agostino, Marcelo; Becerra-Posada, Francisco
Political will and adoption of measures toward the use of eHealth have been steadily increasing, facilitating mobilization of resources necessary to adopt and implement digital services that will make it possible to improve access, expand coverage, and increase financial efficiency of health care systems. Adoption of the Strategy and Plan of Action on eHealth of the Pan American Health Organization (PAHO) in 2011 by all Member States in the Region of the Americas has led the Region to major progress in this regard, including the following: creation of knowledge networks and development of information sources, establishment of eHealth sustainability models, support for development of electronic health records, promotion of standards on health data and related technologies that ensure exchange of information, use of mobile devices to improve health, and improvement in quality of care through telemedicine. This article details the main actions carried out by PAHO with regard to eHealth, specifically by the office of Knowledge Management, Bioethics, and Research in the 2011-2015 period (first period of implementation of the PAHO eHealth strategy and plan of action), which include research and capacity-building activities, development of technical guidelines, and formation of knowledge networks. RESUMEN La voluntad política y la adopción de medidas en relación con el uso de la eSalud han ido en aumento de forma constante, favoreciendo la movilización de los recursos necesarios a fin de adoptar y poner en marcha servicios digitales que permitan mejorar el acceso, ampliar la cobertura y aumentar la eficiencia financiera de los sistemas de atención de salud. Con la aprobación de la Estrategia y Plan de Acción de eSalud de la Organización Panamericana de la Salud (OPS) en 2011 por todos los Estados Miembros de la Región de las Américas, se han realizado importantes avances a este respecto en la Región, entre los que se destacan: la creación de redes de
Full Text Available Abstract Background A commitment to Electronic Health Record (EHR systems now constitutes a core part of many governments’ healthcare reform strategies. The resulting politically-initiated large-scale or national EHR endeavors are challenging because of their ambitious agendas of change, the scale of resources needed to make them work, the (relatively short timescales set, and the large number of stakeholders involved, all of whom pursue somewhat different interests. These initiatives need to be evaluated to establish if they improve care and represent value for money. Methods Critical reflections on these complexities in the light of experience of undertaking the first national, longitudinal, and sociotechnical evaluation of the implementation and adoption of England’s National Health Service’s Care Records Service (NHS CRS. Results/discussion We advance two key arguments. First, national programs for EHR implementations are likely to take place in the shifting sands of evolving sociopolitical and sociotechnical and contexts, which are likely to shape them in significant ways. This poses challenges to conventional evaluation approaches which draw on a model of baseline operations → intervention → changed operations (outcome. Second, evaluation of such programs must account for this changing context by adapting to it. This requires careful and creative choice of ontological, epistemological and methodological assumptions. Summary New and significant challenges are faced in evaluating national EHR implementation endeavors. Based on experiences from this national evaluation of the implementation and adoption of the NHS CRS in England, we argue for an approach to these evaluations which moves away from seeing EHR systems as Information and Communication Technologies (ICT projects requiring an essentially outcome-centred assessment towards a more interpretive approach that reflects the situated and evolving nature of EHR seen within
图书馆平等服务是新世纪以来我国图书馆界倡导的重要理念。文章探讨了对这种理念的认知，我国图书馆界倡导平等理念的意义，以及对图书馆平等服务的深层思考。%Library equitable service is the important concept to advocate in library circle of our country since the new century . This paper discusses the cognition of the concept , significance to advocate the equitable concept in library circle of our country and deep thinking on library equitable service.
Timberlake, S.; Helbig, T.; Fernando, S.; Penn, K.; Alm, E.; Thompson, F.; Thompson, J. R.
The coral reefs of the Abrolhos Bank of Brazil play a vital ecological role in the health of the Southern Atlantic Ocean, but accelerating rates of disease, particularly white plague, threaten this ecosystem. Thus, an understanding of white plague disease and diagnostic tests for it are urgently needed. The coral animal is associated with a distinct microbiome, a diverse assemblage of eukaryotes, bacteria, and viruses. That these microbes have a great influence on the health of the coral has been long known, however, most of their functions are still mysterious. While recent studies have contrasted healthy and white-plague-associated communities, the causative agents and mechanisms of the disease remain unknown. We collected fragments of healthy and diseased corals, as well as post-disease skeleton, from 12 colonies of the genus Mussismilia, the major component of the reef structure in the Abrolhos bank, and increasingly, a victim of white-plague disease. Fragments were flash-frozen in situ, and prepped for culture-free high throughput sequencing of gene transcripts with the Illumina II-G. While the membership of the microbial communities associated with coral has been previously described, the a coral holobiont community's gene function has, to date, never been assayed by this powerful approach. We designed a bioinformatics pipeline to analyze the short-read data from this complex sample: identifying the functions of genes expressed in the holobiont, and describing the active community's taxonomic composition. We show that gene functions expressed by the coral's bacterial assemblage are distinct from those of the underlying skeleton, and we highlight differences in the disease samples. We find that gene markers for the dissimilatory sulfate reduction pathway more abundant in the disease state, and we further quantify this difference with qPCR. Finally, we report the abundant expression of highly repetitive transcripts in the diseased coral samples, and highlight
IBACOS researched the constructability and viability issues of using high performance windows as one component of a larger approach to building houses that achieve the Building America 70% energy savings target.
In my thesis I describe the utilization of solar energy and solar energy with building integration. In introduction it is also mentioned how the solar building works, trying to make more people understand and accept the solar building. The thesis introduces different types of solar heat collectors. I compared the difference two operation modes of solar water heating system and created examples of solar water system selection. I also introduced other solar building applications. It is conv...
Full Text Available OBJECTIVES: Studies have widely documented the socioeconomic inequalities in maternal and child health related outcomes in developing countries including India. However, there is limited research on the inequalities in advice provided by public health workers on maternal and child health during antenatal visits. This paper investigates the inequalities in advice provided by public health workers to women during antenatal visits in rural India. METHODS AND FINDINGS: The District Level Household Survey (2007-08 was used to compute rich-poor ratios and concentration indices. Binary logistic regressions were used to investigate inequalities in advice provided by public health workers. The dependent variables comprised the advice provided on seven essential components of maternal and child health care. A significant proportion of pregnant women who attended at least four ANC sessions were not advised on these components during their antenatal sessions. Only 51%-72% of the pregnant women were advised on at least one of the components. Moreover, socioeconomic inequalities in providing advice were significant and the provision of advice concentrated disproportionately among the rich. Inequalities were highest in the case of advice on family planning methods. Advice on breastfeeding was least unequal. Public health workers working in lower level health facilities were significantly less likely than their counterparts in the higher level health facilities to provide specific advice. CONCLUSION: A significant proportion of women were not advised on recommended components of maternal and child health in rural India. Moreover, there were enormous socioeconomic inequalities. The findings of this study raise questions about the capacity of the public health care system in providing equitable services in India. The Government of India must focus on training and capacity building of the public health workers in communication skills so that they can deliver
The article presents a paradigm current in contemporary medical anthropology - Critical Medical Anthropology (CMA), which merges political-economic approaches with a culturally sensitive analysis of human behaviour grounded in anthropological methods. It is characterized by a strongly applied orientation and a devotion to improving population health and promoting health equity. The beginning of CMA dates back to the 1970s when the interdisciplinary movement called the political economy of health was developed. Today, CMA has grown into one of three major perspectives used in anthropological research devoted to health, illness and wellbeing. The author discusses the origins, key concepts and CMA's usefulness for social research, and its significance for the design of effective policies in the realm of public health. Examplary interventions and ethnographic researches are introduced and wider usage is advocated of such works and methods by bureaucrats and medical staff for understanding the patients' behavior, and the influence of social, economic and political factors on the workings of particular health systems.
Edward G. Lyon
Full Text Available One way to view ‘equitable pedagogy’ is through an opportunity to learn (OTL lens, meaning that regardless of race, class, or culture, a student has access to rigorous and meaningful content, as well as appropriate resources and instruction necessary to learn and demonstrate understanding of that content. Assessment holds a unique position in the classroom in that it can both uncover whether inequitable conditions exist (i.e., performance gaps, denied OTL and provide an OTL by mediating communication between teacher and students regarding learning progress and what is important to learn. Nevertheless, individuals entering teacher education programs often hold deficit views toward marginalized students, such as Language Minorities (LMs, believe that assessment strictly serves to evaluate learning, and do not do consider how language and culture influence student thinking–views supplanting assessment’s role at supporting an equitable pedagogy for LMs. Through surveys, interviews, program artifacts, and classroom observation, I report on a case study of one pre-service physics teacher, Dean, to depict how his expertise at assessing science did evolve throughout his yearlong teacher education program in terms of (a becoming more knowledgeable of the role of language and (b developing a belief in incorporating ‘discourse’ while assessing science. Within the case study, I analyze one particular episode from Dean’s teaching practicum to highlight remaining challenges for pre-service teachers to integrate science and language in classroom assessment—namely, interpreting students’ use of language along with their understanding of core science ideas. The findings underscore the need for connecting language and equity issues to content-area assessment in teacher preparation.
Full Text Available Abstract Background Relative to the amount of global attention and media coverage since the first and second Gulf Wars, very little has been published in the health services research literature regarding the state of health services in Iraq, and particularly on the semi-autonomous region of Kurdistan. Building on findings from a field visit, this paper describes the state of health services in Kurdistan, analyzes their underlying governance structures and policy processes, and their overall impact on the quality, accessibility and cost of the health system, while stressing the importance of reinvesting in public health and community-based primary care. Discussion Very little validated, research-based data exists relating to the state of population health and health services in Kurdistan. What little evidence exists, points to a region experiencing an epidemiological polarization, with different segments of the population experiencing rapidly-diverging rates of morbidity and mortality related to different etiological patterns of communicable, non-communicable, acute and chronic illness and disease. Simply put, the rural poor suffer from malnutrition and cholera, while the urban middle and upper classes deal with issues of obesity and Type 2 diabetes. The inequity is exacerbated by a poorly governed, fragmented, unregulated, specialized and heavily privatized system, that not only leads to poor quality of care and catastrophic health expenditures, but also threatens the economic and political stability of the region. There is an urgent need to revisit and clearly define the core values and goals of a future health system, and to develop an inclusive governance and policy framework for change, towards a more equitable and effective primary care-based health system, with attention to broader social determinants of health and salutogenesis. Summary This paper not only frames the situation in Kurdistan in terms of a human rights or special political
Nowak, Sarah; Eibner, Christine
The Affordable Care Act's "Cadillac tax" will apply a 40 percent excise tax on total employer health insurance premiums in excess of $10,200 for single coverage and $27,500 for family coverage, starting in 2018. Employer spending on premiums is currently excluded from income and payroll taxes. Economists argue that this encourages overconsumption of health care, favors high-income workers, and reduces federal revenue. This issue brief suggests that the Cadillac tax is a "blunt instrument" for addressing these concerns because it will affect workers on a rolling timetable, does relatively little to address the regressive nature of the current exclusion, and may penalize firms and workers for cost variation that is outside their control. Replacing the current exclusion with tax credits for employer coverage that scale inversely with income might allow for regional adjustments in health care costs and eliminate aspects of the tax exclusion that favor high-income over low-income workers.
Makaula, Peter; Bloch, Paul; Banda, Hastings T.;
Primary Health Care (PHC) is a strategy endorsed for attaining equitable access to basic health care including treatment and prevention of endemic diseases. Thirty four years later, its implementation remains sub-optimal in most Sub-Saharan African countries that access to health interventions is...
... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Fair and equitable treatment for holders of each class or series of stock of series investment companies. 270.18f-2 Section 270.18f-2 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) RULES AND REGULATIONS, INVESTMENT COMPANY ACT OF 1940 §...
[Definition and adoption of a building code based on biological and ecological sustainability in the Local Health Authority 11 of Empoli (Tuscany Region, Central Italy): strengths and areas for improvement].
Petronio, Maria Grazia; Battisti, Francesca
Built environment is an important social determinant of health, but nowadays local health authorities (LHAs) have lost their competences in the issuing of building permits, especially since a new legislation introduced the possibility of personal declaration of conformity. They are also usually excluded from the urban planning process. At the same time, in recent years construction of buildings has been developed with insufficient regard to environmental health requirements, proper exposure to sunlight and winds, comfort, building materials, consumption of resources, and waste production. To deal with these issues, an interdepartmental working group was set up under the direction of the Department of Prevention of the LHA of Empoli (Tuscany Region, Central Italy), with members of the Regional Environmental Protection Agency, along with experts of the 15 Municipalities included in the LHA territory and members of other local institutions. The objective of the Working Group was to define and propose as mandatory a set of rules for local governments aimed at regulating construction activities according to criteria of environmental sustainability, eco-efficiency, comfort, and healthiness of living areas, at the same time encouraging the responsible use of natural resources, the reduction of energy consumption and the use of renewable energy sources in order to place environmental safety and health at the heart of all building activities. Experts of six Municipalities joined the working group and the regulation framework was adopted (and made legally binding) in 8 out of 15 Municipalities, with an almost complete overlap with participation in the working group. The active participation of experts, whose work consists in examining municipal building, permits, and declarations, has therefore marked the difference in the transition from theory to practice. The level of know-how attained by the participants and their motivation and enthusiasm have been so relevant in the
Chng, Chwee Lye
Many males still perceive contraception as a woman's responsibility. This paper describes male contraceptives and their effectiveness and draws implications for school and community health education professionals. More equitable sharing of the responsibility for contraception might result in more effective contraception. (PP)
Pettigrew, LM; Mathauer, I
Background Most low- and middle-income countries (LMIC) rely significantly on private health expenditure in the form of out-of-pocket payments (OOP) and voluntary health insurance (VHI). This paper assesses VHI expenditure trends in LMIC and explores possible explanations. This illuminates challenges deriving from changes in VHI expenditure as countries aim to progress equitably towards universal health coverage (UHC). Methods Health expenditure data was retrieved from the WHO Global Health E...
Herrera, Joshua M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)
This report is an analysis of the means of egress and life safety requirements for the laboratory building. The building is located at Sandia National Laboratories (SNL) in Albuquerque, NM. The report includes a prescriptive-based analysis as well as a performance-based analysis. Following the analysis are appendices which contain maps of the laboratory building used throughout the analysis. The top of all the maps is assumed to be north.
Herrera, Joshua M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)
This report is an analysis of the means of egress and life safety requirements for the laboratory building. The building is located at Sandia National Laboratories (SNL) in Albuquerque, NM. The report includes a prescriptive-based analysis as well as a performance-based analysis. Following the analysis are appendices which contain maps of the laboratory building used throughout the analysis. The top of all the maps is assumed to be north.
Matos, Inês Campos; Alarcão, Violeta; Lopes, Elisa; Oiko, Carla; Carreira, Mário
Introdução: O crescimento da população imigrante em Portugal tem sido consistente nas últimas décadas. Apesar disto, a informação sobre a saúde das populações imigrantes é escassa. Esta investigação utiliza dados recolhidos junto da população oriunda do subcontinente indiano a residir no distrito de Lisboa para produzir recomendações para a prestação de serviços de saúde culturalmente adaptados.Material e Métodos: Estudo transversal junto da comunidade imigrante do subcontinente indiano (Bangladesh, Ãçndia e Paquistão) a residir em Lisboa, selecionada com base numa técnica de amostragem bola de neve e recorrendo a inquiridores com acesso privilegiado à população-alvo. O questionário inquiriu sobre a saúde, o acesso aos cuidados de saúde, estilos de vida e atitudes perante a morte. Foi feita uma análise descritiva dos dados e uma comparação entre as três nacionalidades padronizada para a idade.Resultados: Foram administrados questionários a 1011 indivíduos com uma taxa de adesão de 97%. A maioria dos participantes eram adultos do sexo masculino. Os imigrantes indianos relataram mais frequentemente barreiras na utilização dos serviços de saúde e tinham uma maior frequência de doenças crónicas. Os imigrantes paquistaneses tinham piores indicadores de estilos de vida.Discussão: A população imigrante do subcontinente indiano tende a relatar mais dificuldades linguísticas no acesso aos cuidados de saúde quando comparada com outras populações imigrantes. Com base em recomendações da Organização Mundial da saúde, foi possível adaptar este conhecimento para produzir recomendações adaptadas ao contexto português.Conclusão: Existem diversos aspetos na gestão dos serviços de saúde em Portugal que podem ser melhor adaptados à população imigrante do subcontinente indiano.
Sprague Martinez, Linda; Bowers, Edmond; Reich, Amanda J.; Ndulue, Uchenna J.; Le, Albert An; Peréa, Flavia C.
Participation in inquiry-based science education, which focuses on student-constructed learning, has been linked to academic success. Whereas the benefits of this type of science education are evident, access to such high-quality science curriculum and programming is not equitable. Black and Latino students in particular have less access to supplementary science programming, and fewer opportunities to engage in inquiry-based education. This paper describes outcomes associated with an inquiry-based out-of-school time science education program, Nuestro Futuro: Applied Science Education to Engage Black and Latino Youth (NFASE), which sought to build the capacity of middle school students of color to 'think' like health scientists from diverse disciplinary perspectives. The program was designed with the intent of (1) improving student attitudes toward and motivation for science and (2) increasing active and engaged citizenship (AEC). NFASE students explored health inequity and the social determinants of health locally and engaged in developing health promotion, outreach and education efforts targeted to their peers, parents/families, and community. Interest in the program was high overall, but implementation was not without challenges. Although evaluation outcomes indicate that there were no statistically significant changes in science-related attitudes or motivation, students reported significant increases in neighborhood social connection, as well as overall AEC.
Ramsden, Vivian; Martin, Ruth; McMillan, Jennifer; Granger-Brown, Alison; Tole, Brenda
The purpose of this research was to engage, empower and enhance the health and well-being of incarcerated women. The integration of primary health care, community-based participatory research, a settings approach to health promotion, and transformative action research guided the design of this study. A partnership between incarcerated women who became peer-researchers, correctional staff, and academic researchers facilitated the equitable contribution of expertise and decision-making by all partners. The study was conducted in a short sentence (two years or less), minimum/medium security Canadian women's correctional centre. Of the approximately 200 women that joined the research team, 115 participated in writing a 'paragraph of passion' while incarcerated between November, 2005 and August, 2007. Participatory, inductive qualitative, narrative and content analysis were used to illuminate four themes: expertise, transformation, building self-esteem, as well as access and support. The women organized monthly health forums in the prison to share their new knowledge and life experience with other incarcerated women, correctional staff, academics, and community members, and in doing so have built bridges and relationships, some of which have lasted to the present day.
Salaverry García, Oswaldo
Health inequity, main issue of contemporary debates on public health, is based on philosophical and historical concepts that date back to the idea of justice from classic Greece. The Aristotelian approach on distributive justice and its higher form, epiekeia or equity, has been reviewed, as well as how this evolves from the Middle Ages and modernity to the heart of the debate of a variety of thinkers such as liberal Rawls and Nobel laureate Amartya Sen. On this conceptual debate lies the World Health Organization version that links equity to health determinants and intends to make it operational through the equitable provision of health services.
... Training Manually Coded English (MCE) Natural Gestures Speech Speech Reading (Lip Reading) Even though American Sign Language (ASL) is not a building block, it is sometimes used together with one or more building blocks. Close Information For... Media Policy Makers File Formats Help: How do I view ...
DiNola, Ralph; Guerra, Jerry
Discusses the benefits of green, or high-performance, buildings, such as health and comfort, cost effectiveness, and sustainability. Explores the barriers to their use by schools--most notably cost. Offers suggestions on overcoming these barriers. (EV)
Singh, Reshma [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mathew, Paul [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Granderson, Jessica [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Srivastava, Rohini [Carnegie Mellon Univ., Pittsburgh, PA (United States); Shukla, Rash [Center for Environmental Planning and Technology (India)
The U.S.-India Joint Center for Building Energy Research & Development (CBERD), created through the Partnership to Accelerate Clean Energy (PACE) agreement between the United States and India, is a research and development (R&D) center with over 30 institutional and industry partners from both nations. This five-year presidential initiative is jointly funded by the U.S. Department of Energy and the Government of India. CBERD aims to build upon a foundation of collaborative knowledge, tools, and technologies, and human capabilities that will increase development of high-performance buildings. To reach this goal, the R&D focuses on energy use reduction throughout the entire life cycle of buildings—i.e., design, construction, and operations. During the operations phase of buildings, even with best-practice energy-efficient design, actual energy use can be much higher than the design intent. Every day, much of the energy consumed by buildings serves no purpose (Roth et al. 2005). Building energy information systems (EIS) are commercially available systems that building owners and facility managers use to assess their building operations, measure, visualize, analyze, and report energy cost and consumption. Energy information systems can enable significant energy savings by tracking energy use, identifying consumption patterns, and benchmarking performance against similar buildings, thereby identifying improvement opportunities. The CBERD team has identified potential energy savings of approximately 2 quads of primary energy in the United States, while industry building energy audits in India have indicated potential energy savings of up to 30 percent in commercial buildings such as offices. Additionally, the CBERD team has identified healthcare facilities (e.g., hospitals, clinics), hotels, and offices as the three of the highest-growth sectors in India that have significant energy consumption, and that would benefit the most from implementation of EIS.
McBeath, W H
The approach of a millennial passage invites public health to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO's multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services. Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new public health" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society--nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and public health professionals.
Carbon Budget Proposal： An Institutional Framework for an Equitable and Sustainable World Climate Regime%Carbon Budget Proposal： An Institutional Framework for an Equitable and Sustainable World Climate Regime
Pan Jiahua; Chen Ying
Consensus on reducing greenhouse gas emissions has been reached at the technical and political level. However, as the issue involves economic costs and the right to develop, the international institutional framework for addressing greenhouse gas emissions has consistently failed to balance the demands of impartiality and sustainability. However, a sustainable carbon budget proposal is undoubtedly achievable if the global carbon budget （the total amount of carbon permitted by climate security） is made an absolute constraint. If a preliminary distribution was made among the world＇s population on a per capita basis, the total limited global carbon budget could not only meet basic needs but also ensure the proposal＇s equitable. Taking into account historical emission levels and future needs, we should carry out carbon budget transfer payments and devise a corresponding funding mechanism to ensure efficient allocation under the proposal. Unlike the phase-by-phase progress and provisional goals of the Kyoto Protocol, the carbon budget proposal outlined above is a comprehensive and holistic package. Due to the politicization of the climate change issue, however, many technical issues can only be worked out through international political and diplomatic negotiations.
Arunanondchai, Jutamas; Fink, Carsten
Promoting quality health services to large population segments is a key ingredient to human and economic development. At its core, healthcare policymaking involves complex trade-offs between promoting equitable and affordable access to a basic set of health services, creating incentives for efficiencies in the healthcare system and managing constraints in government budgets. International trade in health services influences these trade-offs. It presents opportunities for cost savings and access to better quality care, but it also raises challenges in promoting equitable and affordable access. This paper offers a discussion of trade policy in health services for the ASEAN region. It reviews the existing patterns of trade and identifies policy measures that could further harness the benefits from trade in health services and address potential pitfalls that deeper integration may bring about.
与经济快速繁荣发展和不断增强的国力相比，中国医疗服务体系建设滞后，特别是基础医疗服务价值体系的扭曲，导致服务体系远不能满足广大人民群众的医疗服务需求。本文探讨了中国建设基础医疗服务价值(收费)体系、实施门诊劳务直接收费制度的必要性和紧迫性，以促进惠及全民的基础医疗服务事业的健康发展。% The health service system building has lagged behind the prosperous economic development. The distorted basic health service value system failed to meet the health service demand. We discussed the basic health service value system building, the necessity and urgency to implement labor fee charging system in outpatient, so as to promote the basic health system development.
随着新医改的逐步深入，对卫生信息化的要求不断提高，建立区域卫生信息平台成为卫生医疗系统迫在眉睫的重要工作。文章分析了构建区域卫生信息平台的关键网络技术。并在此基础上探讨了区域卫生信息平台的功能及实现，建立了实现医疗卫生领域各业务系统信息共享的区域卫生信息平台，以供相关工作人员参考。%With the gradual deepening of new health care reform, there is higher requirement of health information technology, and the establishment of regional health information platform has become the imminent important work of health care system. This article analyzed the key network technology of building a regional health information platform, and discussed the function and implementation of regional health information platform on this basis, andestablished business system information sharing regional health information platform for the fields of health care, providing reference for related workers.
Jeanet Kullberg; Isik Kulu-Glasgow
The social inclusion of immigrants and ethnic minorities is a central issue in many European countries. Governments face challenges in ensuring housing for immigrants, delivering public services, promoting neighbourhood coexistence and addressing residential segregation. The Building Inclusion proje
Tommerup, Henrik M.; Elle, Morten
The scientific community agrees that: all countries must drastically and rapidly reduce their CO2 emissions and that energy efficient houses play a decisive role in this. The general attitude at the workshop on Sustainable Buildings was that we face large and serious climate change problems...... that need urgent action. The built environment is an obvious area to put effort into because of the large and cost-effective energy saving potential and potential for Renewable Energy-based supply systems for buildings....
Bloch, Jean-François; Tardieu-Guigues, Elisabeth
The sea will be a source of economic development in the next years. Today the research works in marine biotechnologies supply new products and processes. The introduction in the laboratories of a new technology, synthesis biology, is going to increase the possibilities of creation of new products. Exploitation of product stemming from marine biodiversity has to be made with regard to various rights among which industrial property law, maritime law and the Convention on BioDiversity. All participants involved in the promotion of research in marine biotechnology must address the fair and equitable sharing of any commercial exploitation. Carrying out work involving synthetic biology has increased the number of unanswered questions about how operators should manage in order to avoid any threat of being sued for infringements of IP rights or for alleged bio-piracy. This paper, by no means exhaustive in the field, analyzes some of the issues raised on the modification to the landscape in marine biotechnology by the advent of synthetic biology. Such issues indicate how important the collaboration between researchers, industrialists, lawyers is for allowing proper use of marine biotech.
Most biomedical journals charge readers a hefty access toll to read the full text version of a published research article. These tolls bring enormous profits to the traditional corporate publishing industry, but they make it impossible for most people worldwide--particularly in low and middle income countries--to access the biomedical literature. Traditional publishers also insist on owning the copyright on these articles, making it illegal for readers to freely distribute and photocopy papers, translate them, or create derivative educational works. This article argues that excluding the poor from accessing and freely using the biomedical research literature is harming global public health. Health care workers, for example, are prevented from accessing the information they need to practice effective medicine, while policymakers are prevented from accessing the essential knowledge they require to build better health care systems. The author proposes that the biomedical literature should be considered a global public good, basing his arguments upon longstanding and recent international declarations that enshrine access to scientific and medical knowledge as a human right. He presents an emerging alternative publishing model, called open access, and argues that this model is a more socially responsive and equitable approach to knowledge dissemination.
Hallman, D.G. [World Council of Churches, Toronto, ON (Canada)
The World Council of Churches (WCC) views climate change issues from a theological and ethical perspective. This justice statement regarding climate change was prepared by the WCC in anticipation of the sixth session of the Conference of Parties (COP6) held in the Hague, Netherlands in November 2000. The statement presents the atmosphere as a global commons which envelops the Earth, nurturing and protecting life. Their statement urges that economic and political powers cannot be allowed to hinder the health of the atmosphere nor claim possession of it. The WCC pairs human responsibility with climate change and recognizes that the problem is caused largely by rich industrialized countries, the consequences of which will be suffered mostly by developing nations and by future generations. The statement emphasized that we must be held responsible for the destructive impact of our actions which are leading to climate change. The WCC argued that emissions trading under the Kyoto Protocol would violate the criterion of ecological effectiveness because it would not ensure a reduction in actual emissions. Trading mechanisms such as proposed under the Clean Development Mechanism would raise issues of equity and justice and would risk exacerbating inequities between rich and poor countries. The WCC made several recommendations for COP6. One of them was to refocus climate change negotiations on to options that meet the criteria of environmental effectiveness, equity, responsibility and economic efficiency with priority given to emissions reduction strategies in high per capita polluting countries. This statement also made reference to the use of a Global Atmospheric Commons Fund which would help impoverished countries to move towards a non-carbon economy focusing on renewable energy sources such as solar, biomass, wind and small scale hydroelectric.
Roodman, David Malin; Lenssen, Nicholas
Reviews in detail environmental impacts associated with buildings. Discusses building construction, internal environments, building life spans, building materials, protection from climate, and amenities. (LZ)
The legal concept of“equity” came from domestic law,which was driven by the international judicial practice from the discourse system of common law to the field of maritime demarcation. The justices have practiced and developed the idea of equity,to develop the idea of equity from the equitable principle to determined equitable principle and relevant circum-stances rule. At present,the equitable principle to determined equitable principle and relevant circumstances rule, including many practical connotations, such as justice, circumstances, just delimitation procedure and method,is becoming a general customary international law. A right understanding and appropriate employment of this rule makes a great support China ’ s basic claim for the delimitation of the East China Sea.%“衡平”这个法律概念源于国内法，经国际司法实践的推动从普通法的话语体系进入到海洋划界领域。大法官们实践并发展了衡平理念，努力使衡平理念向衡平原则再向确定的衡平原则及相关情况规则演进。当前的衡平原则及相关情况规则包含了确保结果公正、考虑相关情况、遵循公平划界程序和划界方法等实践内涵，正在成为一般国际习惯法。我国应正确理解和适用该规则以支持我国在东海划界中的基本主张。
Full Text Available As the debate about the need to clarify the content of the human right to science intensifies, this article assesses opportunities for opening a scholarly and policy dialogue on fair and equitable benefit-sharing between international human rights and biodiversity lawyers. To that end, the article contrasts the emerging conceptualizations of the right to science in the context of international cultural rights and of fair and equitable benefit-sharing under international biodiversity law. It then critically assesses the potential for cross-fertilization with specific regard to: the sharing of scientific information and promotion of scientific cooperation, the transfer of technology, and the protection and valorization of traditional knowledge of indigenous peoples and local communities. While acknowledging that both the right to science and fair and equitable benefit-sharing are far from being fully understood or operationalized, the article argues that developments in international biodiversity law concerning the latter may provide insights into how a vague and optimistic concept can (and when it cannot lead to tangible outcomes, rather than remaining merely rhetorical.
Nilce Emy Tomita
Full Text Available This cross-sectional study aimed at evaluating the oral health conditions of building construction workers from a city in the mid-west region of São Paulo, Brazil. This study involved 219 male subjects, aged 17 to 72. The definition of a random sample utilized the functional number of each worker as a criterion to the raffle, which took into account all 450 subjects registered in the Working Accidents Prevention Program. The examination of oral health conditions by DMFT index and need of treatment were carried out according to WHO criteria (1997. This paper reports the prevalence of caries according to age, occupation, and educational level. Among the 219 workers examined, the mean DMFT was 16.9. Amongst the younger workers (Este estudo transversal foi delineado para avaliar as condições de saúde bucal de trabalhadores da construção civil em município da região centro-oeste do Estado de São Paulo. Foram examinados 219 indivíduos do sexo masculino, com idades entre 17 e 72 anos. O levantamento das condições bucais foi realizado em processo de amostragem aleatória simples, a partir do total de 450 inscritos na MEGA-SIPAT 2000 (Semana Interna de Prevenção de Acidentes do Trabalho. Foi utilizado o índice CPOD (cárie dentária e necessidade de tratamento odontológico, segundo metodologia proposta pela Organização Mundial da Saúde (1997. Neste estudo, são descritas a prevalência de cárie segundo a idade, ocupação e escolaridade. Entre os 219 trabalhadores examinados, o valor CPOD apurado foi 16,9. Os trabalhadores mais jovens (<25 anos de idade apresentaram média de 21,3 dentes sem necessidade de tratamento, enquanto os mais velhos mostraram necessidades progressivas de tratamento restaurador e reabilitador (p<0,001. Verificou-se índice CPOD de 15,6 para os trabalhadores de áreas administrativas e 21,7 para os mestres-de-obras, sem significância estatística. Houve aumento do índice CPOD segundo a idade, para todos os
Safe Buildings Alliance, Washington, DC.
Thirty-one critical questions about asbestos, its use in school buildings, and the risks it poses to health are answered in this booklet. Issued by the Safe Buildings Alliance, an incorporated association of manufacturers that once supplied asbestos-containing materials for building construction, the booklet's purpose is to provide information…
Focusing Resources on Effective School Health: A FRESH Start to Enhancing the Quality and Equity of Education. World Education Forum 2000. Final Report = Accorder la priorite a un programme efficace de sante scolaire: Une maniere FRAICHE (FRESH) d'aneliorer la qualite et d'accroitre l'equite dans le domaine de l'education. Forum mondial 2000 sur l'education. Rapport final = Recursos efectivos en salud escolar: Un enfogue NUEVO para mejorar la calidad y la equidad educativa. Foro Mundial par la educacion 2000. Informe final.
United Nations Educational, Scientific, and Cultural Organization, Paris (France).
This booklet, written in English, Spanish, and French, describes the foundation and reasoning behind the partnership to Focus on Resources on Effective School Health (FRESH), making the case that an effective school health program: responds to the greater number of school-age children and the greater proportion of those children attending school;…
Masters, M L; Masters, R J
Total quality management (TQM) is a management philosophy that addresses problems currently faced by health care, specifically reducing costs while improving quality of services. As hospital administrators embrace this new management style, nurse executives and managers will be challenged to implement TQM. Building TQM into nursing management will improve quality and reduce costs while meeting the needs of health care customers.
Borrás, Susana; Edquist, Charles
on the one hand, and the real world of innovation policy-making on the other, typically not speaking to each other. With this purpose in mind, this paper discusses the role of competences and competence-building in the innovation process from a perspective of innovation systems; it examines how governments...... and public agencies in different countries and different times have actually approached the issue of building, maintaining and using competences in their innovation systems; it examines what are the critical and most important issues at stake from the point of view of innovation policy, looking particularly...
A substantial untapped energy saving potential rests in the building sector and is expected to play an important role in achieving reduction of environmental impacts of energy. In order to utilise this potential, effective policy measures need to be adopted to remove the existing barriers...... and create incentives. For that purpose, the cost effective energy saving options together with an optimal level of savings and expected environmental benefits have to be identified. The paper reports on a study that analyses these questions by including heat-saving measures in buildings into an energy....... Furthermore, the results suggest that changes in the energy generation sector are the prime driver behind the reduction of environmental externalities of energy. Heat savings in buildings play only a small role under model assumptions. © 2012Elsevier Ltd. All rights reserved....
Building a new life in Australia: an analysis of the first wave of the longitudinal study of humanitarian migrants in Australia to assess the association between social integration and self-rated health
Chen, Wen; Ling, Li; Renzaho, Andre M N
Objectives To assess the relationship between social integration and physical and mental health among humanitarian migrants (HMs) in Australia. Design, setting and participants We used the recently released first wave of data from the 2013 ‘Building a New Life in Australia’ survey, which is an ongoing nationwide longitudinal study. A total of 2399 HMs participated in the survey. Main outcome measures Self-rated physical health was measured using four items selected from the SF-36 which is a generic measure of health status. The 6-item Kessler Screening Scale for Psychological Distress (K6) was used to measure mental health. Social integration was measured using four dimensions: economic integration, acculturation, social capital and self-identity. Results More than half (63%), 47% and 49% of participants self-rated well on the general health, physical function and role-physical dimensions, respectively and 46% reported not having any bodily pain. Seventeen per cent of participants had a serious mental illness. There was a positive relationship between social integration and physical and mental health. That is, factors associated with better health included less financial hardship (economic integration dimension), better English proficiency and self-sufficiency (acculturation dimension), having the capacity to communicate with locals, having friends from different ethnic/religious groups and attending a place of worship weekly or more often (social capital dimension) and feeling welcomed and having a strong sense of belonging in Australia (self-identity dimension). Conclusions Using a more comprehensive framework of social integration, we found that greater social integration was associated with better physical and mental health outcomes among HMs. Social integration should be embedded in HMs' resettlement programmes in order to reduce migration-related health inequities. PMID:28298368
despite this excellent book, the knowledge, expertise, well-articulated argument and collection of recent research efforts that are provided by the three authors will help to make project success less elusive. The book constitutes a thorough and comprehensive investigation of building procurement, which......, which gives the book a challenging contribution to the existing body of knowledge....
Jensen, Steffen Moltrup Ernø; Korsgaard, Steffen; Shumar, Wes
of entrepreneurship education. Our theoretical and methodological approach builds on Actor-Network Theory. The empirical settings of our study consist of two entrepreneurship courses which differ in terms of temporal extension and physical setting. Data is collected using observation and interview techniques. Our...
Kisner, Mary J.; And Others
Defines school-business partnerships and reviews changes in such partnerships over the past 25 years. Provides steps to building effective partnerships for school-to-work activities: review the school's mission; select partners that will bring strength to the relationship; set clearly defined, realistic goals; maintain the partnership; and…
Economic Efficiency or Gender Equality: Conceptualizing an Equitable “Social Framing” for Economic Evaluations to Support Gender Equality in Disaster Risk- and Environmental-Management Decision-Making
Full Text Available It is unlikely that cost–benefit approaches will be effective in identifying investments that support gender equality without a relevant “social framing”. Criteria for a “social framing” are lacking, yet cost–benefit approaches often guide investment decisions for disaster risk and environmental management. Mainstream approaches typically do a poor job identifying and characterizing costs and benefits, and often fail to address distributive concerns (i.e., how costs and benefits may be distributed throughout society, to whom, etc.. Gender-blind investments may project responsibility for equality “problems” onto one sex, potentially augmenting gender inequalities and disaster risk. This article examines evidence from the gender, disaster, and development literature to identify distributive concerns and criteria for an equitable “social framing” for economic evaluations. Primary distributive concerns identified regard assumptions of women’s homogeneity, agency, “active” participation, and the influence of customary practice and displacement on disaster vulnerability. The need for a “gender-responsive” “social framing” that considers the needs of men and women in relation to one another is evident. Second, cost–benefit studies focused on gender equality concerns are reviewed and the “social framing” is critiqued. Results show most studies are not “gender-responsive”. Women’s health concerns, often exacerbated by disasters, are sidelined by assumptions regarding distributive concerns and reductive outcome measures.
Good, James D.; DeVore, Mary Ann
This model has been designed for use by Missouri secondary schools in attracting females and males into nontraditional occupational programs. The research-based strategies are intended for implementation in the following areas: attracting females into building trades, electronics, machine shop, and welding; and males into secondary health…
Vega, Jeanette; Frenz, Patricia
Underpinning the global commitment to universal health coverage (UHC) is the fundamental role of health for well-being and sustainable development. UHC is proposed as an umbrella health goal in the post-2015 sustainable development agenda because it implies universal and equitable effective delivery of comprehensive health services by a strong health system, aligned with multiple sectors around the shared goal of better health. In this paper, we argue that social determinants of health (SDH) are central to both the equitable pursuit of healthy lives and the provision of health services for all and, therefore, should be expressly incorporated into the framework for monitoring UHC. This can be done by: (a) disaggregating UHC indicators by different measures of socioeconomic position to reflect the social gradient and the complexity of social stratification; and (b) connecting health indicators, both outcomes and coverage, with SDH and policies within and outside of the health sector. Not locating UHC in the context of action on SDH increases the risk of going down a narrow route that limits the right to health to coverage of services and financial protection.
Busch, John; Greenberg, Steve; Rubinstein, Francis; Denver, Andrea; Rawner, Esther; Franconi, Ellen; Huang, Joe; Neils, Danielle
1.1.1 To encourage energy efficient design or retrofit of commercial buildings so that they may be constructed, operated, and maintained in a manner that reduces the use of energy without constraining the building function, the comfort, health, or the productivity of the occupants and with appropriate regard for economic considerations. 1.1.2 To provide criterion and minimum standards for energy efficiency in the design or retrofit of commercial buildings and provide methods for determining compliance with them. 1.1.3 To encourage energy efficient designs that exceed these criterion and minimum standards.
Wang, Qi; Jiao, Jie
China is one of the largest and most populated countries in the world. It has undergone rapid economic growth in recent years. However, the development is not equitable, and the distribution of wealth significantly varies among the regions in China. Geographical and socioeconomic inequalities, together with the lack of an equitable national social support system, cause the high variance of health outcomes among the regions. Furthermore, the fast growth of the economy has evoked many environmental challenges and puts much pressure on the population. The severe environmental deterioration, especially of the atmosphere and water bodies, has affected the health of the people living in China. As a result, cancer has become a major public health issue, and an alarming increase in incidence and mortality has been reported. However, cancer incidence and mortality vary in different areas in China. Cancer and cancer treatment disparities have existed for years. This article will discuss the existing health and cancer disparities associated with the risk factors and how these disparities are managed in China. PMID:28083550
Full Text Available China is one of the largest and most populated countries in the world. It has undergone rapid economic growth in recent years. However, the development is not equitable, and the distribution of wealth significantly varies among the regions in China. Geographical and socioeconomic inequalities, together with the lack of an equitable national social support system, cause the high variance of health outcomes among the regions. Furthermore, the fast growth of the economy has evoked many environmental challenges and puts much pressure on the population. The severe environmental deterioration, especially of the atmosphere and water bodies, has affected the health of the people living in China. As a result, cancer has become a major public health issue, and an alarming increase in incidence and mortality has been reported. However, cancer incidence and mortality vary in different areas in China. Cancer and cancer treatment disparities have existed for years. This article will discuss the existing health and cancer disparities associated with the risk factors and how these disparities are managed in China.
Cabinet是种十分吸引人却很简单的衬线字体，是由一名匿名字体设计师专门为Building Letters最新的资金筹集活动所设计的。这个Building Letters包中包含一个CDROM，有32种字体，以及一本专门设计的杂志和两张由Eboy和Emigre所设计的海报。字体光盘样例是由世界顶级的字体设计师们设计的．
The report Building Bridges adresses the questions why, how and for whom academic audience research has public value, from the different points of view of the four working groups in the COST Action IS0906 Transforming Audiences, Transforming Societies – “New Media Genres, Media Literacy and Trust...... in the Media”, “Audience Interactivity and Participation”, “The Role of Media and ICT Use for Evolving Social Relationships” and “Audience Transformations and Social Integration”. Building Bridges is the result of an ongoing dialogue between the Action and non-academic stakeholders in the field of audience...... Belgrade), Leo Pekkala (Finnish Centre for Media Education and Audiovisual Media/MEKU), Julie Uldam (Network on Civic Engagement and Social Innovation) and Gabriella Velics (Community Media Forum Europe)....
Publikationen er på engelsk. Den omfatter alle indlæg på det fjerde internationale symposium om byggeøkonomi, der blev arrangeret af SBI for det internationale byggeforskningsråd CIB. De fem bind omhandler: Methods of Economic Evaluation, Design Optimization, Ressource Utilization, The Building...... Market og Economics and Technological Forecasting in Construction. Et indledende bind bringer statusrapporter for de fem forskningsområder, og det sidste bind sammenfatter debatten på symposiet....
Ahmad Reza Hosseinpoor
Full Text Available Monitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC. A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodological considerations for equity-oriented monitoring of UHC, and proposes recommendations for monitoring and target setting. Inequality is multidimensional, such that the extent of inequality may vary considerably across different dimensions such as economic status, education, sex, and urban/rural residence. Hence, global monitoring should include complementary dimensions of inequality (such as economic status and urban/rural residence as well as sex. For a given dimension of inequality, subgroups for monitoring must be formulated taking into consideration applicability of the criteria across countries and subgroup heterogeneity. For economic-related inequality, we recommend forming subgroups as quintiles, and for urban/rural inequality we recommend a binary categorization. Inequality spans populations, thus appropriate approaches to monitoring should be based on comparisons between two subgroups (gap approach or across multiple subgroups (whole spectrum approach. When measuring inequality absolute and relative measures should be reported together, along with disaggregated data; inequality should be reported alongside the national average. We recommend targets based on proportional reductions in absolute inequality across populations. Building capacity for health inequality monitoring is timely, relevant, and important. The development of high-quality health information systems, including data collection, analysis, interpretation, and reporting practices that are linked to review and evaluation cycles across health systems, will enable effective global and national health inequality monitoring. These actions will support equity-oriented progressive
Full Text Available This 28th annual volume published by the World Organisation for Animal Health (OIE, addresses the need for a global shift in the way veterinary students are taught veterinary public health (VPH. As well as taking the lead in prevention and control of animal diseases, the OIE develops health and welfare standards to promote food security and equitable international trade in animals and animal products.
D’Agostino, Marcelo; Organización Panamericana de la Salud, Organización Mundial de la Salud.
The main objective of the Strategy and Plan of Action on eHealth (2012-2017) is to contribute to sustainable developmentof health systems of member states. Its adoption aims to improve quality and access to health services through the use ofinformation and communication technologies (ICT), the implementation of digital literacy programs and access to qualityinformation to advance towards more informed, equitable, competitive and democratic societies. PAHO/WHO considers thatin society, free an...
Kohler, Jillian Clare; Mackey, Tim Ken; Ovtcharenko, Natalia
Background Corruption in the health sector can hurt health outcomes. Improving good governance can in turn help prevent health-related corruption. We understand good governance as having the following characteristics: it is consensus-oriented, accountable, transparent, responsive, equitable and inclusive, effective and efficient, follows the rule of law, is participatory and should in theory be less vulnerable to corruption. By focusing on the pharmaceutical system, we explore some of the key...
The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable.
Khodjamurodov, Ghafur; Rechel, Bernd
The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. Tajikistan is undergoing a complex transition from a health system inherited from the Soviet period to new forms of management, financing and health care provision. Following independence and the consequences of the civil war, health funding collapsed and informal out-of-pocket payments became the main source of revenue, with particularly severe consequences for the poor. With the aim of ensuring equitable access to health care and formalizing out-of-pocket payments, the Ministry of Health developed a programme that encompassed a basic benefit package (also known as the guaranteed benefit package) for people in need and formal co-payments for other groups of the population. One of the main challenges for the future will be to reorient the health system towards primary care and public health rather than hospital-based secondary and tertiary care. Pilots of primary care reform, introducing per capita financing, are under way in three of the country's oblasts. There are marked geographical imbalances in health care resources and financing, favouring the capital and regional centres over rural areas. There are also significant inequities in health care expenditures across regions. The quality of care is another major concern, owing to the lack of investment in health facilities and technologies, an insufficient supply of pharmaceuticals, poorly trained health care workers, and a lack of medical protocols and systems for quality improvement.
廖晓艳; 李亚洁; 蔡文智; 朱碧丽
It introduced the education preparation, capacity requirements, access certification and the scope of practice changes of psychiatric - mental health advanced nursing practice during development of American advanced psychiatric - mental health nursing practice. And it analyzed the status quo of psychiatric - mental health nursing in China. It put forward some relevant recommendations for building - up psychiatric - mental health care.%介绍了美国精神-心理健康高级护理实践发展进程中精神-心理健康高级实践护士教育准备、能力要求、准入认证及执业范围的变化,分析了我国精神-心理健康护理的现状,提出了建设我国精神-心理健康护理学科的相关建议.
Evaluation of health factors in high-rise buildings. 2. Bioclimatological consequences resulting from comparative measurements of the air ionisation in a high-rise building located in a heavily contaminated suburban area and at certain altitudes
Moese, J.R.; Fischer, G.
According to accepted scientific theories inhaled small ions deliver their charges in the pulmonary alveoli and this leads to local recharges. This process stimulates structures of the central nervous system and the activity of the endocrine is excited, resulting in an enhancement of the general well-being. These possibilities of interpretation regarding a biological ionic effect are supported, with reservations by positive medical effects during and after a stay in a well-ventilated mountain climate or also in a sea-climate. Owing to their lower mobility the large ions are inhaled as small ions to an increasing extent. The chemical and physical noxa are delivered and deposited in the respiratory tract. They stick the epithelia in the trachea and in the bronchi as well as the endothelia in the lung vesicles. The number of the ciliary movements is reduced. Similar effects are known to be caused also by nicotine abuse. This results in a decreased ability of expectoration and a lower intake of oxygen by the alveoli. These facts could furnish an explanation for the increased vulnerability of city dwellers to infections diseases and to catarrh. The changed ionisation of air in urbanised areas definitely represents only one of the many risk factors. In addition to the attempt to characterize bioclimatically local weather conditions by means of the non-conventional parameter air ionisation our study has also been intended to establish biologically oriented criteria for the living in a high-rise building in a particularly unfavourable location. Under specific microclimatic conditions the uppermost storeys were at times bioclimatically favoured over the lowermost, especially when shallow air inversion is present. In such cases, small ions exclusively were registered in the upper storeys and large ions in the lower floors.
This work is looking in to what possibilites and restrictions comes with using mycelium as a building material for a small house. It includes reasoning around solutions for some of the problems and presenting some ideas of how to use some of the materials properties in your favor. A general background of why we need to start look in to alternative materials for all petroleum materials are presented. Det här arbetet har varit inriktat på att se vilka möjligheter samt begränsningar det skul...
彭祖的养生长寿术虽然不会像先秦文献记载那样简单，但也不可能像后世不断增益、渲染的那样繁冗与玄虚。行之有效的彭祖养生术，应该是主旨集中明确，符合中华民族传统养生理念，形式简洁明了，便于操作，效果显著。汉代以前一直推重吐纳导引和行气。《简明彭祖养生导引术》根据原始文献所提供的线索，试图正本清源，尽可能地体现彭祖长寿养生术通过吐故纳新，促进新陈代谢；平衡阴阳，调理脏腑气血；适度运动肢体、关节、肌肉、韧带，增强生命活力，进而延缓机体衰老速度而延年益寿的精髓与关键。因而是合理并符合科学精神的。本文运用文献检索法和科学提炼法梳理了《简明彭祖养生导引术》的来龙去脉，阐释了其养生机理。%Body-building practices for health and longevity of Pengzu are neither as simple as what has been described in pre-Qin dy-nasties nor as complicated and mysterious as what post-generations have boasted of. Actually effective body-building practices for health and longevity of Pengzu ought to be clear and concise and in line with traditional body-building values and operational. Deep breathing and promoting qi flow by respiration was extremely popular before Han dynasty. Based on the original documents and records, Concise Bodybuilding Practices for Health & Longevity of Pengzu promotes the process of metabolism by such strengthening exercises as deep breathing and promoting qi flow to bring in the new and healthy and get rid of the old and unhealthy, and nurse the organs and blood by balancing Yin and Yang, and enhance vitality by moderately exercising limbs, joints, muscles and ligament. Therefore, the aging process will be slowed down and a healthy life will be extended. Body-building practices for health and longevity of Pengzu are reasonable and scientific. The paper traces back their origin and elaborates on the
通过学习与借鉴美国高校对员工健康服务与管理的理念,从不同侧面深入分析国内高校教职工健康现状及理念以及高校在教职工健康管理方面存在的问题,阐述建立健全高校教职工健康档案的必要性,就存在的问题提出改进建议。%By learning from the ideas of American colleges and universities towards staff's health service and management,different perspectives are chosen to deeply analyze the health status and ideas of teaching and administrative staff in domestic colleges and universities,as well as the problems in the health management of the faculty in colleges and universities,to elaborate the necessity of building and strengthening teaching and administrative staff's health files in colleges and universities,and to put forward improvement suggestions in regard of existing problems.
Zumla, Alimuddin; Dar, Osman; Kock, Richard; Muturi, Matthew; Ntoumi, Francine; Kaleebu, Pontiano; Eusebio, Macete; Mfinanga, Sayoki; Bates, Matthew; Mwaba, Peter; Ansumana, Rashid; Khan, Mishal; Alagaili, Abdulaziz N; Cotten, Matthew; Azhar, Esam I; Maeurer, Markus; Ippolito, Giuseppe; Petersen, Eskild
The appearance of novel pathogens of humans with epidemic potential and high mortality rates have threatened global health security for centuries. Over the past few decades new zoonotic infectious diseases of humans caused by pathogens arising from animal reservoirs have included West Nile virus, Yellow fever virus, Ebola virus, Nipah virus, Lassa Fever virus, Hanta virus, Dengue fever virus, Rift Valley fever virus, Crimean-Congo haemorrhagic fever virus, severe acute respiratory syndrome coronavirus, highly pathogenic avian influenza viruses, Middle East Respiratory Syndrome Coronavirus, and Zika virus. The recent Ebola Virus Disease epidemic in West Africa and the ongoing Zika Virus outbreak in South America highlight the urgent need for local, regional and international public health systems to be be more coordinated and better prepared. The One Health concept focuses on the relationship and interconnectedness between Humans, Animals and the Environment, and recognizes that the health and wellbeing of humans is intimately connected to the health of animals and their environment (and vice versa). Critical to the establishment of a One Health platform is the creation of a multidisciplinary team with a range of expertise including public health officers, physicians, veterinarians, animal husbandry specialists, agriculturalists, ecologists, vector biologists, viral phylogeneticists, and researchers to co-operate, collaborate to learn more about zoonotic spread between animals, humans and the environment and to monitor, respond to and prevent major outbreaks. We discuss the unique opportunities for Middle Eastern and African stakeholders to take leadership in building equitable and effective partnerships with all stakeholders involved in human and health systems to take forward a 'One Health' approach to control such zoonotic pathogens with epidemic potential.
Kjellstrom, Tord; Friel, Sharon; Dixon, Jane; Corvalan, Carlos; Rehfuess, Eva; Campbell-Lendrum, Diarmid; Gore, Fiona; Bartram, Jamie
This paper outlines briefly how the living environment can affect health. It explains the links between social and environmental determinants of health in urban settings. Interventions to improve health equity through the environment include actions and policies that deal with proximal risk factors in deprived urban areas, such as safe drinking water supply, reduced air pollution from household cooking and heating as well as from vehicles and industry, reduced traffic injury hazards and noise, improved working environment, and reduced heat stress because of global climate change. The urban environment involves health hazards with an inequitable distribution of exposures and vulnerabilities, but it also involves opportunities for implementing interventions for health equity. The high population density in many poor urban areas means that interventions at a small scale level can assist many people, and existing infrastructure can sometimes be upgraded to meet health demands. Interventions at higher policy levels that will create more sustainable and equitable living conditions and environments include improved city planning and policies that take health aspects into account in every sector. Health equity also implies policies and actions that improve the global living environment, for instance, limiting greenhouse gas emissions. In a global equity perspective, improving the living environment and health of the poor in developing country cities requires actions to be taken in the most affluent urban areas of the world. This includes making financial and technical resources available from high-income countries to be applied in low-income countries for urgent interventions for health equity. This is an abbreviated version of a paper on "Improving the living environment" prepared for the World Health Organization Commission on Social Determinants of Health, Knowledge Network on Urban Settings.
Greene, Robert; Dasso, Edwin; Ho, Sam; Frank, Jerry; Scandrett, Graeme; Genaidy, Ash
The U.S. health care system is currently heading toward unsustainable health care expenditures and increased dissatisfaction with health outcomes. The objective of this population-based study is to uncover practical insights regarding patients with 1 or more chronic illnesses. A cross-sectional investigation was designed to gather data from health records drawn from diverse US geographic markets. A database of 9.74 million fully-insured, working individuals was used, together with members in the same households. Among nearly 3.43 million patients with claims, 2.22 million had chronic conditions. About 24.3% had 1 chronic condition and 40.4% had multi-morbidity. Health care expenditures for chronic conditions accounted for 92% of all costs (52% for chronic costs and 40% for nonchronic costs). Psychiatry, orthopedics-rheumatology, endocrinology, and cardiology areas accounted for two thirds of these chronic condition costs; nonchronic condition costs were dominated by otolaryngology, gastroenterology, dermatology, orthopedics-rheumatology conditions, and preventive services. About 50.1% of all households had 2 or more members with chronic conditions. In summary, multi-morbidity is prevalent not only among those older than age 65 years but also in younger and working individuals, and commonly occurs among several members of a household. The authors suggest that the disease-focused model of medicine should change to a more holistic illness-wellness model, emphasizing not only the physical but also the mental and social elements that can influence individual health. In that way the chronic care model could be broadened in context and content to improve the health of patients and households.
McLean, Allen; Osgood, Nathaniel; Newstead-Angel, Jill; Stanley, Kevin; Knowles, Dylan; van der Kamp, William; Qian, Weicheng; Dyck, Roland
Public health researchers have traditionally relied on individual self-reporting when collecting much epidemiological surveillance data. Data acquisition can be costly, difficult to acquire, and the data often notoriously unreliable. An interesting option for the collection of individual health (or indicators of individual health) data is the personal smartphone. Smartphones are ubiquitous, and the required infrastructure is well-developed across Canada, including many remote areas. Researchers and health professionals are asking themselves how they might exploit increasing smartphone uptake for the purposes of data collection, hopefully leading to improved individual and public health. A novel smartphone-based epidemiological data collection and analysis system has been developed by faculty and students from the CEPHIL (Computational Epidemiology and Public Health Informatics) Lab in the Department of Computer Science at the University of Saskatchewan. A pilot feasibility study was then designed to examine possible relationships between smartphone sensor data, surveys and individual clinical data within a population of pregnant women. The study focused on the development of Gestational Diabetes (GDM), a transient condition during pregnancy, but with serious potential post-birth complications for both mother and child. The researchers questioned whether real-time smartphone data could improve the clinical management and outcomes of women at risk for developing GDM, enabling earlier treatment. The initial results from this small study did not show improved prediction of GDM, but did demonstrate that real-time individual health and sensor data may be readily collected and analyzed efficiently while maintaining confidentiality. Because the original version of the data collection software could only run on Android phones, this often meant the study participants were required to carry two phones, and this often meant the study phone was not carried, and therefore data
Ruger, Jennifer Prah
Against a backdrop of non-ideal political and legal conditions, this article examines the health capability paradigm and how its principles can help determine what aspects of health care might legitimately constitute positive health care rights-and if indeed human rights are even the best approach to equitable health care provision. This article addresses the long American preoccupation with negative rights rather than positive rights in health care. Positive health care rights are an exception to the overall moral range and general thrust of U.S. legal doctrine. Some positive rights to health care have arisen from U.S. Constitutional Eighth Amendment cases and federal and state laws like Medicare, Medicaid, the State Children's Health Insurance Program, the Emergency Medical Treatment and Active Labor Act, and the Patient Protection and Affordable Care Act. Finally, this article discusses some of the difficulties inherent in implementing a positive right to health care in the U.S.
La Palabra Es Salud: A Comparative Study of the Effectiveness of Popular Education vs. Traditional Education for Enhancing Health Knowledge and Skills and Increasing Empowerment among Parish-Based Community Health Workers
Popular education is a mode of teaching and learning which seeks to bring about more equitable social conditions by creating settings in which people can identify and solve their own problems. While the public health literature offers evidence to suggest that popular education is an effective strategy for increasing empowerment and improving…
王颖; 陈平; 张伟; 李维冬
To optimize the medical treatment process and to improve the medical environment is an important means to solve the problem of medical treatment. The payment function is introduced to all aspects of medical treatment is the trend. The purpose of building the medical one account is making a system of accounts is to ensure the financial security of individuals, under the premise of information security, to build a regional medical institutions in general and the storage value payment systems. Making regional cost settlement process between patient, medical institutions, financial institutions, to improve the patient's medical experience.%优化就医流程、改善就医环境是解决看病难的重要手段之一。将支付功能引入医疗机构各个就诊环节是大势所趋。医疗一账通系统的建设，目的就是在保证个人的资金安全、信息安全的前提下，搭建一种在区域内各医疗机构通用的贮值与交费系统，完成患者、医疗机构、金融机构、三方之间的费用结算流程，提高患者的就医体验。
Se Woon Choi
Full Text Available In this study, a practical and integrative SHM system was developed and applied to a large-scale irregular building under construction, where many challenging issues exist. In the proposed sensor network, customized energy-efficient wireless sensing units (sensor nodes, repeater nodes, and master nodes were employed and comprehensive communications from the sensor node to the remote monitoring server were conducted through wireless communications. The long-term (13-month monitoring results recorded from a large number of sensors (75 vibrating wire strain gauges, 10 inclinometers, and three laser displacement sensors indicated that the construction event exhibiting the largest influence on structural behavior was the removal of bents that were temporarily installed to support the free end of the cantilevered members during their construction. The safety of each member could be confirmed based on the quantitative evaluation of each response. Furthermore, it was also confirmed that the relation between these responses (i.e., deflection, strain, and inclination can provide information about the global behavior of structures induced from specific events. Analysis of the measurement results demonstrates the proposed sensor network system is capable of automatic and real-time monitoring and can be applied and utilized for both the safety evaluation and precise implementation of buildings under construction.
Building a global health education network for clinical care and research. The benefits and challenges of distance learning tools. Lessons learned from the Hopkins Center for Clinical Global Health Education.
Bollinger, Robert C; McKenzie-White, Jane; Gupta, Amita
Expanding the capacity for clinical care and health research is a global priority and a global challenge. The Johns Hopkins Center for Clinical Global Health Education (CCGHE) was established in 2005 to provide access to high-quality training to health care providers in resource-limited settings. The CCGHE made a strategic decision to develop, use, and evaluate distance learning platforms to achieve its mission. In the initial years of this new program, several lessons have been learned that may be helpful to other programs considering the use of distance learning programs to expand global health clinical and research capacity.
Brancaccio-Taras, Loretta; Pape-Lindstrom, Pamela; Peteroy-Kelly, Marcy; Aguirre, Karen; Awong-Taylor, Judy; Balser, Teri; Cahill, Michael J; Frey, Regina F; Jack, Thomas; Kelrick, Michael; Marley, Kate; Miller, Kathryn G; Osgood, Marcy; Romano, Sandra; Uzman, J Akif; Zhao, Jiuqing
The PULSE Vision & Change Rubrics, version 1.0, assess life sciences departments' progress toward implementation of the principles of the Vision and Change report. This paper reports on the development of the rubrics, their validation, and their reliability in measuring departmental change aligned with the Vision and Change recommendations. The rubrics assess 66 different criteria across five areas: Curriculum Alignment, Assessment, Faculty Practice/Faculty Support, Infrastructure, and Climate for Change. The results from this work demonstrate the rubrics can be used to evaluate departmental transformation equitably across institution types and represent baseline data about the adoption of the Vision and Change recommendations by life sciences programs across the United States. While all institution types have made progress, liberal arts institutions are farther along in implementing these recommendations. Generally, institutions earned the highest scores on the Curriculum Alignment rubric and the lowest scores on the Assessment rubric. The results of this study clearly indicate that the Vision & Change Rubrics, version 1.0, are valid and equitable and can track long-term progress of the transformation of life sciences departments. In addition, four of the five rubrics have broad applicability and can be used to evaluate departmental transformation by other science, technology, engineering, and mathematics disciplines.
Goldberg, Lynette R.; Koontz, Jennifer Scott; Rogers, Nicole; Brickell, Jean
The health care needs of older adults can be complex and multifaceted. Safe, effective, equitable, and person-centered service provision relies on skilled interprofessional, team-based practice. Too often, students seeking a career specializing in gerontology are not exposed to such interprofessional, team-based learning and practice during their…
李新辉; 白彩锋; 陈丽丽; 姬春; 李杨春
Objective To promote the ability of health education for nursing students, and then to lay a good foundation for health education activities in future. Methods General training were used for nursing students such as lictures, micro-teaching and community health education practice, and then ana-lyzed the results by quantitative and qualitative methods. Results The average scores of the ability of health education before and after the micro-thaehing was 75.45 and 84.25 respectively, there was a signifi-cant difference between them. The qualitative results indicated that nurisng students had mastered the basic knowledge and skills of science in education and dissemination, had learned how to access information to organize and made health education materials, implement health education activities and evaluated the re-sults. Conclusions Nusing students participate in the extra-curricular health education activities can ef-fective improve their capacity of health education.%目的 提高护生健康教育能力,为今后的健康教育活动奠定良好的基础.方法 运用小讲课培训、微格教学法评价和社区健康教育实践相结合的方法对3名护理专业硕士研究生及50名护理本科生进行健康教育能力培养,并对结果进行定量和定性分析.结果 实施微格教学培养前护生健康教育能力(小讲课)成绩平均为75.45分,培养后为84.25分,培养前后护生的小讲课得分比较差异显著;定性结果显示,护生掌握了教育学和传播学的基本知识和技能,学会了查阅、组织和制作健康教育资料、实施健康教育并能对健康教育结果进行评价.结论 护生积极参加课外健康教育培训和实践活动是提高其健康教育能力的有效途径.
Huish, Robert Lee
Martin Luther King said that “of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Today, despite the overwhelming quantity of attention and resources given towards global health, social inequity has never been worse as many in the global South remain perilously marginalized from the receipt of sustainable primary-care services. Amidst this backdrop Cuba developed the Latin American School of Medicine (ELAM) as a response to the global South’s lagging s...
their homes. These policy measures include building regulations, energy tax and different types of incentives and information dissemination. The conclusion calls for new and innovative policy measures to cope with the realities of renovations of owner-occupied houses and how energy efficiency improvement......This paper deals with the energy consumption of existing owner-occupied detached houses and the question of how they can be energy renovated. Data on the age of the Danish housing stock, and its energy consumption is presented. Research on the potential for energy reductions in the Danish housing...... sector is discussed, and it is shown that there is a huge potential for reductions. It is a well-known problem that even if there are relevant technical means and even if it is economically feasible, the majority of house owners do not energy renovate their homes. This paper intends to address what can...
Steinemann, Anne; Wargocki, Pawel; Rismanchi, Behzad
This paper investigates the concern that green buildings may promote energy efficiency and other aspects of sustainability, but not necessarily the health and well-being of occupants through better indoor air quality (IAQ). We ask ten questions to explore IAQ challenges for green buildings as well...... as opportunities to improve IAQ within green buildings and their programs. Our focus is on IAQ, while recognizing that many factors influence human health and the healthfulness of a building. We begin with an overview of green buildings, IAQ, and whether and how green building certifications address IAQ. Next, we...... questions, that can help green buildings to more effectively promote IAQ. This article supports a growing recognition of the importance of IAQ in green buildings, and the opportunities for improvements. As the World Green Building Council  and others have emphasized, people are the most valuable asset...
Haase, Matthias; Amato, Alex; Heiselberg, Per
There is a global need for a more sustainable building development. About 50% of energy is used in buildings indicating that buildings provide a considerable potential for operational energy savings. Studies were conducted with the following objectives: to perform a state-of-the-art review...... energy strategies to develop guidelines and procedures for estimation of environmental performance of responsive building elements and integrated building concepts This paper introduces the ideas of this collaborative work and discusses its usefulness for Hong Kong and China. Special focus was put...... of responsive building elements, of integrated building concepts and of environmental performance assessment methods to improve and optimize responsive building elements to develop and optimize new building concepts with integration of responsive building elements, HVAC-systems as well as natural and renewable...
Anita A Davies
Full Text Available The increasing importance and complexity of migration globally also implies a global increase in return migration, and thus an increased interest in the health of returning migrants. The health of returning migrants is impacted by the cumulative exposure to social determinants and risk factors of health during the migration process, during the return movement, and following return. Circular migration often occurs among the diaspora, which can result in the transfer of knowledge and skills that contribute to development, including health system strengthening. Migrants with dual nationality often return to countries with better health services than their country of origin when they are sick and can not get care at home. To maintain and improve the health of returning migrants, multi-sectoral policies at global and national levels should facilitate access to appropriate and equitable health services, social services, and continuity of care across and within borders.
Davies, Anita A; Borland, Rosilyne M; Blake, Carolyn; West, Haley E
The increasing importance and complexity of migration globally also implies a global increase in return migration, and thus an increased interest in the health of returning migrants. The health of returning migrants is impacted by the cumulative exposure to social determinants and risk factors of health during the migration process, during the return movement, and following return. Circular migration often occurs among the diaspora, which can result in the transfer of knowledge and skills that contribute to development, including health system strengthening. Migrants with dual nationality often return to countries with better health services than their country of origin when they are sick and can not get care at home. To maintain and improve the health of returning migrants, multi-sectoral policies at global and national levels should facilitate access to appropriate and equitable health services, social services, and continuity of care across and within borders.
Lasserre, Kaye E.; Moffatt, Jennifer J.
The paper reports on a project where the objective was for the Rural Clinical School, The University of Queensland, Australia, to design an acceptable model of research skills workshops for medical students and rural health professionals. Eight, interactive research skills workshops focused on skill development were conducted in rural Queensland,…
Bornehag, Carl-Gustaf; Sundell, Jan; Hagerhed, L.;
-sectional questionnaire study on 14 077 children (1-6 years) focusing on their health and their home environment. There were strong and consistent associations between different "dampness"-indicators and symptoms among children. The combination of floor moisture problems and PVC as flooring material significantly...
Ramsey, Kate; Hingora,Ahmed; Kante, Malick; Jackson, Elizabeth; Exavery, Amon; Pemba, Senga; Manzi, Fatuma; Baynes, Colin; Helleringer, Stephane; Phillips, James F.
Background Tanzania has been a pioneer in establishing community-level services, yet challenges remain in sustaining these systems and ensuring adequate human resource strategies. In particular, the added value of a cadre of professional community health workers is under debate. While Tanzania has the highest density of primary health care facilities in Africa, equitable access and quality of care remain a challenge. Utilization for many services proven to reduce child and maternal mortality ...
Alcaraz, Kassandra I; Sly, Jamilia; Ashing, Kimlin; Fleisher, Linda; Gil-Rivas, Virginia; Ford, Sabrina; Yi, Jean C; Lu, Qian; Meade, Cathy D; Menon, Usha; Gwede, Clement K
Health disparities persist despite ongoing efforts. Given the United States' rapidly changing demography and socio-cultural diversity, a paradigm shift in behavioral medicine is needed to advance research and interventions focused on health equity. This paper introduces the ConNECT Framework as a model to link the sciences of behavioral medicine and health equity with the goal of achieving equitable health and outcomes in the twenty-first century. We first evaluate the state of health equity efforts in behavioral medicine science and identify key opportunities to advance the field. We then discuss and present actionable recommendations related to ConNECT's five broad and synergistic principles: (1) Integrating Context; (2) Fostering a Norm of Inclusion; (3) Ensuring Equitable Diffusion of Innovations; (4) Harnessing Communication Technology; and (5) Prioritizing Specialized Training. The framework holds significant promise for furthering health equity and ushering in a new and refreshing era of behavioral medicine science and practice.
Full Text Available Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR, a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest–posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports.
through billions of years of prebiotic and molecular selection and evolution, there are bio-organic by Shuguang Zhang Building from the bottom up... Health , Du Pont-MIT Alliance, and the Whitaker Foundation. I also gratefully acknowledge Intel Corporation Academic Program for the generous donation
Mackey, Timothy Ken; Liang, Bryan Albert
Global public health is threatened by an imbalance in health worker migration from resource-poor countries to developed countries. This "brain drain" results in health workforce shortages, health system weakening, and economic loss and waste, threatening the well-being of vulnerable populations and effectiveness of global health interventions. Current structural imbalances in resource allocation and global incentive structures have resulted in 57 countries identified by WHO as having a "critical shortage" of health workers. Yet current efforts to strengthen domestic health systems have fallen short in addressing this issue. Instead, global solutions should focus on sustainable forms of equitable resource sharing. This can be accomplished by adoption of mandatory global resource and staff-sharing programs in conjunction with implementation of state-based health services corps.
Brackney, Larry; Parker, Andrew; Long, Nicholas; Metzger, Ian; Dean, Jesse; Lisell, Lars
A building energy analysis system includes a building component library configured to store a plurality of building components, a modeling tool configured to access the building component library and create a building model of a building under analysis using building spatial data and using selected building components of the plurality of building components stored in the building component library, a building analysis engine configured to operate the building model and generate a baseline energy model of the building under analysis and further configured to apply one or more energy conservation measures to the baseline energy model in order to generate one or more corresponding optimized energy models, and a recommendation tool configured to assess the one or more optimized energy models against the baseline energy model and generate recommendations for substitute building components or modifications.
Elizabeth W. Karlson
Full Text Available The Partners HealthCare Biobank is a Partners HealthCare enterprise-wide initiative whose goal is to provide a foundation for the next generation of translational research studies of genotype, environment, gene-environment interaction, biomarker and family history associations with disease phenotypes. The Biobank has leveraged in-person and electronic recruitment methods to enroll >30,000 subjects as of October 2015 at two academic medical centers in Partners HealthCare since launching in 2010. Through a close collaboration with the Partners Human Research Committee, the Biobank has developed a comprehensive informed consent process that addresses key patient concerns, including privacy and the return of research results. Lessons learned include the need for careful consideration of ethical issues, attention to the educational content of electronic media, the importance of patient authentication in electronic informed consent, the need for highly secure IT infrastructure and management of communications and the importance of flexible recruitment modalities and processes dependent on the clinical setting for recruitment.
Builders generally use a 'spec and purchase' business management system (BMS) when implementing energy efficiency. A BMS is the overall operational and organizational systems and strategies that a builder uses to set up and run its company. This type of BMS treats building performance as a simple technology swap (e.g. a tank water heater to a tankless water heater) and typically compartmentalizes energy efficiency within one or two groups in the organization (e.g. purchasing and construction). While certain tools, such as details, checklists, and scopes of work, can assist builders in managing the quality of the construction of higher performance homes, they do nothing to address the underlying operational strategies and issues related to change management that builders face when they make high performance homes a core part of their mission. To achieve the systems integration necessary for attaining 40% + levels of energy efficiency, while capturing the cost tradeoffs, builders must use a 'systems approach' BMS, rather than a 'spec and purchase' BMS. The following attributes are inherent in a systems approach BMS; they are also generally seen in quality management systems (QMS), such as the National Housing Quality Certification program: Cultural and corporate alignment, Clear intent for quality and performance, Increased collaboration across internal and external teams, Better communication practices and systems, Disciplined approach to quality control, Measurement and verification of performance, Continuous feedback and improvement, and Whole house integrated design and specification.
Kjærgaard, Søren K.; Hauschildt, P.; Pejtersen, J.
Objectives. Reactions to emissions from building matrials were studied in a climate chamber as part of an intervention study in an office building. New and existing flooring materials were compared with regard to comfort and health.Methods. Twenty subjects were exposed four times for six hours...... effects by linoleum and carpet used and that changing to vinyl flooring may reduce these....