WorldWideScience

Sample records for challenging health issue

  1. Public health workforce: challenges and policy issues

    Directory of Open Access Journals (Sweden)

    Beaglehole Robert

    2003-07-01

    Full Text Available Abstract This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that must be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organizational base. Although the public health workforce is central to the performance of health systems, very little is known about its composition, training or performance. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems? Other questions concern: the nature of the public health workforce, including its size, composition, skills, training needs, current functions and performance; the appropriate roles of the workforce; and how the workforce can be strengthened to support new approaches to priority health problems. The available evidence to shed light on these policy issues is limited. The World Health Organization is supporting the development of evidence to inform discussion on the best approaches to strengthening public health capacity in developing countries. WHO's priorities are to build an evidence base on the size and structure of the public health workforce, beginning with ongoing data collection activities, and to map the current public health training programmes in developing countries and in Central and Eastern Europe. Other steps will include developing a consensus on the desired functions and activities of the public health workforce and developing a framework and methods for assisting countries to assess and enhance the performance of public health training institutions and of the public health workforce.

  2. Pilot Implementation of Health Information Systems: Issues and challenges

    DEFF Research Database (Denmark)

    Bansler, Jørgen Peter; Havn, Erling C.

    2010-01-01

    Objectives: This study aims to explore the issues and challenges involved in designing and organizing pilot implementations of health information systems (HIS). Pilot implementations are a widely used approach for identifying design flaws and implementation issues before full-scale deployment...... implementation of an electronic Pregnancy Record (ePR) in Denmark. Our primary data collection methods comprised participant observations, semi-structured interviews and document analyses. Results: Based on a comprehensive evaluation of the implementation process, we identify three major challenges...

  3. Disadvantaged Rural Health – Issues and Challenges: A Review

    Directory of Open Access Journals (Sweden)

    Anil K Chillimuntha

    2013-02-01

    Full Text Available Disadvantaged rural health reflected by significantly higher mortality rates in rural areas which indicate less attention paid by the government. The issue of health disadvantage to the rural area in the country is far from settled. The public expenditure on health in India is far too inadequate, less than 10% of the total health budget is allocated to rural area where 75% people live. In spite of rising budgetary provision, many of the rural populace dies without any medical attention. Access to high quality health care services plays an important part in the health of rural communities and individuals. Resolving the health problems of rural communities will require more than simply increasing the quality and accessibility of health services. Until governments begin to take an ‘upside-down’ perspective, focusing on building healthy communities rather than simply on building hospitals to make communities healthy, the disadvantages faced by rural people will continue to be exacerbated. Underutilization of existing rural hospitals and health care facilities can be addressed by a market-centered approach, and more effective government intervention for horizontal and vertical hospital integration. Tele-healthcare, Mobile Health Units and Community-based health insurance are proven helpful in rural areas. Autonomy enjoyed by women and exposure to media also has a significant impact on maternal health care utilization. Accessibility to health facilities is a critical factor in effective health treatment for people in rural areas. Location–allocation models prescribe optimal configurations of health facilities in order to maximize accessibility. [Natl J of Med Res 2013; 3(1.000: 80-82

  4. [Specialist and lay ethical expertise in public health: issues and challenges for discourse ethics].

    Science.gov (United States)

    Massé, Raymond

    2012-01-01

    In recent decades, both public health professionals and the populations targeted by prevention and health promotion programs have shown an increasing interest in ethical issues since some interventions have been seen as impinging on fundamental rights and values. Insofar as bioethics is not adapted to population interventions and community health issues, a specific expertise in public health ethics is now required. However, ethical expertise in this area faces many challenges. The purpose of this paper is to examine four of these challenges. The first three challenges concern professional or specialist expertise. The paper suggests that expertise in public health ethics should go beyond the search for greater sophistication in defining ethical principles. Experts in public health ethics also need to identify appropriate strategies to include public health professionals in ethical analysis and to adopt a critical and reflexive approach to the status of moral experts and moral expertise. However, the main challenge is to identify appropriate ways of reconciling lay and specialist ethical expertise. The paper argues that secular morality and common morality represent two key sources of lay ethics expertise and that the fundamental values that inform discourse ethics should be derived from both forms of expertise.

  5. Information resources for assessing health effects from chemical exposure: Challenges, priorities, and future issues

    Energy Technology Data Exchange (ETDEWEB)

    Seigel, S. [National Library of Medicine, Bethesda, MD (United States)

    1990-12-31

    Issues related to developing information resources for assessing the health effects from chemical exposure include the question of how to address the individual political issues relevant to identifying and determining the timeliness, scientific credibility, and completeness of such kinds of information resources. One of the important ways for agencies to share information is through connection tables. This type of software is presently being used to build information products for some DHHS agencies. One of the challenges will be to convince vendors of data of the importance of trying to make data files available to communities that need them. In the future, information processing will be conducted with neural networks, object-oriented database management systems, and fuzzy-set technologies, and meta analysis techniques.

  6. Taking care of our health: research tackling Europe's grand challenge of future health issues

    NARCIS (Netherlands)

    Chivot, E.; Gehem, M.; Lingemann, S.

    2012-01-01

    Europeans have never been healthier than they are today. Yet although European countries have experienced a continuous improvement of their overall health situation, our increasing wealth has paradoxically become a driving force of new health problems. Aging and unhealthy lifestyles are leading to n

  7. Isoniazid preventive therapy for people living with HIV: public health challenges and implementation issues.

    Science.gov (United States)

    Aït-Khaled, N; Alarcon, E; Bissell, K; Boillot, F; Caminero, J A; Chiang, C-Y; Clevenbergh, P; Dlodlo, R; Enarson, D A; Enarson, P; Ferroussier, O; Fujiwara, P I; Harries, A D; Heldal, E; Hinderaker, S G; Kim, S J; Lienhardt, C; Rieder, H L; Rusen, I D; Trébucq, A; Van Deun, A; Wilson, N

    2009-08-01

    Isoniazid preventive therapy (IPT) is recognised as an important component of collaborative tuberculosis (TB) and human immunodeficiency virus (HIV) activities to reduce the burden of TB in people living with HIV (PLHIV). However, there has been little in the way of IPT implementation at country level. This failure has resulted in a recent call to arms under the banner title of the 'Three I's' (infection control to prevent nosocomial transmission of TB in health care settings, intensified TB case finding and IPT). In this paper, we review the background of IPT. We then discuss the important challenges of IPT in PLHIV, namely responsibility and accountability for the implementation, identification of latent TB infection, exclusion of active TB and prevention of isoniazid resistance, length of treatment and duration of protective efficacy. We also highlight several research questions that currently remain unanswered. We finally offer practical suggestions about how to scale up IPT in the field, including the need to integrate IPT into a package of care for PLHIV, the setting up of operational projects with the philosophy of 'learning while doing', the development of flow charts for eligibility for IPT, the development and implementation of care prior to antiretroviral treatment, and finally issues around procurement, distribution, monitoring and evaluation. We support the implementation of IPT, but only if it is done in a safe and structured way. There is a definite risk that 'sloppy' IPT will be inefficient and, worse, could lead to the development of multidrug-resistant TB, and this must be avoided at all costs.

  8. Global health issues of aflatoxins in food and agriculture: challenges and opportunities

    Science.gov (United States)

    This special research topic eBOOK contains six review articles, three mini reviews and four original research articles. It opens up exciting perspectives on global health issues related to aflatoxins in the food chain and on the development of suitable strategies for preventing toxigenic fungal grow...

  9. The mental health professions: workforce supply and demand, issues, and challenges.

    Science.gov (United States)

    Robiner, William N

    2006-09-01

    The U.S. mental health (MH) workforce is comprised of core disciplines: psychology, psychiatry, social work, psychiatric nursing, and marriage and family therapy. A broader group of practitioners also deserves recognition. Diverse professions provide significant services in a variety of settings, extending the de facto mental health workforce. A tally of key disciplines estimates there are 537,857 MH professionals, or 182 per 100,000 U.S. population. This article provides an overview of the need and demand for mental health services and summarizes the MH professions (e.g., training, educational credentials, workforce estimates). It also discusses a range of challenges confronting MH professionals and the need for greater understanding of the workforce and integration of services. Methodological factors that confound estimates of the magnitude of the MH workforce are reviewed.

  10. The Challenges and Issues Regarding E-Health and Health Information Technology Trends in the Healthcare Sector

    Science.gov (United States)

    Esmaeilzadeh, Pouyan; Sambasivan, Murali; Kumar, Naresh

    Like other industries, the utilization of the internet and Information Technology (IT) has increased in the health sector. Different applications attributed to the internet and IT in healthcare practice. It includes a range of services that intersect the edge of medicine, computer and information science. The presence of the internet helps healthcare practice with the use of electronic processes and communication. Also, health IT (HIT) deals with the devices, clinical guidelines and methods required to improve the management of information in healthcare. Although the internet and HIT has been considered as an influential means to enhance health care delivery, it is completely naive to imagine all new tools and mechanisms supported by the internet and HIT systems are simply adopted and used by all organizational members. As healthcare professionals play an important role in the healthcare sector, there is no doubt that mechanism of newly introduced HIT and new application of the internet in medical practice should be coupled with healthcare professionals' acceptance. Therefore, with great resistance by healthcare professionals new mechanism and tools supported by IT and the internet cannot be used properly and subsequently may not improve the quality of medical care services. However, factors affecting the healthcare professionals' adoption behavior concerning new e-health and HIT mechanism are still not conclusively identified. This research (as a theoretical study) tries to propose the source of resistance in order to handle the challenges over new e-technology in the health industry. This study uses the involved concepts and develops a conceptual framework to improve overall acceptance of e-health and HIT by healthcare professionals.

  11. Electrolyte materials - Issues and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Balbuena, Perla B. [Department of Chemical Engineering, and Department of Materials Science and Engineering, Texas A and M University, College Station, Texas, 77843 (United States)

    2014-06-16

    Electrolytes are vital components of an electrochemical energy storage device. They are usually composed of a solvent or mixture of solvents and a salt or a mixture of salts which provide the appropriate environment for ionic conduction. One of the main issues associated with the selection of a proper electrolyte is that its electronic properties have to be such that allow a wide electrochemical window - defined as the voltage range in which the electrolyte is not oxidized or reduced - suitable to the battery operating voltage. In addition, electrolytes must have high ionic conductivity and negligible electronic conductivity, be chemically stable with respect to the other battery components, have low flammability, and low cost. Weak stability of the electrolyte against oxidation or reduction leads to the formation of a solid-electrolyte interphase (SEI) layer at the surface of the cathode and anode respectively. Depending on the materials of the electrolyte and those of the electrode, the SEI layer may be composed by combinations of organic and inorganic species, and it may exert a passivating role. In this paper we discuss the current status of knowledge about electrolyte materials, including non-aqueous liquids, ionic liquids, solid ceramic and polymer electrolytes. We also review the basic knowledge about the SEI layer formation, and challenges for a rational design of stable electrolytes.

  12. A situational analysis of sexual and reproductive health issues in physically challenged people, attending a tertiary care hospital in New Delhi

    Directory of Open Access Journals (Sweden)

    Utkarsha Agarwal

    2016-01-01

    Full Text Available Background and Objectives: Physically challenged people constitute the most stigmatized sections of society, and are excluded from outreach programs, besides being considered sexually inactive. They have unaddressed sexual and reproductive healthcare (SRH issues, predisposing them to sexual abuse and sexually transmitted infections (STIs. The huge paucity of data in this field prompted us to undertake this study. Materials and Methods: A cross-sectional survey was conducted on 100 people with more than 40% of permanent disability, attending various out/inpatient facilities of a tertiary care hospital in New Delhi, India. A structured, pretested questionnaire was used to assess SRH issues. Samples were collected from consenting individuals for diagnosis of various STIs, wherever relevant. Statistical analysis was done using Pearson's Chi-square test, considering significant at P <0.05. Results: Most people were in the age group of 15–30 years. Limbs were most commonly affected, and the use of assistive devices was statistically related to income levels (P = 0.045, 43% was married and 41% had children. Contraceptive usage was 33%, with a significant association (P = 0.03 with education levels. Issues related to sexual health included conditions ranging from nerve sensation loss in genitalia to fertility and gynecological issues, only 10% had received sexual counseling during rehabilitation. There were several misconceptions prevalent regarding HIV and STIs; 35% of the samples tested positive for chlamydia IgG. Interpretation and Conclusions: This is a pioneer study on a grossly neglected issue in India. There is a dire need to overcome hurdles and address the SRH issues of physically challenged people to achieve the universal WHO goal of “Health for All.”

  13. The challenge of contemporary nurse education programmes. Perceived stressors of nursing students: mental health and related lifestyle issues.

    Science.gov (United States)

    Timmins, F; Corroon, A M; Byrne, G; Mooney, B

    2011-11-01

    This study aimed to identify the lifestyle behaviours of nursing students. The research tool was a 146-item questionnaire based upon the College Lifestyle and Attitudinal National survey. Most students considered their mental health as either good or very good. Those in the final year were more likely to rate their mental health poorly. Many experienced programme-related stressors including examinations and assignments and studies in general. More than one-third also reported stressors related to relationships with clinical staff and clinical assessment of competence. There is a concern that the added demands of modern nursing programmes place the student under considerably more pressure, because of competing demands. While many students talk to their peers or family, many do not and prefer rather to go it alone, with some choosing to escape through alcohol or drugs. The support and encouragement of healthy coping mechanisms among nursing students is paramount to ensure a healthy nursing workforce for the future. Nursing students support the mental and physical health of others, and therefore in many ways ought to a role model. Nurturing and supporting their mental health is crucial to the future of profession.

  14. ISSUES, CHALLENGES, AND SOLUTIONS: BIG DATA MINING

    Directory of Open Access Journals (Sweden)

    Jaseena K.U.

    2014-12-01

    Full Text Available Data has become an indispensable part of every economy, industry, organization, business function and individual. Big Data is a term used to identify the datasets that whose size is beyond the ability of typical database software tools to store, manage and analyze. The Big Data introduce unique computational and statistical challenges, including scalability and storage bottleneck, noise accumulation, spurious correlation and measurement errors. These challenges are distinguished and require new computational and statistical paradigm. This paper presents the literature review about the Big data Mining and the issues and challenges with emphasis on the distinguished features of Big Data. It also discusses some methods to deal with big data.

  15. RFID Technologies : emerging issues and challenges

    NARCIS (Netherlands)

    Lieshout, M.J. van; Kool, L.

    2007-01-01

    In this paper we will present the results of a technology and policy assessment we have performed on emerging issues and policy challenges of RFID technologies. RFID is a basic component of the future internet of things. A balanced view on opportunities and threats, on drivers and barriers is needed

  16. Human missions to Mars: issues and challenges

    Science.gov (United States)

    Race, M.; Kminek, G.

    Recent announcements of the planned future human exploration of Mars by both European and US space agencies have raised a host of questions and challenges that must be addressed in advance of long-duration human missions. While detailed mission planning is a long way off, numerous issues can already be identified in the broad context of planetary protection. In this session, a panel of experts will provide brief overviews of the types of challenges ahead, such as the protection of the martian environment; the integration of human and robotic mission elements and operations; precursor scientific information necessary to plan human missions; development and use of nuclear and other technologies for the protection and support of astronauts during the mission; protection of Earth upon return; and societal and ethical questions about human exploration. The session has been designed to encourage and incorporate audience participation in the discussion about the issues and challenges ahead.

  17. Current Issues in Maritime Health

    DEFF Research Database (Denmark)

    Wagtmann, Maria Anne

    2008-01-01

     In the early part of 2008, Maria Anne Wagtmann had the opportunity to interview the former president of the International Maritime Health Association, Dr. Tim Carter, in London about a number of current maritime health issues. In this interview, Dr. Tim Carter, who is cur­rently employed...

  18. Science Education in Bhutan: Issues and challenges

    Science.gov (United States)

    Childs, Ann; Tenzin, Wangpo; Johnson, David; Ramachandran, Kiran

    2012-02-01

    Science education in a developing country is pivotal in the developmental process. Bhutan, like other developing countries, places great importance in institutionalising a relevant and challenging science curriculum for all of its school-aged children. A number of factors have made the review of the science curriculum in Bhutan a priority including international debates about scientific literacy and the changing time and needs of Bhutanese society and its students. This article reports on the findings of a study to investigate the present status and challenges of the current science curriculum from interviews with teachers, students, and other key stakeholders such as higher education lecturers and employers. The study also draws on observations of science classes and key curriculum documents. This study was conducted as a prelude to the major science curriculum reform prioritised in the government's 10th Five Year Plan (2008-2012) in order to provide a research informed perspective for science curriculum development. The findings from the research are reported here and show a number of positive issues in science education including good student motivation in lower classes. Challenges are identified including issues of teacher development, resourcing, and fragmentation and discontinuity in the current curriculum. These issues and challenges are discussed in the light of literature on science education in developing countries.

  19. Stressful life events, social health issues and low birthweight in an Australian population-based birth cohort: challenges and opportunities in antenatal care

    Directory of Open Access Journals (Sweden)

    Sutherland Georgina A

    2011-03-01

    Full Text Available Abstract Background Investment in strategies to promote 'a healthy start to life' has been identified as having the greatest potential to reduce health inequalities across the life course. The aim of this study was to examine social determinants of low birthweight in an Australian population-based birth cohort and consider implications for health policy and health care systems. Methods Population-based survey distributed by hospitals and home birth practitioners to >8000 women six months after childbirth in two states of Australia. Participants were women who gave birth to a liveborn infant in Victoria and South Australia in September/October 2007. Main outcome measures included stressful life events and social health issues, perceived discrimination in health care settings, infant birthweight. Results 4,366/8468 (52% of eligible women returned completed surveys. Two-thirds (2912/4352 reported one or more stressful life events or social health issues during pregnancy. Women reporting three or more social health issues (18%, 768/4352 were significantly more likely to have a low birthweight infant ( Conclusions There is a window of opportunity in antenatal care to implement targeted preventive interventions addressing potentially modifiable risk factors for poor maternal and infant outcomes. Developing the evidence base and infrastructure necessary in order for antenatal services to respond effectively to the social circumstances of women's lives is long overdue.

  20. Challenges for the German Health Care System.

    Science.gov (United States)

    Dietrich, C F; Riemer-Hommel, P

    2012-06-01

    The German Health Care System (GHCS) faces many challenges among which an aging population and economic problems are just a few. The GHCS traditionally emphasised equity, universal coverage, ready access, free choice, high numbers of providers and technological equipment; however, real competition among health-care providers and insurance companies is lacking. Mainly in response to demographic changes and economic challenges, health-care reforms have focused on cost containment and to a lesser degree also quality issues. In contrast, generational accounting, priorisation and rationing issues have thus far been completely neglected. The paper discusses three important areas of health care in Germany, namely the funding process, hospital management and ambulatory care, with a focus on cost control mechanisms and quality improving measures as the variables of interest. Health Information Technology (HIT) has been identified as an important quality improvement tool. Health Indicators have been introduced as possible instruments for the priorisation debate.

  1. Tell Me More: Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Harwati Hashim

    2012-07-01

    Full Text Available Integration of technology into language education has become an everyday occurrence. Educational multimedia courseware as resource materials to enhance the teaching and learning of English language was produced extensively. Regardless of the cost, computers and courseware are becoming important tools for learning in institutions. Therefore, a considerable pressure is being put on the ESL teachers to make use of the courseware marvels in their lesson since the cost of the courseware is rather expensive. This paper aims to investigate the issues and challenges faced by the ESL lecturers on the use of a courseware named TELL ME MORE in a polytechnic in Melaka. Data was collected via semi-structured interviews with four ESL lecturers at the polytechnic. Findings show that the courseware is a useful tool for language learning. However, there are certain challenges that the ESL lecturers had to face such as time and lack of facilities.

  2. Trends, Issues and Challenges Concerning Spam Mails

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    Jitendra Nath Shrivastava

    2012-07-01

    Full Text Available Traditional correspondence system has now been replaced by internet, which has now become indispensable in everyone’s life. With the advent of the internet, majority of people correspond through emails several times in a day. However, as internet has evolved, email is being exploited by spammers so as to disturb the recipients’. The entire internet community pays the price, every time there pops a spam mail. Online privacy of the users is compromised when spam disturbs a network by crashing mail servers and filling up hard disks. Servers classified as spam sites are forfeited from sending mails to the recipients’. This paper gives the broader view of spam, issues challenges and statistical losses occurred on account of spams.

  3. Challenges and Issues in Knowledge Management

    DEFF Research Database (Denmark)

    and its members, that the KM system is "owned" by organizational members with particular emphasis on executive sponsorship and team member acceptance, and that it be understood as an ongoing process rather than simply another management objective or faddish consulting tool. The focus, therefore, should......"Challenges and Issues in Knowledge Management" - the fifth volume in the "Research on Management Consulting" series - presents sixteen chapters that explore these various perspectives, focusing on knowledge management within the context of the management consulting industry, the dynamics...... associated with knowledge sharing and dissemination, methodological approaches to studying knowledge in organizations, and reflections on knowledge management and management consulting. As the chapters underscore, it is important to ensure that KM initiatives are aligned with the needs of the organization...

  4. Corporate Governance- Issues and Challenges in Pakistan

    Directory of Open Access Journals (Sweden)

    Beenish Ameer

    2013-04-01

    Full Text Available Pakistani companies are crucial for attaining the better position in the global market by adopting the actual concept of corporate governance. Corporate governance is a worldwide phenomenon. Corporate Governance is the system of rules, practices and processes by which a company is directed and controlled. This research paper focuses on the finding & reviewing of the issues and challenges faced by corporate governance in Pakistan. Keeping in view the objectives of this study , research design was adopted to have greater accuracy and in depth analysis of the research study. Available secondary data was extensively used for the study. The investigator procures the required data through secondary survey method. Different news articles, Books and Web were used which were enumerated and recorded The causes of poor corporate governance in Pakistani companies are ineffectiveness of INED’s in Pakistani companies, a lack of understanding, inadequately trained personnel, coverage, policy etc. further adds to the reach and effectiveness of corporate governance programs.

  5. Challenges of health measurement in studies of health disparities.

    Science.gov (United States)

    Burgard, Sarah A; Chen, Patricia V

    2014-04-01

    Health disparities are increasingly studied in and across a growing array of societies. While novel contexts and comparisons are a promising development, this commentary highlights four challenges to finding appropriate and adequate health measures when making comparisons across groups within a society or across distinctive societies. These challenges affect the accuracy with which we characterize the degree of inequality, limiting possibilities for effectively targeting resources to improve health and reduce disparities. First, comparisons may be challenged by different distributions of disease and second, by variation in the availability and quality of vital events and census data often used to measure health. Third, the comparability of self-reported information about specific health conditions may vary across social groups or societies because of diagnosis bias or diagnosis avoidance. Fourth, self-reported overall health measures or measures of specific symptoms may not be comparable across groups if they use different reference groups or interpret questions or concepts differently. We explain specific issues that make up each type of challenge and show how they may lead to underestimates or inflation of estimated health disparities. We also discuss approaches that have been used to address them in prior research, note where further innovation is needed to solve lingering problems, and make recommendations for improving future research. Many of our examples are drawn from South Africa or the United States, societies characterized by substantial socioeconomic inequality across ethnic groups and wide disparities in many health outcomes, but the issues explored throughout apply to a wide variety of contexts and inquiries.

  6. Adolescent HIV/AIDS: Issues and challenges

    Directory of Open Access Journals (Sweden)

    Naswa Smriti

    2010-01-01

    Full Text Available Adolescence (10- 19 years is a phase of physical growth and development accompanied by sexual maturation, often leading to intimate relationships. Adolescent HIV/AIDS is a separate epidemic and needs to be handled and managed separately from adult HIV. The adolescents can be subdivided into student, slum and street youth; street adolescents being most vulnerable to HIV/AIDS. Among various risk factors and situations for adolescents contracting HIV virus are adolescent sex workers, child trafficking, child labor, migrant population, childhood sexual abuse, coercive sex with an older person and biologic (immature reproductive tract as well as psychological vulnerability. The most common mode of transmission is heterosexual, yet increasing number of perinatally infected children are entering adolescence. This is due to "bimodal progression" (rapid and slow progressors among the vertically infected children. Clinically, the HIV infected adolescents present as physically stunted individuals, with delayed puberty and adrenarche. Mental illness and substance abuse are important co-morbidities. The disclosure and declaration of HIV status to self and family is challenging and guilt in sexually infected adolescents and tendency to blame parents if vertically affected need special consideration and proper counseling. Serodiscordance of the twins and difference in disease progression of seroconcordant twins are added causes of emotional trauma. Treatment related issues revolve around the when and what of initiation of ART; the choice of antiretrovirals and their dosages; issues related to long term ADRs; sense of disinhibition following ART commencement; adherence and resistance.

  7. Framing global health: the governance challenge.

    Science.gov (United States)

    McInnes, Colin; Kamradt-Scott, Adam; Lee, Kelley; Reubi, David; Roemer-Mahler, Anne; Rushton, Simon; Williams, Owain David; Woodling, Marie

    2012-01-01

    With the emergence of global health comes governance challenges which are equally global in nature. This article identifies some of the initial limitations in analyses of global health governance (GHG) before discussing the focus of this special supplement: the framing of global health issues and the manner in which this impacts upon GHG. Whilst not denying the importance of material factors (such as resources and institutional competencies), the article identifies how issues can be framed in different ways, thereby creating particular pathways of response which in turn affect the potential for and nature of GHG. It also identifies and discusses the key frames operating in global health: evidence-based medicine, human rights, security, economics and development.

  8. Mental Health Issues and Students with Emotional and Behavioral Disorders

    Science.gov (United States)

    DeLoach, Kendra P.; Dvorsky, Melissa; Miller, Elaine; Paget, Michael

    2012-01-01

    Students with emotional and behavioral challenges are significantly impacted by mental health issues. Teachers and other school staff need mental health knowledge to work more effectively with these students. Collaboration with mental health professionals and sharing of information is essential. [For complete volume, see ED539318.

  9. Logistics in Namibia: Issues and challenges

    Directory of Open Access Journals (Sweden)

    Christopher J. Savage

    2013-05-01

    Full Text Available Logistics is perceived to be important for Namibia’s growth and development, but this may be a matter of conjecture as there is a dearth of documented information about the industry in Namibia. Furthermore, it is uncertain what the understanding of logistics is for key stakeholders in the country. This article reports on a project; the objectives were to address some of these issues and to lay the foundation for a more thorough investigation in the future. The findings of the initial project were disseminated in 2012 by: a conference paper showing the challenges and opportunities facing logistics in Namibia in 2012; a report; and through a Logistics and Transport Workshop held in Walvis Bay, Namibia in September 2012. These reports, additional interviews and subsequent discussions highlighted some potential opportunities and problems. This article summarises the project to date, showing the methodology and findings as updated by subsequent feedback and further interviews. The findings from key stakeholders of the logistics industry in Namibia include: universal agreement on the importance of logistics to Namibia; the variety in the understanding of the term logistics; the strength of the continuing influence of South Africa as the dominant economic power in southern Africa; and contrasting views on the main factors limiting logistics development, including infrastructure, attitude, government, customs, training, railways, corruption and driver shortage.

  10. Health Care Challenges in Iran

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    M Davari

    2005-10-01

    Full Text Available All health systems across the world have faced new challenges, which is primarily referable to increasing the cost of health care services as well as growing demands for new and expensive health technologies. The aim of this study is to analyse the main challenges facing the Iranian health system. A review of available governmental and relevant publications about Iranian health care system was undertaken to assess the direction of future healthcare policy. Electronic news agencies, newspapers, and parliament’s electronic news also reviewed to realise policy-makers points of view about the health system. Healthcare services in Iran have had a great success in primary healthcare services in last 25 years, which is mainly attributable to National Health Networks policy. Between 1979 and 2003, average life expectancy at birth increased from 57 to 70 and infant mortality rate fell from 104 to 26 per thousand live births. Active vaccination system, very good distribution and coverage, free end point services, family planning, maternal teaching, and primary referral system are of strong advantages of health networks in Iran. However, the healthcare system is now subject to a range of new pressures that must be addressed. Many of these pressures are common to all health services (rising consumer demands and expectations for expensive new technologies, changing disease patterns, and resources shortage, but some are largely specific to Iran. Financial fairness contribution of the population to health system, responsiveness of health system, overusing new technologies, inadequate integration of health services, and inequitable distribution of the resources are of the main challenges of health system in Iran. In addition, considering demographic changes of the Iranian population in recent decades, which made Iranian population young, potential pressures due to an aging population will reveal in coming years. Many of these pressures relate to policies and

  11. Issues and Trends in Higher Education Health

    Science.gov (United States)

    Tietjen-Smith, Tara

    2016-01-01

    Public speculation about bioterrorism and the increasing obesity epidemic are examples of current public health issues that continue to be illuminated in the spotlight. Major public health threats continue to drive the health job market and impact higher education health curricula (e.g., public health, health promotion, community health). Also,…

  12. Mobile healthcare applications: system design review, critical issues and challenges.

    Science.gov (United States)

    Baig, Mirza Mansoor; GholamHosseini, Hamid; Connolly, Martin J

    2015-03-01

    Mobile phones are becoming increasingly important in monitoring and delivery of healthcare interventions. They are often considered as pocket computers, due to their advanced computing features, enhanced preferences and diverse capabilities. Their sophisticated sensors and complex software applications make the mobile healthcare (m-health) based applications more feasible and innovative. In a number of scenarios user-friendliness, convenience and effectiveness of these systems have been acknowledged by both patients as well as healthcare providers. M-health technology employs advanced concepts and techniques from multidisciplinary fields of electrical engineering, computer science, biomedical engineering and medicine which benefit the innovations of these fields towards healthcare systems. This paper deals with two important aspects of current mobile phone based sensor applications in healthcare. Firstly, critical review of advanced applications such as; vital sign monitoring, blood glucose monitoring and in-built camera based smartphone sensor applications. Secondly, investigating challenges and critical issues related to the use of smartphones in healthcare including; reliability, efficiency, mobile phone platform variability, cost effectiveness, energy usage, user interface, quality of medical data, and security and privacy. It was found that the mobile based applications have been widely developed in recent years with fast growing deployment by healthcare professionals and patients. However, despite the advantages of smartphones in patient monitoring, education, and management there are some critical issues and challenges related to security and privacy of data, acceptability, reliability and cost that need to be addressed.

  13. Special Issue: The First Provenance Challenge

    Energy Technology Data Exchange (ETDEWEB)

    Moreau, Luc; Ludaescher, Bertram T.; Altintas, Ilkay; Barga, Roger S.; Bowers, Shawn; Callahan, Steven P.; Chin, George; Clifford, Ben; Cohen, Shirley; Cohen-Boulakia, Sarah; Davidson, Susan; Deelman, Ewa; digiampietri, Luciano; Foster, Ian T.; Freire, Juliana; Frew, James; Futrelle, Joe; Gibson, Tara D.; Gil, Yolanda; Goble, Carole; Golbeck, Jennifer; Groth, Paul; Holland, David A.; Jiang, Sheng; Kim, Jihie; Koop, David; Krenek, Ales; McPhillips, Timothy; Mehta, Gaurang; Miles, Simon; Metzger, Dominic; Munroe, Steve; Myers, James D.; Plale, Beth A.; Podhorszki, norbert; Ratnakar, Varun; Emanuele , Santos; scheidegger, Carlos E.; Schuchardt, Karen L.; Seltzer, Margo I.; Simmhan, Yogesh L.; Claudio, Silva T.; Slaughter, Peter; Stephan, Eric G.; Stevens, Robert; Turi, Daniele; Vo, Huy T.; Wilde, Mike J.; Zhao, Jun; Zhao, Yong

    2008-04-01

    The first Provenance Challenge was set up in order to provide a forum for the community to help understand the capabilities of different provenance systems and the expressiveness of their provenance representations. To this end, a Functional Magnetic Resonance Imaging workflow was defined, which participants had to either simulate or run in order to produce some provenance representation, from which a set of identified queries had to be implemented and executed. Sixteen teams responded to the challenge, and submitted their inputs. In this paper, we present the challenge workflow and queries, and summarise the participants contributions.

  14. Manufacturing plant control challenges and issues

    OpenAIRE

    Morel, Gérard; Valckenaers, Paul; Faure, Jean-Marc; Pereira, Carlos Eduardo; Diedrich, Christian

    2007-01-01

    International audience; Enterprise control system integration between business systems, manufacturing execution systems and shop-floor process-control systems remains a key issue for facilitating the deployment of plant-wide information control systems for practical e-business-to-manufacturing industry-led issues. Achievement of the integration-in-manufacturing paradigm based on centralized/distributed hardware/software automation architectures is evolving using the intelligence-in-manufactur...

  15. ISSUES, CHALLENGES, AND SOLUTIONS: BIG DATA MINING

    OpenAIRE

    Jaseena K.U,; Julie M. David

    2014-01-01

    Data has become an indispensable part of every economy, industry, organization, business function and individual. Big Data is a term used to identify the datasets that whose size is beyond the ability of typical database software tools to store, manage and analyze. The Big Data introduce unique computational and statistical challenges, including scalability and storage bottleneck, noise accumulation, spurious correlation and measurement errors. These challenges are distinguishe...

  16. Nanometrology - challenges for health regulation

    Directory of Open Access Journals (Sweden)

    Jailton Carreteiro Damasceno

    2013-11-01

    Full Text Available The relationship between metrology, nanotechnology and nanoscience and sanitary regulation is discussed from the point of view of its importance and the interrelationship between the themes for the development of products and services involving nanotech-nology. The discussion involves the main techniques for measuring dimensional, chemical and biological properties of materials, and presents some of the challenges for the future. Issues such as processes of standardization and regulation in Europe, U.S. and Brazil are also addressed, providing an overview of how these processes are related to sanitary regulation.

  17. Issues and Challenges in Sedentary Behavior Measurement

    Science.gov (United States)

    Kang, Minsoo; Rowe, David A.

    2015-01-01

    Previous research has shown the negative impact of sedentary behavior on health, including cardiovascular risk factors, chronic disease-related morbidity, and mortality. Accurate measurement of sedentary behavior is thus important to plan effective interventions and to inform public health messages. This article (a) provides an overview of the…

  18. Community Colleges--Prevention Challenges. Issues in Prevention

    Science.gov (United States)

    Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012

    2012-01-01

    This issue of "Issues in Prevention" focuses on prevention challenges facing community colleges. This issue contains the following articles: (1) Prevention at Community Colleges; (2) Q&A With William Auvenshine; (3) Chancellor's Initiative at the University of Wisconsin-Stout; (4) Alcohol Marketing in the Digital Age; and (5) Higher Education…

  19. CHALLENGING ISSUES AND LIMITATIONS OF MOBILE COMPUTING

    Directory of Open Access Journals (Sweden)

    Kusuma Kumari B.M

    2015-11-01

    Full Text Available Mobile computing is becoming increasingly important due to the rise in the number of portable computers and the desire to have continuous network connectivity to the Internet irrespective of the physical location of the node. Mobile computing has fast become an important new paradigm in today's world of networked computing systems. Ranging from wireless laptops to cellular phones and WiFi/Bluetooth-enabled PDA's to wireless sensor networks, mobile computing has become ubiquitous in its impact on the people daily lives. The goal of this paper is to point out some of the limitations, constraints, mobility, challenges and applications of mobile computing.

  20. Challenging Issues and Limitations of Mobile Computing

    Directory of Open Access Journals (Sweden)

    Kusuma Kumari B.M

    2014-02-01

    Full Text Available Mobile computing is becoming increasingly important due to the rise in the number of portable computers and the desire to have continuous network connectivity to the Internet irrespective of the physical location of the node. Mobile computing has fast become an important new paradigm in today's world of networked computing systems. Ranging from wireless laptops to cellular phones and WiFi/Bluetooth-enabled PDA's to wireless sensor networks, mobile computing has become ubiquitous in its impact on the people daily lives. The goal of this paper is to point out some of the limitations, constraints, mobility, challenges and applications of mobile computing.

  1. Air quality management in China: issues, challenges, and options.

    Science.gov (United States)

    Wang, Shuxiao; Hao, Jiming

    2012-01-01

    This article analyzed the control progress and current status of air quality, identified the major air pollution issues and challenges in future, proposed the long-term air pollution control targets, and suggested the options for better air quality in China. With the continuing growth of economy in the next 10-15 years, China will face a more severe situation of energy consumption, electricity generation and vehicle population leading to increase in multiple pollutant emissions. Controlling regional air pollution especially fine particles and ozone, as well as lowering carbon emissions from fossil fuel consumption will be a big challenge for the country. To protect public health and the eco-system, the ambient air quality in all Chinese cities shall attain the national ambient air quality standards (NAAQS) and ambient air quality guideline values set by the World Health Organization (WHO). To achieve the air quality targets, the emissions of SO2, NOx, PM10, and volatile organic compounds (VOC) should decrease by 60%, 40%, 50%, and 40%, respectively, on the basis of that in 2005. A comprehensive control policy focusing on multiple pollutants and emission sources at both the local and regional levels was proposed to mitigate the regional air pollution issue in China. The options include development of clean energy resources, promotion of clean and efficient coal use, enhancement of vehicle pollution control, implementation of synchronous control of multiple pollutants including SO2, NOx, VOC, and PM emissions, joint prevention and control of regional air pollution, and application of climate friendly air pollution control measures.

  2. Air quality management in China: Issues, challenges, and options

    Institute of Scientific and Technical Information of China (English)

    Shuxiao Wang; Jiming Hao

    2012-01-01

    This article analyzed the control progress and current status of air quality,identified the major air pollution issues and challenges in future,proposed the long-term air pollution control targets,and suggested the options for better air quality in China.With the continuing growth of economy in the next 10-15 years,China will face a more severe situation of energy consumption,electricity generation and vehicle population leading to increase in multiple pollutant emissions.Controlling regional air pollution especially fine particles and ozone,as well as lowering carbon emissions from fossil fuel consumption will be a big challenge for the country.To protect public health and the eco-system,the ambient air quality in all Chinese cities shall attain the national ambient air quality standards (NAAQS)and ambient air quality guideline values set by the World Health Organization (WHO).To achieve the air quality targets,the emissions of SO2,NOx,PM10,and volatile organic compounds (VOC) should decrease by 60%,40%,50%,and 40%,respectively,on the basis of that in 2005.A comprehensive control policy focusing on multiple pollutants and emission sources at both the local and regional levels was proposed to mitigate the regional air pollution issue in China.The options include development of clean energy resources,promotion of clean and efficient coal use,enhancement of vehicle pollution control,implementation of synchronous control of multiple pollutants including SO2,NOx,VOC,and PM emissions,joint prevention and control of regional air pollution,and application of climate friendly air pollution control measures.

  3. MODERN NETWORK SECURITY: ISSUES AND CHALLENGES

    Directory of Open Access Journals (Sweden)

    SHAILJA PANDEY

    2011-05-01

    Full Text Available Secure Network has now become a need of any organization. The security threats are increasing day by day and making high speed wired/wireless network and internet services, insecure andunreliable. Now – a - days security measures works more importantly towards fulfilling the cutting edge demands of today’s growing industries. The need is also induced in to the areas like defense, where secure and authenticated access of resources are the key issues related to information security. In this paper Author has described the important measures and parameters regarding large industry/organizational requirements for establishing a secure network. Wi-Fi networks are very common in providing wirelessnetwork access to different resources and connecting various devices wirelessly. There are need of different requirements to handle Wi-Fi threats and network hacking attempts. This paper exploresimportant security measures related to different network scenarios, so that a fully secured network environment could be established in an organization. Author also has discussed a case study to illustratethe minimal set of measures required for establishing network security in any organization.

  4. Health Issues Facing Black Women.

    Science.gov (United States)

    Reid, Inez Smith

    Black women in the United States experience a high incidence of serious health problems and, as a group, receive insufficient and inadequate medical care. The death rate for black women suffering from breast cancer has increased substantially since 1950. Also of great concern is the high incidence of cervical cancer in low income black women…

  5. Public engagement on global health challenges

    Directory of Open Access Journals (Sweden)

    Minhas Gunjeet S

    2008-05-01

    Full Text Available Abstract Background Experience with public engagement activities regarding the risks and benefits of science and technology (S&T is growing, especially in the industrialized world. However, public engagement in the developing world regarding S&T risks and benefits to explore health issues has not been widely explored. Methods This paper gives an overview about public engagement and related concepts, with a particular focus on challenges and benefits in the developing world. We then describe an Internet-based platform, which seeks to both inform and engage youth and the broader public on global water issues and their health impacts. Finally, we outline a possible course for future action to scale up this and similar online public engagement platforms. Results The benefits of public engagement include creating an informed citizenry, generating new ideas from the public, increasing the chances of research being adopted, increasing public trust, and answering ethical research questions. Public engagement also fosters global communication, enables shared experiences and methodology, standardizes strategy, and generates global viewpoints. This is especially pertinent to the developing world, as it encourages previously marginalized populations to participate on a global stage. One of the core issues at stake in public engagement is global governance of science and technology. Also, beyond benefiting society at large, public engagement in science offers benefits to the scientific enterprise itself. Conclusion Successful public engagement with developing world stakeholders will be a critical part of implementing new services and technologies. Interactive engagement platforms, such as the Internet, have the potential to unite people globally around relevant health issues.

  6. Vocational and Technical Education in Lebanon: Strategic Issues and Challenges

    Science.gov (United States)

    Karam, Gebran

    2006-01-01

    The current status of the Lebanese vocational and technical education (VTE) system is assessed and the strategic issues and challenges facing it are identified. In addition to the economic and social challenges that are common to many developing countries, the Lebanese system suffers from idiosyncratic problems, which may require innovative and…

  7. Security issues of new innovative payments and their regulatory challenges

    NARCIS (Netherlands)

    Kasiyanto, Safari; Gabriella, Gimigliano

    2016-01-01

    Kasiyanto discusses how the security issues of M-payments and Bitcoin as new forms of innovative payments challenge the existing EU regulatory frameworks, and whether the proposed regulatory frameworks suffice to address such challenges. The regulatory frameworks Kasiyanto discusses mainly focus on

  8. Health Issues: Do Cell Phones Pose a Health Hazard?

    Science.gov (United States)

    ... Procedures Home, Business, and Entertainment Products Cell Phones Health Issues Share Tweet Linkedin Pin it More sharing ... it Email Print Do cell phones pose a health hazard? Many people are concerned that cell phone ...

  9. Economic evaluation in stratified medicine: methodological issues and challenges

    Directory of Open Access Journals (Sweden)

    Hans-Joerg eFugel

    2016-05-01

    Full Text Available Background: Stratified Medicine (SM is becoming a practical reality with the targeting of medicines by using a biomarker or genetic-based diagnostic to identify the eligible patient sub-population. Like any healthcare intervention, SM interventions have costs and consequences that must be considered by reimbursement authorities with limited resources. Methodological standards and guidelines exist for economic evaluations in clinical pharmacology and are an important component for health technology assessments (HTAs in many countries. However, these guidelines have initially been developed for traditional pharmaceuticals and not for complex interventions with multiple components. This raises the issue as to whether these guidelines are adequate to SM interventions or whether new specific guidance and methodology is needed to avoid inconsistencies and contradictory findings when assessing economic value in SM.Objective: This article describes specific methodological challenges when conducting health economic (HE evaluations for SM interventions and outlines potential modifications necessary to existing evaluation guidelines /principles that would promote consistent economic evaluations for SM.Results/Conclusions: Specific methodological aspects for SM comprise considerations on the choice of comparator, measuring effectiveness and outcomes, appropriate modelling structure and the scope of sensitivity analyses. Although current HE methodology can be applied for SM, greater complexity requires further methodology development and modifications in the guidelines.

  10. Gender Issues in Health Sector

    Directory of Open Access Journals (Sweden)

    Prakash Prabhakarrao Doke

    2015-04-01

    Full Text Available Gender wise analysis of data brings out biological, behavioural and social variables which indicate inequality in the health parameters in male and female sex. There is discrimination against women. Right to birth is denied by sex selective elimination, right to survival is denied by the neglect of girl child resulting in declining trend of child sex ratio which has reached an alarming low level of 914 in 2011 in spite of the fact that the female sex is biologically stronger. The mortality and morbidity indicators are unfavourable to the females. Maternal mortality in developing countries including India is unacceptably high. There is a failure of achievement of Millennium Development Goals in relation to maternal mortality and gender equality and empowerment of women. Crime against women is increasing. Violence is domestic or at workplace or occurring in public places. Social factors like male dominance and subordinate status of women make them vulnerable to unfair treatment, discrimination, denial of basic human rights to survival, education, health, inheritance, etc. The preventive measures in the form of education of masses for effective change in behaviour against gender discrimination, provision of facilities for achieving gender equality, and legislative measures for controlling violence against women at domestic and public level need intensification to achieve social justice of gender equality.

  11. Health Issues for Lesbians: Prevention First

    Science.gov (United States)

    ... 2014. How can people prevent HPV? Centers for Disease Control and Prevention. http://www.cdc.gov/hpv/prevention.html. Accessed July 13, 2014. Aug. 20, 2014 Original article: http://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/health-issues-for-lesbians/ ...

  12. Health Issues for Gay Men: Prevention First

    Science.gov (United States)

    ... 2014. How can people prevent HPV? Centers for Disease Control and Prevention. http://www.cdc.gov/hpv/prevention.html. Accessed July 13, 2014. Aug. 15, 2014 Original article: http://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/health-issues-for-gay- ...

  13. Issues in consumer mental health information.

    Science.gov (United States)

    Angier, J J

    1984-07-01

    Consumer health information as applied to mental health includes areas such as the diagnosis, management, and treatment of mental illness, as well as self-help, emotional wellness, and the relationship between life events, stress, and disease. This paper presents issues specific to the provision of mental health information to the layperson, e.g., confidentiality, literacy, competence, the social stigma of mental illness, the state of the art in psychiatry, popular psychology, and treatment fads. The development of a community education pamphlet illustrates how one organization addressed these issues.

  14. Issues in consumer mental health information.

    OpenAIRE

    Angier, J J

    1984-01-01

    Consumer health information as applied to mental health includes areas such as the diagnosis, management, and treatment of mental illness, as well as self-help, emotional wellness, and the relationship between life events, stress, and disease. This paper presents issues specific to the provision of mental health information to the layperson, e.g., confidentiality, literacy, competence, the social stigma of mental illness, the state of the art in psychiatry, popular psychology, and treatment f...

  15. Challenges for health care development in Croatia.

    Science.gov (United States)

    Ostojić, Rajko; Bilas, Vlatka; Franc, Sanja

    2012-09-01

    The main aim of the research done in this paper was to establish key challenges and perspectives for health care development in the Republic of Croatia in the next two decades. Empirical research was conducted in the form of semi-structured interviews involving 49 subjects, representatives of health care professionals from both, public and private sectors, health insurance companies, pharmaceutical companies, drug wholesalers, and non-governmental organisations (patient associations). The results have shown that key challenges and problems of Croatian health care can be divided into three groups: functioning of health care systems, health care personnel, and external factors. Research has shown that key challenges related to the functioning of health care are inefficiency, financial unviability, inadequate infrastructure, and the lack of system transparency. Poor governance is another limiting factor. With regard to health care personnel, they face the problems of low salaries, which then lead to migration challenges and a potential shortage of health care personnel. The following external factors are deemed to be among the most significant challenges: ageing population, bad living habits, and an increase in the number of chronic diseases. However, problems caused by the global financial crisis and consequential macroeconomic situation must not be neglected. Guidelines for responding to challenges identified in this research are the backbone for developing a strategy for health care development in the Republic of Croatia. Long-term vision, strategy, policies, and a regulatory framework are all necessary preconditions for an efficient health care system and more quality health services.

  16. Techniques, Applications and Challenging Issue in Text Mining

    Directory of Open Access Journals (Sweden)

    Shaidah Jusoh

    2012-11-01

    Full Text Available Text mining is a very exciting research area as it tries to discover knowledge from unstructured texts. These texts can be found on a desktop, intranets and the internet. The aim of this paper is to give an overview of text mining in the contexts of its techniques, application domains and the most challenging issue. The focus is given on fundamentals methods of text mining which include natural language possessing and information extraction. This paper also gives a short review on domains which have employed text mining. The challenging issue in text mining which is caused by the complexity in a natural language is also addressed in this paper.

  17. Metabolic syndrome in youth: current issues and challenges.

    Science.gov (United States)

    Huang, Terry T-K; Ball, Geoff D C; Franks, Paul W

    2007-02-01

    The current paper reviews the important issues and challenges facing children and adolescents with the metabolic syndrome (MetS). Studies suggest that the MetS and its risk components may be on the rise in children along with rising rates of obesity; however, further study remains warranted. The topics reviewed encompass the definition of the syndrome, its prevalence, clustering and tracking of metabolic risk factors, the role of physical activity and diet in the development of the MetS, criticisms and utility of the MetS definition, and special considerations needed in the pediatric population. Physical activity and diet may play important roles in the MetS; however, research with precise measurements of activity, diet, and metabolic outcomes is needed. The paper concludes by emphasizing that regardless of one's position in the ongoing debate about the MetS, the long-term risks attributable to each individual risk component are real. The abnormality of one component should automatically prompt the screening of other components. Among children and adolescents, lifestyle modification should always serve as the frontline strategy. Prevention during childhood is key to the largest possible impact on adult health at the population level.

  18. Current health issues in Korean adolescents

    Directory of Open Access Journals (Sweden)

    Chang Ho Hong

    2011-10-01

    Full Text Available During the adolescent period, they experience rapid physical, emotional, cognitive developments while they establish their lifestyle and habitual routines that strongly influence adult health and life. Recent rapid economic growth in Korea, and the earlier onset of physical, sexual, and psychological maturation of adolescents, has resulted in changes in the health status of adolescents from many years ago. Risk-taking behaviors such as drinking alcohol, smoking, and sexual experiences are critical issues that affect the health of, adolescents. Therefore, it is important for pediatricians to note the that risk-taking behaviors of adolescents in Korea that are caused by individual psychosocial factors. This review article illustrates the current health status of Korean adolescents and provides an overview of risktaking behaviors, to inform pediatricians about some of the key issues.

  19. Facing the Issues: Challenges, Censorship, and Reflection through Dialogue

    Science.gov (United States)

    Lent, ReLeah Cossett

    2008-01-01

    ReLeah Cossett Lent provides practical advice for ensuring that books are kept on shelves and in classrooms for students to read. She outlines steps for creating professional learning communities that engage with censorship issues and prepare schools to deal with book challenges in thoughtful, supportive ways. (Contains 4 figures.)

  20. Value-Creating Networks: Organizational Issues and Challenges

    Science.gov (United States)

    Allee, Verna

    2009-01-01

    Purpose: The purpose of this paper is to provide examples of evaluating value-creating networks and to address the organizational issues and challenges of a network orientation. Design/methodology/approach: Value network analysis was first developed in 1993 and was adapted in 1997 for intangible asset management. It has been applied from shopfloor…

  1. Renewal of Central Higher Education: Issues and Challenges.

    Science.gov (United States)

    Cerych, Ladislav

    1991-01-01

    The heritage of the past 50 years is the greatest challenge facing higher education in central Europe. Issues to be addressed include the traditional separation of teaching and research, low enrollment and labor market needs, diversification, access, the role of the government, and the economic context and impact of higher education. (MSE)

  2. Older Workers' Learning within Organizations: Issues and Challenges

    Science.gov (United States)

    Findsen, Brian

    2015-01-01

    As increasing numbers of older adults stay in the workforce or engage in encore careers, they are subjected to diverse issues and challenges. The new dynamics of the workplace in a global market exert pressure on older workers and employers alike in which training and development has a potentially significant function for achieving greater…

  3. Routing in Highly Dynamic Ad Hoc Networks: Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Varun G Menon

    2016-04-01

    Full Text Available The aim of this research paper is to analyze the various issues and challenges involved in routing of data packets in highly mobile ad hoc networks. Routing in ad hoc networks has always been a challenging and tough task due to the dynamic topology and error prone wireless channel. There are a number of issues like lack of centralized control, constantly moving nodes etc that has to be considered while routing a data packet from the source to the destination in the ad hoc network. Routing of data packets becomes much more difficult with increased mobility of nodes. This paper analyses the various issues in routing of data packets from the source to the destination node and also lists down the parameters that has to be considered while designing and selecting a routing protocol for highly mobile ad hoc networks.

  4. Tough New Issues Refocus Health Education

    Science.gov (United States)

    Dessoff, Alan

    2011-01-01

    From dating violence to sexting and social networking, districts are struggling to address a number of sensitive and relatively new health education issues that are aggravated by students' increasing access to computers, cell phones and other digital devices. Through new or revised curricula, administrators are attempting to deal with these and…

  5. Issues and special features of animal health research

    Directory of Open Access Journals (Sweden)

    Ducrot Christian

    2011-08-01

    Full Text Available Abstract In the rapidly changing context of research on animal health, INRA launched a collective discussion on the challenges facing the field, its distinguishing features, and synergies with biomedical research. As has been declared forcibly by the heads of WHO, FAO and OIE, the challenges facing animal health, beyond diseases transmissible to humans, are critically important and involve food security, agriculture economics, and the ensemble of economic activities associated with agriculture. There are in addition issues related to public health (zoonoses, xenobiotics, antimicrobial resistance, the environment, and animal welfare. Animal health research is distinguished by particular methodologies and scientific questions that stem from the specific biological features of domestic species and from animal husbandry practices. It generally does not explore the same scientific questions as research on human biology, even when the same pathogens are being studied, and the discipline is rooted in a very specific agricultural and economic context. Generic and methodological synergies nevertheless exist with biomedical research, particularly with regard to tools and biological models. Certain domestic species furthermore present more functional similarities with humans than laboratory rodents. The singularity of animal health research in relation to biomedical research should be taken into account in the organization, evaluation, and funding of the field through a policy that clearly recognizes the specific issues at stake. At the same time, the One Health approach should facilitate closer collaboration between biomedical and animal health research at the level of research teams and programmes.

  6. Issues and special features of animal health research.

    Science.gov (United States)

    Ducrot, Christian; Bed'hom, Bertrand; Béringue, Vincent; Coulon, Jean-Baptiste; Fourichon, Christine; Guérin, Jean-Luc; Krebs, Stéphane; Rainard, Pascal; Schwartz-Cornil, Isabelle; Torny, Didier; Vayssier-Taussat, Muriel; Zientara, Stephan; Zundel, Etienne; Pineau, Thierry

    2011-08-24

    In the rapidly changing context of research on animal health, INRA launched a collective discussion on the challenges facing the field, its distinguishing features, and synergies with biomedical research. As has been declared forcibly by the heads of WHO, FAO and OIE, the challenges facing animal health, beyond diseases transmissible to humans, are critically important and involve food security, agriculture economics, and the ensemble of economic activities associated with agriculture. There are in addition issues related to public health (zoonoses, xenobiotics, antimicrobial resistance), the environment, and animal welfare.Animal health research is distinguished by particular methodologies and scientific questions that stem from the specific biological features of domestic species and from animal husbandry practices. It generally does not explore the same scientific questions as research on human biology, even when the same pathogens are being studied, and the discipline is rooted in a very specific agricultural and economic context.Generic and methodological synergies nevertheless exist with biomedical research, particularly with regard to tools and biological models. Certain domestic species furthermore present more functional similarities with humans than laboratory rodents.The singularity of animal health research in relation to biomedical research should be taken into account in the organization, evaluation, and funding of the field through a policy that clearly recognizes the specific issues at stake. At the same time, the One Health approach should facilitate closer collaboration between biomedical and animal health research at the level of research teams and programmes.

  7. Public Health Challenges and Priorities for Kazakhstan

    Directory of Open Access Journals (Sweden)

    Altyn Aringazina

    2012-11-01

    Full Text Available The Republic of Kazakhstan is one of the largest and fastest growing post-Soviet economies in Central Asia. Despite recent improvements in health care in response to Kazakhstan 2030 and other state-mandated policy reforms, Kazakhstan still lags behind other members of the Commonwealth of Independent States of the European Region on key indicators of health and economic development. Although cardiovascular diseases are the leading cause of mortality among adults, HIV/AIDS, tuberculosis, and blood-borne infectious diseases are of increasing public health concern. Recent data suggest that while Kazakhstan has improved on some measures of population health status, many environmental and public health challenges remain. These include the need to improve public health infrastructure, address the social determinants of health, and implement better health impact assessments to inform health policies and public health practice. In addition, more than three decades after the Declaration of Alma-Ata, which was adopted at the International Conference on Primary Health Care convened in Kazakhstan in 1978, facilitating population-wide lifestyle and behavioral change to reduce risk factors for chronic and communicable diseases, as well as injuries, remains a high priority for emerging health care reforms and the new public health. This paper reviews the current public health challenges in Kazakhstan and describes five priorities for building public health capacity that are now being developed and undertaken at the Kazakhstan School of Public Health to strengthen population health in the country and the Central Asian Region.

  8. Electronic Health Record (EHR and Cloud Security: The Current Issues

    Directory of Open Access Journals (Sweden)

    Emmanuel Kusi Achampong

    2014-02-01

    Full Text Available With the advent of the cloud computing and its associated challenges, building a secured electronic health record (EHR in a cloud computing environment has attracted a lot of attention in both healthcare industry and academic community. Cloud computing concept is becoming a popular information technology (IT infrastructure for facilitating EHR sharing and integration. In this study we discuss security concepts related to EHR sharing and integration in healthcare clouds and analyse the arising security and privacy issues in access and management of EHRs. This paper focus on the current challenges that comes with the use of the cloud computing for EHR purposes.

  9. Emerging Issues and Opportunities in Health Information Technology.

    Science.gov (United States)

    Nardi, Elizabeth A; Lentz, Lisa Korin; Winckworth-Prejsnar, Katherine; Abernethy, Amy P; Carlson, Robert W

    2016-10-01

    When used effectively, health information technology (HIT) can transform clinical care and contribute to new research discoveries. Despite advances in HIT and increased electronic health record adoption, many challenges to optimal use, interoperability, and data sharing exist. Data standardization across systems is limited, and scanned medical note documents result in unstructured data that make reporting on quality measures for reimbursement burdensome. Different policies and initiatives, including the Health Information Technology for Economic and Clinical Health Act, the Medicare Access and CHIP Reauthorization Act, and the National Cancer Moonshot initiative, among others, all recognize the impact that HIT can have on cancer care. Given the growing role HIT plays in health care, it is vital to have effective and efficient HIT systems that can exchange information, collect credible data that is analyzable at the point of care, and improves the patient-provider relationship. In June 2016, NCCN hosted the Emerging Issues and Opportunities in Health Information Technology Policy Summit. The summit addressed challenges, issues, and opportunities in HIT as they relate to cancer care. Keynote presentations and panelists discussed moving beyond Meaningful Use, HIT readiness to support and report on quality care, the role of HIT in precision medicine, the role of HIT in the National Cancer Moonshot initiative, and leveraging HIT to improve quality of clinical care.

  10. Human Dignity in International Law: Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Izabela Bratiloveanu

    2012-05-01

    Full Text Available We intend to present in this synthesis study the concept of human dignity, reviewing the main legalinstruments on the protection of human rights that defines it, concisely analysing the jurisprudence of theEuropean Court of Justice and of the European Court of Human Rights, focusing on the key moments of itsjurisprudential definition. Human dignity, through its continuously expending presence in international lawand through the controversies related to it, is an exciting and challenging topic of debate for Romanian andforeign literature, being one of the issues and challenges of the new millennium.

  11. Measuring child exposure to violence and mental health reactions in epidemiological studies: challenges and current issues Criança, violência e saúde: desafios e questões atuais

    Directory of Open Access Journals (Sweden)

    Cristiane Seixas Duarte

    2009-04-01

    Full Text Available This paper examines challenges and current issues involved in measuring exposure to different types of violence which are associated mental health problems in children and adolescents. Standardized measures suitable for epidemiological studies, selected based on their relevance in the current literature, are briefly described and commented. The assessment of child's exposure to violence may focus on a specific event (e.g., kidnapping, a specific context (e.g., war or even of a certain type of exposure (e.g., intrafamilial physical violence. The assessment of child mental health after exposure to violence has traditionally focused on posttraumatic stress disorder (PTSD - most frequently measured through non-diagnostic scales. However, other mental health reactions may be present and screening as well as diagnostic instruments which may be used to assess these reactions are also described. Two issues of emerging importance - the assessment of impairment and of traumatic grief in children - are also presented. Availability of culturally appropriate instruments is a crucial step towards proper identification of child mental health problems after exposure to violence.Este artigo examina os desafios e perspectivas atuais envolvidos na mensuração da exposição a diferentes tipos de violência e problemas de saúde mental em crianças e adolescentes. Instrumentos padronizados apropriados para estudos epidemiológicos, selecionados com base em sua relevância na literatura, são brevemente descritos e comentados. A avaliação de exposição à violência em crianças pode dizer respeito a um evento específico (como sequestro ou um contexto específico (como guerra ou mesmo um determinado tipo de exposição (como violência física intrafamiliar. A avaliação da saúde mental infantil após a exposição à violência tradicionalmente concentrou-se na avaliação do transtorno de estresse pós-traumático (TEPT - freqüentemente avaliado atrav

  12. International challenges and opportunities in health.

    Science.gov (United States)

    Evans, John R

    1993-01-01

    It is not easy to fit an introductory address to the topics of AIDS, transplantation, women's health, reproductive health, national health insurance and epidemiology and public health. I have been asked to speak on international challenges and opportunities in health care in the hope that the global context might frame your specific discussions in the broadest possible perspective. I will speak primarily about the widening gap in health status between rich and poor people and rich and poor nations -- a gap which poses great risks for the poor but increasing risks for all of us as well.

  13. [Health services waste management: a biosafety issue].

    Science.gov (United States)

    Garcia, Leila Posenato; Zanetti-Ramos, Betina Giehl

    2004-01-01

    The subject of "health services waste" is controversial and widely discussed. Biosafety, the principles of which include safeguarding occupational health, community health, and environmental safety, is directly involved in the issue of medical waste management. There are controversies as to the risks posed by medical waste, as evidenced by diverging opinions among authors: some advocate severe approaches on the basis that medical waste is hazardous, while others contend that the potential for infection from medical waste is nonexistent. The Brazilian National Health Surveillance Agency (ANVISA) has published resolution RDC 33/2003 to standardize medical waste management nationwide. There is an evident need to implement biosafety procedures in this area, including heath care workers' training and provision of information to the general population.

  14. EEG/MEG Source Imaging: Methods, Challenges, and Open Issues

    OpenAIRE

    Katrina Wendel; Outi Väisänen; Jaakko Malmivuo; Gencer, Nevzat G.; Bart Vanrumste; Piotr Durka; Ratko Magjarević; Selma Supek; Mihail Lucian Pascu; Hugues Fontenelle; Rolando Grave de Peralta Menendez

    2009-01-01

    We present the four key areas of research—preprocessing, the volume conductor, the forward problem, and the inverse problem—that affect the performance of EEG and MEG source imaging. In each key area we identify prominent approaches and methodologies that have open issues warranting further investigation within the community, challenges associated with certain techniques, and algorithms necessitating clarification of their implications. More than providing definitive answers we aim to identif...

  15. Human resource issues in university health services.

    Science.gov (United States)

    Meilman, P W

    2001-07-01

    To provide first-rate services to students, college health services need the best possible staff. Managers and supervisors play a critical role in guiding the work of their employees so as to enhance performance. Reference checks for new employees and regular performance appraisal dialogues for ongoing employees are important tools in this process. The author discusses these issues and suggests formats for reference checks and performance appraisals.

  16. Some current challenges in research on air pollution and health.

    Science.gov (United States)

    Samet, Jonathan M

    2014-01-01

    This commentary addresses some of the diverse questions of current interest with regard to the health effects of air pollution, including exposure-response relationships, toxicity of inhaled particles and risks to health, multipollutant mixtures, traffic-related pollution, accountability research, and issues with susceptibility and vulnerability. It considers the challenges posed to researchers as they attempt to provide useful evidence for policy-makers relevant to these issues. This commentary accompanies papers giving the results from the ESCALA project, a multi-city study in Latin America that has an overall goal of providing policy-relevant results. While progress has been made in improving air quality, driven by epidemiological evidence that air pollution is adversely affecting public health, the research questions have become more subtle and challenging as levels of air pollution dropped. More research is still needed, but also novel methods and approaches to address these new questions.

  17. Issues and challenges in flood risk management: Editorial for the special issue on flood risk management

    NARCIS (Netherlands)

    Jonkman, S.N.; Dawson, R.J.

    2012-01-01

    Recent flood-related disasters (Japan, Thailand, US, Australia) emphasize the need for an effective management of flood risks. As an introduction to this special issue, this editorial summarizes some of the key challenges in the field. Flood risk management needs to recognize the interconnections be

  18. Remote sensing of ecosystem health: opportunities, challenges, and future perspectives.

    Science.gov (United States)

    Li, Zhaoqin; Xu, Dandan; Guo, Xulin

    2014-11-07

    Maintaining a healthy ecosystem is essential for maximizing sustainable ecological services of the best quality to human beings. Ecological and conservation research has provided a strong scientific background on identifying ecological health indicators and correspondingly making effective conservation plans. At the same time, ecologists have asserted a strong need for spatially explicit and temporally effective ecosystem health assessments based on remote sensing data. Currently, remote sensing of ecosystem health is only based on one ecosystem attribute: vigor, organization, or resilience. However, an effective ecosystem health assessment should be a comprehensive and dynamic measurement of the three attributes. This paper reviews opportunities of remote sensing, including optical, radar, and LiDAR, for directly estimating indicators of the three ecosystem attributes, discusses the main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system, and provides some future perspectives. The main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system are: (1) scale issue; (2) transportability issue; (3) data availability; and (4) uncertainties in health indicators estimated from remote sensing data. However, the Radarsat-2 constellation, upcoming new optical sensors on Worldview-3 and Sentinel-2 satellites, and improved technologies for the acquisition and processing of hyperspectral, multi-angle optical, radar, and LiDAR data and multi-sensoral data fusion may partly address the current challenges.

  19. Remote Sensing of Ecosystem Health: Opportunities, Challenges, and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Zhaoqin Li

    2014-11-01

    Full Text Available Maintaining a healthy ecosystem is essential for maximizing sustainable ecological services of the best quality to human beings. Ecological and conservation research has provided a strong scientific background on identifying ecological health indicators and correspondingly making effective conservation plans. At the same time, ecologists have asserted a strong need for spatially explicit and temporally effective ecosystem health assessments based on remote sensing data. Currently, remote sensing of ecosystem health is only based on one ecosystem attribute: vigor, organization, or resilience. However, an effective ecosystem health assessment should be a comprehensive and dynamic measurement of the three attributes. This paper reviews opportunities of remote sensing, including optical, radar, and LiDAR, for directly estimating indicators of the three ecosystem attributes, discusses the main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system, and provides some future perspectives. The main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system are: (1 scale issue; (2 transportability issue; (3 data availability; and (4 uncertainties in health indicators estimated from remote sensing data. However, the Radarsat-2 constellation, upcoming new optical sensors on Worldview-3 and Sentinel-2 satellites, and improved technologies for the acquisition and processing of hyperspectral, multi-angle optical, radar, and LiDAR data and multi-sensoral data fusion may partly address the current challenges.

  20. Halal Supply Chain Management Streamlined Practices: Issues and Challenges

    Science.gov (United States)

    Hijrah Abd Kadir, Muhammad; Zuraidah Raja Mohd Rasi, Raja; Omar, Siti Sarah; Manap, Zariq Imran Abdul

    2016-11-01

    The quickly developing worldwide halal in business sector has given a remarkable window of chance, which empowers Malaysia to the renowned halal centre in worldwide (known as Halal-hubs). Malaysia also has proactively taken a lead in halal activities, which is presently considered as the benchmark for a halal framework worldwide. Malaysia also set up the Halal Industry Development Corporation (HDC) which driving a wide range of halal activities since the demand of halal food has increased significantly which is very crucial for a Muslim in ensuring its authenticity and integrity. Even in parallel to this developments, many studies has been conducted because there are many issues still occurs in the food industry. The issue of consumer awareness and understanding the halal principles, mixing of halal and non- halal products, halal certification and logo compliance with Shariah law and lack of regulation and enforcement need the serious attention by all parties along the supply chain. The challenges occur mainly in the halal food segregation and halal traceability of the products. The unit of analysis in this study different halal stakeholders group which are JAKIM, Halal Development Centre (HDC), Raw Material Manufacturers, Retailers and Government Agencies. This paper attempt discusses the issues and challenges occurs in the halal supply chain and faced by the practitioners as well as the relevant parties involved in the industry especially for food products manufacturers. The study would like to give a basic information about the issues and challenges in the contribution of Halal Supply Chain Management (HSCM) as well as for the future studies.

  1. Reforming health care in Canada: current issues

    Directory of Open Access Journals (Sweden)

    Baris Enis

    1998-01-01

    Full Text Available This paper examines the current health care reform issues in Canada. The provincial health insurance plans of the 1960s and 1970s had the untoward effects of limiting the federal government's clout for cost control and of promoting a system centered on inpatient and medical care. Recently, several provincial commissions reported that the current governance structures and management processes are outmoded in light of new knowledge, new fiscal realities and the evolution of power among stake-holders. They recommend decentralized governance and restructuring for better management and more citizen participation. Although Canada's health care system remains committed to safeguarding its guiding principles, the balance of power may be shifting from providers to citizens and "technocrats". Also, all provinces are likely to increase their pressure on physicians by means of salary caps, by exploring payment methods such as capitation, limiting access to costly technology, and by demanding practice changes based on evidence of cost-effectiveness.

  2. Health psychology meets behavioral economics: introduction to special issue.

    Science.gov (United States)

    Hanoch, Yaniv; Finkelstein, Eric Andrew

    2013-09-01

    Introduces the special issue of Health Psychology, entitled Health Psychology Meets Behavioral Economics. Psychologists have long been interested in understanding the processes that underlie health behaviors and, based on health behavior models that they have developed, have devised a spectrum of effective prevention and treatment programs. More recently, behavioral economists have also provided evidence of effective behavior change strategies through nonprice mechanisms in a variety of contexts, including smoking cessation, weight loss, and illicit drug use. Yet, although all are addressing similar issues, surprisingly little cross-fertilization has taken place between traditional economists, behavioral economists, and psychologists. This special issue is rooted in the assumption that collaboration between economists and psychologists can promote the development of new methodologies and encourage exploration of novel solutions to enduring health problems. The hope is that readers will be intrigued and inspired by the methodologies used in the different articles and will explore whether they might be applicable to the problems they are addressing. Collaborative efforts, although challenging and at times risky, are a promising way to produce more innovative studies, results, and interventions.

  3. Current issues in occupational health nursing. A Canadian perspective.

    Science.gov (United States)

    Hunter, C

    1991-07-01

    The National Association of Occupational Health Nurses is still in its infancy and is striving to become an interest group under the umbrella of the Canadian Nurses Association. This will bring together the provincial associations in a common goal of promoting worker health and safety. The diversity of the country and the sheer magnitude of the various occupations of Canadians reflect the need for the occupational health nurse to be well educated and kept abreast of new developments. Changes in the worksite echo changes in health and safety legislation that will help to improve conditions in the workplace. Future challenges arise from changes in the work force and the nature of work and include: ergonomic issues, job stress, older workers, EAPs, and increased competition.

  4. Climate change and health: Research challenges for health in the developing countries

    Directory of Open Access Journals (Sweden)

    Pandve Harshal

    2010-01-01

    Full Text Available Climate change has emerged as one of the most important environmental issues ever to confront humanity. Recent events have emphatically demonstrated our growing vulnerability to climate change, and health hazards are a major concern. Research pertaining to the effects of climate change on human health is the need of the hour. This paper discusses the broad challenges in health research in developing countries with specific reference to climate change.

  5. Ethical issues in electronic health records: A general overview

    Directory of Open Access Journals (Sweden)

    Fouzia F Ozair

    2015-01-01

    Full Text Available Electronic health record (EHR is increasingly being implemented in many developing countries. It is the need of the hour because it improves the quality of health care and is also cost-effective. Technologies can introduce some hazards hence safety of information in the system is a real challenge. Recent news of security breaches has put a question mark on this system. Despite its increased usefulness, and increasing enthusiasm in its adoption, not much attention is being paid to the ethical issues that might arise. Securing EHR with an encrypted password is a probable option. The purpose of this article is to discuss the various ethical issues arising in the use of the EHRs and their possible solutions.

  6. Decentralising the health sector: issues in Brazil.

    Science.gov (United States)

    Collins, C; Araujo, J; Barbosa, J

    2000-06-01

    The health sector in Brazil has undergone important changes, particularly with the development of the Unified Health System (SUS). Decentralisation is an important principle of SUS and advances have been made in transferring responsibilities and resources to the local government units, known as municipios. This article describes the changes introduced, focusing on the system of municipio classification and the funding mechanisms introduced through the basic operating rule (BOR) of 1996. The paper then moves on to analysing three key issues of decentralisation in Brazil that are related to the policy process, the system of decentralisation and the output of decentralisation. Firstly, the formal process by which decisions on health sector reform are made is discussed with particular attention being paid to the negotiated and relatively open policy space. Secondly, the role of the states is discussed within the decentralised system. Thirdly, the impact of decentralisation on equity is discussed with particular reference to the resourcing of the Municipal Health Funds. The article concludes by emphasising the political nature of health sector decentralisation and the need to develop the conditions for effectiveness in decentralisation programmes.

  7. Nanotechnologies for Climate Friendly Construction – Key Issues and Challenges

    DEFF Research Database (Denmark)

    Andersen, Maj Munch; Geiker, Mette Rica

    2009-01-01

    Expectations as to the climate potentials of nanotechnology are high, none the least related to the construction sector. This paper seeks to highlight key aspects in the early development and application of eco-innovative nanotech solutions in the construction sector, “nanoconstruction”. The paper...... provides a framework for addressing relevant issues of green nanoconstruction and takes stock of current challenges. Eco-innovative nanoconstruction has the potential to simultaneously enhance the competitiveness and climate potential of the construction sector and could become a key strategic factor...

  8. National health data warehouse: issues to consider.

    Science.gov (United States)

    Blewett, Lynn A; Parente, Stephen T; Finch, Michael D; Peterson, Eileen

    2004-01-01

    A national data warehouse that links public and private data could be used to monitor trends in healthcare costs, utilization, quality of care, and adherence to quality guidelines and changes in treatment protocols. The development of the data warehouse, however, would require overcoming a number of political and technical challenges to gain access to private insurance data. This article outlines recommendations from a national conference sponsored by the Agency for Healthcare Research and Quality (AHRQ) on the private sector's role in quality monitoring and provides an operational outline for the development of a national private sector health data warehouse.

  9. Challenging orthodoxies: the road ahead for health and human rights.

    Science.gov (United States)

    Farmer, Paul

    2008-01-01

    Two decades of work delivering health care in poor communities provide a standpoint from which to challenge conventional doctrines in human rights and public health. These orthodoxies include the priority often assigned to civil and political rights over economic and social rights and a narrow concept of cost-effectiveness in public health policy. An analysis based on economic and social rights underscores, for example, that effectively treating infectious diseases in poor communities requires ensuring that people receive adequate food The challenge of maternal mortality in low-income settings similarly shows the need for an approach to rights that is simultaneously comprehensive and pragmatic. In many settings, paying community health workers for their efforts on behalf of their neighbors can also be seen as a critical strategy to realize right. Across contexts, the yield on the expanded and pragmatic view of health and human rights adumbrated here may be considerable. In forthcoming issues, Health and Human Rights will continue to investigate the conceptual, but above all the practical aspects of such issues, seeking to shift the health and rights agenda in a way that may make sense to the world's poor and marginalized, the chief victims of contemporary human rights violations.

  10. Health Issues at Work: Opportunities for Industrial/Organizational Psychology.

    Science.gov (United States)

    Ilgen, Daniel R.

    1990-01-01

    Discusses why health issues should be addressed, and why industrial/organizational psychologists should address these issues in the workplace. Presents five models for addressing health at work. Explores health-related criteria as sources for studying and developing programs concerning health. Discusses responses to health at work on an individual…

  11. Relating realist metatheory to issues of gender and mental health.

    Science.gov (United States)

    Bergin, M; Wells, John S G; Owen, Sara

    2010-06-01

    This paper seeks to advance the debate that considers critical realism as an alternative approach for understanding gender and mental health and its relatedness to mental health research and practice. The knowledge base of how 'sex' and 'gender' affect mental health and illness is expanding. However, the way we conceptualize gender is significant and challenging as quite often our ability to think about 'gender' as independent of 'sex' is not common. The influences and interplay of how sex (biological) and gender (social) affect mental health and illness requires consideration. Critical realism suggests a shared ontology and epistemology for the natural and social sciences. While much of the debate surrounding gender is guided within a constructivist discourse, an exploration of the concept 'gender' is reflected on and some key realist propositions are considered for mental health research and practice. This is achieved through the works of some key realist theorists. Critical realism offers potential for research and practice in relation to gender and mental health because it facilitates changes in our understanding, while simultaneously, not discarding that which is already known. In so doing, it allows the biological (sex) and social (gender) domains of knowledge for mental health and illness to coexist, without either being reduced to or defined by the other. Arguably, greater depth and explanations for gender and mental health issues are presented within a realist metatheory.

  12. Cultural Heritage Tourism in Malaysia: Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Ismail Norhasimah

    2014-01-01

    Full Text Available Malaysia is experiencing an incredible pace of tourism development and heritage tourism is one of the tourism branches that have long contributed to appeal the tourist destination and acts as important marketing tool to attract tourist especially with special interests in heritage and arts. Cultural heritage tourism has emerged as a potential form of alternative tourism among both international tourists as well as Malaysian domestic travelers. The difference of ethnics present in Malaysia brought different local knowledge discipline ranging from its architecture, handicrafts, traditional attire, music and dance, which reflects a colorful heritage and an amalgamated culture. There are arise of conflict in management of cultural heritage tourism in Malaysia face by tourism managers, stakeholders, governments, cultural heritage managers and local community itself. In order to maintain, conserve and preserve the resources and assets of cultural heritage in Malaysia, a system or management need to be develop that take into consideration on every issues and challenge, so that the decision making process is reliable to optimize the value of cultural heritage tourism industry in Malaysia. The purpose of this paper is to give an overview and discuss the status, issues and challenge of cultural heritage tourism in Malaysia.

  13. Mental Health Issues of Women After Release From Jail and Prison: A Systematic Review.

    Science.gov (United States)

    Stanton, Ann E; Kako, Peninnah; Sawin, Kathleen J

    2016-05-01

    The aim of this review article is to gain an understanding of the mental health issues of women released from jail or prison. Thirty-six studies were synthesized using the biopsychosocial model. Results indicate that released women's mental health issues include psychiatric diagnoses, psychological trauma, substance use disorders; access to psychological medications and services; and motherhood challenges, support, access to basic needs, and criminalized behaviors. Nurses can promote released women's mental health through pre-release assessment and treatment of mental health issues and ensuring access to post-release resources.  Future research should examine released women's mental health experiences.

  14. Reviews on Security Issues and Challenges in Cloud Computing

    Science.gov (United States)

    An, Y. Z.; Zaaba, Z. F.; Samsudin, N. F.

    2016-11-01

    Cloud computing is an Internet-based computing service provided by the third party allowing share of resources and data among devices. It is widely used in many organizations nowadays and becoming more popular because it changes the way of how the Information Technology (IT) of an organization is organized and managed. It provides lots of benefits such as simplicity and lower costs, almost unlimited storage, least maintenance, easy utilization, backup and recovery, continuous availability, quality of service, automated software integration, scalability, flexibility and reliability, easy access to information, elasticity, quick deployment and lower barrier to entry. While there is increasing use of cloud computing service in this new era, the security issues of the cloud computing become a challenges. Cloud computing must be safe and secure enough to ensure the privacy of the users. This paper firstly lists out the architecture of the cloud computing, then discuss the most common security issues of using cloud and some solutions to the security issues since security is one of the most critical aspect in cloud computing due to the sensitivity of user's data.

  15. Reproductive health issues in rural Western Kenya

    Directory of Open Access Journals (Sweden)

    Ouma Peter

    2008-03-01

    Full Text Available Abstract Background We describe reproductive health issues among pregnant women in a rural area of Kenya with a high coverage of insecticide treated nets (ITNs and high prevalence of HIV (15%. Methods We conducted a community-based cross-sectional survey among rural pregnant women in western Kenya. A medical, obstetric and reproductive history was obtained. Blood was obtained for a malaria smear and haemoglobin level, and stool was examined for geohelminths. Height and weight were measured. Results Of 673 participants, 87% were multigravidae and 50% were in their third trimester; 41% had started antenatal clinic visits at the time of interview and 69% reported ITN-use. Malaria parasitemia and anaemia (haemoglobin Conclusion In this rural area with a high HIV prevalence, the reported use of condoms before pregnancy was extremely low. Pregnancy health was not optimal with a high prevalence of malaria, geohelminth infections, anaemia and underweight. Chances of losing a child after birth were high. Multiple interventions are needed to improve reproductive health in this area.

  16. Perceived Health Issues: A perspective from East-African immigrants

    Directory of Open Access Journals (Sweden)

    M. P-L Shipp

    2014-05-01

    Full Text Available This Study explores Somali and Ethiopian community leaders’ perceptions about health issues in their communities and the barriers to access and utilization of primary health care services. Fourteen in-depth interviews were conducted with community leaders and thematic analysis was used to analyze interviews. Participants identified chronic diseases, the unhealthy behaviors associated with them, and mental health as major health issues. Infectious diseases were secondarily mentioned as important health concerns. Lack of insurance and limited understanding of the health system were viewed as barriers to utilizing health care services. Other identified needs were: better education within immigrant communities about major health issues, enhanced cultural awareness of health care providers, improved health care access, and assistance with the acculturation process. Recommendations to improve the communities’ health status included enhancing providers' cultural competence, educating immigrants about major health issues, and increasing mental health care access.

  17. Mental health issues in unaccompanied refugee minors

    Directory of Open Access Journals (Sweden)

    Huemer Julia

    2009-04-01

    Full Text Available Abstract Previous studies about unaccompanied refugee minors (URMs showed that they are a highly vulnerable group who have greater psychiatric morbidity than the general population. This review focuses on mental health issues among URMs. Articles in databases PsycINFO, Medline and PubMed from 1998 to 2008 addressing this topic were reviewed. The literature had a considerable emphasis on the assessment of PTSD symptoms. Results revealed higher levels of PTSD symptoms in comparison to the norm populations and accompanied refugee minors. In several studies, age and female gender predicted or influenced PTSD symptoms. The existing literature only permits limited conclusions on this very hard to reach population. Future research should include the analysis of long-term outcomes, stress management and a more thorough analysis of the whole range of psychopathology. Additionally, the development of culturally sensitive norms and standardized measures for diverse ethnic groups is of great importance.

  18. Emerging health issues of cyanobacterial blooms

    Directory of Open Access Journals (Sweden)

    Maura Manganelli

    2012-12-01

    Full Text Available This paper describes emerging issue related to cyanobacterial dynamics and toxicity and human health risks. Data show an increasing cyanobacteria expansion and dominance in many environments. However there are still few information on the toxic species fitness, or on the effects of specific drivers on toxin production. Open research fields are related to new exposure scenario (cyanotoxins in water used for haemodialysis and in food supplements; to new patterns of co-exposure between cyanotoxins and algal toxins and/or anthropogenic chemicals; to dynamics affecting toxicity and production of different cyanotoxin variants under environmental stress; to the accumulation of cyanotoxins in the food web. In addition, many data gaps exist in the characterization of the toxicological profiles, especially about long term effects.

  19. Green Cellular Networks: A Survey, Some Research Issues and Challenges

    CERN Document Server

    Hasan, Ziaul; Bhargava, Vijay K

    2011-01-01

    Energy efficiency in cellular networks is a growing concern for cellular operators to not only maintain profitability, but also to reduce the overall environment effects. This emerging trend of achieving energy efficiency in cellular networks is motivating the standardization authorities and network operators to continuously explore future technologies in order to bring improvements in the entire network infrastructure. In this article, we present a brief survey of methods to improve the power efficiency of cellular networks, explore some research issues and challenges and suggest some techniques to enable an energy efficient or "green" cellular network. Since base stations consume a maximum portion of the total energy used in a cellular system, we will first provide a comprehensive survey on techniques to obtain energy savings in base stations. Next, we discuss how heterogenous network deployment based on micro, pico and femto-cells can be used to achieve this goal. Since cognitive radio and cooperative rela...

  20. Mobile mental health: a challenging research agenda.

    Science.gov (United States)

    Olff, Miranda

    2015-01-01

    The field of mobile health ("m-Health") is evolving rapidly and there is an explosive growth of psychological tools on the market. Exciting high-tech developments may identify symptoms, help individuals manage their own mental health, encourage help seeking, and provide both preventive and therapeutic interventions. This development has the potential to be an efficient cost-effective approach reducing waiting lists and serving a considerable portion of people globally ("g-Health"). However, few of the mobile applications (apps) have been rigorously evaluated. There is little information on how valid screening and assessment tools are, which of the mobile intervention apps are effective, or how well mobile apps compare to face-to-face treatments. But how feasible is rigorous scientific evaluation with the rising demands from policy makers, business partners, and users for their quick release? In this paper, developments in m-Health tools-targeting screening, assessment, prevention, and treatment-are reviewed with examples from the field of trauma and posttraumatic stress disorder. The academic challenges in developing and evaluating m-Health tools are being addressed. Evidence-based guidance is needed on appropriate research designs that may overcome some of the public and ethical challenges (e.g., equity, availability) and the market-driven wish to have mobile apps in the "App Store" yesterday rather than tomorrow.

  1. The issue of mental health in occupational health surveillance

    Directory of Open Access Journals (Sweden)

    Luís Henrique da Costa Leão

    2014-12-01

    Full Text Available This paper addresses the issue of mental health in the Occupational Health Surveillance (VISAT context. It seeks to present theoretical aspects and institutional policies contributing to the incorporation of mental health dimensions into the VISAT process, in view of the pressing need to attend to this demand that is becoming increasingly important in the occupational health area, especially within the scope of the National Comprehensive Occupational Healthcare Network (RENAST. Some theoretical approaches and practical experiences in mental health and work are systematically presented and discussed in this essay. A survey is also conducted of potential strategies to integrate mental health into VISAT actions. It is our view that the origins of illnesses and ensuing harm are closely linked to the elements involved in work organization and management. Consequently, surveillance practices should include and identify generating components of these negative aspects. The diversity of illnesses caused by work processes and conditions calls for major investment to ascertain and change the situations that give rise to such illnesses.

  2. Identifying Key Challenges in Performance Issues in Cloud Computing

    Directory of Open Access Journals (Sweden)

    Ashraf Zia

    2012-10-01

    Full Text Available Cloud computing is a harbinger to a newer era in the field of computing where distributed and centralized services are used in a unique way. In cloud computing, the computational resources of different vendors and IT services providers are managed for providing an enormous and a scalable computing services platform that offers efficient data processing coupled with better QoS at a lower cost. The on-demand dynamic and scalable resource allocation is the main motif behind the development and deployment of cloud computing. The potential growth in this area and the presence of some dominant organizations with abundant resources (like Google, Amazon, Salesforce, Rackspace, Azure, GoGrid, make the field of cloud computing more fascinating. All the cloud computing processes need to be in unanimity to dole out better QoS i.e., to provide better software functionality, meet the tenant’s requirements for their desired processing power and to exploit elevated bandwidth.. However, several technical and functional e.g., pervasive access to resources, dynamic discovery, on the fly access and composition of resources pose serious challenges for cloud computing. In this study, the performance issues in cloud computing are discussed. A number of schemes pertaining to QoS issues are critically analyzed to point out their strengths and weaknesses. Some of the performance parameters at the three basic layers of the cloud — Infrastructure as a Service, Platform as a Service and Software as a Service — are also discussed in this paper.

  3. Electronic Warfare:Issues and Challenges for Emitter Classification

    Directory of Open Access Journals (Sweden)

    Manish Gupta

    2011-04-01

    Full Text Available Electronic warfare (EW is an important capability that provides advantage to defence forces over their adversaries. Defence forces gather tactical intelligence through EW sensors, which provide the means to counter hostile actions of enemy forces. Functions of an EW system is threat detection and the area surveillance so as to determine the identity of surrounding emitters. Emitter classification system identifies possible threats by analysing intercepted signals. Problem of identifying emitters based on its intercepted signal characteristics is a challenging problem in electronic warfare studies. Major issues and challenges for emitter classification such as drifting of emitter parameters due to aging, operational characteristic of an emitter, i.e., same emitter can operate on multiple bands and multiple pulse repetition frequencies (PRFs are highlighted. A novel approach based on some well-known statistical methods, e.g., regression analysis, hypothesis testing, and discriminent analysis is proposed. The effectiveness of the proposed approach has been tested over ELINT (Electronic Intelligence data and illustrated using simulation data. The proposed approach can play a solution for wide variety of problems in emitter classification in electronic warfare studies.Defence Science Journal, 2011, 61(3, pp.228-234, DOI:http://dx.doi.org/10.14429/dsj.61.529

  4. Adolescent Reproductive Health:Challenges and Change

    Institute of Scientific and Technical Information of China (English)

    Laurie Schwab Zabin

    2004-01-01

    @@ The field of reproductive health has had long experience negotiating challenging environments in ways that other health fields have not -- perhaps because other health fields usually deal with illness which everyone agrees is not a good thing. Or maybe because we have all been born, we all think we know something about reproduction. Whatever the reason,we have over the years seen bitter political and ideological debates over population and family planning, abortion, the treatment of HIV/AIDS, in vitro fertilization, new contraceptive technologies--and now adolescent reproductive health. We shouldn't be surprised.But just as we have had to prevail in those debates in the past, they are crucial today: the numbers of young people entering their reproductive years throughout the world, especially the developing world, make it essential that youth be reached not only with messages and services crafted in the last 40 years but also with new messages, new ideas and new services.

  5. Human Resources for Health Challenges in Nigeria and Nurse Migration.

    Science.gov (United States)

    Salami, Bukola; Dada, Foluke O; Adelakun, Folake E

    2016-05-01

    The emigration of sub-Saharan African health professionals to developed Western nations is an aspect of increasing global mobility. This article focuses on the human resources for health challenges in Nigeria and the emigration of nurses from Nigeria as the country faces mounting human resources for health challenges. Human resources for health issues in Nigeria contribute to poor population health in the country, alongside threats from terrorism, infectious disease outbreaks, and political corruption. Health inequities within Nigeria mirror the geographical disparities in human resources for health distribution and are worsened by the emigration of Nigerian nurses to developed countries such as the United States and the United Kingdom. Nigerian nurses are motivated to emigrate to work in healthier work environments, improve their economic prospects, and advance their careers. Like other migrant African nurses, they experience barriers to integration, including racism and discrimination, in receiving countries. We explore the factors and processes that shape this migration. Given the forces of globalization, source countries and destination countries must implement policies to more responsibly manage migration of nurses. This can be done by implementing measures to retain nurses, promote the return migration of expatriate nurses, and ensure the integration of migrant nurses upon arrival in destination countries.

  6. Challenging machismo: promoting sexual and reproductive health with Nicaraguan men.

    Science.gov (United States)

    Sternberg, P

    2000-03-01

    This article presents the results of a participatory exploration of male attitudes towards sexual and reproductive health issues in Nicaragua. Nicaraguan culture views men in a machismo concept. The study examined the knowledge, attitudes and behavior of men in relation to the social construction of masculinity: sexuality, reproduction, and fatherhood. Employing 90 men from both rural and urban communities, attitudes towards sexuality, reproduction, abortion and fatherhood were discussed. Several insights were gathered from the research, which explains men's behavior. Thus, it was deemed imperative that in empowering women by promoting sexual and reproductive health among men would require challenging male hegemony and persuading men to participate in health promotion. However, the setting and application of a men's agenda for sexual health promotion should not result in the curtailment of services for women because funds are being reallocated to men, nor should it give men the opportunity to more subtle forms of domination and exploitation.

  7. Issues in Mental Health Counseling with Persons with Mental Retardation.

    Science.gov (United States)

    Prout, H. Thompson; Strohmer, Douglas C.

    1998-01-01

    Reviews mental-health issues concerning persons with mental retardation, particularly as these issues apply to mental-health counseling. Included in this review is a discussion of the prevalence of psychopathology, types of problems presented, issues in clinical bias, access to community services, assessment techniques, and specific…

  8. National health insurance policy in Nepal: challenges for implementation

    Directory of Open Access Journals (Sweden)

    Shiva Raj Mishra

    2015-08-01

    Full Text Available The health system in Nepal is characterized by a wide network of health facilities and community workers and volunteers. Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. But the reality is a far cry. Only 61.8% of the Nepalese households have access to health facilities within 30 min, with significant urban (85.9% and rural (59% discrepancy. Addressing barriers to health services needs urgent interventions at the population level. Recently (February 2015, the Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme (SHS after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias. Mechanisms should be built for monitoring unfair pricing and unaffordable copayments, and an overall benefit package be crafted to include coverage of major health services including non-communicable diseases. Regulations should include such issues as accreditation mechanisms for private providers. Health system strengthening should move along with the roll-out of SHS. Improving the efficiency of hospital, motivating the health workers, and using appropriate technology can improve the quality of health services. Also, as currently a constitution drafting is being finalized, careful planning and deliberation is necessary about what insurance structure may suit the proposed future federal structure in Nepal.

  9. Health challenges in Kazakhstan and Central Asia.

    Science.gov (United States)

    Adambekov, Shalkar; Kaiyrlykyzy, Aiym; Igissinov, Nurbek; Linkov, Faina

    2016-01-01

    The Central Asian region, which encompasses Kazakhstan, Uzbekistan, Tajikistan, Turkmenistan and Kyrgyzstan, is an interesting geographic region with a rich history dating back to the Silk Road, Mongol conquests and expansion of the Russian Empire. However, from a public health viewpoint, the Central Asian region is under-investigated, and many public health challenges exist, as countries of Central Asia inherited the centralised medical systems practiced in the Soviet Union, and are currently undergoing rapid transitions. A large number of low and middle-income countries around the world, including countries of Central Asia, face a double burden of chronic and infectious disease. This essay focuses on the exploration of the most important public health challenges in the Central Asian region, including limited scientific productivity, the double burden of chronic and infectious disease, the need for healthcare reform and the reduction in care variation. Central Asia has a large number of medical schools, medical centres, and emerging research institutes that can be used to foster a change in medical and public health practice in the region.

  10. Mobile mental health: a challenging research agenda

    Directory of Open Access Journals (Sweden)

    Miranda Olff

    2015-05-01

    Full Text Available The field of mobile health (“m-Health” is evolving rapidly and there is an explosive growth of psychological tools on the market. Exciting high-tech developments may identify symptoms, help individuals manage their own mental health, encourage help seeking, and provide both preventive and therapeutic interventions. This development has the potential to be an efficient cost-effective approach reducing waiting lists and serving a considerable portion of people globally (“g-Health”. However, few of the mobile applications (apps have been rigorously evaluated. There is little information on how valid screening and assessment tools are, which of the mobile intervention apps are effective, or how well mobile apps compare to face-to-face treatments. But how feasible is rigorous scientific evaluation with the rising demands from policy makers, business partners, and users for their quick release? In this paper, developments in m-Health tools—targeting screening, assessment, prevention, and treatment—are reviewed with examples from the field of trauma and posttraumatic stress disorder. The academic challenges in developing and evaluating m-Health tools are being addressed. Evidence-based guidance is needed on appropriate research designs that may overcome some of the public and ethical challenges (e.g., equity, availability and the market-driven wish to have mobile apps in the “App Store” yesterday rather than tomorrow.

  11. The Data Issue: Opportunities and Challenges for Scientific Publishers

    Science.gov (United States)

    Murphy, F.; Irving, D. H.

    2011-12-01

    Using the recent report for the 'Opportunities in Data Exchange' Project produced by - and for - researchers, libraries/data centres and publishers (and which is based on a broad range of studies, questionnaires and evidence) we have defined current practices and expectations, and the gaps and dilemmas involved in producing data and datasets, and then analysed their relationship to formal publications. As a result, we identified potential opportunities to evolve scientific insights to be more useful and re-useful: with consequent implications for custodianship and long-term data management. We also defined a number of key incentives and barriers towards achieving these objectives. As a case study, the earth and environmental sciences have come under particularly close scrutiny with respect to data-ownership and -sharing arrangements, sometimes with damaging results to the discipline's reputation. These issues, along with considerable technological challenges, have to be handled effectively in order to best support all the users along the data chain. To that end, we show that key stakeholders - among them scientific publishers - need to have a clear idea of how to progress data-intensive derived information, which we demonstrate is often not the case. Towards bridging this knowledge gap, we have compiled a roadmap of next steps and key issues to be acknowledged and addressed by the scientific publishing community. These include: engaging directly with researchers, policy-makers, funding bodies and direct competitors to build innovative partnerships and enhance impact; providing technological and training investment and developing alongside the emerging discipline of 'data scientist': the 'data publisher'. This individual/company will need to combine a close understanding of researchers' priorities, together with market, legal and technical opportunities and restrictions.

  12. [Mental health in Chile and Finland: Challenges and lessons].

    Science.gov (United States)

    Retamal C, Pedro; Markkula, Niina; Peña, Sebastián

    2016-07-01

    This article analyses and compares the epidemiology of mental disorders and relevant public policies in Chile and Finland. In Chile, a specific mental health law is still lacking. While both countries highlight the role of primary care, Finland places more emphasis on participation and recovery of service users. Comprehensive mental health policies from Finland, such as a successful suicide prevention program, are presented. Both countries have similar prevalence of mental disorders, high alcohol consumption and high suicide rates. In Chile, the percentage of total disease burden due to psychiatric disorders is 13% and in Finland 14%. However, the resources to address these issues are very different. Finland spends 4.5% of its health budget on mental health, while in Chile the percentage is 2.2%. This results in differences in human resources and service provision. Finland has five times more psychiatric outpatient visits, four times more psychiatrists, triple antidepressant use and twice more clinical guidelines for different psychiatric conditions. In conclusion, both countries have similar challenges but differing realities. This may help to identify gaps and potential solutions for public health challenges in Chile. Finland’s experience demonstrates the importance of political will and long-term vision in the construction of mental health policies.

  13. Energy for sustainable development: Key issues and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Kaygusuz, K. [Karadeniz Technical University, Trabzon (Turkey). Dept. of Chemistry

    2007-07-01

    Energy generation and use are strongly linked to all elements of sustainable development such as economic, social, and environmental. The history of human development rests on the availability and use of energy, the transformation from the early use of fire and animal power that improved lives, to the present world with use of electricity and clean fuels for a multitude of purposes. Energy is the neglected issue of the development debate. The lack of access to reliable and clean energy supplies is a major barrier to improving human well-being around the globe. There are an estimated 1.6 billion people living in the rural areas of developing countries who lack access to electricity, and so dependence on fossil fuels. Combustion of fossil fuels produces large amounts of CO{sub 2}, an important greenhouse gas. In response to increasing concern about the effect of anthropogenic greenhouse gases on global climate, international action has been agreed to reduce these emissions. On the other hand, renewable energy is the great, barely tapped solution to the two great challenges of the coming century such as poverty and global warming. Not only can renewable energy provide a clean, flexible power source for homes, schools and hospitals, at the micro-to-medium scale it has huge potential to create meaningful and useful jobs.

  14. Wind power policy: Issues and challenges in India

    Energy Technology Data Exchange (ETDEWEB)

    Lad, C.J. [TMES Institute of Business Management and Computer Studies, Mandvi, Gujarat (India); Mistry, S.H. [C. K. Pithawalla Institute of Management, Surat, Gujarat (India)

    2012-07-01

    The energy policy of India is much concerned with the country's ever increasing energy deficit and increased focus on developing alternative sources of energy, particularly nuclear, solar and wind energy. About 70% of country's energy generation capacity is from fossil fuels. Our nation is heavily dependent on fossil fuel imports to meet its energy demands. It is estimated that by 2030; India's dependence on energy imports is expected to exceed 53% of the country's total energy consumption. So, renewable energy usage can be sustainable alternative to country's energy demand. India has the world's fifth largest wind power market. To promote the usage of wind energy, government have declared tax incentives and other incentives but still the most of the estimated wind potential is not realized for energy need of country. In this paper author tries to identify the issues and challenges for promotion of wind power promotion in India and will suggest for the correction in the existing energy policy. (Author)

  15. Challenging issues in assessing analytical similarity in biosimilar studies

    Directory of Open Access Journals (Sweden)

    Chow SC

    2015-05-01

    Full Text Available Shein-Chung Chow Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA Abstract: For assessing biosimilarity of biosimilar products, the US Food and Drug Administration (FDA proposed a stepwise approach for providing totality-of-the-evidence of similarity between a proposed biosimilar product and a US-licensed (reference product. The stepwise approach starts with an assessment of critical quality attributes (CQAs that are relevant to clinical outcomes in structural and functional characterization in manufacturing process of the proposed biosimilar product. The FDA suggests that these critical quality–relevant attributes be identified and classified into three tiers depending their criticality or risk ranking. To assist the sponsors, the FDA also suggests some statistical approaches for the assessment of analytical similarity for CQAs from different tiers, namely equivalence test for Tier 1, quality range approach for Tier 2, and descriptive raw data and graphical comparison for Tier 3. In this paper, challenging issues to the FDA's recommended approaches are discussed followed by alternative methods for the assessment of analytical similarity (mainly for CQAs from Tier 1. Keywords: stepwise approach, critical quality attribute, CQA, equivalence test, quality range approach 

  16. Technologies for HIV prevention and care: challenges for health services.

    Science.gov (United States)

    Maksud, Ivia; Fernandes, Nilo Martinez; Filgueiras, Sandra Lucia

    2015-09-01

    This article aims to consider some relevant challenges to the provision of "new prevention technologies" in health services in a scenario where the "advances" in the global response to AIDS control are visible. We take as material for analysis the information currently available on the HIV post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP), treatment as prevention (TASP) and over the counter. The methodology consisted of the survey and analysis of the Biblioteca Virtual em Saúde (BVS: MEDLINE, LILACS, WHOLIS, PAHO, SciELO) articles that addressed the issue of HIV prevention and care in the context of so-called new prevention technologies. The results of the studies show that there is assistance on the ground of clinics for the treatment of disease responses, but there are several challenges related to the sphere of prevention. The articles list some challenges regarding to management, organization of services and the attention given by health professionals to users. The current context shows evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission, but the challenges for the provision of preventive technologies in health services permeate health professionals and users in their individual dimensions and health services in organizational and structural dimension. Interventions should be made available in a context of community mobilization; there should be no pressure on people to make HIV testing, antiretroviral treatment or for prevention. In the management is responsible for the training of health professionals to inform, clarify and make available to users, partners and family information about the new antiretroviral use strategies.

  17. Challenges to Issues of Balance and Representativeness in African Lexicography

    Directory of Open Access Journals (Sweden)

    Thapelo Joseph Otlogetswe

    2011-10-01

    Full Text Available

    Abstract: Modern dictionaries depend on corpora of different sizes and types for frequency listings, concordances and collocations, illustrative sentences and grammatical information. With the help of computer software, retrieving such information has increasingly become relatively easy. However, the quality of retrieved information for lexicographic purposes depends on the information input at the stage of corpus construction. If corpora are not representative of the different language usages of a speech community, they may prove to be unreliable sources of lexicographic information. There are, however, issues in African languages which make many African corpora questionable. These issues include a lack of texts of different genres, the unavailability of balanced and representative written texts, a complete absence of spoken texts as well as literacy problems in African societies. This article therefore explores the different challenges to the construction of reliable corpora in African languages. It argues that African languages face peculiar challenges and corpus research may require a different treatment compared to European and American corpus research. It finally concludes that issues of balance and representativeness appear theoretically impossible when looking at the results of sociolinguistic research on the different existing language varieties which are difficult to represent accurately in a corpus.

    Keywords: AFRICAN LANGUAGES, BALANCE, BANK OF ENGLISH, BORROWING,BRITISH NATIONAL CORPUS, COBUILD, CODE-SWITCHING, COMPUTERS, CORPORA,DIALECT, DICTIONARIES, FREQUENCY, LANGUAGE VARIETY, REPRESENTATIVENESS,SETSWANA, SOCIOLINGUISTICS, SPEECH, TEXT

    Opsomming: Uitdagings betreffende kwessies van balans en verteenwoordigendheidin Afrikaleksikografie. Moderne woordeboeke steun op korpusse vanverskillende groottes en soorte vir frekwensielyste, konkordansies en kollokasies, voorbeeldsinneen taalkundige inligting. Met die hulp van

  18. Health claims on foods: challenge for clinical research companies

    Directory of Open Access Journals (Sweden)

    Essi Sarkkinen

    2012-06-01

    Full Text Available Background The Nutrition and Health Claim Regulation 1924/2006/EC, together with EFSA guidances on the scientific requirements for different type of health claims, is setting the basis for health claim substantiation in the EU. Aim The aim of this presentation is to bring up the key challenges that the food industry and clinical research organizations are facing when meeting these requirements. Results and discussion Key issues in clinical research planning to meet the requirements set for the health claim substantiation are: (1 Selection of right outcome markers since the selection of outcome marker defines actually the formulation of the health claim to be used on food or food ingredient. (2 Selection of right target population since that determines the target consumer group for the food with a health claim. (3 Selection of dose regime and food matrices used since these largely determine the conditions set for the use of the health claim. One of the major challenges in health claim substantiation is the deviant approach to risk factors or biomarkers. From the regulation point of view, a single risk factor approach is emphasized, but from the clinical and scientific point of view the pattern of different risk markers or biomarkers could, in some cases, be a more relevant choice to reflect the final health outcome. This is especially the case in the nutrition and health area because we are often dealing with weak but multiple health effects of certain food items or ingredients. Also the lack of validated well-established biomarkers potent to be affected by diet is a challenge in health claim substantiation.The selection of right target population is often a compromise between choosing a more potential target group to obtain efficacy (i.e. risk factors elevated vs. patient groups and choosing a rationale to generalize the results to wider population (target consumer group.The selection of optimal dosing regime and matrices for a clinical study is

  19. mHealth For Aging China: Opportunities and Challenges.

    Science.gov (United States)

    Sun, Jing; Guo, Yutao; Wang, Xiaoning; Zeng, Qiang

    2016-01-01

    The aging population with chronic and age-related diseases has become a global issue and exerted heavy burdens on the healthcare system and society. Neurological diseases are the leading chronic diseases in the geriatric population, and stroke is the leading cause of death in China. However, the uneven distribution of caregivers and critical healthcare workforce shortages are major obstacles to improving disease outcome. With the advancement of wearable health devices, cloud computing, mobile technologies and Internet of Things, mobile health (mHealth) is rapidly developing and shows a promising future in the management of chronic diseases. Its advantages include its ability to improve the quality of care, reduce the costs of care, and improve treatment outcomes by transferring in-hospital treatment to patient-centered medical treatment at home. mHealth could also enhance the international cooperation of medical providers in different time zones and the sharing of high-quality medical service resources between developed and developing countries. In this review, we focus on trends in mHealth and its clinical applications for the prevention and treatment of diseases, especially aging-related neurological diseases, and on the opportunities and challenges of mHealth in China. Operating models of mHealth in disease management are proposed; these models may benefit those who work within the mHealth system in developing countries and developed countries.

  20. Health Recommender Systems: Concepts, Requirements, Technical Basics and Challenges

    Directory of Open Access Journals (Sweden)

    Martin Wiesner

    2014-03-01

    Full Text Available During the last decades huge amounts of data have been collected in clinical databases representing patients’ health states (e.g., as laboratory results, treatment plans, medical reports. Hence, digital information available for patient-oriented decision making has increased drastically but is often scattered across different sites. As as solution, personal health record systems (PHRS are meant to centralize an individual’s health data and to allow access for the owner as well as for authorized health professionals. Yet, expert-oriented language, complex interrelations of medical facts and information overload in general pose major obstacles for patients to understand their own record and to draw adequate conclusions. In this context, recommender systems may supply patients with additional laymen-friendly information helping to better comprehend their health status as represented by their record. However, such systems must be adapted to cope with the specific requirements in the health domain in order to deliver highly relevant information for patients. They are referred to as health recommender systems (HRS. In this article we give an introduction to health recommender systems and explain why they are a useful enhancement to PHR solutions. Basic concepts and scenarios are discussed and a first implementation is presented. In addition, we outline an evaluation approach for such a system, which is supported by medical experts. The construction of a test collection for case-related recommendations is described. Finally, challenges and open issues are discussed.

  1. Health recommender systems: concepts, requirements, technical basics and challenges.

    Science.gov (United States)

    Wiesner, Martin; Pfeifer, Daniel

    2014-03-03

    During the last decades huge amounts of data have been collected in clinical databases representing patients' health states (e.g., as laboratory results, treatment plans, medical reports). Hence, digital information available for patient-oriented decision making has increased drastically but is often scattered across different sites. As as solution, personal health record systems (PHRS) are meant to centralize an individual's health data and to allow access for the owner as well as for authorized health professionals. Yet, expert-oriented language, complex interrelations of medical facts and information overload in general pose major obstacles for patients to understand their own record and to draw adequate conclusions. In this context, recommender systems may supply patients with additional laymen-friendly information helping to better comprehend their health status as represented by their record. However, such systems must be adapted to cope with the specific requirements in the health domain in order to deliver highly relevant information for patients. They are referred to as health recommender systems (HRS). In this article we give an introduction to health recommender systems and explain why they are a useful enhancement to PHR solutions. Basic concepts and scenarios are discussed and a first implementation is presented. In addition, we outline an evaluation approach for such a system, which is supported by medical experts. The construction of a test collection for case-related recommendations is described. Finally, challenges and open issues are discussed.

  2. Health Care Personnel challenges encountering patients with Female Genital Mutilation

    OpenAIRE

    Nilsson, Raili

    2015-01-01

    Background: People are moving more and it demands more of health care in the countries receiving people from cultures and countries different from their own. I wanted to write this essay to try to answer what are the challenges for healthcare staff, and how to solve those problems when it comes to female genital-mutilation which is a widespread practice in Africa and in Islam. Aim: Female genital mutilation is an important issue because it affects a woman's life, both mentally and physical...

  3. Introduction to the Special Issue: Public Health Genetics and Genomics.

    Science.gov (United States)

    McWalter, Kirsty; Gaviglio, Amy

    2015-06-01

    This special issue of the Journal of Genetic Counseling is dedicated to public health genetics and genomics. The seventeen papers featured in this issue span such topics as genetic counselors in public health roles, newborn screening, population screening, ethics, and health beliefs and behaviors. In this introduction to the special issue, we review some history of public health genetics and genomics, present the Centers for Disease Control and Prevention's "10 Essential Public Health Services" with associated genetics specific recommendations and priorities, and briefly overview how each article ties into the world of public health genetics and genomics. We hope this issue encourages genetic counselors to visualize their ever expanding and important roles in public health genetics and genomics, as well as their contributions to improving population health.

  4. Special Issue: The Family and Health Care.

    Science.gov (United States)

    Doherty, William J., Ed.; McCubbin, Hamilton I., Ed.

    1985-01-01

    Discusses research and interventions related to family health care. Topics include health promotion; risk behaviors; vulnerability and illness onset; choosing health care systems; stress; caregiving and coping; family counseling; and family responses to Alzheimer's Disease, pediatric cancer, cystic fibrosis, diabetes, and obesity. (JAC)

  5. Health issues of asylum seekers and refugees.

    Science.gov (United States)

    Kisely, Stephen; Stevens, Margaret; Hart, Bret; Douglas, Charles

    2002-02-01

    This paper is written on behalf of the West Australian Branch of the Australasian Faculty of Public Health Medicine. As public health physicians, we feel it is important that public health professionals should contribute constructively to address the needs of a socially deprived, marginalised group with high rates of physical and psychiatric morbidity. Depending on the definition, there are between 18 and 48 million asylum seekers and refugees in the world. Most seek protection in neighbouring countries, largely in Africa and Asia, rather than coming to North America, Europe and Australasia. Contrary to popular belief, numbers of successful applications to Australia's humanitarian program have actually fallen. This article attempts to correct misperceptions and misapprehensions about the effect of asylum seekers on the public health. Public health professionals should lobby for changes to Govemment policy that at present leave asylum seekers vulnerable to a cycle of poverty, ill-health and limited access to health services.

  6. Meeting the challenges related to material issues in chemical industries

    Indian Academy of Sciences (India)

    Baldev Raj; U Kamachi Mudali; T Jayakumar; K V Kasiviswanathn; K Natarajan

    2000-12-01

    Reliable performance and profitability are two important requirements for any chemical industry. In order to achieve high level of reliability and excellent performance, several issues related to design, materials selection, fabrication, quality assurance, transport, storage, inputs from condition monitoring, failure analysis etc. have to be adequately addressed and implemented. Technology related to nondestructive testing and monitoring of the plant is also essential for precise identification of defect sites and to take appropriate remedial decision regarding repair, replacement or modification of process conditions. The interdisciplinary holistic approach enhances the life of critical engineering components in chemical plants. Further, understanding the failure modes of the components through the analysis of failed components throws light on the choice of appropriate preventive measures to be taken well in advance, to have a control over the overall health of the plant. The failure analysis also leads to better design modification and condition monitoring methodologies, for the next generation components and plants. At the Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam, a unique combination of the expertise in design, materials selection, fabrication, NDT development, condition monitoring, life prediction and failure analysis exists to obtain desired results for achieving high levels of reliability and performance assessment of critical engineering components in chemical industries. Case studies related to design, materials selection and fabrication aspects of critical components in nuclear fuel reprocessing plants, NDT development and condition monitoring of various components of nuclear power plants, and important failure investigations on critical engineering components in chemical and allied industries are discussed in this paper. Future directions are identified and planned approaches are briefly described.

  7. Ethical Issues in Health Services: A Report and Annotated Bibliography.

    Science.gov (United States)

    Carmody, James

    This publication identifies, discusses, and lists areas for further research for five ethical issues related to health services: 1) the right to health care; 2) death and euthanasia; 3) human experimentation; 4) genetic engineering; and, 5) abortion. Following a discussion of each issue is a selected annotated bibliography covering the years 1967…

  8. Emerging Ethical Issues in College Health Services.

    Science.gov (United States)

    Hersh, Jeffrey B.; And Others

    1981-01-01

    Current ethical issues of clinical competence and confidentiality are explored in relation to changes in the college population and its relationship to the community. Case examples are presented. (JN)

  9. Clinical Issues in Career Counseling of Adults: A New Challenge.

    Science.gov (United States)

    Chiappone, Janice M.

    1989-01-01

    Work is an expression of identity and is related to other life roles and responsibilities. Among the interrelated issues that adults bring to career counseling are self-esteem, indecisiveness, family influences, transitions, and depression. Counselors should recognize and integrate the psychological issues that affect clients' career development.…

  10. Literacy at a Distance in Multilingual Contexts: Issues and Challenges

    Science.gov (United States)

    Ofulue, Christine I.

    2011-01-01

    Literacy is perhaps the most fundamental skill required for effective participation in education (formal and non-formal) for national development. At the same time, the choice of language for literacy is a complex issue in multilingual societies like Nigeria. This paper examines the issues involved, namely language policy, language and teacher…

  11. Health Issues in the Latino Community.

    Science.gov (United States)

    Aguirre-Molina, Marilyn, Ed.; Molina, Carlos W., Ed.; Zambrana, Ruth Enid, Ed.

    This collection of papers includes 6 parts. Part 1, "Latino Populations in the United States," includes: (1) "Latino Health Policy: Beyond Demographic Determinism" (Angelo Falcon, Marilyn Aguirre-Molina, and Carlos W. Molina); (2) "Latino Health Status" (Olivia Carter-Pokras and Ruth Enid Zambrana); and (3)…

  12. Moral issues in workplace health promotion

    NARCIS (Netherlands)

    S.J.W. Robroek (Suzan); S. van de Vathorst (Suzanne); M.T. Hilhorst (Medard); A. Burdorf (Alex)

    2011-01-01

    textabstractPurpose: There is debate to what extent employers are entitled to interfere with the lifestyle and health of their workers. In this context, little information is available on the opinion of employees. Within the framework of a workplace health promotion (WHP) program, moral consideratio

  13. Ethical and Social Issues in Health Research Involving Incarcerated People.

    Science.gov (United States)

    Coughlin, Steven S; Lewis, Sharon R; Smith, Selina A

    2016-01-01

    The use of inmates in research in the U.S. was restricted by the recommendations of the National Commission and by federal regulations and guidelines that followed. By the 1980s, many health care officials became concerned about the exclusion of inmates from experimental treatments for human immunodeficiency virus infection (HIV). These developments in ethics occurred in the context of racial/ethnic disparities in health. In this article, ethical considerations in clinical and public health research on HIV in prison and jail settings are considered. Ethical considerations in mental health research are summarized as well as issues pertaining to research involving female inmates. Issues related to oversight of research involving incarcerated people are considered along with the ethics of public health research. The ethics of research involving incarcerated people extends beyond traditional issues in human subjects ethics to include issues within the domains of bioethics and public health ethics.

  14. Innovating in Health Care – Modern Challenges

    Directory of Open Access Journals (Sweden)

    Sebija Izetbegović

    2013-12-01

    Full Text Available Introduction: The goal of this article is to present that innovating in health care begins to become an imperative in present time. Innovating will enable the achievement of the highest quality health care results and the patients' satisfaction with the least amount of financial resources.Methods: The thorough literature review of multifaceted sources was conducted including: studies, books, monographies and peer – reviewed journals with the goal of achieving the clearer picture of today's modern challenges in the complex fi eld of health care innovation.Discussion: Theoretical and empirical studies clearly indicate that the innovation is one of the key factors in the competitiveness of the organization and its survival in the market. Developed countries of the world today are making significant efforts in order for innovation to become a national priority, with special emphasis placed on measuring innovation performance. Results of theoretical and practical studies show that in the future, treatment of the most diffi cult and complex diseases of our time, through the entirely new discoveries and results, derived from the process of innovation, will project entirely new positive forms and outcomes in the health care.Conclusion: There is no doubt that the humanity and medical science will through innovation succeed to win the battles against the majority of the most complex contemporary diseases. Malignant neoplasm of tomorrow, through the application of a new, innovative approaches to research, processes and treatments will become a chronic diseases. Among many, the particular problem in the process of innovation will represent the cost of research and development (R&D, production and the safety of prescription drugs.

  15. Health emigration: a challenge in paediatric oncology.

    Science.gov (United States)

    Massimo, Luisa M; Wiley, Thomas J; Caprino, Daniela

    2008-06-01

    For the past 10 years European states have experienced an increasing flow of emigrating families from developing countries seeking better medical care for their sick children. For Italian paediatricians this has become a new challenge, considering the cultural differences in customs regarding the illness. The onset of a life-threatening disease has a strong impact on the family. The natural bond between the patient and the family must be preserved and strengthened; parents should be encouraged to entertain their child during hospitalization. The inclusion of art therapy may facilitate communication, especially for children of a different language and culture. This approach can help medical staff to understand better both the child's and the parents' anxieties and feelings. This article discusses facets of the now well-known phenomenon of ;health emigration', that is, when a family searches abroad in the hope of finding the most advanced medical treatment possible for their sick child.

  16. Human resources for health in southeast Asia: shortages, distributional challenges, and international trade in health services.

    Science.gov (United States)

    Kanchanachitra, Churnrurtai; Lindelow, Magnus; Johnston, Timothy; Hanvoravongchai, Piya; Lorenzo, Fely Marilyn; Huong, Nguyen Lan; Wilopo, Siswanto Agus; dela Rosa, Jennifer Frances

    2011-02-26

    In this paper, we address the issues of shortage and maldistribution of health personnel in southeast Asia in the context of the international trade in health services. Although there is no shortage of health workers in the region overall, when analysed separately, five low-income countries have some deficit. All countries in southeast Asia face problems of maldistribution of health workers, and rural areas are often understaffed. Despite a high capacity for medical and nursing training in both public and private facilities, there is weak coordination between production of health workers and capacity for employment. Regional experiences and policy responses to address these challenges can be used to inform future policy in the region and elsewhere. A distinctive feature of southeast Asia is its engagement in international trade in health services. Singapore and Malaysia import health workers to meet domestic demand and to provide services to international patients. Thailand attracts many foreign patients for health services. This situation has resulted in the so-called brain drain of highly specialised staff from public medical schools to the private hospitals. The Philippines and Indonesia are the main exporters of doctors and nurses in the region. Agreements about mutual recognition of professional qualifications for three groups of health workers under the Association of Southeast Asian Nations Framework Agreement on Services could result in increased movement within the region in the future. To ensure that vital human resources for health are available to meet the needs of the populations that they serve, migration management and retention strategies need to be integrated into ongoing efforts to strengthen health systems in southeast Asia. There is also a need for improved dialogue between the health and trade sectors on how to balance economic opportunities associated with trade in health services with domestic health needs and equity issues.

  17. Issues and challenges in implementing cervical cancer screenings in the emergence of HPV vaccination in Thailand.

    Science.gov (United States)

    Juntasopeepun, Phanida; Davidson, Patricia M; Srisomboon, Jatupol

    2012-01-01

    The discovery of the HPV vaccine has been a major breakthrough in preventing cervical cancer and other HPV-related diseases around the globe. Cervical cancer is a significant public health problem in Thailand. Despite the long-time availability of cervical cancer screening programs in Thailand, the uptake among the target female population remains low. HPV vaccines were approved by the Food and Drug Administration of Thailand in 2007. As of March 2011, due to financial limitations, HPV vaccines have still not been included in the national immunization program under the public health benefit plans although individuals has the option to pay privately for the vaccine. This paper discusses the issues and challenges in implementing cervical cancer screening programs in the era of HPV vaccination in Thailand. Recommendations to increase the uptake of cervical cancer screening and further research to inform a policy regarding the cervical cancer screening measures are proposed.

  18. The ethics of health service delivery: a challenge to public health leadership.

    Science.gov (United States)

    DeLuca, D M

    1989-01-01

    The ethical distribution of health care is a central issue now that AIDS has started to be a drain on health care resources. If the worst predictions are true, the next half century will be capitalized by a great stress of the health care delivery system in the Pacific. The critical challenges that face the current leadership are: sustaining commitment to all levels of administration to reduce social and health inequities; making sound decisions on policies, priorities and goals that are based on valid information; strengthen health infrastructure, based on the principle of primary health care, including appropriate distribution of staffing, skills, technology and resources. The goals of the Pacific Health Promotion and Development center must not focus exclusively on AIDs. Hepatitis B control measures, hypertension and diabetes, primary care in remote areas, and rehabilitation initiatives must be kept in place. Humanitarian interests for AIDs patients must be balanced with the pragmatic reality of saving children's hearing, or extending useful lives. The attributes of respect, accountability, leadership, judgement, fairness, integrity and honesty controlled by principles of social justice must be part of the administrative decision making process. The 2 major issues facing public health professional are: (1) the financial considerations involved with increasingly expensive technology, services and research, contrasted against the need to prioritize their use and development; (2) pragmatic and ideological needs must be balanced to maximize preventative and curative services and make them available to those who can benefit from them.

  19. Good Health Is a Global Issue

    Science.gov (United States)

    ... both show that diseases don't respect borders. Globalization has increased the movement of people and products ... the global health picture changing as populations in developing countries live longer and adopt a more western life ...

  20. Ethical issues posed by cluster randomized trials in health research

    Directory of Open Access Journals (Sweden)

    Donner Allan

    2011-04-01

    Full Text Available Abstract The cluster randomized trial (CRT is used increasingly in knowledge translation research, quality improvement research, community based intervention studies, public health research, and research in developing countries. However, cluster trials raise difficult ethical issues that challenge researchers, research ethics committees, regulators, and sponsors as they seek to fulfill responsibly their respective roles. Our project will provide a systematic analysis of the ethics of cluster trials. Here we have outlined a series of six areas of inquiry that must be addressed if the cluster trial is to be set on a firm ethical foundation: 1. Who is a research subject? 2. From whom, how, and when must informed consent be obtained? 3. Does clinical equipoise apply to CRTs? 4. How do we determine if the benefits outweigh the risks of CRTs? 5. How ought vulnerable groups be protected in CRTs? 6. Who are gatekeepers and what are their responsibilities? Subsequent papers in this series will address each of these areas, clarifying the ethical issues at stake and, where possible, arguing for a preferred solution. Our hope is that these papers will serve as the basis for the creation of international ethical guidelines for the design and conduct of cluster randomized trials.

  1. Measuring health: a practical challenge with a philosophical solution?

    Science.gov (United States)

    Shroufi, Amir; Chowdhury, Rajiv; Aston, Louise M; Pashayan, Nora; Franco, Oscar H

    2011-03-01

    With the current demographic shift being experienced by populations globally, almost linear increases in life expectancy have been seen and can be expected. However, increases in healthy life expectancy may not keep pace. Among older populations the proportion of time spent in less than full health tends to increase. As a result, the accurate valuation of life spent in states less than full health will become increasingly important. Different techniques and approaches have been used to measure health in populations. The use of summary measures of population health such as DALYs (Disability Adjusted Life Years) has become common, and is widely used to compare health between populations and to evaluate the potential impact of interventions in economic analyses. Most of the commonly used summary measures of health express some measure of life lived in full health and life lived with disability or in a state of sub-optimal health. Critical to the construction of summary health measures are values assigned to health states. Current tools used in determining these values include the standard gamble, time trade off, person trade off, and the visual analogue scale. However, these techniques all have the disadvantage of incorporating individual biases (derived from particular characteristics specific to individuals or populations) into the process through which health state valuations are derived. As a consequence health states are often not directly comparable between populations, since characteristics such as nationality and ethnicity can influence how health states are valued. Furthermore, health can be judged differently by those of different ages, with the young often assigning a lower value to life lived at less than full health compared to older people. The challenge of obtaining opinions which are not influenced by an individual's own circumstances is not new. This issue was encountered and described by the American philosopher John Rawls in 'A Theory of Justice

  2. Different Categories of Astronomical Heritage: Issues and Challenges

    Science.gov (United States)

    Ruggles, Clive

    2012-09-01

    different forms of astronomical heritage, including its intangible aspects, that will help in the development of more integrated approaches to identification and cataloguing, protection and preservation; and 3. to increase global awareness of regional, national and local initiatives relating to astronomical heritage in all its forms. In pursuance of these aims, the meeting also recommended that the AWHWG, working in collaboration with the WGs on Astronomical Instruments and Archives, and other bodies as appropriate, should develop the following additional projects: 1. to establish guidelines to help in the identification and safeguarding of tangible and intangible astronomical heritage in all its forms; 2. to gather examples of existing best practice, and to make these available as case studies on their website; and 3. to develop the website of the Astronomy and World Heritage Initiative (AWHI) as a portal to existing on-line catalogues and thesauri. It also recommended that the WGs should work together to: 1. formulate recommendations about the ways in which links and common approaches should be developed in the future; and 2. organise a meeting of international experts in the historical and heritage aspects of astronomical structures, instruments, and archives, focussed specifically upon the task of developing more integrated approaches to identification and cataloguing, protection and preservation. This joint session will attempt to make headway on as many as possible of these issues. In this opening talk I will attempt to lay out some of the main challenges that we face, and outline what we hope to achieve in this session.

  3. Comparing Mental Health Issues among Undergraduate and Graduate Students

    Science.gov (United States)

    Wyatt, Tammy; Oswalt, Sara B.

    2013-01-01

    Background: Stress and other mental health issues can negatively impact the health and academic performance of college students. Purpose: Examine relationships among stress, mental health, and academic classification in a national sample of college students. Methods: Analyses utilized secondary data from 27 387 college students responding to the…

  4. Zika Virus: An Emerging Public Health Challenge

    Directory of Open Access Journals (Sweden)

    Sumeena Basundra

    2016-07-01

    Full Text Available Emerging infectious diseases comprise a substantial proportion of global morbidity and mortality. The world has been hit by Zika virus (ZIKV after it was able to surmount an effective public health response for its control. ZIKV disease is an emerging mosquitoborne disease which occurred as large outbreaks in Yap since 2007, Polynesia in 2013 and Brazil in 2015. ZIKV infection in pregnant women has been observed to be associated with congenital microcephaly with neurological and autoimmune sequelae in general population of Brazil. The incubation period of ZIKV varies from few days to weeks. Only 20% of infected cases have symptoms like any other arboviral illness. ZIKV is diagnosed using RT-PCR (reverse transcriptase-polymerase chain reaction and virus isolation from blood samples. The treatment comprises of relief of symptoms by conservative management with no specific vaccine being available. The prevention and control of ZIKV is based on reduction of vector density by Integrated Vector Management and personal protection measures. As per Indian scenario, Ministry of Health had issued guidelines based on effective surveillance, risk communication, laboratory and travel regulations. Approaches to such a potential global health security threat should be consistent, proactive, and should involve coordinated, multi-pronged, multilateral collaborative efforts since the concern is at the highest and immediate because of Global epidemic, Rio de Janeiro Olympic Games starting from Aug 5-21, 2016 and strong association with microcephaly. Most importantly the need of the hour is the development of vaccine for protection especially the young women who are in the reproductive age groups. The research for which is ongoing as far as the current situation of global epidemic response is concerned.

  5. Issues of Safety and Security: New Challenging to Malaysia Tourism Industry

    Directory of Open Access Journals (Sweden)

    Mohd Ayob Norizawati

    2014-01-01

    Full Text Available The safety and security issues nowadays become one of the forces causing changes in tourism industry in era of millennium. The main concern of this issues more focus on crime rates, terrorism, food safety, health issues and natural disaster. This topic gained the popularity in tourism research after 9/11 tragedy and since then the academicians and practitioners started seeking the best solution in ways to mitigate these negative impacts. For Malaysia, the image as safety and secure destination was tarnished a few years lately and new unfortunates incident in this year bring more damage to Malaysia image. Healthy issues, terrorism, Lahad Datu intrusion, repeated kidnapping and shooting in Sabah, twin airlines incident, riot and illegal demonstration and false reporting by international media brings new challenging to Malaysia. Although some incident may be had short-term impact to Malaysia tourism industry, but it’s still gave the big impact to Malaysia branding process. Many travellers and Malaysian itself still believe that Malaysia is a one of safer destination and country to visit and stayed in, but more outstanding efforts was require to make sure Malaysia tourism industry was capable to recover from this negative impact as soon as possible.

  6. Personal health records: key adoption issues and implications for management.

    Science.gov (United States)

    Raisinghani, Mahesh S; Young, Erika

    2008-01-01

    Electronic Personal Health Records (PHRs) has been perceived as the tool to empower consumers to become active decision-makers of their healthcare instead of leaving the decision to providers. However, there has been the lack of enthusiasm and adoption of PHRs. This paper examines the current healthcare climate and attempts to understand the major challenges associated with PHRs adoption. The paper-based and fragmented healthcare system is no longer appropriate for the digital economy of the 21st century. The integrated health information technology system is the solution to transform clinical practice to consumer centric and information driven. Tools such as PHRs are means to an end that provide better, safer and more affordable healthcare for consumers. However, there has been little research conducted to demonstrate PHR's tangible value, despite the widespread perceived value of these technologies. Although survey data reveals that there is a lack of awareness among the public, consumers are receptive to this concept, especially when a physician recommends it. Key issues in adopting PHRs and strategies for successful implementation of PHRs are discussed.

  7. Afghan refugees in California: mental health issues.

    Science.gov (United States)

    Lipson, J G

    1993-01-01

    Refugees are a particularly vulnerable population that is at risk for mental health problems for a variety of reasons: traumatic experiences in and escapes from their countries of origin, difficult camp or transit experiences, culture conflict and adjustment problems in the country of resettlement, and multiple losses--family members, country, and way of life. Afghan refugees comprise the largest refugee population in the world, at its peak numbering more than 6 million, living mainly in Pakistan and Iran. Based on an ethnographic study of Afghan refugees in Northern California, this article describes common antecedents to and examples of mental health problems in this population, such as depression, somatic symptoms, and posttraumatic stress disorder. It reviews some of the literature on traumatized refugees and makes some suggestions to mental health providers.

  8. Tackling poor parenting: a public health issue.

    Science.gov (United States)

    Poole, Judith

    2003-01-01

    The adverse consequences associated with poor parenting persist down the generations and are a problem for society as well as individuals. The author cites evidence suggesting that in many cases poor parenting is associated with socioeconomic deprivation, including health inequalities. She argues that most parents (especially mothers, as the main child carers) are motivated to do their best for their children but that many families struggle against poverty. Poor parenting skills may be a product of poverty and social exclusion rather than the fault of individual parents. A public health approach, based on partnership with parents to meet their expressed needs in appropriate ways, could offer a constructive way forward.

  9. E-Health Interventions for Eating Disorders: Emerging Findings, Issues, and Opportunities.

    Science.gov (United States)

    Aardoom, Jiska J; Dingemans, Alexandra E; Van Furth, Eric F

    2016-04-01

    This study aimed to review the emerging findings regarding E-health interventions for eating disorders and to critically discuss emerging issues as well as challenges for future research. Internet-based cognitive behavioral therapy and guided self-help have demonstrated promising results in terms of reducing eating disorder psychopathology. Emerging findings also suggest that E-health interventions reach an underserved population and improve access to care. The use of smartphone applications is becoming increasingly popular and has much potential although their clinical utility and effectiveness is presently unknown and requires investigation. Important challenges include the diagnostic process in E-health interventions, the optimization of E-health within existing health care models, and the investigation and implementation of blended care. More high-quality research is needed to bring the field forward and to determine the place for E-health in our health care service delivery systems.

  10. Issues surrounding health claims for barley.

    Science.gov (United States)

    Ames, Nancy P; Rhymer, Camille R

    2008-06-01

    Government-approved health claims support dietary intervention as a safe and practical approach to improving consumer health and provide industry with regulatory guidelines for food product labels. Claims already allowed in the United States, United Kingdom, Sweden, and The Netherlands for reducing cholesterol through consumption of oat or barley soluble fiber provide a basis for review, but each country may have different criteria for assessing clinical evidence for a physiological effect. For example, the FDA-approved barley health claim was based on a petition that included 39 animal model studies and 11 human clinical trials. Since then, more studies have been published, but with few exceptions, clinical data continue to demonstrate that the consumption of barley products is effective for lowering total and LDL cholesterol. More research is needed to fully understand the mechanism of cholesterol reduction and the role of beta-glucan molecular weight, viscosity, and solubility. In an assessment of the physiological efficacy of a dietary intervention, consideration should also be given to the potential impact of physical and thermal food-processing treatments and genotypic variation in the barley source. New barley cultivars have been generated specifically for food use, possessing increased beta-glucan, desirable starch composition profiles, and improved milling/processing traits. These advances in barley production, coupled with the establishment of a government-regulated health claim for barley beta-glucan, will stimulate new processing opportunities for barley foods and provide consumers with reliable, healthy food choices.

  11. Managing a scarce resource: addressing critical health workforce challenges.

    NARCIS (Netherlands)

    Giepmans. P.; Dussault, G.; Batenburg, R.; Frich, J.; Olivers, R.; Sermeus, W.

    2013-01-01

    With health care services significantly changing, the challenge is to initiate innovative, situational and integrated workforce forecasting and planning. Many health systems require a shift in mindset to move to the planning of skill mixes for health care professionals. This implies great challenges

  12. Wireless networks and security issues, challenges and research trends

    CERN Document Server

    Pathan, Al-Sakib

    2013-01-01

     “Wireless Networks and Security” provides a broad coverage of wireless security issues including cryptographic coprocessors, encryption, authentication, key management, attacks and countermeasures, secure routing, secure medium access control, intrusion detection, epidemics, security performance analysis, security issues in applications. The contributions identify various vulnerabilities in the physical layer, MAC layer, network layer, transport layer, and application layer, and focus on ways of strengthening security mechanisms and services throughout the layers. This carefully edited monograph is targeting  for researchers, post-graduate students in universities, academics, and industry practitioners or professionals.  

  13. Basel III implementation: Issues and challenges for Indian banks

    Directory of Open Access Journals (Sweden)

    M. Jayadev

    2013-06-01

    Full Text Available The Basel III framework, whose main thrust has been enhancing the banking sector's safety and stability, emphasises the need to improve the quality and quantity of capital components, leverage ratio, liquidity standards, and enhanced disclosures. This article first lays the context of Basel III and then incorporates the views of senior executives of Indian banks and risk management experts on addressing the challenges of implementing the Basel III framework, especially in areas such as augmentation of capital resources, growth versus financial stability, challenges for enhanced profitability, deposit pricing, cost of credit, maintenance of liquidity standards, and strengthening of risk architecture.

  14. Internationalizing Business Education in Latin America: Issues and Challenges

    Science.gov (United States)

    Elahee, Mohammad; Norbis, Mario

    2009-01-01

    This article examines the extent of internationalization of business education in Latin America and identifies the key challenges facing the Latin American business schools. Based on a survey of the business schools that are members of CLADEA (Consejo Latinoamericano de Escuelas de Administracion--Latin American Council of Management Schools), and…

  15. Critical Performative Pedagogy: Emergent Bilingual Learners Challenge Local Immigration Issues

    Science.gov (United States)

    Harman, Ruth; Varga-Dobai, Kinga

    2012-01-01

    Recent anti-immigration policies and practices in the Southeast of the United States have presented difficult challenges for newly arrived bilingual learners and their families. To validate student voices within this socio-political context, our school/university collaboration implemented an arts-based participatory approach to English Language…

  16. Globalization and health--some issues.

    Science.gov (United States)

    Rowson, M

    2000-01-01

    Globalization is happening. But it appears that it has been associated with a rise in inequalities both between and within nations. Financial and trade liberalization, the main motors of the current phase of globalization, have been introduced with reckless abandon and little thought to the consequences. Future policy advice must bolster the role of the state in defending populations from the excesses of market forces, and there should be rigorous analysis of the health and other social impacts of economic policies.

  17. What Health Issues or Conditions Are Specific to Women Only?

    Science.gov (United States)

    ... are specific to women only? Skip sharing on social media links Share this: Page Content Women experience unique health issues and conditions, from pregnancy and menopause to gynecological conditions, such as uterine ...

  18. Urban Place and Health Equity: Critical Issues and Practices

    Directory of Open Access Journals (Sweden)

    Jason Corburn

    2017-01-01

    Full Text Available Urban places and health equity are two of the most challenging concepts for 21st century environmental health. More people live in cities than at any other time in human history and health inequities are increasing. Health inequities are avoidable differences in the social, environmental and political conditions that shape morbidity and mortality, and disproportionately burden the poor, racial, ethnic and religious minorities and migrants. By linking urban place and health inequities, research and action brings into sharp relief the challenges of achieving urban environmental justice. This article briefly reviews the complex definitions of urban places and how they can shape health equity in cities. I suggest that a more relational or integrated approach to defining urban places and acting on health equity can complement other approaches and improve the ability of public health to meet 21st century challenges. I close with suggestions for research and practice that might focus environmental public health on healthy urban place making. The practices include community driven map making, Health in All Policies (HiAP, promoting urban ecosystem services for health, and participatory and integrated approaches to urban slum upgrading. I conclude that if the global community is serious about the sustainable development goals (SDGs, greater attention must be paid to understanding and acting to improve urban places, living conditions and the social and economic conditions that can promote health equity.

  19. [General organizational issues in disaster health response].

    Science.gov (United States)

    Pacifici, L E; Riccardo, F; De Rosa, A G; Pacini, A; Nardi, L; Russo, G; Scaroni, E

    2007-01-01

    Recent studies show how in the 2004-2005 period there has been an increase in natural disasters of 18% worldwide. According to a renowned author planning for disaster response is as valid as the starting hypothesis. The study of an inductive mental process in disaster response planning is the key to avoiding the invention and re-invention of the wheel for each emergency. Research in this field however is hampered by different factors one of which is data collection that during disaster response requires specific training. Standardization of data collection models with limitation of the number of variables is required as is taking into account problems related to people migration and subsequent sampling problems and retrospective analysis. Moreover poor attention to the training of the volunteers employed on the field is an issue to be considered.

  20. Health issues of Afghan refugees in California.

    Science.gov (United States)

    Lipson, J G; Omidian, P A

    1992-09-01

    Since the 1979 Soviet invasion of Afghanistan, more than 6 million Afghan refugees have become the world's largest refugee population. Although refugees in Pakistan and Iran are now beginning to repatriate, continuing political turmoil in Afghanistan and children's acculturation and educational opportunities will keep many Afghans in the United States permanently. Although there are no accurate statistics, local resettlement agencies and Afghan community leaders estimate that there are 10,000 to 35,000 Afghans in northern California. They suffer from a variety of problems common to refugees: language, economic and occupational problems, and substantial challenges in psychological, family, social, and cultural adjustment to the United States. Although many Afghans are doing well, many others have depression, psychosomatic symptoms, and posttraumatic stress disorder.

  1. Refugees and the State Mental Health Systems: Issues and Impacts.

    Science.gov (United States)

    Neider, John R.; And Others

    This paper examines critical issues for states and advocacy groups in trying to develop short-term goals to address mental health needs of refugees and to plan long-term strategies for state and county service systems for this population. The paper begins with a discussion of the following issues: (1) centralized versus decentralized state mental…

  2. Health and safety challenges associated with immigrant dairy workers

    Directory of Open Access Journals (Sweden)

    J. Rosecrance

    2013-09-01

    Full Text Available Faced with increasing industrialization, high demands on production, and decreasing domestic participation in the labor force, dairy producers are employing an immigrant workforce to help meet operational demands. There is little data regarding the number of immigrant workers in the dairy industry, but the trend of hiring immigrant workers in some of the world’s highest producing countries is increasing. There are many challenges associated with managing immigrant workers includinghow to effectively train this workforce about safe and efficient work methods. Methods: Ethnographic methods from the anthropology field served as the primary tool to identify barriers and facilitators of safe work practices in large-herd dairy operations in the United States. Following the weeklong emersion by the research anthropologist at a selected dairy, focus groups were organized at three large-herd dairies. All focus group conversations were tape recorded, transcribed and translated into English. The focus group transcripts were coded for specific themes related to issues that participants felt were barriers or facilitators of worker health and safety. Results: Twenty-two Latino workers 18 to 58 years of age participated in the three focus groups conducted at one Colorado and two South Dakota dairies. Six major themes relating to barriers and facilitators of worker health and safety were identified and included: communication, integration owner and worker cultures, work organization, leadership, support for animal health, and attention to safety culture within the organization. Conclusions: Although not often considered by agricultural engineers, an anthropological perspective to challenges involving an immigrant workforce may assist with improved work methods and safe work practices. Through this approach, agricultural engineers may better understand the cultural challenges and complexities facing the dairy industry. Successful integration of immigrant

  3. [Women, health, and labor in Brazil: challenges for new action].

    Science.gov (United States)

    Aquino, E M; Menezes, G M; Marinho, L F

    1995-01-01

    Despite the remarkable rise in women's participation in the labor market in Brazil, its consequences on health are still virtually unknown. This study aims to identify theoretical and methodological problems in the relationship between labor and women's health from a gender perspective. Characteristics of women's occupational placement are described and analyzed as resulting from their role in social reproduction. The study examines the development of several conciliatory strategies between paid work and housework which are discussed as potential determinants of health problems and support the need for a critical reappraisal of theoretical and methodological strategies to reach a better understanding of the complexity and specificities of women's living and working conditions. The author also stresses the role of women's recent participation in the trade union movements in defense of health, body rights, and women's issues in the workplace, as well as the need for a new framework embodied in the women's social movement. The study thus points to the challenge to produce knowledge on this subject in order to unveil the uniqueness of the national scenario marked by unemployment, informal jobs, low salaries, weak trade unions and other civil organizations, and traditional domestic and marriage relationships.

  4. Issues for Engagement: Asian Perspectives on Transnational Security Challenges

    Science.gov (United States)

    2010-01-01

    for refugees . refugee lecture to seminar on east asia security. Kuala lumpur, malaysia , 9 July. xxixus Dos trafficking in Persons report 2009...transnatIonal securIty challenges 175 sex workers, mostly in china, cambodia and the larger cities of vietnam, but also in macau, thailand, and malaysia ...128 Perceptions of transnational security threat in malaysia and singapore: Windows of cooperative opportunities for the united states by

  5. Assessment in health psychology: Introduction to the special issue.

    Science.gov (United States)

    Butt, Zeeshan

    2016-09-01

    For the past 27 years, has been committed to publishing empirical research relevant to clinical assessment of basic and applied cognition, personality, interpersonal behavior, psychopathology, forensics, and biological psychology. There is growing interest in the use of patient-centered outcomes in medical/surgical care and for measuring health care performance. Patient-centered outcome measures complement traditional clinical outcomes of morbidity and mortality, capturing the patient's perspective regarding their health and its treatment. In this issue, we highlight 11 articles that address different aspects of such work. The articles in this special issue represent both the depth and breadth of the opportunities that exist for psychological assessment in the health setting. While there are countless patient-centered measures currently in use to measure health and health outcomes, the evidence base for their use can be quite variable (Butt, 2016). The hope is that future issues of will highlight more work in this area. (PsycINFO Database Record

  6. Transdisciplinary Higher Education—A Challenge for Public Health Science

    Directory of Open Access Journals (Sweden)

    Alexandra Krettek

    2011-01-01

    Full Text Available This paper highlights and discusses issues associated with transdisciplinary teaching and suggests ways to overcome the challenges posed by different epistemologies, methods, and ethical positions. Our own transdisciplinary teaching experience in public health helped us identify some important questions including (i what is transdisciplinary research in practice, and does methods triangulation yield more valid results?, (ii from a teaching perspective, how do biopsychosocial and medical research differ?, (iii what is the difference between deductive and inductive research, and does each discipline represent a different ethical position?, and (iv does pure inductive research lack theories, and does it require a hypothesis—a “rule of thumb”—on how to proceed? We also suggest ways to facilitate and enhance transdisciplinary teaching, focusing on what unites us and not on what sets us apart, openly underlining and highlighting our differences. Using diverse methodologies, a newly educated transdisciplinary workforce will likely extend current knowledge and facilitate solutions for complex public health issues.

  7. Gender-based violence: a crucial challenge for public health.

    Science.gov (United States)

    Sanjel, S

    2013-01-01

    This article attempts to summarize the situations of gender-based violence, a major public health issue. Due to the unequal power relations between men and women, women are violated either in family, in the community or in the State. Gender-based violence takes different forms like physical, sexual or psychological/ emotional violence. The causes of gender-based violence are multidimensional including social, economic, cultural, political and religious. The literatures written in relation to the gender-based violence are accessed using electronic databases as PubMed, Medline and Google scholar, Google and other Internet Websites between 1994 and first quarter of 2013 using an internet search from the keywords such as gender-based violence, women violence, domestic violence, wife abuse, violence during pregnancy, women sexual abuse, political gender based violence, cultural gender-based violence, economical gender-based violence, child sexual abuse and special forms of gender-based violence in Nepal. As GBVs remain one of the most rigorous challenges of women's health and well-being, it is one of the indispensable issues of equity and social justice. To create a gender-based violence free environment, a lot works has to be done. Hence, it is suggested to provide assistance to the victims of violence developing the mechanism to support them.

  8. Gender issues on occupational safety and health.

    Science.gov (United States)

    Sorrentino, Eugenio; Vona, Rosa; Monterosso, Davide; Giammarioli, Anna Maria

    2016-01-01

    The increasing proportion of women in the workforce raises a range of gender-related questions about the different effects of work-related risks on men and women. Few studies have characterized gender differences across occupations and industries, although at this time, the gender sensitive approach is starting to acquire relevance in the field of human preventive medicine. The European Agency for Safety and Health at Work has encouraged a policy of gender equality in all European member states. Italy has adopted European provisions with new specific legislation that integrates the previous laws and introduces the gender differences into the workplace. Despite the fact that gender equal legislation opportunities have been enacted in Italy, their application is delayed by some difficulties. This review examines some of these critical aspects.

  9. Issues and Challenges on Venturing into Facebook Commerce

    Directory of Open Access Journals (Sweden)

    Caroline Sumathi

    2015-08-01

    Full Text Available The study examines the challenges encountered by small entrepreneurs when venturing into Facebook commerce. Social media has revolutionized not only our daily lives, but also the business world. This study involved 50 small entrepreneurs and adopted mixed method of quantitative and qualitative designs to collect data. The study revealed that lack of IT knowledge and set of cost significantly affected the respondents ‘decision to venture into Facebook commerce. However, many small entrepreneurs are also found to be interested in Facebook commerce.

  10. Innovation in surgical technology and techniques: Challenges and ethical issues.

    Science.gov (United States)

    Geiger, James D; Hirschl, Ronald B

    2015-06-01

    The pace of medical innovation continues to increase. The deployment of new technologies in surgery creates many ethical challenges including how to determine safety of the technology, what is the timing and process for deployment of a new technology, how are patients informed before undergoing a new technology or technique, how are the outcomes of a new technology evaluated and how are the responsibilities of individual patients and society at large balanced. Ethical considerations relevant to the implementation of ECMO and robotic surgery are explored to further discussion of how we can optimize the delicate balance between innovation and regulation.

  11. An Elective Course in Women’s Health Issues

    Directory of Open Access Journals (Sweden)

    Natalie A. DiPietro, PharmD, MPH;Associate Professor of Pharmacy Practice

    2013-01-01

    Full Text Available Purpose: To develop, implement, and evaluate an elective course for the Doctor of Pharmacy (PharmD curriculum that provides students with a comprehensive overview of women’s health across the lifespan and exposes them to social and economic issues that impact women’s health. Case Study: At the time of this writing, the class has been delivered 3 times to a total of 56 students. Students read and discussed (both in-class and online timely articles in women’s health issues on topics including sex-based biology; women in clinical trials; maternal and child health; women’s health coverage and access to care in the United States; gender and health communication; abuse and the role of healthcare professionals; and international issues in women’s health and women’s rights. Students completed a pre- and post-test; developed seminar presentations regarding women’s health issues; wrote reflective essays about the course; and designed and implemented health promotion projects for National Women’s Health Week (NWHW. At the end of the course, the number of correct answers on the post-test significantly improved from the pre-test (p<0.001. Through anonymous course evaluations, students indicated that the assignments fulfilled the learning objectives (mean 4.68 on a 5-point Likert scale and the exercises were useful in helping their understanding of the material (mean 4.66 on a 5-point Likert scale. Over 500 women from the campus and community participated in the NWHW projects. Implications: An elective course was designed to educate pharmacy students regarding women’s health issues and to provide students with an opportunity to perform community outreach.

  12. Health, safety and environmental issues in thin film manufacturing

    NARCIS (Netherlands)

    Alsema, E.A.; Baumann, A.E.; Hill, R.; Patterson, M.H.

    2006-01-01

    An investigation is made of Health, Safety and Environmental (HSE) aspects for the manufacturing, use and decommissioning of CdTe, CIS and a-Si modules. Issues regarding energy requirements, resource availability, emissions of toxic materials, occupational health and safety and module waste treatmen

  13. Environmental Health Research Involving Human Subjects: Ethical Issues

    Directory of Open Access Journals (Sweden)

    David B. Resnik

    2008-01-01

    Full Text Available This article reviews some of the ethical issues that arise in environmental health research with human subjects, such as minimizing risks to subjects, balancing benefits and risks in research, intentional exposure studies with human subjects, protecting third parties in research, informing subjects about environmental hazards, communicating health information to subjects, and protecting privacy and confidentiality.

  14. Ecological Issues Related to Children's Health and Safety

    Science.gov (United States)

    Aldridge, Jerry; Kohler, Maxie

    2009-01-01

    Issues concerning the health and safety of children and youth occur at multiple levels. Bronfenbrenner (1995) proposed an ecological systems approach in which multiple systems interact to enhance or diminish children's development. The same systems are at work in health promotion. The authors present and review articles that reflect the multiple…

  15. Prisoner reentry: a public health or public safety issue for social work practice?

    Science.gov (United States)

    Patterson, George T

    2013-01-01

    A significant literature identifies the policy, economic, health, and social challenges that confront released prisoners. This literature also describes the public health and public safety risks associated with prisoner reentry, provides recommendations for improving the reentry process, and describes the effectiveness of prison-based programs on recidivism rates. Public health and public safety risks are particularly significant in communities where large numbers of prisoners are released and few evidence-based services exist. The purpose of this article is to describe the public health and public safety risks that released prisoners experience when they reenter communities, and to discuss the social justice issues relevant for social work practice.

  16. Literacy at a Distance in Multilingual Contexts: Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Christine I. Ofulue

    2011-10-01

    Full Text Available Literacy is perhaps the most fundamental skill required for effective participation in education (formal and non-formal for national development. At the same time, the choice of language for literacy is a complex issue in multilingual societies like Nigeria. This paper examines the issues involved, namely language policy, language and teacher development, and the role of distance education and information and communication technologies (ICTs, in making literacy accessible in as many languages as possible. Two distance learning literacy projects are presented as case studies and the lessons learned are discussed. The findings of this study suggest that although there is evidence of growing accessibility to ICTs like mobile phones, their use and success to increase access to literacy in the users’ languages are yet to be attained and maximised. The implication of the lessons learned should be relevant to other multilingual nations that seek the goal of increasing access to learning and promoting development so as to harvest economic benefits.

  17. Cloud Based Educational Systems 
And Its Challenges And Opportunities And Issues

    Directory of Open Access Journals (Sweden)

    Prantosh Kr. PAUL

    2014-01-01

    Full Text Available Cloud Computing (CC is actually is a set of hardware, software, networks, storage, services an interface combines to deliver aspects of computing as a service. Cloud Computing (CC actually uses the central remote servers to maintain data and applications. Practically Cloud Computing (CC is extension of Grid computing with independency and smarter tools and technological gradients. Healthy Cloud Computing helps in sharing of software, hardware, application and other packages with the help of internet tools and wireless media. Cloud Computing, has benefits in several field and applications domain such as Agriculture, Business and Commerce, Health Care, Hospitality and Tourism, Education and Training sector and so on. In Education Systems, it may be applicable in general regular education and other education systems including general and vocational training. This paper is talks about opportunities that provide Cloud Computing (CC; however the intention would be challenges and issues in relation to Education, Education Systems and Training programme.

  18. Road safety in a globalised and more sustainable world: current issues and future challenges.

    Science.gov (United States)

    Daniels, Stijn; Risser, Ralf

    2014-01-01

    Although many countries have had considerable success in reducing traffic injuries over recent decades, there are still some fundamental problems in this area. At the same time, there is increasing focus on road safety research and policy development in the context of globalisation, sustainability, liveability and health. This special section presents a selection of papers that were presented at the annual ICTCT workshop held on the 8th and 9th of November 2012 in Hasselt, Belgium, and accepted for publication in Accident Analysis and Prevention following the journal's reviewing procedure. The aim of the ICTCT workshop was to analyse road safety facts, data and visions for the future in the wider context of current issues and future challenges in road safety.

  19. Transitions: Issues, Challenges and Solutions in International Assistance

    Science.gov (United States)

    2010-11-01

    Americans, and the Making of a Democracy, (Cha- pel Hill: The University of North Carolina Press, 2007), 1. 52 See Rafael Pardo Rueda, La Historia ...Foundation - Center for Disaster and Humanitarian Assistance Medicine (CDHAM), Uniformed Services University of the Health Science 10. THE IMPORTANCE...CONCLUSION This text cannot provide a universal solution for every transition, or any one transition in particular. What it aspires to do is inform the

  20. Trauma and Child Health: An Introduction to the Special Issue.

    Science.gov (United States)

    La Greca, Annette M; Comer, Jonathan S; Lai, Betty S

    2016-01-01

    Potentially traumatic events are common occurrences that can lead to significant psychological distress, and yet, there has been remarkably little attention to the associations between traumatic events and youth's physical health. The articles contained in this Special Issue of the Journal of Pediatric Psychology represent a significant step forward in the establishment of "Trauma and Child Health" as a major area of study within the field of pediatric psychology. In this introductory article, we briefly describe several contextual issues that may help to set the stage for the articles contained in this Special Issue. These contextual issues include the most common types of traumatic events that are studied, as well as the features of traumatic events that may affect physical and mental health outcomes, such as whether casualties or interpersonal violence is involved.

  1. Ethical issues in health research with novel online sources.

    Science.gov (United States)

    Vayena, Effy; Mastroianni, Anna; Kahn, Jeffrey

    2012-12-01

    Health-related research is increasingly drawing on novel sources of online data, such as crowdsourced information about disease outbreaks, consumer-supplied information provided to health or wellness Web sites, Internet search queries about personal health, and social network postings that identify health behaviors. We offer examples of online sources and their uses, identify ethical and policy issues they generate, and formulate key questions for future discussion and investigation. Further work in this area will require cross-disciplinary collaboration to develop ethics and policy guidance for the ethical use of these novel data sources in health-related research.

  2. Public Health and Terrorism Preparedness: Cross-Border Issues

    OpenAIRE

    Olson, Debra; Leitheiser, Aggie; Atchison, Christopher; Larson, Susan; Homzik, Cassandra

    2005-01-01

    On December 15, 2003, the Centers for Public Health Preparedness at the University of Minnesota and the University of Iowa convened the “Public Health and Terrorism Preparedness: Cross-Border Issues Roundtable.” The purpose of the roundtable was to gather public health professionals and government agency representatives at the state, provincial, and local levels to identify unmet cross-border emergency preparedness and response needs and develop strategies for addressing these needs. Represen...

  3. Rural Public Libraries and Digital Inclusion: Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Brian Real

    2014-03-01

    Full Text Available Rural public libraries have been relatively understudied when compared to public libraries as a whole. Data are available to show that rural libraries lag behind their urban and suburban counterparts in technology service offerings, but the full meaning and impact of such disparities is unclear. The authors combine data from the Public Library Technology and Access Study with data from smaller studies to provide greater insight to these issues. By filtering these data through the Digital Inclusion framework, it becomes clear that disparities between rural and non-rural libraries are not merely a problem of weaker technological infrastructure. Instead, rural libraries cannot reach their full customer service potential because of lower staffing (but not lower staff dedication and funding mechanisms that rely primarily on local monies. The authors suggest possible solutions to these disparities, while also discussing the barriers that must be overcome before such solutions can be implemented.

  4. Health Literacy in Schools: Prioritising Health and Well-Being Issues through the Curriculum

    Science.gov (United States)

    Kilgour, Lindsey; Matthews, Nic; Christian, Polly; Shire, Jo

    2015-01-01

    Health literacy (HL) is a relatively new concept in health promotion and is concerned with empowering people through enhancing their knowledge of health issues and improving their ability to make choices about their health and well-being. Schools are seen increasingly as key settings for the dissemination of health messages through curricula and…

  5. Physical education issues for students with autism: school nurse challenges.

    Science.gov (United States)

    Rutkowski, Elaine M; Brimer, Debbie

    2014-08-01

    Extant studies indicate persons with autism have difficulties in social interaction, verbal and nonverbal communication, repetitive behaviors, and poor ability to generalize learned skills. Obesity has also been identified as significantly affecting children with autism spectrum disorders (ASD). Negative experience in physical education (PE) may be the antecedent behavior to lack of activities that are mediators to sedentary lifestyles and contributors to the chronic illnesses associated with overweight and obesity. Students with ASD often cannot perform required activities to meet required PE standards. It is imperative school nurses be aware of the many challenges students with ASD bring into a PE class. School nurses provide education for the members of the school community, including the Individualized Education Plan team, regarding the need for attention to limitations, including physical activity, of students with ASD.

  6. Issues for eHealth in Psychiatry: Results of an Expert Survey

    Science.gov (United States)

    Huckvale, Kit; Larsen, Mark Erik; Basu, Ashna; Batterham, Philip J; Shaw, Frances; Sendi, Shahbaz

    2017-01-01

    Background Technology has changed the landscape in which psychiatry operates. Effective, evidence-based treatments for mental health care are now available at the fingertips of anyone with Internet access. However, technological solutions for mental health are not necessarily sought by consumers nor recommended by clinicians. Objective The objectives of this study are to identify and discuss the barriers to introducing eHealth technology-supported interventions within mental health. Methods An interactive polling tool was used to ask “In this brave new world, what are the key issues that need to be addressed to improve mental health (using technology)?” Respondents were the multidisciplinary attendees of the “Humans and Machines: A Quest for Better Mental Health” conference, held in Sydney, Australia, in 2016. Responses were categorized into 10 key issues using team-based qualitative analysis. Results A total of 155 responses to the question were received from 66 audience members. Responses were categorized into 10 issues and ordered by importance: access to care, integration and collaboration, education and awareness, mental health stigma, data privacy, trust, understanding and assessment of mental health, government and policy, optimal design, and engagement. In this paper, each of the 10 issues are outlined, and potential solutions are discussed. Many of the issues were interrelated, having implications for other key areas identified. Conclusions As many of the issues identified directly related to barriers to care, priority should be given to addressing these issues that are common across mental health delivery. Despite new challenges raised by technology, technology-supported mental health interventions represent a tremendous opportunity to address in a timely way these major concerns and improve the receipt of effective, evidence-based therapy by those in need. PMID:28246068

  7. ISSUES AND CHALLENGES IN WATER GOVERNANCE IN MALAYSIA

    Directory of Open Access Journals (Sweden)

    N. W. Chan

    2009-07-01

    Full Text Available Water is one of the central issues in the 21st century in Malaysia. Of all the issues associated with water management, governance is considered of primary importance. This paper examines water governance in Malaysia and concludes that it is successful in the sense that water is served to more than 95 % of the population, water tariffs are some of the cheapest in the world, the poor is not denied access, and water supply is 24 hours per day. However, there are many areas that need improvement to achieve better governance in water management. One is to improve Government-controlled water departments by ensuring their workers are well-trained and committed to excellence, public service and integrity instead of the usual laid-back government-servant mentality. Another is to ensure politicians do not interfere in the water sector. Currently, it is widely believed that many water companies are linked to powerful politicians, making the awarding of contracts, tariffs and other management aspects non-transparent and ineffective. Ideally, politicians that govern should act on the professional advice of the water managers and not the other way around. Another area of water governance that needs to be intensified is the war against corruption. In the water sector, there should also be an all-out war on corruption at all levels of governance, in both the public and private sectors. Government should make all contracts in the water sector awarded through open tender with public consultation to ensure professionalism, fairness, transparency, accountability and good governance. Equally, all contracts and other relevant documents drawn up between the government and private companies should not be “classified” but instead be public documents available to the public for discussion, review and improvement. Another area to ensure better governance is for the government to engage and actively involved all stakeholders in the water sector, especially civil

  8. [Health and immigration: new situations and challenges].

    Science.gov (United States)

    Jansà, Josep M; García de Olalla, Patricia

    2004-05-01

    The new social and demographic framework in Spain that has appeared since the arrival of new migrant populations, raises the need to improve the knowledge of their health status and to identify preventive measures and priorities in heath services.A bibliographic review of the available information on migration and health in Spain is performed, together with an analysis of their contents from a Public Health point of view. The high proportion of new borns from foreign mothers, the mental needs, deficits in oral and dental health, and the increase of tuberculosis in migrants, together with limited vaccine coverage in children, define the main health needs of these populations. The analysis of health services, reveals a high use of pediatric, obstetric and gynecologic resources by migrant populations. Conclusions; although no particular health needs have been identified for migrants, special attention for tuberculosis, mother and child health and health promotion and prevention, have to be funded for specific migrant populations. Health resources and services have to be reinforced with health agents, human resources, and specialized education for health professionals.

  9. The Migrant Farmworker: Health Care Challenge.

    Science.gov (United States)

    Freudenberg, Kathy

    1992-01-01

    Describes health problems experienced by the 12,000 migrants in New Jersey. Illustrates the needs for more attention and resources from the medical community. New Jersey programs, including school health services, are relatively advanced in protecting the rights and health of migrant workers, but a lack of resources limits the delivery of…

  10. Mobile Computing in Digital Ecosystems: Design Issues and Challenges

    CERN Document Server

    D'Angelo, Gabriele; Ghini, Vittorio; Panzieri, Fabio

    2011-01-01

    In this paper we argue that the set of wireless, mobile devices (e.g., portable telephones, tablet PCs, GPS navigators, media players) commonly used by human users enables the construction of what we term a digital ecosystem, i.e., an ecosystem constructed out of so-called digital organisms (see below), that can foster the development of novel distributed services. In this context, a human user equipped with his/her own mobile devices, can be though of as a digital organism (DO), a subsystem characterized by a set of peculiar features and resources it can offer to the rest of the ecosystem for use from its peer DOs. The internal organization of the DO must address issues of management of its own resources, including power consumption. Inside the DO and among DOs, peer-to-peer interaction mechanisms can be conveniently deployed to favor resource sharing and data dissemination. Throughout this paper, we show that most of the solutions and technologies needed to construct a digital ecosystem are already availabl...

  11. Mining Health-Related Issues in Consumer Product Reviews by Using Scalable Text Analytics.

    Science.gov (United States)

    Torii, Manabu; Tilak, Sameer S; Doan, Son; Zisook, Daniel S; Fan, Jung-Wei

    2016-01-01

    In an era when most of our life activities are digitized and recorded, opportunities abound to gain insights about population health. Online product reviews present a unique data source that is currently underexplored. Health-related information, although scarce, can be systematically mined in online product reviews. Leveraging natural language processing and machine learning tools, we were able to mine 1.3 million grocery product reviews for health-related information. The objectives of the study were as follows: (1) conduct quantitative and qualitative analysis on the types of health issues found in consumer product reviews; (2) develop a machine learning classifier to detect reviews that contain health-related issues; and (3) gain insights about the task characteristics and challenges for text analytics to guide future research.

  12. Challenges/issues of NIS used in particle accelerator facilities

    Science.gov (United States)

    Faircloth, Dan

    2013-09-01

    High current, high duty cycle negative ion sources are an essential component of many high power particle accelerators. This talk gives an overview of the state-of-the-art sources used around the world. Volume, surface and charge exchange negative ion production processes are detailed. Cesiated magnetron and Penning surface plasma sources are discussed along with surface converter sources. Multicusp volume sources with filament and LaB6 cathodes are described before moving onto RF inductively coupled volume sources with internal and external antennas. The major challenges facing accelerator facilities are detailed. Beam current, source lifetime and reliability are the most pressing. The pros and cons of each source technology is discussed along with their development programs. The uncertainties and unknowns common to these sources are discussed. The dynamics of cesium surface coverage and the causes of source variability are still unknown. Minimizing beam emittance is essential to maximizing the transport of high current beams; space charge effects are very important. The basic physics of negative ion production is still not well understood, theoretical and experimental programs continue to improve this, but there are still many mysteries to be solved.

  13. APPROACH TO CYBER SECURITY ISSUES IN NIGERIA: CHALLENGES AND SOLUTION

    Directory of Open Access Journals (Sweden)

    Frank Ibikunle

    2013-06-01

    Full Text Available Cyber-space refers to the boundless space known as the internet. Cyber-security is the body of rules put in place for the protection of the cyber space. Cyber-crime refers to the series of organized crime attacking both cyber space and cyber security. The Internet is one of the fastest-growing areas of technical infrastructure development. Over the past decades, the growth of the internet and its use afforded everyone this opportunity. Google, Wikipedia and Bing to mention a few, give detailed answers to millions of questions every day. Cyberspace is a world that contains just about anything one is searching for. With the advent of these advancements in information accessibility and the advantages and applications of the internet comes an exponentially growing disadvantage- Cyber Crime. Cyber security has risen to become a national concern as threats concerning it now need to be taken more seriously. This paper attempts to provide an overview of Cybercrime and Cyber-security. It defines the concept of cybercrime, identify reasons for cyber-crime and its eradication. It look at those involved and the reasons for their involvement. Methods of stepping up cyber security and the recommendations that would help in checking the increasing rate of cyber-crimes were highlighted. The paper also attempts to name some challenges of cybercrime and present practical and logical solutions to these threats.

  14. TCP Issues in Mobile Ad Hoc Networks: Challenges and Solutions

    Institute of Scientific and Technical Information of China (English)

    Wei-Qiang Xu; Tie-Jun Wu

    2006-01-01

    Mobile ad hoc networks (MANETs) are a kind of very complex distributed communication systems with wireless mobile nodes that can be freely and dynamically self-organized into arbitrary and temporary network topologies. MANETs inherit several limitations of wireless networks, meanwhile make new challenges arising from the specificity of MANETs, such as route failures, hidden terminals and exposed terminals. When TCP is applied in a MANET environment, a number of tough problems have to be dealt with. In this paper, a comprehensive survey on this dynamic field is given. Specifically, for the first time all factors impairing TCP performance are identified based on network protocol hierarchy, I.e., lossy wireless channel at the physical layer; excessive contention and unfair access at the MAC layer; frail routing protocol at the network layer, the MAC layer and the network layer related mobile node; unfit congestion window size at the transport layer and the transport layer related asymmetric path. How these factors degrade TCP performance is clearly explained. Then, based on how to alleviate the impact of each of these factors listed above, the existing solutions are collected as comprehensively as possible and classified into a number of categories, and their advantages and limitations are discussed. Based on the limitations of these solutions, a set of open problems for designing more robust solutions is suggested.

  15. A social explanation for the rise and fall of global health issues.

    Science.gov (United States)

    Shiffman, Jeremy

    2009-08-01

    This paper proposes an explanation concerning why some global health issues such as HIV/AIDS attract significant attention from international and national leaders, while other issues that also represent a high mortality and morbidity burden, such as pneumonia and malnutrition, remain neglected. The rise, persistence and decline of a global health issue may best be explained by the way in which its policy community--the network of individuals and organizations concerned with the problem--comes to understand and portray the issue and establishes institutions that can sustain this portrayal. This explanation emphasizes the power of ideas and challenges interpretations of issue ascendance and decline that place primary emphasis on material, objective factors such as mortality and morbidity levels and the existence of cost-effective interventions. This explanation has implications for our understanding of strategic public health communication. If ideas in the form of issue portrayals are central, strategic communication is far from a secondary public health activity: it is at the heart of what global health policy communities do.

  16. Techno-Anthropological Sensibilities in Health Informatics: Opportunities and challenges.

    Science.gov (United States)

    Bossen, Claus

    2015-01-01

    What kind of knowledges, skills and competences may be required by Techno-Anthropology engaging with health informatics? If we understand Techno-Anthropology to mean conducting anthropological analyses of the interwoven and mutually shaping relationship between organizing, technologies and actors in healthcare, such engagements and interventions can take many forms: Short-term consultancy work dedicated to achieving specific goals, long-term studies of broad changes in healthcare; management support within hospitals and public healthcare administration; or technology development with vendors of healthcare IT. The opportunities would seem to be manifold. Since the healthcare sector is a heterogeneous mix of interests, political agendas, professions et cetera, there is great merit in having people knowledgeable about this heterogeneity; able to facilitate meetings and processes between the various professions and organizations; and skilled in generating analyses and proposing new solutions. Also, people with insight into how action, technologies and organizing are interwoven and redistribute competences, responsibilities and risks are invaluable: Look at from afar, technologies seem to cause and determine social development, whereas detailed studies reveal that determinants and causes are both technical and social. The challenges include the one of making one's knowledge and skills legitimate and relevant to health informatics. Having a degree from arts or social sciences is not necessarily impressive for people with similar degrees in medicine, computer science, and business administration. Another challenge is to design an engagement with health informatics that will generate insights which often requires time, while also providing quick results for project sponsors or collaborators. The chapter points at three issues that seem to be central foundations for appropriate and quality-driven research and interventions of the 'quick and proper' kind: Modes of engagement

  17. [Reproductive health: definitions, data and challenges].

    Science.gov (United States)

    Mundigo, A

    1994-01-01

    Emergence of the concept of reproductive health over the past decade was stimulated by distinct currents in the fields of health and of feminist theory. The broadened concept represents a reaction to the essentially demographic justification offered for population policies and their principal instrument of action, family planning, since the 1970s. The new focus is more affirmative, and its discourse promotes the right to health, to improved access to services, and to health services offering quality and respect for women. Social justice aspects, especially nondiscrimination against the poor and other specific groups, and free selection of contraceptive options and services have assumed greater importance. Reproductive health is viewed as encompassing psychological aspects and power relations within marital unions. Very general provisional definitions of the concept of reproductive health are acceptable for the moment. But it is important to arrive at a definition that will be clear and specific and will combine the preoccupations of the health field with feminist concerns. The problem of measurement is related to the problem of definition. Satisfactory indicators of reproductive health are lacking. Existing indicators such as maternal mortality, fertility measures, or contraceptive prevalence continue to be used despite their narrow focus. Several priority areas of research in reproductive health have been identified, including aspects and determinants of sexual behavior, roles of men and women in reproductive health, the dynamics of contraceptive usage, undesired pregnancy, determinants and consequences of induced abortion, lactation and spacing and their relationship to sterilization, and maternal morbidity and mortality.

  18. Childhood and adolescence: challenges in mental health.

    Science.gov (United States)

    Shrivastava, Saurabh Rambiharilal; Shrivastava, Prateek Saurabh; Ramasamy, Jegadeesh

    2013-05-01

    Mental health is an integral and essential component of health. The World Health Organization (WHO) constitution states: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." More than 450 million people suffer from mental disorders worldwide. In India, mental health services, especially for children and adolescents, are limited both in terms of number of facilities as well as trained professionals. The majority of mental health services are restricted to urban areas, that is, medical colleges or regional mental health institutes. Mere presence of a treatment facility does not guarantee that all children/adolescents suffering from mental illness will utilize such services. In fact, most of the time there is a significant delay from the patient side in accessing mental health services either because of lack of awareness or associated stigma. It is high time to promote positive mental health in children, adolescents and their parents through health education. Parental counseling is of utmost importance in order to avoid the delay in treatment seeking.

  19. Closing the Revolving Door? The role of diversion services in supporting offenders with mental health issues and learning disabilities

    OpenAIRE

    Biddle, Paul; Northumbria University

    2015-01-01

    The presentation, delivered at the 2015 Northumbria Research Conference, presented findings from a research project that explored the role of diversion services in supporting offenders with mental health issues and learning disablities. The presentation included policy background, a discussion of current issues, information about the development, delivery and outcomes of diversion services, challenges faced by diversion services and possible future directions.

  20. Methodologic issues in research on religion and health.

    Science.gov (United States)

    Flannelly, Kevin J; Ellison, Christopher G; Strock, Adrienne L

    2004-12-01

    This study examines several methodologic issues in research on religion and health, including the measurement of the concept of religion, research designs, sampling, and statistical controls for assessing the "net" effects of religion on health outcomes. It briefly discusses differences in analytical perspectives that have contributed to the debate about the effects of religion on health. The authors review some of the methodologic problems of past research in this area of study and address what needs to be done to enhance the quality of the research. The authors conclude that the research methodology used in studies of religion and health has improved over time and that it continues to do so.

  1. Supplier challenges in health tech innovation

    DEFF Research Database (Denmark)

    Rolfstam, Max

    Suppliers, in particular small innovative firms, is an important contributor not only for innovation in health-tech, but also a component to consider in the light of the emerging policy interest for using public procurement as a means to stimulate innovation. Research on barriers preventing...... these firms from providing innovations to public health authorities is therefore easily justified. Although substantive knowledge already prevails on the topic, it appears to be a lack in the literature concerning small innovative firms. To help to overcome this gap the paper discusses preliminary case study...... findings collected in the context of the Baltic Sea Health Region HealthPort project. The overall aim with the project was to facilitate ‘business acceleration’ by providing support, training and bridging innovative SMEs and health care organisations ultimately to strengthen the Baltic Sea Region health...

  2. Challenges Faced by Teachers Implementing Socio-Scientific Issues as Core Elements in Their Classroom Practices

    Science.gov (United States)

    Bossér, Ulrika; Lundin, Mattias; Lindahl, Mats; Linder, Cedric

    2015-01-01

    Teachers may face considerable challenges when implementing socio-scientific issues (SSI) in their classroom practices, such as incorporating student-centred teaching practices and exploring knowledge and values in the context of socioscientific issues. This year-long study explores teachers' reflections on the process of developing their…

  3. Health issues of whey proteins: 3. Gut health promotion

    NARCIS (Netherlands)

    Schaafsma, G.

    2007-01-01

    This paper reviews the potential of whey protein to promote gut health. The high digestibility and specific amino acid composition of whey protei, as present in whey powder, whey protein concentrate and whey protein isolate, explain why ingestion of whey protein will exert this beneficial effect. Th

  4. Health issues of whey proteins: 3. gut health promotion

    NARCIS (Netherlands)

    Schaafsma, Gertjan

    2007-01-01

    This paper reviews the potential of whey protein to promote gut health. The high digestibility and specific amino acid composition of whey protein, as present in whey powder, whey protein concentrate and whey protein isolate, explain why ingestion of whey protein will exert this beneficial effect.

  5. UK community health visiting: challenges faced during lean implementation

    Directory of Open Access Journals (Sweden)

    Carr SM

    2012-01-01

    Full Text Available Susan M Carr1,2, Pauline Pearson1, Lesley Young-Murphy3, Barbara Cleghorn41Centre for Community Health & Education Studies Research & Enterprise, Northumbria University, Newcastle upon Tyne, UK; 2School of Health, University of New England, Armidale, New South Wales, Australia; 3NHS North of Tyne, Newcastle upon Tyne, UK, 4Newcastle PCT, Newcastle upon Tyne, UKAbstract: This paper presents an overview of the challenges and potential of lean implementation for the health visiting service in England and examines the rhetoric and the reality of the situation. It is coauthored by academic researchers and senior service providers so as to embrace the multidimensional issues impacting on this subject. If lean thinking is to be implemented in relation to health visiting, it is important to understand how it is likely to be viewed by practitioners and line managers in settings where it is used. In order to contextualize the discussion, an introduction to the roles, systems, and structures of health visiting are provided. The literature on what lean implementation is, what it means, and in particular the application and potential of the approach to primary care and public health services is reviewed. The process and findings from a focus group convened within a large primary care organization in the National Health Service during their lean implementation is reported. The paper concludes that it is important for staff at all levels to see a clear link between strategic aims and objectives and the planning processes operated by providers and commissioners. It appears that the successful introduction of lean thinking should focus more on productive working and thereby reducing waste. This has the potential to refresh workforce models to ensure that health visiting and other practitioners liberate the use of their specialist knowledge and skills. In a context of enhanced partnership working, the stage is then set for providers to add value to the whole

  6. [Health in Mexico: old and rising challenges. An updated assessment].

    Science.gov (United States)

    Narro Robles, José; Zepeda Tena, Carolina

    2012-01-01

    In recent decades, Mexico has come a long way in health care matters, which has influenced the standard of living of the population and the development of the country. However, much remains to be done and changes should happen faster. Some of the main challenges Mexico faces currently are presented in this document and include: the challenge of reducing poverty in order to improve the health status of society; the development of health services that affect the slowdown in the pace of evolution of demographic indicators, life expectancy at birth and infant mortality; the challenge of reducing inequality; the challenge of great infrastructure available in the country for health care and the limited performance obtained in terms of organization, management and financing; the challenge resulting from human resources training systems, both undergraduate and postgraduate; the challenge that relates to academic and scientific productivity; the challenge of diabetes as an example of a serious public health problem; and the challenge of ethical implications in the organization and administration of health services, specifically, the allocation of public resources to them.

  7. [The modern international public health and globalization challenges].

    Science.gov (United States)

    2012-01-01

    The article deals with the issues of impact of globalization on population health and public health. The positive and negative aspects of this process are analyzed. The role of international organizations (UN, WHO, UNESCO, ILO, UNISEF) is demonstrated in the area of management of globalization impact on public health of different countries, Russia included.

  8. Bed Bug Epidemic: A Challenge to Public Health

    Science.gov (United States)

    Ratnapradipa, Dhitinut; Ritzel, Dale O.; Haramis, Linn D.; Bliss, Kadi R.

    2011-01-01

    In recent years, reported cases of bed bug infestations in the U.S. and throughout the world have escalated dramatically, posing a global public health problem. Although bed bugs are not known to transmit disease to humans, they pose both direct and indirect public health challenges in terms of health effects, treatment, cost, and resource…

  9. Challenging the Conceptual Limits in Health Psychology

    DEFF Research Database (Denmark)

    Kristensen, Kasper Andreas

    2015-01-01

    . Hence, I will argue for the concept of conduct of life as an important concept for health psychology. The concept of conduct of life enables an analysis of how people conduct their activities and of their access to life possibilities, within social settings and societal power systems. The concept can......This contribution explores the connection between health and subjectivity. Up until recently a marginally discussed topic in health theories, recent critical research in health psychology introduces notions of subjectivity to theories of health. These notions can be linked to phenomenology......, embodied subjectivity, and psychosocial theories that have moved away from a partial, internal understanding of subjectivity. These recent theories tend to define subjectivity as a coherence of concrete, embodied and situated subjectivity that extends capabilities and activities towards a world of social...

  10. Health information technology: medical record documentation issues in the electronic era.

    Science.gov (United States)

    Dacey, Bill; Bholat, Michelle Anne

    2012-12-01

    This article outlines the regulatory movement propelling physicians into the electronic health record environment and the subsequent emergence of quality issues in the medical record. There are benefits and downside risks for implementing electronic health records as part of the desire of a practice or institution to build patient-centered medical homes. The intersection of how a practice or institution collects and reports quality metrics using health information technology and subsequently submits claims for services rendered has created unforeseen challenges for which leadership must be aware and address proactively.

  11. Building Interdisciplinary Research Capacity: a Key Challenge for Ecological Approaches in Public Health

    Directory of Open Access Journals (Sweden)

    Lindsay P. Galway

    2016-06-01

    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.

  12. Mental health challenges of LGBT forced migrants

    Directory of Open Access Journals (Sweden)

    Ariel Shidlo

    2013-04-01

    Full Text Available Many LGBT forced migrants have significant and sometimesincapacitating psychological scars. Mental health providers can assistin documenting the psychological impact of anti-LGBT persecutionand its impact on the ability to secure refugee status.

  13. Gender-Specific Health Challenges Facing Women

    Science.gov (United States)

    ... NIAID, NIH Partnerships with Foreign Countries, NIAID, NIH Public-Private Partnerships Technology Transfer Collaborations Resources by Health/ ... Services Office of Biodefense Research & Surety Communications Government Relations ... Dr. John J. McGowan Visitor Information

  14. Financing Mental Health Care in Spain: Context and critical issues

    Directory of Open Access Journals (Sweden)

    L. Salvador-Carulla

    2006-03-01

    Full Text Available BACKGROUND: Financing and the way in which funds are then allocated are key issues in health policy. They can act as an incentive or barrier to system reform , can prioritise certain types or sectors of care and have long term consequences for the planning and delivery of services. The way in which these issues can impact on the funding of mental health services across Europe has been a key task of the Mental Health Economics European Network. (MHEEN This paper draws on information prepared for MHEEN and provides an analysis of the context and the main issues related to mental health financing in Spain. METHODS: A structured questionnaire developed by the MHEEN group was used to assess the pattern of financing, eligibility and coverage for mental healthcare. In Spain contacts were made with the Mental Health agencies of the 17 Autonomous Communities (ACs, and available mental health plans and annual reports were reviewed. A direct collaboration was set up with four ACs (Madrid, Navarre, Andalusia, Catalonia. RESULTS: In Spain, like many other European countries mental healthcare is an integral part of the general healthcare with universal coverage funded by taxation. Total health expenditure accounted for 7.7% of GDP in 2003 (public health expenditure was 5.6% of GDP. Although the actual percentage expended in mental care is not known and estimates are unreliable, approximately 5% of total health expenditure can be attributed to mental health. Moreover what is often overlooked is that many services have been shifted from the health to the social care sector as part of the reform process. Social care is discretionary, and provides only limited coverage. This level of expenditure also appears low by European standards, accounting for just 0.6% of GDP. COMMENTS: In spite of its policy implications, little is known about mental healthcare financing in Spain. Comparisons of expenditure for mental health across the ACs are problematic, making it

  15. Infectious Diseases: Current Issues in School and Community Health.

    Science.gov (United States)

    Bower, Wilma; And Others

    1986-01-01

    Some children in American schools have known and unknown communicable diseases, including herpes, cytomegalovirus, AIDS, mononucleosis, pinworms, and hepatitis. This article examines major public health issues, school responsibility, preventative measures (like basic hygiene), and the need for more effective community education programs. A disease…

  16. Mental Health Issues and Higher Education Psychology Teaching

    Science.gov (United States)

    Craig, Naomi

    2010-01-01

    This paper focuses on widening participation and accessibility in relation to mental health issues and undergraduate psychology students. Sections 1 and 2 set the context and outline the scope and aims of this paper. Section 3 presents evidence of the student experience from the Improving Provisions for Disabled Psychology Students (IPDPS)…

  17. Occupational safety and health issues associated with green building

    NARCIS (Netherlands)

    Terwoert, J.; Ustailieva, E.

    2013-01-01

    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

  18. Food and Health Some Current Issues and Future Trends

    OpenAIRE

    Gormley, T. R. (Thomas Ronan)

    1991-01-01

    This paper deals with some of the many current issues and future trends in the area of food, diet and health in Europe. A complete coverage would be impossible in a short article in view of the extent and complexity of the food system and its major interaction with health. It is also important to stress at the outset that food/diet is only one component of health and other factors such as environment, overall lifestyle and genetics also play a major role. The genetic dimension is of particula...

  19. An analysis of the health status of the United Arab Emirates: the ‘Big 4’ public health issues

    Directory of Open Access Journals (Sweden)

    Tar-Ching Aw

    2013-02-01

    Full Text Available Background: The United Arab Emirates (UAE is a rapidly developing country composed of a multinational population with varying educational backgrounds, religious beliefs, and cultural practices, which pose a challenge for population-based public health strategies. A number of public health issues significantly contribute to morbidity and mortality in the UAE. This article summarises the findings of a panel of medical and public health specialists from UAE University and various government health agencies commissioned to report on the health status of the UAE population. Methods: A systematic literature search was conducted to retrieve peer-reviewed articles on health in the UAE, and unpublished data were provided by government health authorities and local hospitals. Results: The panel reviewed and evaluated all available evidence to list and rank (1=highest priority the top four main public health issues: 1 Cardiovascular disease accounted for more than 25% of deaths in 2010; 2 Injury caused 17% of mortality for all age groups in 2010; 3 Cancer accounted for 10% of all deaths in 2010, and the incidence of all cancers is projected to double by 2020; and 4 Respiratory disorders were the second most common non-fatal condition in 2010. Conclusion: The major public health challenges posed by certain personal (e.g. ethnicity, family history, lifestyle, occupational, and environmental factors associated with the development of chronic disease are not isolated to the UAE; rather, they form part of a global health problem, which requires international collaboration and action. Future research should focus on population-based public health interventions that target the factors associated with the development of various chronic diseases.

  20. Challenges of citizen participation in regional health authorities.

    Science.gov (United States)

    Frankish, C James; Kwan, Brenda; Ratner, Pamela A; Higgins, Joan Wharf; Larsen, Craig

    2002-05-01

    Citizen participation has been included as part of health reform, often in the form of lay health authorities. In Canada, these authorities are variously known as regional health boards or councils. A set of challenges is associated with citizen participation in regional health authorities. These challenges relate to: differences in opinion about whether there should be citizen participation at all; differences in perception of the levels and processes of participation; differences in opinion with respect to the roles and responsibilities of health authority members; differences in opinion about the appropriate composition of the authorities; differences in opinion about the requisite skills and attributes of health authority members; having a good support base (staff, good information, board development); understanding and operationalizing various roles of the board (governance and policy setting) versus the board staff (management and administration); difficulties in ensuring the accountability of the health authorities; and measuring the results of the work and decisions of the health authorities. Despite these challenges, regional health authorities are gaining support as both theoretically sound and pragmatically based approaches to health-system reform. This review of the above challenges suggests that each of the concerns remains a significant threat to meaningful public participation.

  1. Sea otter health: challenging a pet hypothesis

    Science.gov (United States)

    Lafferty, Kevin D.

    2015-01-01

    A recent series of studies on tagged sea otters (Enhydra lutris nereis) challenges the hypothesis that sea otters are sentinels of a dirty ocean, in particular, that pet cats are the main source of exposure to Toxoplasma gondii in central California. Counter to expectations, sea otters from unpopulated stretches of coastline are less healthy and more exposed to parasites than city-associated otters. Ironically, now it seems that spillover from wildlife, not pets, dominates spatial patterns of disease transmission.

  2. Issues on E-health Adoption in Nigeria

    Directory of Open Access Journals (Sweden)

    Kolawole J. Adebayo

    2014-09-01

    Full Text Available E-health is the application of information technology for health care management. It includes all applications of information communication technologies to promote healthcare services support, delivery and education for improving efficiency in health care delivery to the citizens. Many factors contribute to the poor state of the medical sector of Nigeria, and in fact many developing countries, two of the most important being record keeping and accessibility. Nigeria still operates a paper based healthcare delivery system; meeting demands of citizens have been increasingly difficult due to her huge population, understaffed hospitals, apathy towards embracing ICTs and other issues. On the other hand, ICT applications have been used successfully in developed countries to address most of these problems. This paper presents an in-depth analysis of the healthcare system in Nigeria while highlighting confronting issues with a view to proposing a viable solution.

  3. Hispanic Medical Organizations' Support for LGBT Health Issues.

    Science.gov (United States)

    Sánchez, John Paul; Sola, Orlando; Ramallo, Jorge; Sánchez, Nelson Felix; Dominguez, Kenneth; Romero-Leggott, Valerie

    2014-09-01

    Hispanics represent the fastest growing ethnic segment of the lesbian, gay, bisexual, and transgender (LGBT) community in the United States and are disproportionately burdened by LGBT-related health issues and limited political support from Hispanic medical organizations. Recently, the Latino Medical Student Association, the National Hispanic Medical Association, and the Hispanic Serving Health Professions Schools, representing over 60,000 Hispanic students and providers and 35 institutions, collaborated to support a resolution opposing discrimination based on sexual orientation or gender identity and recognizing the obstacles encountered by LGBTQ Hispanics. The resolution provides an important framework for organizational members and leaders to address LGBT health issues and serve to support a more positive sociopolitical climate for the Hispanic LGBT community nationally and internationally.

  4. Using critical ethnography to explore issues in health promotion.

    Science.gov (United States)

    Cook, Kay E

    2005-01-01

    In this article, the author outlines the need for a critical research method in the field of health promotion to explore the determinants of health. These determinants, including healthy child development, employment and working conditions, and education, for example, underlie many of the health issues that individuals experience. They are, in turn, influenced by nebulous factors such as patterns of inequality, and cultural norms, which are difficult to research using conventional methodologies. The author provides an overview of critical ethnography as a method for health promotion research. She describes specific data collection and analysis techniques, with the addition of critical discourse analysis to add scope to ethnographic findings. She concludes with an overview of the congruence between critical ethnography and health promotion research, including a discussion of the differences between critical ethnography and participatory action research.

  5. Five Critical Challenges for Public Health

    Science.gov (United States)

    Kumanyika, Shiriki K.

    2014-01-01

    This article presents comments and observations given by Dr. Shiriki K. Kumanyika as the Lautenberg Award Lecture at the commencement of the University of Medicine and Dentistry of New Jersey-Rutgers School of Public Health, May 20, 2013. The award is named after Senator Frank Lautenberg, who served as a U.S. Senator from New Jersey during 1982 to…

  6. Supreme Court issues limited ruling in challenge to Utah abortion ban.

    Science.gov (United States)

    1996-06-28

    A law passed in Utah in 1991 which prohibited abortion except in cases of life endangerment, rape, incest, risk of grave damage to a woman's medical health, or grave fetal defects. The exceptions for women who had been sexually abused were eliminated after 20 weeks gestation. In December 1992, US District Court Judge J. Thomas Greene found the ban unconstitutional as applied to abortions prior to 20 weeks but upheld it as applied to procedures after that point in pregnancy. A three-judge appellate panel later reversed the district court decision in August 1995 on the argument that the prohibition on post-20-week abortions could not stand independent of the ban on earlier procedures. The appeals court also struck down a requirement that physicians performing those abortions allowed after viability use the method most likely to give the fetus the best chance of survival, unless it would endanger a woman's life or cause grave damage to her medical health. In an unsigned opinion issued on June 17, 1996, the US Supreme Court reversed the appeals court decision which struck down Utah's original 1991 ban on abortions. Five justices ruling in Leavitt v. Jane L. found that the US Court of Appeals for the Tenth Circuit misapplied Utah precedent when it found that the criminal abortion statute could not be divided into two separate abortion bans, one before and one after 20 weeks gestation. Health care providers will now argue that the ban on post-20-week abortions should be struck down on constitutional grounds. This is the first challenge to a state abortion law to come under High Court review since Planned Parenthood v. Casey in 1992.

  7. Studying health in Greenland: Obligations and challenges

    DEFF Research Database (Denmark)

    Bjerregaard, Peter; Mulvad, Gert; Olsen, Jørn

    2003-01-01

    rapid epidemiological transition carries prospects of global significance. The Inuit are a genetically distinct people living under extreme physical conditions. Their traditional living conditions and diet are currently undergoing a transformation, which may approach their disease pattern...... to that of the industrialized world, while still including local outbreaks of tuberculosis. Health research in Greenland is logistically difficult and costly, but offers opportunities not found elsewhere in the world. A long tradition of registration enhances the possibilities for research. A number of research institutions...

  8. Pilot Implementation of Health Information Systems: Issues and challenges

    DEFF Research Database (Denmark)

    Bansler, Jørgen P.; Havn, Erling C.

    2009-01-01

    of the proposed system designs. This calls for studies that seek to uncover and analyze the reasons for failure, so that guidelines for conducting such pilots can be developed. In this paper, we present a qualitative field study of an ambitious, but unsuccessful pilot implementation of a Danish healthcare...

  9. The health and health system of South Africa: historical roots of current public health challenges.

    Science.gov (United States)

    Coovadia, Hoosen; Jewkes, Rachel; Barron, Peter; Sanders, David; McIntyre, Diane

    2009-09-01

    The roots of a dysfunctional health system and the collision of the epidemics of communicable and non-communicable diseases in South Africa can be found in policies from periods of the country's history, from colonial subjugation, apartheid dispossession, to the post-apartheid period. Racial and gender discrimination, the migrant labour system, the destruction of family life, vast income inequalities, and extreme violence have all formed part of South Africa's troubled past, and all have inexorably affected health and health services. In 1994, when apartheid ended, the health system faced massive challenges, many of which still persist. Macroeconomic policies, fostering growth rather than redistribution, contributed to the persistence of economic disparities between races despite a large expansion in social grants. The public health system has been transformed into an integrated, comprehensive national service, but failures in leadership and stewardship and weak management have led to inadequate implementation of what are often good policies. Pivotal facets of primary health care are not in place and there is a substantial human resources crisis facing the health sector. The HIV epidemic has contributed to and accelerated these challenges. All of these factors need to be addressed by the new government if health is to be improved and the Millennium Development Goals achieved in South Africa.

  10. [Health integration processes: challenges for MERCOSUR in the health field].

    Science.gov (United States)

    Sánchez, Delia M

    2007-01-01

    This paper describes the institutional background in Latin American integration in both the economy and health, and proposes a systematization of possible health integration modalities. Facilitating and inhibiting factors for integration according to each modality are identified, and their feasibility is discussed in the present context. The structure and functioning of MERCOSUR health structures (Ministerial Meeting and Sub-group 11) are briefly described, as well as the advances achieved to date, reflecting on the possible causes of uneven progress in different areas.

  11. Feminization of migration: a global health challenge.

    Science.gov (United States)

    de Leon Siantz, Mary Lou

    2013-09-01

    Demographers are slowly bringing the migration of women to the forefront as women become the majority of migrants worldwide. Migration can provide new opportunities for women on their own or jointly with their spouses to improve their lives, escape oppressive social relations, and support children and other family members who are left behind. It also can expose women to new vulnerabilities resulting from their precarious legal status, abusive working conditions, and health risks.(1) Migrant women are triply disadvantaged by race/ethnicity, their status as nonnationals, and gender inequalities.(2.)

  12. Health issues in adolescents' Internet use - benefits and risks.

    Science.gov (United States)

    Hardoff, D

    2013-09-01

    The Internet has turned during the past decade into a major information resource in various domains of life and a communication venue among adolescents who seek health information via the net. The increasing availability of computers in homes, as well as wireless Internet access, means that adolescents today can go online anywhere, at any time. The media are not the leading cause of any major health problem, but they do contribute significantly to a variety of adolescent health problems, including aggressive behavior, sexual activity, drug use, obesity, sleep disorders, eating disorders, depression, suicide and self harm. This paper focuses on 3 major health issues in adolescents' Internet use: Body image and eating behaviors; sexuality and reproductive health behaviors; and self harm and suicidal behavior. This paper also demonstrates Internet venues where reliable health information is provided to young people by health professionals. Health professionals need to recognize the hazards of adolescents Internet use, and to address potential Internet abuse when encountering adolescents in clinical settings.

  13. The female athlete triad: components, nutrition issues, and health consequences.

    Science.gov (United States)

    Manore, Melinda M; Kam, Lynn Ciadella; Loucks, Anne B

    2007-01-01

    This paper, which was part of the International Association of Athletics Federations (IAAF) 2007 Nutritional Consensus Conference, briefly reviews the components of the female athlete triad (Triad): energy availability, menstrual status, and bone health. Each component of the Triad spans a continuum from health to disease, and female athletes can have symptoms related to each component of the Triad to different degrees. Low energy availability is the primary factor that impairs menstrual dysfunction and bone health in the Triad. We discuss nutritional issues associated with the Triad, focusing on intakes of macronutrients needed for good health, and stress fractures, the most common injury associated with the Triad. Finally, we briefly discuss screening and treatment for the Triad and the occurrence of the Triad in men.

  14. A Short Study on Cooperative Sector in Iran. Challenges and Issues

    Directory of Open Access Journals (Sweden)

    Hassan Danaee Fard

    2010-10-01

    Full Text Available This paper aims to study the issues of cooperative sector in Iran. According to the theories,among the three sectors i.e. Public, private and cooperative sector probably cooperative sectorbecause of participating people directly in its process, can work better for economic development andcan be considered as a country economic developer example by job creation and others, Prior Workbecause Islam religion has invited people for having cooperation and also Iranian is a Muslim countrythen there have been a lot work on cooperative sector and this work is among the others who looks forthe challenges and issues in this sector, Approach this paper looks for the challenges and issues ofthe cooperative sector in Iran to run effective cooperation, Results Cooperative sector in alldeveloped and undeveloped and developing countries has its own challenges and in Iran as a fastdeveloping country which want to speed the developing process then needs to consider thecooperative sector challenges in Iran and other countries as well, Implications Practitioners,academician and others who want to work on challenges and issues of cooperative sector in Iran andothers . Value among the other important variables in economic development, cooperative has thepriority because of its fast returned effects in economic development then this paper aims to study thechallenges of this sector.

  15. Health burden of urban transport: The technical challenge

    Indian Academy of Sciences (India)

    Carlos Dora

    2007-08-01

    The burden on health-related issues due to unplanned urban policies is higher despite the present knowledge of interventions and availability of current technologies. This burden could increase substantially, given the rapid growth in urban populations and the application of partial or misguided solutions to urban transport problems. Part of the reason is the failure to consider holistically the health, social and environment consequences and the related costs of individual travel choices and government policies in the field of traffic and mobility. Urban transport-related issues and its impact on health, environment, costs and benefits are discussed in this paper.

  16. Adolescent mental health: Challenges with maternal noncompliance

    Directory of Open Access Journals (Sweden)

    Vicki A Nejtek

    2010-03-01

    Full Text Available Vicki A Nejtek, Sarah Hardy, Scott WinterUniversity of North Texas Health Science Center, Fort Worth, TX, USAAbstract: The leading cause of suicide ideation, attempts, and completion in adolescents is persistent and unresolved parental conflict. National statistics show extremely high rates of childhood neglect and abuse are perpetrated most often by single mothers. Psychiatric disorders arising from maternal–child dysfunction are well-documented. However, resources to prevent offspring victimization are lacking. Here, we report maternal neglect of a 15-year-old male brought to the psychiatric emergency room for suicidal ideation. An inpatient treatment plan including pharmacotherapy, family therapy and psychological testing was initiated. The patient’s mother failed to attend clinic appointments or family therapy sessions. Clinician attempts to engage the mother in the treatment plan was met with verbal assaults, aggression, and threatening behavior. The patient decompensated in relation to the mother’s actions. Child Protective Services were contacted and a follow-up assessment with the patient and mother is pending. Psychiatric treatment of the mother may be a necessary intervention and prevention regimen for both the adolescent and the mother. Without consistent Child Protective Services oversight, medical and psychosocial follow-up, the prognosis and quality of life for this adolescent is considered very poor. Stringent mental health law and institutional policies are needed to adequately intercede and protect adolescents with mental illness.Keywords: adolescent, suicide, maternal treatment noncompliance, maternal neglect

  17. [AGING, HEALTH AND SOCIETY: CHALLENGES FOR NEXT DECADE].

    Science.gov (United States)

    Ribera Casado, José Manuel

    2014-01-01

    Main challenges that may appear in our country along next decade related with the aging process are discussed. First of these challenges must take into account demography changes. Absolute number and. rates of elderly people increases permanently and it will be so in the next future. To assume the UN slogan "active aging" could be a positive attitude, and in this way both, each individual and social collectives, must be involved. In relation with health challenges, chronic disease and disability are the two most important problems. Prevention and permanent searching attitude of efficient political health answers are two essential pillars. Challenges on the social field must be focussed on ageism. The main objective must be to fight against any form of age discrimination (ageism). Beside that educational policies oriented over professionals and citizens. Last group of challenges concerns to managers and politicians and must be focussed on the look for resources and educational promotion.

  18. Smartphone-Based Solutions for Fall Detection and Prevention: Challenges and Open Issues

    Directory of Open Access Journals (Sweden)

    Mohammad Ashfak Habib

    2014-04-01

    Full Text Available This paper presents a state-of-the-art survey of smartphone (SP-based solutions for fall detection and prevention. Falls are considered as major health hazards for both the elderly and people with neurodegenerative diseases. To mitigate the adverse consequences of falling, a great deal of research has been conducted, mainly focused on two different approaches, namely, fall detection and fall prevention. Required hardware for both fall detection and prevention are also available in SPs. Consequently, researchers’ interest in finding SP-based solutions has increased dramatically over recent years. To the best of our knowledge, there has been no published review on SP-based fall detection and prevention. Thus in this paper, we present the taxonomy for SP-based fall detection and prevention solutions and systematic comparisons of existing studies. We have also identified three challenges and three open issues for future research, after reviewing the existing articles. Our time series analysis demonstrates a trend towards the integration of external sensing units with SPs for improvement in usability of the systems.

  19. Public health and terrorism preparedness: cross-border issues.

    Science.gov (United States)

    Olson, Debra; Leitheiser, Aggie; Atchison, Christopher; Larson, Susan; Homzik, Cassandra

    2005-01-01

    On December 15, 2003, the Centers for Public Health Preparedness at the University of Minnesota and the University of Iowa convened the "Public Health and Terrorism Preparedness: Cross-Border Issues Roundtable." The purpose of the roundtable was to gather public health professionals and government agency representatives at the state, provincial, and local levels to identify unmet cross-border emergency preparedness and response needs and develop strategies for addressing these needs. Representatives from six state and local public health departments and three provincial governments were invited to identify cross-border needs and issues using a nominal group process. The result of the roundtable was identification of the needs considered most important and most doable across all the focus groups. The need to collaborate on and exchange plans and protocols among agencies was identified as most important and most doable across all groups. Development of contact protocols and creation and maintenance of a contact database was also considered important and doable for a majority of groups. Other needs ranked important across the majority of groups included specific isolation and quarantine protocols for multi-state responses; a system for rapid and secure exchange of information; specific protocols for sharing human resources across borders, including emergency credentials for physicians and health care workers; and a specific protocol to coordinate Strategic National Stockpile mechanisms across border communities.

  20. Nursing challenges for universal health coverage: a systematic review

    Directory of Open Access Journals (Sweden)

    Mariana Cabral Schveitzer

    2016-01-01

    Full Text Available Objectives to identify nursing challenges for universal health coverage, based on the findings of a systematic review focused on the health workforce' understanding of the role of humanization practices in Primary Health Care. Method systematic review and meta-synthesis, from the following information sources: PubMed, CINAHL, Scielo, Web of Science, PsycInfo, SCOPUS, DEDALUS and Proquest, using the keyword Primary Health Care associated, separately, with the following keywords: humanization of assistance, holistic care/health, patient centred care, user embracement, personal autonomy, holism, attitude of health personnel. Results thirty studies between 1999-2011. Primary Health Care work processes are complex and present difficulties for conducting integrative care, especially for nursing, but humanizing practices have showed an important role towards the development of positive work environments, quality of care and people-centered care by promoting access and universal health coverage. Conclusions nursing challenges for universal health coverage are related to education and training, to better working conditions and clear definition of nursing role in primary health care. It is necessary to overcome difficulties such as fragmented concepts of health and care and invest in multidisciplinary teamwork, community empowerment, professional-patient bond, user embracement, soft technologies, to promote quality of life, holistic care and universal health coverage.

  1. Occupational safety and health issues associated with green building

    OpenAIRE

    Terwoert, J.; Ustailieva, E.

    2013-01-01

    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...

  2. L’intégration professionnelle de médecins diplômés à l’étranger au Québec : un enjeu d’envergure en santé mondiale Professional integration of IMGs in Quebec: a challenging issue for Global Health

    Directory of Open Access Journals (Sweden)

    Marie-Jeanne Blain

    2012-11-01

    Full Text Available Dans un contexte où les processus de production et de transfert des expertises techniques sont imbriqués dans une logique de marché à l’échelle mondiale, les systèmes de santé contemporains sont interpellés par de nombreux défis liés à la mobilité internationale des professionnels de la santé. Nous inspirant de diverses approches de l’anthropologie de la santé et de la sociologie des organisations, nous souhaitons examiner les dynamiques complexes qui se tissent entre des phénomènes globaux associés à la mondialisation des sociétés contemporaines et des enjeux locaux associés à la mobilité internationale des professionnels de la santé, plus spécifiquement, l’intégration de médecins diplômés à l’étranger sur le marché du travail québécois. Cet article vise à souligner la contribution d’une approche socio-anthropologique de la santé mondiale afin de mettre au jour l’interrelation entre des jeux de pouvoir locaux et des inégalités sociales à l’échelle mondiale.In a context where the processes of production and transfer of technical expertise are nested in a logic of global markets, current health care systems have to face many challenges related to the international mobility of health professionals. Inspired by theoretical approaches of anthropology of health and the sociology of organizations, we discuss the complex dynamics between global phenomena associated to the globalization of contemporary societies and local issues concerning the international mobility of health professionals and, in this specific case, the integration of international medical graduates in Quebec’s labor market. In this perspective, a socio-anthropological approach to Global Health sheds light on the interplay between local power strategies and global social inequalities.

  3. Public Health Genetics : Challenging "Public Health at the Crossroads"

    Directory of Open Access Journals (Sweden)

    Angela Brand

    2005-03-01

    Full Text Available

    Dear public health professionals, Honestly, isn’t it time to ask whether or not we are doing “the right things”in public health? Are our present public health strategies evidence-based? The public health agenda demands a vision that reaches beyond research to the application of public health and the determination of it’s impact. In this scenario what is the role of genomics? In the past twenty years, advances in genome research have revolutionised what is known about the role of inheritance in health and disease.[1]

    Nowadays,we know that our DNA determines not only the cause of single-gene disorders, but also determines our predisposition to common diseases.Whereas medicine is currently undergoing extraordinary developments from its morphological and phenotype orientation to a molecular and genotype orientation, promoting the importance of prognosis and prediction, public health practice has to date concerned itself with environmental determinants of health and disease and has paid scant attention to genetic variations within the population.

     The advances brought about by genomics is changing these perceptions.[2,3] Many predict, that this knowledge will enable health promotion messages and disease prevention programmes to be specifically directed at susceptible individuals or at subgroups of the population, based on their genetic profile.[4,5]

    The new technologies will allow researchers to examine genetic mutations at the functional genomic unit level, and to better understand the significance of environmental factors such as noxious agents, nutrition and personal behaviour in relation to the causation of diseases such as cardiovascular diseases, psychiatric disorders and infectious diseases.

  4. Challenges of Public Health Education in the former Soviet Union: Example of Ukraine

    Directory of Open Access Journals (Sweden)

    Anna Piekkala

    2012-10-01

    Full Text Available BACKGROUND: Many former Soviet Union (fSU countries face a high burden of disease and a much lower life expectancy compared to western countries. Many of the underlying causes are amenable to public health interventions, but the prevailing Soviet approach to prevention has largely failed to address the new and more complex public health issues these countries face. This study looks at public health challenges in Ukraine, in particular at those related to public health education. METHODS: The research is based on a small-scale, qualitative analysis of information collected through i review of literature related to public health and public health education in the former Soviet Union and Ukraine, as well as curricula and training material for epidemiology students in Ukrainian medical schools, ii observations during workshops for epidemiology students and teachers from Ukrainian medical schools and iii semi-structured interviews with epidemiology students and teachers from Ukrainian medical schools. The collected data was interpreted using the method of thematic discourse analysis, which allowed identifying major areas challenging public health education in the country. RESULTS: The main challenges identified were seen in the outdated conceptual understanding of public health, particularly in epidemiology. These challenges underlie further problems including limited hours and narrow content of epidemiology training, lack of training in research skills, inadequate training material and conservative attitudes among teachers and students towards prevailing ideas and development. DISCUSSION AND CONCLUSION: There is urgent need for a wider definition of public health, moving towards the “New Public Health” approach and subsequently a series of changes to education curricula and materials. Curricula reform should provide additional hours for covering non-communicable diseases, non-medical topics such as health policy and health promotion and ensure

  5. Addressing the "Global Health Tax" and "Wild Cards": Practical Challenges to Building Academic Careers in Global Health.

    Science.gov (United States)

    Palazuelos, Daniel; Dhillon, Ranu

    2016-01-01

    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.

  6. Promoting Space Education and Awareness in Pakistan- Initiatives, Achievements, Challenges and Issues

    Science.gov (United States)

    Jagirani, Aisha

    With about 180 million inhabitants, Pakistan is the sixth most populous and the 34th largest country in the world in terms of area. Pakistan's economy, which is pre-dominantly based on agriculture, is the 26th largest in the world in terms of purchasing power parity and 45th largest in terms of nominal GDP. Pakistan is counted among the Next Eleven (N11) countries that have the potential to become the world's largest economies in the 21st century. Despite considerable potential to develop into a stable, moderate and democratic state, major challenges of internal security, poor agricultural productivity, inadequate infrastructure, food insecurity, insufficient health and educational facilities, depletion of natural resources, rapid environmental degradation and recurring natural disasters have burdened the country and have hampered sustainable development of Pakistan. Space technology applications offer a cost-effective means of addressing many of the above mentioned issues and have made impressive advances in the last few years in different countries in the region. Unfortunately, for various reasons, Pakistan has not been able to fully exploit the benefits of space technology and its applications to meet the challenges she faces. One of the reasons is lack of awareness and understanding by planners, decision-makers and users about the potential benefits of space technology in planning and implementation of developmental plans as well as good governance. Similarly, Pakistan's space program enjoys little public support due, primarily, to lack of awareness of the benefits space offers and the ubiquitousness of space applications in modern life. There is thus an acute need to create awareness and educate all segments of the society and stakeholders in Pakistan about the potential benefits of space technology and its applications. In the past ten years, many initiatives have been taken to promote space education and awareness for students as well as decision-makers in

  7. Digital Technology and Mental Health Interventions: Opportunities and Challenges

    Directory of Open Access Journals (Sweden)

    Aguilera, Adrian

    2015-02-01

    Full Text Available The growth of the Internet, mobile phones, social media and other digital technologies has changed our world in many ways. It has provided individuals with information that was previously only available to a select few. An example of the reach of technology is data that as of October 2012, there are over 6 billion phones worldwide (BBC, 2012. The availability of data in real time has presented hopes of intervening more efficiently and managing health problems by leveraging limited human resources. It also has an impact in changing the roles of providers and patients and in legal and ethical issues including privacy in digital health interactions. This paper will discuss why digital technology has received recent attention in the area of mental health, present some applications of technology for mental health to date, explore the challenges to full implementation in clinical settings, and present future opportunities for digital technologies.El crecimiento del Internet, los teléfonos móviles, las redes sociales y otras tecnologías digitales ha cambiado nuestro mundo de muchas maneras. Ha proporcionado a las personas con la información que antes sólo estaba disponible para un grupo selecto, por ejemplo a partir de octubre de 2012. Un ejemplo del alcance de la tecnología son los datos que dicen que hay más de 6 millones de teléfonos en todo el mundo (BBC, 2012. La disponibilidad de los datos en tiempo real a presentado la esperanza de intervenir de manera más eficiente y manejar los problemas de salud los recursos humanos limitados. También tiene un impacto en el cambio de los roles de los proveedores y los pacientes y en aspectos legales y éticos, incluyendo la privacidad en las interacciones de salud digital. Este artículo discutirá unas razones por cual la tecnología digital ha recibido atención recientemente en el área de salud mental, presentará algunas aplicaciones de la tecnología para mejorar la salud mental hasta la fecha

  8. E-waste: a problem or an opportunity? Review of issues, challenges and solutions in Asian countries.

    Science.gov (United States)

    Herat, Sunil; Agamuthu, P

    2012-11-01

    Safe management of electronic and electrical waste (e-waste/WEEE) is becoming a major problem for many countries around the world. In particular, developing countries face a number of issues with the generation, transboundary movement and management of e-waste. It is estimated that the world generates around 20-50 million tonnes of e-waste annually, most of it from Asian countries. Improper handling of e-waste can cause harm to the environment and human health because of its toxic components. Several countries around the world are now struggling to deal with this emerging threat. Although the current emphasis is on end-of-life management of e-waste activities, such as reuse, servicing, remanufacturing, recycling and disposal, upstream reduction of e-waste generation through green design and cleaner production is gaining much attention. Environmentally sound management (ESM) of e-waste in developing countries is absent or very limited. Transboundary movement of e-waste is a major issue throughout the region. Dealing with the informal recycling sector is a complex social and environmental issue. There are significant numbers of such challenges faced by these countries in achieving ESM of e-waste. This article aims to present a review of challenges and issues faced by Asian countries in managing their e-waste in a sustainable way.

  9. Emerging issues and challenges in conservation of biodiversity in the rangelands of Tanzania

    Directory of Open Access Journals (Sweden)

    Jafari Kideghesho

    2013-11-01

    Full Text Available Tanzania rangelands are a stronghold for biodiversity harbouring a variety of animal and plant species of economic, ecological and socio-cultural importance. Efforts to protect these resources against destruction and loss have involved, among other things, setting aside some tracks of land as protected areas in the form of national parks, nature reserves, game reserves, game controlled and wildlife management areas. However, these areas and adjacent lands have long been subjected to a number of emerging issues and challenges, which complicate their management, thus putting the resources at risk of over exploitation and extinction. These issues and challenges include, among other things, government policies, failure of conservation (as a form of land use to compete effectively with alternative land uses, habitat degradation and blockage of wildlife corridors, overexploitation and illegal resource extraction, wildfires, human population growth, poverty, HIV/AIDS pandemic and human-wildlife conflicts. In this paper, we review the emerging issues and challenges in biodiversity conservation by drawing experience from different parts of Tanzania. The paper is based on the premise that, understanding of the issues and challenges underpinning the rangelands is a crucial step towards setting up of plausible objectives, strategies and plans that will improve and lead to effective management of these areas. We conclude by recommending some proactive measures that may enhance the sustainability of the rangeland resources for the benefit of the current and future generations.

  10. Introducing GaLA: Serious Game potentials, challenges and TEL-related issues

    NARCIS (Netherlands)

    Earp, Jeffrey; Klemke, Roland

    2011-01-01

    Earp, J., & Klemke, R. (2011, 21 September). Introducing GaLA: Serious Game potentials, challenges and TEL-related issues. Presented at TEL-Think-Tank Workshop at the 6th European conference on Technology enhanced learning: towards ubiquitous learning (EC-TEL 2011), Palermo, Italy.

  11. Challenges in Coordinating and Managing Services and Supports in Secondary and Postsecondary Options. Issue Brief.

    Science.gov (United States)

    Hart, Debra; Zimbrich, Karen; Whelley, Teresa

    This issue brief discusses the challenges that youth with disabilities face as they prepare to leave secondary school and how service coordination can help these students find appropriate services and supports for adult life. It reviews federal legislation designed to address transitions to postsecondary education and employment and current models…

  12. Inclusion of Student with Special Needs within Higher Education in UAE: Issues and Challenges

    Science.gov (United States)

    Gaad, Eman; Almotairi, Mishal

    2013-01-01

    This is an oral interactive presentation supported by evidences that present the current status of inclusion of students with special needs in the Higher Education sector in the UAE. It looks at the related issues and challenges in a country that is certainly heading towards inclusion of all learners in regular education following the ratification…

  13. Ageism and the Baby Boomers: Issues, Challenges and the TEAM Approach

    Science.gov (United States)

    Gibson, Jane Whitney; Jones, J. Preston; Cella, Jennifer; Clark, Cory; Epstein, Alexandra; Haselberger, Jennifer

    2010-01-01

    This paper considers the issues and challenges associated with ageism relating to the Baby Boomer generation in Corporate America. Stereotypes about older workers are examined along with types of discrimination facing Boomers. The TEAM approach is proposed to combat ageism in the workplace. The strategy includes using intergenerational teams,…

  14. Humor, laughter, and physical health: methodological issues and research findings.

    Science.gov (United States)

    Martin, R A

    2001-07-01

    All published research examining effects of humor and laughter on physical health is reviewed. Potential causal mechanisms and methodological issues are discussed. Laboratory experiments have shown some effects of exposure to comedy on several components of immunity, although the findings are inconsistent and most of the studies have methodological problems. There is also some evidence of analgesic effects of exposure to comedy, although similar findings are obtained with negative emotions. Few significant correlations have been found between trait measures of humor and immunity, pain tolerance, or self-reported illness symptoms. There is also little evidence of stress-moderating effects of humor on physical health variables and no evidence of increased longevity with greater humor. More rigorous and theoretically informed research is needed before firm conclusions can be drawn about possible health benefits of humor and laughter.

  15. Neglected organization and management issues in mental health systems development.

    Science.gov (United States)

    Greenley, J R

    1992-10-01

    Fragmented and often uncoordinated public services for the more severely mentally ill are often characteristic of the current U.S. mental health system. The creation of local mental health authorities has been promoted as part of a solution, as has happened in Wisconsin at the county level and is championed in the ongoing Robert Wood Johnson Foundation funded innovative service sites for severely mentally ill adults. There are indications that these innovative mental health authorities will fall short of fulfilling their promise. Basic principles from the management and organizations literature are used to identify several organization and management issues that may have been neglected. These include resource management, attention to system goals, monitoring and feedback, and the promotion of desirable interorganizational cultures.

  16. Peer-to-Peer Live Streaming and Video On Demand Design Issues and its Challenges

    CERN Document Server

    K, Hareesh

    2011-01-01

    Peer-to-Peer Live streaming and Video on Demand is the most popular media applications over the Internet in recent years. These systems reduce the load on the server and provide a scalable content distribution. A new paradigm of P2P network collaborates to build large distributed video applications on existing networks .But, the problem of designing the system are at par with the P2P media streaming, live and Video on demand systems. Hence a comprehensive design comparison is needed to build such kind of system architecture. Therefore, in this paper we elaborately studied the traditional approaches for P2P streaming architectures, and its critical design issues, as well as practicable challenges. Thus, our studies in this paper clearly point the tangible design issues and its challenges, and other intangible issues for providing P2P VoD services.

  17. An Appraisal of Social Network Theory and Analysis as Applied to Public Health: Challenges and Opportunities.

    Science.gov (United States)

    Valente, Thomas W; Pitts, Stephanie R

    2017-03-20

    The use of social network theory and analysis methods as applied to public health has expanded greatly in the past decade, yielding a significant academic literature that spans almost every conceivable health issue. This review identifies several important theoretical challenges that confront the field but also provides opportunities for new research. These challenges include (a) measuring network influences, (b) identifying appropriate influence mechanisms, (c) the impact of social media and computerized communications, (d) the role of networks in evaluating public health interventions, and (e) ethics. Next steps for the field are outlined and the need for funding is emphasized. Recently developed network analysis techniques, technological innovations in communication, and changes in theoretical perspectives to include a focus on social and environmental behavioral influences have created opportunities for new theory and ever broader application of social networks to public health topics.

  18. Current issues in the design of academic health sciences libraries: findings from three recent facility projects.

    Science.gov (United States)

    Nelson, Patricia P

    2003-07-01

    Planning a new health sciences library at the beginning of the twenty-first century is a tremendous challenge. Technology has radically changed the way libraries function in an academic environment and the services they provide. Some individuals question whether the library as place will continue to exist as information becomes increasingly available electronically. To understand how libraries resolve programming and building design issues, visits were made to three academic health sciences libraries that have had significant renovation or completed new construction. The information gathered will be valuable for planning a new library for the University of Colorado Health Sciences Center and may assist other health sciences librarians as they plan future library buildings.

  19. STUDY OF HEALTH STATUS AND ETIOLOGICAL FACTORS OF MENTALLY CHALLENGED CHILDREN IN SCHOOL FOR MENTALLY CHALLENGED

    Directory of Open Access Journals (Sweden)

    Nadeem Ahmad

    2009-03-01

    Full Text Available The mental health of the child affects his physical health and the learning process. The present study was conducted to study the health status and etiological factors among 58 mentally challenged children in school for mentally challenged at Sangamner. Majority of mentally challenged children (68.0% were in 5-9 years age group. Most of them had moderate retardation. (43.0% In majority of children (70.68%no clinical syndrome was present. Most common clinical syndrome was Down’s syndrome (17.23%,followed by Fragile X syndrome (6.89%. More than sixty percent children were off springs of consanguineous marriages. Idiopathic causes (63.8% followed by genetic causes (29.31% were common etiological factor responsible for mental retardation. Mental handicap can be prevented by genetic counseling.

  20. African American College Students' Health Behaviors and Perceptions of Related Health Issues.

    Science.gov (United States)

    Ford, Denyce S.; Goode, Carolyn R.

    1994-01-01

    A study of African American college students compared students' health-related behaviors with their perceptions of corresponding health issues. Students had low smoking rates but higher alcohol consumption. Most students did not practice good nutrition or daily physical activity. Over half managed stress well, and three-quarters were sexually…

  1. Perspectives on Terminology and Conceptual and Professional Issues in Health Education and Health Promotion Credentialing

    Science.gov (United States)

    Taub, Alyson; Allegrante, John P.; Barry, Margaret M.; Sakagami, Keiko

    2009-01-01

    This article was prepared to inform the deliberations of the Galway Consensus Conference by providing a common and global reference point for the discussion of terminology and key conceptual and professional issues in the credentialing of health education and health promotion specialists. The article provides a review of the terminology that is…

  2. Global Health Governance Challenges 2016 – Are We Ready?

    Directory of Open Access Journals (Sweden)

    Ilona Kickbusch

    2016-06-01

    Full Text Available The year 2016 could turn out to be a turning point for global health, new political realities and global insecurities will test governance and financing mechanisms in relation to both people and planet. But most importantly political factors such as the global power shift and “the rise of the rest” will define the future of global health. A new mix of health inequity and security challenges has emerged and the 2015 humanitarian and health crises have shown the limits of existing systems. The global health as well as the humanitarian system will have to prove their capacity to respond and reform. The challenge ahead is deeply political, especially for the rising political actors. They are confronted with the consequences of a model of development that has neglected sustainability and equity, and was built on their exploitation. Some direction has been given by the path breaking international conferences in 2015. Especially the agreement on the Sustainable Development Goals (SDGs and the Paris agreement on climate change will shape action. Conceptually, we will need a different understanding of global health and its ultimate goals - the health of people can no longer be seen separate from the health of the planet and wealth measured by parameters of growth will no longer ensure health.

  3. Global Health Governance Challenges 2016 - Are We Ready?

    Science.gov (United States)

    Kickbusch, Ilona

    2016-02-29

    The year 2016 could turn out to be a turning point for global health, new political realities and global insecurities will test governance and financing mechanisms in relation to both people and planet. But most importantly political factors such as the global power shift and "the rise of the rest" will define the future of global health. A new mix of health inequity and security challenges has emerged and the 2015 humanitarian and health crises have shown the limits of existing systems. The global health as well as the humanitarian system will have to prove their capacity to respond and reform. The challenge ahead is deeply political, especially for the rising political actors. They are confronted with the consequences of a model of development that has neglected sustainability and equity, and was built on their exploitation. Some direction has been given by the path breaking international conferences in 2015. Especially the agreement on the Sustainable Development Goals (SDGs) and the Paris agreement on climate change will shape action. Conceptually, we will need a different understanding of global health and its ultimate goals - the health of people can no longer be seen separate from the health of the planet and wealth measured by parameters of growth will no longer ensure health.

  4. Methodological, practical, and ethical challenges to inner-city health research.

    Science.gov (United States)

    Bayoumi, Ahmed M; Hwang, Stephen W

    2002-12-01

    Inner-city health research can be challenging because it deals with vulnerable populations and sometimes puts investigators in difficult situations. Some challenges are methodological, including selecting the optimal research design, implementing effective methods of recruitment and retention, and determining the best approach to data analysis. Other issues are practical, including addressing potential biases in social research; dealing with conflicting research agendas among investigators, community agencies, and funding agencies; and disseminating research findings effectively. Another set of issues relates to the ethical conduct of research, including ensuring privacy, maintaining confidentiality, and obtaining consent that is informed, not coerced, and not influenced by undue inducements. Throughout the research endeavor, the inner-city health researcher must carefully balance the roles of investigator, advocate, activist, and caregiver.

  5. Myth of reincarnation: a challenge for mental health profession.

    Science.gov (United States)

    Gadit, A A Muhammad

    2009-02-01

    Mental health practitioners often come across a number of challenges in their clinical practice. One such challenge that posed a management dilemma presented with the history of reincarnation. This subject has been discussed in non-scientific literature at length but there is an absolute paucity in scientific literature. This paper describes a case where a boy presented with memories of previous life that started haunting him and caused significant anxiety. The subject of reincarnation needs extensive research in order to understand and manage the resultant clinical challenges.

  6. The Belo Horizonte Observatory for Urban Health: its history and current challenges.

    Science.gov (United States)

    Dias, Maria Angelica de Salles; Friche, Amélia Augusta de Lima; Oliveira, Veneza Berenice de; Caiaffa, Waleska Teixeira

    2015-11-01

    The Belo Horizonte Observatory for Urban Health (OSUBH), housed in an academic setting, was founded in 2002 as part of a broader agenda to strengthen local and national health systems. Its mission is to build the capacity of the workforce in research on population health and to conduct studies on urban issues that can guide the planning of activities aimed at improving the health of populations, especially in heavily urbanized areas, associated with intra-urban inequalities. It focuses on the acquisition of advanced knowledge on urban health (metric) through scientific research, to contribute to public policies that may interfere with health, both at individual and community levels. During its lifetime, many partnerships and studies have been developed, but many challenges still exist in order for it to consolidate its position as a legitimate space and as a tool to generate systematic information for governments and populations.

  7. [Qualitative research in collective health: overview and challenges].

    Science.gov (United States)

    Bosi, Maria Lúcia Magalhães

    2012-03-01

    This article provides an overview of the nuclear themes in the debate about the qualitative health research approach in the Brazilian scientific context and more specifically in the public health field. The author begins by defining some central concepts in the analysis conducted. Then, combining the literature on the subject with her academic praxis, she examines the current status of this research tradition, highlighting an extensive set of challenges. The discussion focuses on each challenge, moving between the different epistemic, ethical and operational planes in relation to the scientific status of this approach to public health. Considering various questions and based on empirical examples, analysis shows that, despite the expansion observed in qualitative research and its contributions to public health, this approach still faces many challenges before consolidating its status. The situation demands investments in dialogue with the other approaches which form the core area. Despite these challenges, the paper concludes by pointing to the possibility of new pacts in the public health field in order to incorporate innovations to address the diversity and complexity of this field.

  8. Perspectives on Games, Computers, and Mental Health: Questions about Paradoxes, Evidences, and Challenges.

    Science.gov (United States)

    Desseilles, Martin

    2016-01-01

    In the field of mental health, games and computerized games present questions about paradoxes, evidences, and challenges. This perspective article offers perspectives and personal opinion about these questions, evidences, and challenges with an objective of presenting several ideas and issues in this rapidly developing field. First, games raise some questions in the sense of the paradox between a game and an issue, as well as the paradox of using an amusing game to treat a serious pathology. Second, games also present evidence in the sense that they involve relationships with others, as well as learning, communication, language, emotional regulation, and hedonism. Third, games present challenges, such as the risk of abuse, the critical temporal period that may be limited to childhood, their important influence on sociocognitive learning and the establishment of social norms, and the risk of misuse of games.

  9. Profile of men's health in Malaysia: problems and challenges.

    Science.gov (United States)

    Tong, Seng Fah; Low, Wah Yun; Ng, Chirk Jenn

    2011-07-01

    Men's health concerns have evolved from the traditional andrology and male sexual health to a more holistic approach that encompasses male psychological, social and physical health. The poor state of health in men compared to their female counterparts is well documented. A review of the epidemiological data from Malaysia noted a similar trend in which men die at higher rates in under 1 and above 15 years old groups and most disease categories compared to women. In Malaysia, the main causes of death in men are non-communicable diseases and injuries. Risk factors, such as risk-taking behaviour, smoking and hypertension, are prevalent and amenable to early interventions. Erectile dysfunction, premature ejaculation and prostate disorders are also prevalent. However, many of these morbidities go unreported and are not diagnosed early; therefore, opportunities for early intervention are missed. This reflects poor health knowledge and inadequate health-care utilisation among Malaysian men. Their health-seeking behaviour has been shown to be strongly influenced by family members and friends. However, more research is needed to identify men's unmet health-care needs and to develop optimal strategies for addressing them. Because the Malaysian population is aging and there is an increase in sedentary lifestyles, optimizing men's health will remain a challenge unless effective measures are implemented. The existing male-unfriendly health-care system and the negative influence of masculinity on men's health behaviour must be addressed. A national men's health policy based on a male-friendly approach to health-care delivery is urgently needed to provide a framework for addressing these challenges.

  10. Smoking Health Professional Student: An Attitudinal Challenge for Health Promotion?

    Directory of Open Access Journals (Sweden)

    Daniel Cauchi

    2012-07-01

    Full Text Available Tobacco is a major preventable cause of premature morbidity and mortality. Health professionals are uniquely positioned to provide targeted interventions and should be empowered to provide cessation counselling that influence patient smoking. A cross-sectional national survey was administered to all third year students in four disciplines at the University of Malta. The Global Health Professional Student Survey (GHPSS questionnaire was distributed to collect standardised demographic, smoking prevalence, behavioural, and attitudinal data. 81.9% completed the questionnaire (n = 173/211. A positive significant association between tobacco smoke exposure at home and current smoking status was identified. Non-smokers regarded anti-tobacco policies more favourably than smokers, being more likely to agree with banning of tobacco sales to adolescents (OR 3.6; 95% CI: 2.5–5.3; p ≤ 0.001; and with a smoking ban in all public places (OR 8.9; 95% CI: 6.1–13.1; p ≤ 0.001. Non-smokers favoured a role for health professionals in promoting smoking cessation (OR 5.1; 95% CI: 3.1–8.5; p ≤ 0.001. Knowledge of antidepressants as tools for smoking cessation was also associated with a perceived role for skilled health professionals in cessation counselling (OR 4.9; 95% CI: 1.8–13.3; p = 0.002. Smoking negatively influences beliefs and attitudes of students toward tobacco control. There is a need to adopt a standard undergraduate curriculum containing comprehensive tobacco prevention and cessation training to improve their effectiveness as role models.

  11. Financing Small and Medium Enterprises in Bangladesh – Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Fuad Hasan

    2014-08-01

    Full Text Available Abstract. Now-a-days, Small and Medium Enterprises (SMEs have become an important sector that is supposed to play a pivotal role in boosting the economy of Bangladesh. But, SME financing is still facing some remarkable challenges that limit its potential success in contributing to the economy. Lots of thinking has contributed to the initiation and development of SMEs in Bangladesh. Now is the time to identify the challenges and making adjustments to the initial thinking. This paper is, therefore, an attempt to analyze various issues and challenges of financing this particular sector and find some worthy ways out to overcome these challenges. It will also survey various literatures and reports on the concerned field and recommend supporting actions to help this highly prospective industrial sector operate in a fully yielding manner.Keywords: SME, Financing, Development, Bangladesh economy, Industrial sector

  12. [Ethics and reproductive health: the issue of HPV vaccination].

    Science.gov (United States)

    Matejić, Bojana; Kesić, Vesna

    2013-01-01

    The ethics of reproductive health covers a wide field of different issues, from the ethical dimensions of assisted reproduction, life of newborns with disabilities to the never-ending debate on the ethical aspects of abortion. Furthermore, increasing attention is paid to the ethical dimensions of using stem cells taken from human embryos, the creation of cloned embryos of patients for possible self-healing, and the increasingly present issue of reproductive cloning. Development of vaccines against human papillomavirus (HPV) has introduced new ethical aspects related to reproductive health and the need for a consensus of clinical and public-healthcare population. Today immunization with HPV vaccine is a measure for the primary prevention of cervical cancer and it provides effective protection against certain types of viruses included in the vaccine. The most often mentioned issues of discussions on ethical concerns about HPV vaccination are the recommended age of girls who should be informed and vaccinated (12-14 years), attitudes and fears of parents concerning discussion with their preadolescent daughters on issues important for their future sexual behavior, dilemma on the vaccination of boys and the role of the chosen pediatrician in providing information on the vaccination. In Serbia, two HPV vaccines have been registered but the vaccination is not compulsory. Up-till-now there has been no researches on the attitudes of physicians and parents about HPV vaccination. Nevertheless, it is very important to initiate education of general and medical public about the fact that the availability of vaccine, even if we disregard all aforementioned dilemmas, does not lead to the neglect of other preventive strategies against cervical cancer, primarily screening. The National Program for Cervical Cancer Prevention involves organized screening, i.e. regular cytological examinations of the cervical smear of all women aged 25-69 years, every three years, regardless of the

  13. Ethics and reproductive health: The issue of HPV vaccination

    Directory of Open Access Journals (Sweden)

    Matejić Bojana

    2013-01-01

    Full Text Available The ethics of reproductive health covers a wide field of different issues, from the ethical dimensions of assisted reproduction, life of newborns with disabilities to the never-ending debate on the ethical aspects of abortion. Furthermore, increasing attention is paid to the ethical dimensions of using stem cells taken from human embryos, the creation of cloned embryos of patients for possible self-healing, and the increasingly present issue of reproductive cloning. Development of vaccines against human papillomavirus (HPV has introduced new ethical aspects related to reproductive health and the need for a consensus of clinical and public-healthcare population. Today immunization with HPV vaccine is a measure for the primary prevention of cervical cancer and it provides effective protection against certain types of viruses included in the vaccine. The most often mentioned issues of discussions on ethical concerns about HPV vaccination are the recommended age of girls who should be informed and vaccinated (12-14 years, attitudes and fears of parents concerning discussion with their preadolescent daughters on issues important for their future sexual behavior, dilemma on the vaccination of boys and the role of the chosen pediatrician in providing information on the vaccination. In Serbia, two HPV vaccines have been registered but the vaccination is not compulsory. Up-till-now there has been no researches on the attitudes of physicians and parents about HPV vaccination. Nevertheless, it is very important to initiate education of general and medical public about the fact that the availability of vaccine, even if we disregard all aforementioned dilemmas, does not lead to the neglect of other preventive strategies against cervical cancer, primarily screening. The National Program for Cervical Cancer Prevention involves organized screening, i.e. regular cytological examinations of the cervical smear of all women aged 25-69 years, every three years

  14. Albinism in Africa as a public health issue

    Directory of Open Access Journals (Sweden)

    Hong Esther S

    2006-08-01

    Full Text Available Abstract Background Oculocutaneous albinism (OCA is a genetically inherited autosomal recessive condition and OCA2, tyrosine-positive albinism, is the most prevalent type found throughout Africa. Due to the lack of melanin, people with albinism are more susceptible to the harmful effects of ultraviolet radiation exposure. This population must deal with issues such as photophobia, decreased visual acuity, extreme sun sensitivity and skin cancer. People with albinism also face social discrimination as a result of their difference in appearance. The World Health Organization is currently investigating the issues concerning this vulnerable population. Methods Systematic electronic search of articles in PubMed concerning albinism in Africa. Furthermore, a World Health Organization (WHO pilot survey of albinism was drafted in English, French and Portuguese, and distributed to African countries through WHO African Regional Offices (AFRO in an attempt to gather further information on albinism. Results Epidemiologic data on albinism, such as prevalence, were available for South Africa, Zimbabwe, Tanzania and Nigeria. Prevalences as high as 1 in 1,000 were reported for selected populations in Zimbabwe and other specific ethnic groups in Southern Africa. An overall estimate of albinism prevalences ranges from 1/5,000 – 1/15,000. In addition, both the literature review and the survey underscored the medical and social issues facing people with albinism. Conclusion The estimated prevalence of albinism suggests the existence of tens of thousands of people living with albinism in Africa. This finding reiterates the need for increased awareness of and public health interventions for albinism in order to better address the medical, psychological and social needs of this vulnerable population.

  15. Oral health in Libya: addressing the future challenges.

    Science.gov (United States)

    Peeran, Syed Wali; Altaher, Omar Basheer; Peeran, Syed Ali; Alsaid, Fatma Mojtaba; Mugrabi, Marei Hamed; Ahmed, Aisha Mojtaba; Grain, Abdulgader

    2014-01-01

    Libya is a vast country situated in North Africa, having a relatively better functioning economy with a scanty population. This article is the first known attempt to review the current state of oral health care in Libya and to explore the present trends and future challenges. Libyan health system, oral health care, and human resources with the present status of dental education are reviewed comprehensively. A bibliographic study of oral health research and publications has been carried out. The results point toward a common indicator that oral health-related research is low. Strategies have to be developed to educate the medical and dental professionals, to update the current curriculum and enable the system to be competent in all aspects of oral health care management.

  16. NETWORKS OF HEALTH CARE: A CHALLENGE TO SUS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Camila Dubow

    2013-09-01

    Full Text Available The article proposes a critical reflection, based on national law, scholarly, scientific, on the current development of Networks of Health Care, as a strategy for strengthening the Single Health System (SUS. Are weighted inefficiency of traditional ways of organizing care and management, the challenge of Network Health Care for comprehensive care and management mechanisms used in this process. The work provides subsidies for the care practices and health management are reflected, pointing strategies that result in disruptions of paradigms through a refocusing of attention in existing models. For networks of health care can be consolidated, is fundamental to political sensitivity of health managers with a commitment to build a new model of care, through the struggle to consolidate the SUS and the realization of the principles of universality, comprehensiveness and equity.

  17. [Human resources for health in Chile: the reform's pending challenge].

    Science.gov (United States)

    Méndez, Claudio A

    2009-09-01

    Omission of human resources from health policy development has been identified as a barrier in the health sector reform's adoption phase. Since 2002, Chile's health care system has been undergoing a transformation based on the principles of health as a human right, equity, solidarity, efficiency, and social participation. While the reform has set forth the redefinition of the medical professions, continuing education, scheduled accreditation, and the introduction of career development incentives, it has not considered management options tailored to the new setting, a human resources strategy that has the consensus of key players and sector policy, or a process for understanding the needs of health care staff and professionals. However, there is still time to undo the shortcomings, in large part because the reform's implementation phase only recently has begun. Overcoming this challenge is in the hands of the experts charged with designing public health strategies and policies.

  18. Public Administration Efficiency and the Aggravation of Public Health Issues

    Directory of Open Access Journals (Sweden)

    Vladimir Aleksandrovich Ilyin

    2015-12-01

    Full Text Available December 3, 2015, the President of Russia Vladimir Putin delivered his annual Address to the Federal Assembly. Having analyzed the Address, experts pointed out the President’s worries and concerns about the efficiency of execution of development priorities he had set out. Vladimir Putin repeatedly urged the Government to implement effective measures on specific issues in the shortest time possible. However, it has not been done so far; therefore, we think that the President’s concern is reasonable. Recent research carried out by ISEDT RAS reveals certain alarming trends in the social health of the regional society

  19. Six challenges in modelling for public health policy

    Directory of Open Access Journals (Sweden)

    C.J.E. Metcalf

    2015-03-01

    Full Text Available The World Health Organisation's definition of public health refers to all organized measures to prevent disease, promote health, and prolong life among the population as a whole (World Health Organization, 2014. Mathematical modelling plays an increasingly important role in helping to guide the most high impact and cost-effective means of achieving these goals. Public health programmes are usually implemented over a long period of time with broad benefits to many in the community. Clinical trials are seldom large enough to capture these effects. Observational data may be used to evaluate a programme after it is underway, but have limited value in helping to predict the future impact of a proposed policy. Furthermore, public health practitioners are often required to respond to new threats, for which there is little or no previous data on which to assess the threat. Computational and mathematical models can help to assess potential threats and impacts early in the process, and later aid in interpreting data from complex and multifactorial systems. As such, these models can be critical tools in guiding public health action. However, there are a number of challenges in achieving a successful interface between modelling and public health. Here, we discuss some of these challenges.

  20. Is periodontal disease a public health issue in Colombia?

    Directory of Open Access Journals (Sweden)

    Jorge Hernán Ramírez

    2007-09-01

    purpose of «to evaluate the oral health status, to control the risk factors for periodontal disease and caries, and to support adequate oral hygiene practices»16. However, periodontal treatment in pregnant women is not included in the POS.General medical practitioners and specialists could play a pivotal role in the promotion of oral health. However, most doctors do not know general health periodontitis implications, are not trained to diagnose periodontal disease, and are not sensitized to refer high-risk patients as diabetic and pregnant women to the dentist. The perception of medicine and dentistry as individual health sciences has made difficult the development of an effective oral health policy to improve oral health indicators.It is necessary to implement cost-effective policies of public health to decrease oral health inequalities in Colombian population. Oral health goals in Colombia can only be accomplished by a public health strategy including education programs to the community, facilitating the dentist-physician collaboration, increasing access of the population to dentist, and give financial support to interdisciplinary research projects. Additionally, periodontitis treatment should be included in the POS, especially for diabetic patients and pregnant women. This year the Universidad del Valle will present the anterior proposal to the Colombian Association of Dentistry Faculties (ACFO, to the Colombian Association of Medical Faculties (ASCOFAME and to the Colombian Association of Nurses Faculties (ASCOFAEN with the aim of to elaborate a recommendations manuscript for the Ministry of Health consideration on this issue.

  1. Guest Editorial ~ Issues, Challenges and Possibilities for Academics and Tutors at Open and Distance Learning Environments

    Directory of Open Access Journals (Sweden)

    Heather Kanuka

    2006-09-01

    Full Text Available Institutions of open and distance learning present a number of special challenges for academics. Development loads and teaching effectiveness are increasing, while traditional demands for research productivity have become a new and/ or increased pressure. The size, complexity, and structure of the networked learning environment at most institutions of open and distance learning have been known to contribute to feelings of isolation and loneliness leading to disengagement experienced by many new and not so new academics. It is possible if we do not address the disconnectedness experienced by many open and distance academics and tutors that detachment to our institutions will occur, resulting in an increased migration to either collaborate with, or work in, other institutions.Retaining faculty members is not only important for the stability and health of open and distance organizations, but retention – and recruitment – are also issues that institutions of open and distance learning need to be concerned about. The large numbers of senior faculty appointed in the mid 1970s are moving into retirement and/ or later-life careers. It has been estimated that 40 percent of university faculty will retire within the next 10 years. Recruitment and retention of academics is a pressing concern for all universities – but particularly for open and distance universities. The current detached environment may result in a serious employment problem down the road as other traditional universities begin an intensive competition for the best academics. And while these problems exist to some extent at all universities, there is probably no other type of university where building a sense of community is needed.

  2. Mental health issues and discrimination among older LGBTI people.

    Science.gov (United States)

    Tinney, Jean; Dow, Briony; Maude, Phillip; Purchase, Rachel; Whyte, Carolyn; Barrett, Catherine

    2015-09-01

    LGBT is an acronym used to describe people from diverse sexual orientation or gender identity, people that are gay, lesbian, bisexual, or transgender. LGBT people do not constitute a single group nor does each individual "group" constitute a homogeneous unity. However, as higher rates of depression and/or anxiety have been observed in older LGBT people, compared to their heterosexual counterparts (Guasp, 2011) there is a need to raise the profile of mental health issues amongst these groups. The additional letter I is also often included in the acronym LGBTI as intersex people are often included as another gender diverse group. However, there is very little research that includes intersex people and none on older intersex people's mental health so this editorial is restricted to consideration of older LGBT people.

  3. Human and environmental health challenges for the next decade (2010–2020).

    Science.gov (United States)

    Bonnefoi, Marc S; Belanger, Scott E; Devlin, Dennis J; Doerrer, Nancy G; Embry, Michelle R; Fukushima, Shoji; Harpur, Ernest S; Hines, Ronald N; Holsapple, Michael P; Kim, James H; MacDonald, James S; O'Lone, Raegan; Pettit, Syril D; Stevens, James L; Takei, Ayako S; Tinkle, Sally S; van der Laan, Jan Willem

    2010-11-01

    The public health and environmental communities will face many challenges during the next decade. To identify significant issues that might be addressed as part of the International Life Sciences Institute (ILSI) Health and Environmental Sciences Institute (HESI) scientific portfolio, an expert group of key government, academic, and industry scientists from around the world were assembled in 2009 to map the current and future landscape of scientific and regulatory challenges. The value of the scientific mapping exercise was the development of a tool which HESI, individual companies, research institutions, government agencies, and regulatory authorities can use to anticipate key challenges, place them into context, and thus strategically refine and expand scientific project portfolios into the future.

  4. Social Determinants in Health: The Impact of Socio-Economical Issues on Individuals’ Health Conditions

    Directory of Open Access Journals (Sweden)

    Akbar Azizi Zeinalhajlu

    2015-08-01

    Full Text Available Background and objectives: Health, being as an important social and individual value, has many influences and consequences all through the social and individual levels. Individual’s health is one of those fundamental issues and a great target regarding countries development. Nowadays, we are witnessing changes in disease patterns from infectious to chronic in one hand and on the other hand, we can see a widening gap between health condition, life expectancy and death rate in the worldwide. Based on global statistics, chronic diseases are rapidly increasing regardless the fact that there have been remarkable achievements in health promotions. There are many kinds of differences between various countries or social levels in terms of health conditions, life expectancy and death rate. In order to determine above mentioned changes, comprehensive perspectives with biomedical orientations should be applied alongside the concentration on health social factors at the same time. The present study is aimed at investigating socio-economical issues on individuals’ health. Material and Methods: The present study is a review. UN and WHO databases, English/Persian databases containing ISI, PUBMED, MEDLINE, SID, reports by health organizations, books, thesis, magazines and journals concerning health policies in Iran have been scrutinized. Conclusion: Health is a multi-dimensional structure and can be influenced by several factors. In fact, provision, protecting and promotion of public health can go beyond the abilities of Health Ministry. In order to achieve a healthy society, it is needed to focus on social health factors and intersectional cooperation. Without any comprehensive approach to determine health and disease and replacing health based orientation with treatment based orientations, it is impossible to achieve appropriate level of health and development and will lead in wasting society resources.

  5. Using Promotores Programs to Improve Latino Health Outcomes: Implementation Challenges for Community-based Nonprofit Organizations.

    Science.gov (United States)

    Twombly, Eric C; Holtz, Kristen D; Stringer, Kimberly

    2012-05-01

    Promotores are community lay health workers, who provide outreach and services to Latinos. Little research on the promotores programs exists and the focus of this article is to identify the challenges faced by community-based nonprofits when implementing promotores programs. To explore this type of program telephone interviews were conducted with ten promotores academic experts and nonprofit executives. The results suggest that implementation challenges fall into three major categories: the lack of standardized information on promotores programs, labor issues, and organizational costs. Future recommendations are made which highlight promotores recruitment and retention strategies, and the development of a clearinghouse of programmatic implementation information for community-based nonprofits.

  6. Gay Couples, Gay Communities, and HIV: Challenges for Health Education

    Science.gov (United States)

    Reece, Michael

    2005-01-01

    For the last 2 decades, researchers and practitioners dedicated to improving the health of gay and bisexual men have largely focused their work on the need to reduce the incidence of HIV infection. This is certainly warranted given the intensity of this particular epidemic in the gay community and the challenges it has presented to the nation's…

  7. From mobile mental health to mobile wellbeing: opportunities and challenges.

    Science.gov (United States)

    Gaggioli, Andrea; Riva, Giuseppe

    2013-01-01

    The combination of smart phones, wearable sensor devices and social media offer new ways of monitoring and promoting mental and physical wellbeing. In this contribution, we describe recent developments in the field of mobile healthcare (or mHealth), by focusing in particular on mobile mental health applications. First, we examine the potential benefits associated with this approach, providing examples from existing projects. Next, we identify and explain possible differences in focus between mobile mental health and mobile wellbeing applications. Finally, we discuss some open challenges associated with the implementation of this vision, ranging from the lack of evidence-based validation to privacy, security and ethical concerns.

  8. Emerging challenges in implementing universal health coverage in Asia.

    Science.gov (United States)

    Bredenkamp, Caryn; Evans, Timothy; Lagrada, Leizel; Langenbrunner, John; Nachuk, Stefan; Palu, Toomas

    2015-11-01

    As countries in Asia converge on the goal of universal health coverage (UHC), some common challenges are emerging. One is how to ensure coverage of the informal sector so as to make UHC truly universal; a second is how to design a benefit package that is responsive and appropriate to current health challenges, yet fiscally sustainable; and a third is how to ensure "supply-side readiness", i.e. the availability and quality of services, which is a necessary condition for translating coverage into improvements in health outcomes. Using examples from the Asia region, this paper discusses these three challenges and how they are being addressed. On the first challenge, two promising approaches emerge: using general revenues to fully cover the informal sector, or employing a combination of tax subsidies, non-financial incentives and contributory requirements. The former can produce fast results, but places pressure on government budgets and may induce informality, while the latter will require a strong administrative mandate and systems to track the ability-to-pay. With respect to benefit packages, we find considerable variation in the nature and rigor of processes underlying the selection and updating of the services included. Also, in general, packages do not yet focus sufficiently on non-communicable diseases (NCDs) and related preventive outpatient care. Finally, there are large variations and inequities in the supply-side readiness, in terms of availability of infrastructure, equipment, essential drugs and staffing, to deliver on the promises of UHC. Health worker competencies are also a constraint. While the UHC challenges are common, experience in overcoming these challenges is varied and many of the successes appear to be highly context-specific. This implies that researchers and policymakers need to rigorously, and regularly, assess different approaches, and share these findings across countries in Asia - and across the world.

  9. Integrating an Academic Electronic Health Record: Challenges and Success Strategies.

    Science.gov (United States)

    Herbert, Valerie M; Connors, Helen

    2016-08-01

    Technology is increasing the complexity in the role of today's nurse. Healthcare organizations are integrating more health information technologies and relying on the electronic health record for data collection, communication, and decision making. Nursing faculty need to prepare graduates for this environment and incorporate an academic electronic health record into a nursing curriculum to meet student-program outcomes. Although the need exists for student preparation, some nursing programs are struggling with implementation, whereas others have been successful. To better understand these complexities, this project was intended to identify current challenges and success strategies of effective academic electronic health record integration into nursing curricula. Using Rogers' 1962 Diffusion of Innovation theory as a framework for technology adoption, a descriptive survey design was used to gain insights from deans and program directors of nursing schools involved with the national Health Informatics & Technology Scholars faculty development program or Cerner's Academic Education Solution Consortium, working to integrate an academic electronic health record in their respective nursing schools. The participants' experiences highlighted approaches used by these schools to integrate these technologies. Data from this project provide nursing education with effective strategies and potential challenges that should be addressed for successful academic electronic health record integration.

  10. A Survey on Big Data Analytics: Challenges, Open Research Issues and Tools

    Directory of Open Access Journals (Sweden)

    D. P. Acharjya

    2016-02-01

    Full Text Available A huge repository of terabytes of data is generated each day from modern information systems and digital technolo-gies such as Internet of Things and cloud computing. Analysis of these massive data requires a lot of efforts at multiple levels to extract knowledge for decision making. Therefore, big data analysis is a current area of research and development. The basic objective of this paper is to explore the potential impact of big data challenges, open research issues, and various tools associated with it. As a result, this article provides a platform to explore big data at numerous stages. Additionally, it opens a new horizon for researchers to develop the solution, based on the challenges and open research issues.

  11. Information for Government Agencies about Specific Environmental Health Issues in Child-Care Settings

    Science.gov (United States)

    research on child care environmental health issues, identify key state and regional healthy child care organizations for partnerships, and see how other states are addressing child care environmental health issues.

  12. Challenges to fair decision-making processes in the context of health care services

    DEFF Research Database (Denmark)

    Shayo, Elizabeth H.; Norheim, Ole F.; Mboera, Leonard E. G.

    2012-01-01

    ABSTRACT: BACKGROUND: Fair processes in decision making need the involvement of stakeholders who can discuss issues and reach an agreement based on reasons that are justifiable and appropriate in meeting people's needs. In Tanzania, the policy of decentralization and the health sector reform place...... challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. We draw on the principle of fairness as outlined in the deliberative democratic theory. METHODS: The study was carried out in the Mbarali District...... such differences should be considered fair. The differences in levels of influence emerged most clearly at the community level, and were largely perceived as legitimate. CONCLUSIONS: Existing challenges related to individuals' influence of decision making processes in health care need to be addressed if greater...

  13. The impact of globalization and environmental change on health: challenges for nurse education.

    Science.gov (United States)

    Kirk, Maggie

    2002-01-01

    The environment is an established domain of nursing knowledge, but some authors argue that the traditional perspective is too narrowly focused on the immediate environment to appreciate the relevance of the global environment. This article explores how human activities are bringing about global changes through their impact on biogeochemical cycles, land use and mobility of organisms, altering biodiversity and climate, and ultimately compromising the ecosystems services that sustain our planet. The consequences of global change for population health are examined, including the emergence of drug-resistant diseases, and the implications of climate warming and pollution for health. Addressing these issues presents a considerable challenge for nursing at all levels, in promoting sustainable policies, integrating environmental considerations into clinical practice, and in the nursing role as health educators. The greatest challenge is to education, to raise awareness of the relevance and importance of the global environment to health, and to empower nurses with sufficient understanding of the issues to apply them to practice, participate in debate and contribute to policy-making that aims to reduce the burden of global changes. The extent to which the profession is prepared to diversify in response to these challenges is discussed.

  14. Creating virtual communities of practice for learning technology in higher education: issues, challenges and experiences

    OpenAIRE

    Jacqueline A. Dempster; Beetham, Helen; Jackson, Peter; Richardson, Steven

    2003-01-01

    The need for a Web portal to support the rapidly growing field of learning technology has been well established through a number of national surveys and scoping studies over recent years. The overarching vision has been the provision of a virtual environment to assist in informing and developing professional practice in the use of learning technologies. This paper outlines the issues and challenges in creating such a portal through the experiences of developing the RESULTs Network. In the pap...

  15. Federal Government Funding Reforms: Issues and Challenges Facing Malaysian Public Universities

    OpenAIRE

    Abd Rahman Ahmad; Alan Farley

    2013-01-01

    The purpose of this paper is to explore the shift in funding reforms currently facing at Malaysian public universities focusing on issues and challenges experienced by the Focused Universities in particular. Previous research has shown that shifts in funding mechanisms to public universities are more likely to result in behavioural changes at such institutions. Under the National Higher Education Strategic Plan beyond 2020, the Federal Government has launched a strategic plan of government ob...

  16. Federal funding of health policy in Brazil: trends and challenges

    Directory of Open Access Journals (Sweden)

    Cristiani Vieira Machado

    2014-01-01

    Full Text Available The article analyzes Federal funding of health policy in Brazil in the 2000s, focusing on the Ministry of Health’s budget implementation. Federal spending on health was less unstable between 2000 and 2002 and has expanded since 2006. However, it fluctuated as a share of both the Gross Domestic Product and Gross National Revenue. Federal intergovernmental transfers increased, exceeding 70% in 2007. Meanwhile, the proportion of Federal investments remained low, varying from 3.4% to 6.3%. The highest absolute amount of spending was on specialized outpatient and hospital care. The decade showed a proportionally greater increase in spending on pharmaceutical care. The growing allocation of Federal funds to States in the North and Northeast, especially for primary care and epidemiological surveillance, failed to offset the sharp regional inequalities in per capita Federal spending. The main characteristics of health funding limit Federal health policy governance and pose several challenges for the Brazilian Unified National Health System.

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

    Science.gov (United States)

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

    2005-11-01

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

  18. Public health engineering education in India: current scenario, opportunities and challenges.

    Science.gov (United States)

    Hussain, Mohammad Akhtar; Sharma, Kavya; Zodpey, Sanjay

    2011-01-01

    Public health engineering can play an important and significant role in solving environmental health issues. In order to confront public health challenges emerging out of environmental problems we need adequately trained public health engineers / environmental engineers. Considering the current burden of disease attributable to environmental factors and expansion in scope of applications of public health / environmental engineering science, it is essential to understand the present scenario of teaching, training and capacity building programs in these areas. Against this background the present research was carried out to know the current teaching and training programs in public health engineering and related disciplines in India and to understand the potential opportunities and challenges available. A systematic, predefined approach was used to collect and assemble the data related to various teaching and training programs in public health engineering / environmental engineering in India. Public health engineering / environmental engineering education and training in the country is mainly offered through engineering institutions, as pre-service and in-service training. Pre-service programs include diploma, degree (graduate) and post-graduate courses affiliated to various state technical boards, institutes and universities, whereas in-service training is mainly provided by Government of India recognized engineering and public health training institutes. Though trainees of these programs acquire skills related to engineering sciences, they significantly lack in public health skills. The teaching and training of public health engineering / environmental engineering is limited as a part of public health programs (MD Community Medicine, MPH, DPH) in India. There is need for developing teaching and training of public health engineering or environmental engineering as an interdisciplinary subject. Public health institutes can play an important and significant role in this

  19. Public health engineering education in India: Current scenario, opportunities and challenges

    Directory of Open Access Journals (Sweden)

    Mohammad Akhtar Hussain

    2011-01-01

    Full Text Available Public health engineering can play an important and significant role in solving environmental health issues. In order to confront public health challenges emerging out of environmental problems we need adequately trained public health engineers / environmental engineers. Considering the current burden of disease attributable to environmental factors and expansion in scope of applications of public health / environmental engineering science, it is essential to understand the present scenario of teaching, training and capacity building programs in these areas. Against this background the present research was carried out to know the current teaching and training programs in public health engineering and related disciplines in India and to understand the potential opportunities and challenges availables. A systematic, predefined approach was used to collect and assemble the data related to various teaching and training programs in public health engineering / environmental engineering in India. Public health engineering / environmental engineering education and training in the country is mainly offered through engineering institutions, as pre-service and in-service training. Pre-service programs include diploma, degree (graduate and post-graduate courses affiliated to various state technical boards, institutes and universities, whereas in-service training is mainly provided by Government of India recognized engineering and public health training institutes. Though trainees of these programs acquire skills related to engineering sciences, they significantly lack in public health skills. The teaching and training of public health engineering / environmental engineering is limited as a part of public health programs (MD Community Medicine, MPH, DPH in India. There is need for developing teaching and training of public health engineering or environmental engineering as an interdisciplinary subject. Public health institutes can play an important and

  20. eHealth in Wound Care,- overview and key issues to consider before implementation

    DEFF Research Database (Denmark)

    Moore, Zena; Angel, Donna; Bjerregaard, Julie;

    2015-01-01

    Purpose This document aims to provide wound care clinicians with a rapid and structured overview of the key issues related to use of eHealth applications (telemedicine and telehealth) within wound care. This includes: • An overview of terminology and available literature • Guidance on the methodo......Purpose This document aims to provide wound care clinicians with a rapid and structured overview of the key issues related to use of eHealth applications (telemedicine and telehealth) within wound care. This includes: • An overview of terminology and available literature • Guidance...... professionals in safeguarding that eHealth solutions meet the needs of the patients. Methodology The document sections lean on the structure and focus areas of the Model for ASsessment of Telemedicine (MAST) which defines crucial items to evaluate an eHealth application. The content of the document is developed...... domains are not examined in any of the available studies. Thus, more research is required to identify the potential benefits and harms to patients, and the possible challenges related to implementation of eHealth solutions in wound care. Potential barriers and facilitators for the implementation of e...

  1. Deliberative democracy in health care: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Safaei J

    2015-12-01

    Full Text Available Jalil Safaei Department of Economics, University of Northern British Columbia, Prince George, BC, CanadaBackground: There is a vast body of literature on deliberative, participative, or engaged democracy. In the area of health care there is a rapidly expanding literature on deliberative democracy as embodied in various notions of public engagement, shared decision-making (SDM, patient-centered care, and patient/care provider autonomy over the past few decades. It is useful to review such literature to get a sense of the challenges and prospects of introducing deliberative democracy in health care.Objective: This paper reviews the key literature on deliberative democracy and SDM in health care settings with a focus on identifying the main challenges of promoting this approach in health care, and recognizing its progress so far for mapping out its future prospects in the context of advanced countries.Method: Several databases were searched to identify the literature pertinent to the subject of this study. A total of 56 key studies in English were identified and reviewed carefully for indications and evidence of challenges and/or promising avenues of promoting deliberative democracy in health care.Results: Time pressure, lack of financial motivation, entrenched professional interests, informational imbalance, practical feasibility, cost, diversity of decisions, and contextual factors are noted as the main challenges. As for the prospects, greater clarity on conception of public engagement and policy objectives, real commitment of the authorities to public input, documenting evidence of the effectiveness of public involvement, development of patient decision supports, training of health professionals in SDM, and use of multiple and flexible methods of engagement leadership suited to specific contexts are the main findings in the reviewed literature.Conclusion: Seeking deliberative democracy in health care is both challenging and rewarding. The

  2. [Nutritional challenges in the Brazilian Unified National Health System for building the interface between health and food and nutritional security].

    Science.gov (United States)

    Rigon, Silvia do Amaral; Schmidt, Suely Teresinha; Bógus, Cláudia Maria

    2016-03-01

    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.

  3. E-Business: Application of software and technology in selected Ethiopian banks - Issues and challenges

    Directory of Open Access Journals (Sweden)

    Bhaskar Reddy Muvva Vijay

    2011-11-01

    Full Text Available The application of software and technology is inevitable in the present competitive banking industry. Ethiopian banking system is one of the most underdeveloped compared to the rest of the world. In Ethiopia cash is still the most dominant medium of exchange and Electronic-banking is not well known, let alone used for transacting banking issues. The article tries to examine specific issues and challenges in Ethiopian banking system. The present study further highlights various selecting issues and service quality systems practiced in selected banks. Survey method is used to collect data from practicing managers of banking industry. It further analyzes the present obstacles and hindrances in improving and facilitating the present banking services with application of customize software and technology.

  4. Social implications and workforce issues in the oral health of an ageing population.

    Science.gov (United States)

    Wright, Fac

    2015-03-01

    A functional and socially acceptable level of oral health is an integral part of healthy ageing! More teeth, more sophisticated dental technology and increasing co-morbidities of an ageing Australian society will have significant impacts on oral health professionals and their capacities to work within expanded teams of health, education and social organizations. Society is adapting its perspective on the social role of older citizens; replacing its perception of the elderly as an economic social burden, to one of senior citizens as being a respected and active source of social and economic benefit. Maintaining general and oral health for older Australians will bring into sharp focus the need for recognizing and managing not only the biological markers associated with ageing and frailty, but also the potential mediators on health outcomes associated with changing health and social behaviours. Increasing social capital of older Australians through national policy initiatives such as the Living Longer Living Better reforms, and greater involvement of allied health and carers' organizations in oral health education and health promotion will set a new scene for the roles of dental professionals. Issues of equity will drive the service delivery agenda, and a socio-cultural shift to 'consumer-directed' health outcomes will shape the range of services, quality of care and support required by an older Australian population. Formal education and training modules for aged care workers, allied health practitioners and geriatricians will develop. The challenge for the dental profession is the coordination and integration of these changes into new models of dental and general health care.

  5. Evaluating complex community-based health promotion: addressing the challenges.

    Science.gov (United States)

    Jolley, Gwyneth

    2014-08-01

    Community-based health promotion is poorly theorised and lacks an agreed evidence-base. This paper examines characteristics of community-based health promotion and the challenges they present to evaluation. A review of health promotion evaluation leads to an exploration of more recent approaches, drawing on ideas from complexity theory and developmental evaluation. A reflexive analysis of three program evaluations previously undertaken as an evaluation consultant is used to develop a conceptual model to help in the design and conduct of health promotion evaluation. The model is further explored by applying it retrospectively to one evaluation. Findings suggest that the context-contingent nature of health promotion programs; turbulence in the community context and players; multiple stakeholders, goals and strategies; and uncertainty of outcomes all contribute to the complexity of interventions. Bringing together insights from developmental evaluation and complexity theory can help to address some evaluation challenges. The proposed model emphasises recognising and responding to changing contexts and emerging outcomes, providing rapid feedback and facilitating reflexive practice. This will enable the evaluator to gain a better understanding of the influence of context and other implementation factors in a complex setting. Use of the model should contribute to building cumulative evidence and knowledge in order to identify the principles of health promotion effectiveness that may be transferable to new situations.

  6. [Mixed methods research in public health: issues and illustration].

    Science.gov (United States)

    Guével, Marie-Renée; Pommier, Jeanine

    2012-01-01

    For many years, researchers in a range of fields have combined quantitative and qualitative methods. However, the combined use of quantitative and qualitative methods has only recently been conceptualized and defined as mixed methods research. Some authors have described the emerging field as a third methodological tradition (in addition to the qualitative and quantitative traditions). Mixed methods research combines different perspectives and facilitates the study of complex interventions or programs, particularly in public health, an area where interdisciplinarity is critical. However, the existing literature is primarily in English. By contrast, the literature in French remains limited. The purpose of this paper is to present the emergence of mixed methods research for francophone public health specialists. A literature review was conducted to identify the main characteristics of mixed methods research. The results provide an overall picture of the mixed methods approach through its history, definitions, and applications, and highlight the tools developed to clarify the approach (typologies) and to implement it (integration of results and quality standards). The tools highlighted in the literature review are illustrated by a study conducted in France. Mixed methods research opens new possibilities for examining complex research questions and provides relevant and promising opportunities for addressing current public health issues in France.

  7. Austerity and the challenges of health for all in Nigeria

    Directory of Open Access Journals (Sweden)

    Ogundana Folakemi

    2012-09-01

    Full Text Available The economic downturn experienced by Nigeria and many sub-Saharan African countries led to the adoption of austerity to restore the country’s economy since the 1980s. Since austerity emphasizes privatization and commercialization, instead of restoration, it had, however, impacted especially the Nigerian health sector negatively. Nigeria has indeed continued to bear witness to some of the worst health and healthcare statistics in the world. Evidence from key health indicators in Nigeria also clearly shows that the country’s health situation has experienced massive deterioration. Given the above, the paper argues that austerity constitutes a major impediment to the attainment of a good state of health as well as effective and viable healthcare delivery to all in Nigeria. The paper, therefore suggests: (1 reframing and recognizing health as a human right issue; (2 integration of indigenous medicine into the Nigerian national health delivery systems; (3 recognition of State investment in social services as quite necessary and important such that budget allocation to health is increased as ways forward.

  8. Financing health care for all: challenges and opportunities.

    Science.gov (United States)

    Kumar, A K Shiva; Chen, Lincoln C; Choudhury, Mita; Ganju, Shiban; Mahajan, Vijay; Sinha, Amarjeet; Sen, Abhijit

    2011-02-19

    India's health financing system is a cause of and an exacerbating factor in the challenges of health inequity, inadequate availability and reach, unequal access, and poor-quality and costly health-care services. Low per person spending on health and insufficient public expenditure result in one of the highest proportions of private out-of-pocket expenses in the world. Citizens receive low value for money in the public and the private sectors. Financial protection against medical expenditures is far from universal with only 10% of the population having medical insurance. The Government of India has made a commitment to increase public spending on health from less than 1% to 3% of the gross domestic product during the next few years. Increased public funding combined with flexibility of financial transfers from centre to state can greatly improve the performance of state-operated public systems. Enhanced public spending can be used to introduce universal medical insurance that can help to substantially reduce the burden of private out-of-pocket expenditures on health. Increased public spending can also contribute to quality assurance in the public and private sectors through effective regulation and oversight. In addition to an increase in public expenditures on health, the Government of India will, however, need to introduce specific methods to contain costs, improve the efficiency of spending, increase accountability, and monitor the effect of expenditures on health.

  9. Operationalizing the One Health approach: the global governance challenges.

    Science.gov (United States)

    Lee, Kelley; Brumme, Zabrina L

    2013-10-01

    While there has been wide-ranging commitment to the One Health approach, its operationalisation has so far proven challenging. One Health calls upon the human, animal and environmental health sectors to cross professional, disciplinary and institutional boundaries, and to work in a more integrated fashion. At the global level, this paper argues that this vision is hindered by dysfunctions characterising current forms of global health governance (GHG), namely institutional proliferation, fragmentation, competition for scarce resources, lack of an overarching authority, and donor-driven vertical programmes. This has contributed, in part, to shortcomings in how One Health has been articulated to date. An agreed operational definition of One Health among key global institutions, efforts to build One Health institutions from the ground up, comparative case studies of what works or does not work institutionally, and high-level global support for research, training and career opportunities would all help to enable One Health to help remedy, and not be subsumed by, existing dysfunctions in GHG.

  10. Large system change challenges: addressing complex critical issues in linked physical and social domains

    Science.gov (United States)

    Waddell, Steve; Cornell, Sarah; Hsueh, Joe; Ozer, Ceren; McLachlan, Milla; Birney, Anna

    2015-04-01

    Most action to address contemporary complex challenges, including the urgent issues of global sustainability, occurs piecemeal and without meaningful guidance from leading complex change knowledge and methods. The potential benefit of using such knowledge is greater efficacy of effort and investment. However, this knowledge and its associated tools and methods are under-utilized because understanding about them is low, fragmented between diverse knowledge traditions, and often requires shifts in mindsets and skills from expert-led to participant-based action. We have been engaged in diverse action-oriented research efforts in Large System Change for sustainability. For us, "large" systems can be characterized as large-scale systems - up to global - with many components, of many kinds (physical, biological, institutional, cultural/conceptual), operating at multiple levels, driven by multiple forces, and presenting major challenges for people involved. We see change of such systems as complex challenges, in contrast with simple or complicated problems, or chaotic situations. In other words, issues and sub-systems have unclear boundaries, interact with each other, and are often contradictory; dynamics are non-linear; issues are not "controllable", and "solutions" are "emergent" and often paradoxical. Since choices are opportunity-, power- and value-driven, these social, institutional and cultural factors need to be made explicit in any actionable theory of change. Our emerging network is sharing and building a knowledge base of experience, heuristics, and theories of change from multiple disciplines and practice domains. We will present our views on focal issues for the development of the field of large system change, which include processes of goal-setting and alignment; leverage of systemic transitions and transformation; and the role of choice in influencing critical change processes, when only some sub-systems or levels of the system behave in purposeful ways

  11. Food, Populations and Health — global Patterns and Challenges

    DEFF Research Database (Denmark)

    2016-01-01

    discusses the health effects later in life of under-nutrition in the womb. The dynamics between food, health, population size and economy was the subject of Larsen, who showed how — over prehistoric and historic times — diets have changed, and also that the proportions of energy-rich and more nutritious......The present volume is based on presentations at a symposium at the Royal Danish Academy of Sciences and Letters in September 2014 with the title Food, Population and Health – global Patterns and Challenges. Food has played a fundamental role in the history of all societies over the World....... Availability and abundance of food has been crucial for the health and subsequently for the wealth of societies. In the first section Bothmer points out that agriculture began about 10 000 BP and that the first domesticated crops were grasses that subsequently underwent migration and adaptations and finally...

  12. A life cycle model of public policy issues in health care: the importance of strategic issues management.

    Science.gov (United States)

    Rakich, J S; Feit, M D

    2001-01-01

    Public policy affects health and social services organizations. Senior management has a responsibility to prevent inappropriate demands of stakeholders from predominating and to influence the outcome of public policy to the benefit of their organization through the strategic issues management process. This article presents a public policy issue life cycle model, life-cycle stages and suggested strategies, paths issues can take in the life cycle, and factors that affect issue paths. An understanding of these dynamics can aid senior managers in shaping and changing public policy issues and lessening external environment threats to their organization.

  13. Anti-biofilm Activity as a Health Issue.

    Science.gov (United States)

    Miquel, Sylvie; Lagrafeuille, Rosyne; Souweine, Bertrand; Forestier, Christiane

    2016-01-01

    The formation and persistence of surface-attached microbial communities, known as biofilms, are responsible for 75% of human microbial infections (National Institutes of Health). Biofilm lifestyle confers several advantages to the pathogens, notably during the colonization process of medical devices and/or patients' organs. In addition, sessile bacteria have a high tolerance to exogenous stress including anti-infectious agents. Biofilms are highly competitive communities and some microorganisms exhibit anti-biofilm capacities such as bacterial growth inhibition, exclusion or competition, which enable them to acquire advantages and become dominant. The deciphering and control of anti-biofilm properties represent future challenges in human infection control. The aim of this review is to compare and discuss the mechanisms of natural bacterial anti-biofilm strategies/mechanisms recently identified in pathogenic, commensal and probiotic bacteria and the main synthetic strategies used in clinical practice, particularly for catheter-related infections.

  14. Anti-biofilm activity as a health issue

    Directory of Open Access Journals (Sweden)

    Sylvie eMiquel

    2016-04-01

    Full Text Available The formation and persistence of surface-attached microbial communities, known as biofilms, are responsible for 75% of human microbial infections (National Institutes of Health. Biofilm lifestyle confers several advantages to the pathogens, notably during the colonization process of medical devices and/or patients’ organs. In addition, sessile bacteria have a high tolerance to exogenous stress including anti-infectious agents. Biofilms are highly competitive communities and some microorganisms exhibit anti-biofilm capacities such as bacterial growth inhibition, exclusion or competition, which enable them to acquire advantages and become dominant. The deciphering and control of anti-biofilm properties represent future challenges in human infection control. The aim of this review is to compare and discuss the mechanisms of natural bacterial anti-biofilm strategies/mechanisms recently identified in pathogenic, commensal and probiotic bacteria and the main synthetic strategies used in clinical practice, particularly for catheter-related infections.

  15. Human Health Effects of Trichloroethylene: Key Findings and Scientific Issues

    Science.gov (United States)

    Jinot, Jennifer; Scott, Cheryl Siegel; Makris, Susan L.; Cooper, Glinda S.; Dzubow, Rebecca C.; Bale, Ambuja S.; Evans, Marina V.; Guyton, Kathryn Z.; Keshava, Nagalakshmi; Lipscomb, John C.; Barone, Stanley; Fox, John F.; Gwinn, Maureen R.; Schaum, John; Caldwell, Jane C.

    2012-01-01

    Background: In support of the Integrated Risk Information System (IRIS), the U.S. Environmental Protection Agency (EPA) completed a toxicological review of trichloroethylene (TCE) in September 2011, which was the result of an effort spanning > 20 years. Objectives: We summarized the key findings and scientific issues regarding the human health effects of TCE in the U.S. EPA’s toxicological review. Methods: In this assessment we synthesized and characterized thousands of epidemiologic, experimental animal, and mechanistic studies, and addressed several key scientific issues through modeling of TCE toxicokinetics, meta-analyses of epidemiologic studies, and analyses of mechanistic data. Discussion: Toxicokinetic modeling aided in characterizing the toxicological role of the complex metabolism and multiple metabolites of TCE. Meta-analyses of the epidemiologic data strongly supported the conclusions that TCE causes kidney cancer in humans and that TCE may also cause liver cancer and non-Hodgkin lymphoma. Mechanistic analyses support a key role for mutagenicity in TCE-induced kidney carcinogenicity. Recent evidence from studies in both humans and experimental animals point to the involvement of TCE exposure in autoimmune disease and hypersensitivity. Recent avian and in vitro mechanistic studies provided biological plausibility that TCE plays a role in developmental cardiac toxicity, the subject of substantial debate due to mixed results from epidemiologic and rodent studies. Conclusions: TCE is carcinogenic to humans by all routes of exposure and poses a potential human health hazard for noncancer toxicity to the central nervous system, kidney, liver, immune system, male reproductive system, and the developing embryo/fetus. PMID:23249866

  16. Application of GIS technology in public health: successes and challenges.

    Science.gov (United States)

    Fletcher-Lartey, Stephanie M; Caprarelli, Graziella

    2016-04-01

    The uptake and acceptance of Geographic Information Systems (GIS) technology has increased since the early 1990s and public health applications are rapidly expanding. In this paper, we summarize the common uses of GIS technology in the public health sector, emphasizing applications related to mapping and understanding of parasitic diseases. We also present some of the success stories, and discuss the challenges that still prevent a full scope application of GIS technology in the public health context. Geographical analysis has allowed researchers to interlink health, population and environmental data, thus enabling them to evaluate and quantify relationships between health-related variables and environmental risk factors at different geographical scales. The ability to access, share and utilize satellite and remote-sensing data has made possible even wider understanding of disease processes and of their links to the environment, an important consideration in the study of parasitic diseases. For example, disease prevention and control strategies resulting from investigations conducted in a GIS environment have been applied in many areas, particularly in Africa. However, there remain several challenges to a more widespread use of GIS technology, such as: limited access to GIS infrastructure, inadequate technical and analytical skills, and uneven data availability. Opportunities exist for international collaboration to address these limitations through knowledge sharing and governance.

  17. [The challenges of citizenship and participation in the health systems].

    Science.gov (United States)

    Serapioni, Mauro

    2014-12-01

    The themes of citizen participation and citizenship have assumed great relevance in public policy in most countries of the world. In this article, after briefly summarizing the main stages of development of the concept of citizenship, the prominence of social participation as a practice of citizenship will be depicted. Next, the potential and limits of deliberative approaches established to promote new strategies of citizens' participation in health will be analyzed. The paper will then focus on critical aspects that contribute to reducing or hindering the exercise of citizenship rights, including: the issue of representation underpinning the citizen participation methods; the issue of the influence of participatory devices in decision-making processes; and the limited experience and interest in assessing the effectiveness of citizen participation in the health sector.

  18. [Human resources and health work: challenges for a research agenda].

    Science.gov (United States)

    Assunção, Ada Avila; Belisário, Soraya Almeida; Campos, Francisco Eduardo; D'Avila, Luciana Souza

    2007-01-01

    This article discusses several key concepts for human resources policy in health in the context of Latin America's regional integration efforts. The article focuses on different concepts of integration to emphasize the analytical distinction between regional and conceptual integration. It also presents labor and human resources concepts before discussing, in the final analysis, the challenges that a common research agenda faces in the context of current health sector reforms in Latin America. The conclusion emphasizes the need to develop a technology and research system capable of supporting the agenda for exchange between MERCOSUR member countries.

  19. Dietary copper and human health: Current evidence and unresolved issues.

    Science.gov (United States)

    Bost, Muriel; Houdart, Sabine; Oberli, Marion; Kalonji, Esther; Huneau, Jean-François; Margaritis, Irène

    2016-05-01

    Although copper (Cu) is recognized as an essential trace element, uncertainties remain regarding Cu reference values for humans, as illustrated by discrepancies between recommendations issued by different national authorities. This review examines human studies published since 1990 on relationships between Cu intake, Cu balance, biomarkers of Cu status, and health. It points out several gaps and unresolved issues which make it difficult to assess Cu requirements. Results from balance studies suggest that daily intakes below 0.8 mg/day lead to net Cu losses, while net gains are consistently observed above 2.4 mg/day. However, because of an incomplete collection of losses in all studies, a precise estimation of Cu requirements cannot be derived from available data. Data regarding the relationship between Cu intake and potential biomarkers are either too preliminary or inconclusive because of low specificity or low sensitivity to change in dietary Cu over a wide range of intakes. Results from observation and intervention studies do not support a link between Cu and a risk of cardiovascular disease, cognitive decline, arthritis or cancer for intakes ranging from 0.6 to 3mg/day, and limited evidence exists for impaired immune function in healthy subjects with a very low (0.38 mg/day) Cu intake. However, data from observation studies should be regarded with caution because of uncertainties regarding Cu concentration in various foods and water. Further studies that accurately evaluate Cu exposure based on reliable biomarkers of Cu status are needed.

  20. Investigating the Relationship of Resilience to Academic Persistence in College Students with Mental Health Issues

    Science.gov (United States)

    Hartley, Michael T.

    2013-01-01

    In this study, the relationships between measures of inter- and intrapersonal resilience and mental health were examined with respect to academic persistence in college students with mental health issues. A sample of 121 undergraduate students with mental health issues was recruited from campus mental health offices offering college counseling,…

  1. Psycho-Socio-Economic Issues Challenging Multidrug Resistant Tuberculosis Patients: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Beena Elizabeth Thomas

    Full Text Available Limited treatment options, long duration of treatment and associated toxicity adversely impact the physical and mental well-being of multidrug-resistant tuberculosis (MDR-TB patients. Despite research advances in the microbiological and clinical aspects of MDR-TB, research on the psychosocial context of MDR-TB is limited and less understood.We searched the databases of PubMed, MEDLINE, Embase and Google Scholar to retrieve all published articles. The final manuscripts included in the review were those with a primary focus on psychosocial issues of MDR-TB patients. These were assessed and the information was thematically extracted on the study objective, methodology used, key findings, and their implications. Intervention studies were evaluated using components of the methodological and quality rating scale. Due to the limited number of studies and the multiple methodologies employed in the observational studies, we summarized these studies using a narrative approach, rather than conducting a formal meta-analysis. We used 'thematic synthesis' method for extracting qualitative evidences and systematically organised to broader descriptive themes.A total of 282 published articles were retrieved, of which 15 articles were chosen for full text review based on the inclusion criteria. Six were qualitative studies; one was a mixed methods study; and eight were quantitative studies. The included studies were divided into the following issues affecting MDR-TB patients: a psychological issues b social issues and economic issues c psychosocial interventions. It was found that all studies have documented range of psychosocial and economic challenges experienced by MDR-TB patients. Depression, stigma, discrimination, side effects of the drugs causing psychological distress, and the financial constraints due to MDR-TB were some of the common issues reported in the studies. There were few intervention studies which addressed these psychosocial issues most of

  2. The challenge of benchmarking health systems: is ICT innovation capacity more systemic than organizational dependent?

    Science.gov (United States)

    Lapão, Luís Velez

    2015-01-01

    The article by Catan et al. presents a benchmarking exercise comparing Israel and Portugal on the implementation of Information and Communication Technologies in the healthcare sector. Special attention was given to e-Health and m-Health. The authors collected information via a set of interviews with key stakeholders. They compared two different cultures and societies, which have reached slightly different implementation outcomes. Although the comparison is very enlightening, it is also challenging. Benchmarking exercises present a set of challenges, such as the choice of methodologies and the assessment of the impact on organizational strategy. Precise benchmarking methodology is a valid tool for eliciting information about alternatives for improving health systems. However, many beneficial interventions, which benchmark as effective, fail to translate into meaningful healthcare outcomes across contexts. There is a relationship between results and the innovational and competitive environments. Differences in healthcare governance and financing models are well known; but little is known about their impact on Information and Communication Technology implementation. The article by Catan et al. provides interesting clues about this issue. Public systems (such as those of Portugal, UK, Sweden, Spain, etc.) present specific advantages and disadvantages concerning Information and Communication Technology development and implementation. Meanwhile, private systems based fundamentally on insurance packages, (such as Israel, Germany, Netherlands or USA) present a different set of advantages and disadvantages - especially a more open context for innovation. Challenging issues from both the Portuguese and Israeli cases will be addressed. Clearly, more research is needed on both benchmarking methodologies and on ICT implementation strategies.

  3. mHealth For Aging China: Opportunities and Challenges

    OpenAIRE

    Sun, Jing; Guo, Yutao; Wang, Xiaoning; Zeng, Qiang

    2016-01-01

    The aging population with chronic and age-related diseases has become a global issue and exerted heavy burdens on the healthcare system and society. Neurological diseases are the leading chronic diseases in the geriatric population, and stroke is the leading cause of death in China. However, the uneven distribution of caregivers and critical healthcare workforce shortages are major obstacles to improving disease outcome. With the advancement of wearable health devices, cloud computing, mobile...

  4. Analyzing the Challenges of IS implementation in public health institutions of a developing country

    DEFF Research Database (Denmark)

    Mengiste, Shegaw Anagaw

    2010-01-01

    This paper explores the challenges of introducing computer-based health information systems in the context of the Ethiopian public health care system. Drawing empirical examples from the process of introducing computer-based health information system(HIS) in two regional states (Amhara and Benish......This paper explores the challenges of introducing computer-based health information systems in the context of the Ethiopian public health care system. Drawing empirical examples from the process of introducing computer-based health information system(HIS) in two regional states (Amhara...... base and cultivation the paper examines the socio-technical issues and factors that influenced the process of developing, customizing, and implementing computerised HIS in different settings. The findings of this paper revealed that contextual differences in terms of access to infrastructural reources...... diffferent flexible strategies: the strategy of gateways, top-down vs bottom-up approaches, flexible essential data sets and clustering have beed identified as being useful in implementing computer-based systems in different settings of the Ethiopian public health care system....

  5. Health care – an everlasting challenge in temporal and spatial domains

    Directory of Open Access Journals (Sweden)

    Wenxi Chen

    2010-10-01

    Full Text Available Wenxi ChenBiomedical Information Technology Laboratory, the University of Aizu, Aizu-Wakamatsu City, Fukushima, JapanAbstract: Health care is an everlasting challenge that requires effort at all levels, from national and organizational to individual domains, over a long-term period. This article reviews the historical development of health care-related issues worldwide and accentuates the necessity of health care in the current era. Through investigating the historical background in both the occidental and the oriental worlds and the latest achievements from academic and industrial endeavors, many lessons can be learnt, and as a result, an integrative strategy is proposed to meet today’s pressing needs. A government-funded project, “Challenge to 100 years of age”, which involved more than 600 residents in west Aizu village, lasted over 15 years. After reviewing its outcomes, a metrology of health based upon the three-dimensional phase space, which integrates with social well-being, mental status, and physical condition for a lifelong span, is advocated as a measure of the holistic view of health state.Keywords: triangle framework, metrology, holistic view, systematic review, health care worldwide, health care history

  6. Challenges and issues in moving towards sustainable landfilling in a transitory country - Malaysia.

    Science.gov (United States)

    Agamuthu, P; Fauziah, S H

    2011-01-01

    Malaysia disposes of 28,500 tonnes of municipal solid waste directly into landfills daily. This fact alone necessitates sustainable landfills to avoid adverse impacts on the population and the environment. The aim of the present study was to elucidate the issues and challenges faced by waste managers in moving towards sustainable landfilling in Malaysia. Various factors influence the management of a landfill. Among them is the human factor, which includes attitude and public participation. Although Malaysia's economy is developing rapidly, public concern and awareness are not evolving in parallel and therefore participation towards sustainable waste management through the 'reduce, reuse and recycle' approach (3Rs) is severely lacking. Consequently, landfill space is exhausted earlier than scheduled and this is no longer sustainable in terms of security of disposal. Challenges also arise from the lack of funding and the increase in the price of land. Thus, most waste managers normally aim for 'just enough' to comply with the regulations. Investment for the establishment of landfills generally is minimized since landfilling operations are considered uneconomical after closure. Institutional factors also hamper the practice of sustainable landfilling in the country where 3Rs is not mandatory and waste separation is totally absent. Although there are huge obstacles to be dealt with in moving towards sustainable landfilling in Malaysia, recent developments in waste management policy and regulations have indicated that positive changes are possible in the near future. Consequently, with the issues solved and challenges tackled, landfills in Malaysia can then be managed effectively in a more sustainable manner.

  7. Teaching and Learning with ICT Tools: Issues and Challenges from Teachers’ Perceptions

    Directory of Open Access Journals (Sweden)

    Simin Ghavifekr

    2016-04-01

    Full Text Available In this digital era, ICT use in the classroom is important for giving students opportunities to learn and apply the required 21st century skills. Hence studying the issues and challenges related to ICT use in teaching and learning can assist teachers in overcoming the obstacles and become successful technology users.  Therefore, the main purpose of this study is to analyze teachers’ perceptions of the challenges faced in using ICT tools in classrooms. A quantitative research design was used to collect the data randomly from a sample of 100 secondary school teachers in the state of Melaka, Malaysia. Evidence has been collected through distribution of a modified‐ adopted survey questionnaire. Overall, the key issues and challenges found to be significant in using ICT tools by teachers were: limited accessibility and network connection, limited technical support, lack of effective training, limited time and lack of teachers’ competency. Moreover, the results from independent t‐ test show that use of ICT tools by male teachers (M =2.08, SD = .997 in the classroom is higher compared to female teachers (M = 2.04, SD = .992. It is hoped that the outcome of this research provides proper information and recommendation to those responsible for integrating new technologies into the school teaching and learning process.  

  8. Multicultural social policy and community participation in health: new opportunities and challenges for indigenous people.

    Science.gov (United States)

    Torri, Maria Costanza

    2012-01-01

    Community participation in local health has assumed a central role in the reforms of public healthcare, being increasingly associated with the issue of decentralization of the health system. The aim of this paper is to raise questions regarding the structural approaches to multicultural social policy in Chile and to analyze the results of its implementation. The article analyzes the case study of Makewe Hospital, one of the pioneering experiences of intercultural health initiative in Chile. The Makewe Hospital, which involves the indigenous community of the Mapuche, provides interesting insights to understand the dynamics of multicultural social policy and presents an example of a successful initiative that has succeeded in involving local communities in multicultural health policy. This case study discusses the effectiveness of grassroots participation in multicultural healthcare provision and presents the main strengths and challenges for the replicability of this experience in other settings.

  9. City planning and population health: a global challenge.

    Science.gov (United States)

    Giles-Corti, Billie; Vernez-Moudon, Anne; Reis, Rodrigo; Turrell, Gavin; Dannenberg, Andrew L; Badland, Hannah; Foster, Sarah; Lowe, Melanie; Sallis, James F; Stevenson, Mark; Owen, Neville

    2016-12-10

    Significant global health challenges are being confronted in the 21st century, prompting calls to rethink approaches to disease prevention. A key part of the solution is city planning that reduces non-communicable diseases and road trauma while also managing rapid urbanisation. This Series of papers considers the health impacts of city planning through transport mode choices. In this, the first paper, we identify eight integrated regional and local interventions that, when combined, encourage walking, cycling, and public transport use, while reducing private motor vehicle use. These interventions are destination accessibility, equitable distribution of employment across cities, managing demand by reducing the availability and increasing the cost of parking, designing pedestrian-friendly and cycling-friendly movement networks, achieving optimum levels of residential density, reducing distance to public transport, and enhancing the desirability of active travel modes (eg, creating safe attractive neighbourhoods and safe, affordable, and convenient public transport). Together, these interventions will create healthier and more sustainable compact cities that reduce the environmental, social, and behavioural risk factors that affect lifestyle choices, levels of traffic, environmental pollution, noise, and crime. The health sector, including health ministers, must lead in advocating for integrated multisector city planning that prioritises health, sustainability, and liveability outcomes, particularly in rapidly changing low-income and middle-income countries. We recommend establishing a set of indicators to benchmark and monitor progress towards achievement of more compact cities that promote health and reduce health inequities.

  10. Internet Addiction May Be Red Flag for Other Mental Health Issues: Study

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_161028.html Internet Addiction May Be Red Flag for Other Mental Health ... 19, 2016 SUNDAY, Sept. 18, 2016 (HealthDay News) -- Internet addiction may signal other mental health issues among college ...

  11. Health and Human Rights: New challenges for social responsiveness

    Directory of Open Access Journals (Sweden)

    Leslie London

    2009-11-01

    Full Text Available South Africa’s struggle against apartheid discrimination, including struggles in the health sector, laid the basis for a vibrant engagement of staff and students in human rights research, teaching and outreach in the Health Sciences Faculty at the University of Cape Town (UCT. This article provides a brief overview of this background context, then shows how this engagement has continued with new challenges emerging in the post-apartheid democratic period. Teaching at undergraduate and postgraduate levels has been complemented by a programme of ‘Training the Trainers’ in health and human rights. The programme targets teachers of health professionals at institutions in South and Southern Africa, resulting in national adoption of human rights competencies as an essential component of health professionals’ skills base. Research has also extended lessons learnt from the apartheid period into work with vulnerable groups, such as rural farm workers and the deaf, and seeks to build the capacity of marginal populations to change the conditions of their vulnerability in order to realize their rights. Partnerships with civil society organisations have been a strong thread, creating new knowledge and new ways of joint work towards realizing the right to health, including advocacy engagement in civil society movements and regional networks. Further, a focus on health professionals’ practice, in terms of dealing with potential dual loyalty conflicts and their role as gatekeepers in the health services on matters of patients’ rights, has shaped the research agenda. This article illustrates how knowledge production for the public good extends beyond notions of enhancing economic productivity for national development and provides a base for transdisciplinary and transinstitutional engagement. Additionally, non-traditional forms of knowledge networking and transfer have also been explored, including engagement with policy-makers and health managers

  12. Health workforce issues and the Global Fund to fight AIDS, Tuberculosis and Malaria: an analytical review

    Directory of Open Access Journals (Sweden)

    Dal Poz Mario R

    2006-08-01

    Full Text Available Abstract Recent studies have shown evidence of a direct and positive causal link between the number of health workers and health outcomes. Several studies have identified an adequate health workforce as one of the key ingredients to achieving improved health outcomes. Global health initiatives are faced with human resources issues as a major, system-wide constraint. This article explores how the Global Fund addresses the challenges of a health workforce bottleneck to the successful implementation of priority disease programmes. Possibilities for investment in human resources in the Global Fund's policy documents and guidelines are reviewed. This is followed by an in-depth study of 35 Global Fund proposals from five African countries: Ethiopia, Ghana, Kenya, Malawi and Tanzania. The discussion presents specific human resources interventions that can be found in proposals. Finally, the comments on human resources interventions in the Global Fund's Technical Review Panel and the budget allocation for human resources for health were examined. Policy documents and guidelines of the Global Fund foster taking account of human resources constraints in recipient countries and interventions to address them. However, the review of actual proposals clearly shows that countries do not often take advantage of their opportunities and focus mainly on short-term, in-service training in their human resources components. The comments of the Technical Review Panel on proposed health system-strengthening interventions reveal a struggle between the Global Fund's goal to fight the three targeted diseases, on the one hand, and the need to strengthen health systems as a prerequisite for success, on the other. In realizing the opportunities the Global Fund provides for human resources interventions, countries should go beyond short-term objectives and link their activities to a long-term development of their human resources for health.

  13. Maternal mental health: pathways of care for women experiencing mental health issues during pregnancy.

    Science.gov (United States)

    Makregiorgos, Helen; Joubert, Lynette; Epstein, Irwin

    2013-01-01

    Perinatal mental health has become the focus for policymakers, government, research, the acute health sector, and health practitioners. The aim of this clinical data-mining study ( Epstein, 2010 ) was to undertake a retrospective exploration into the primary mental health and psychosocial issues experienced by women who were pregnant and accessing obstetric care at one of the largest maternity hospitals in Australia. The study also investigated service pathways and gaps. Aboriginal women were overrepresented, demonstrating their ongoing disadvantage, whereas other linguistically and culturally diverse women were underrepresented, suggesting the existence of barriers to service. Although psychosocial factors tend to be underreported ( Buist et al., 2002 ), the findings highlighted the integral rather than peripheral nature of these factors during pregnancy ( Vilder, 2006 ) and suggest the need for change to systems that work to support women's perinatal mental health.

  14. E-health-oriented community health information system in china: our challenges, solution, and experience.

    Science.gov (United States)

    Zhao, Junping; Zhang, Zhenjiang; Guo, Huayuang; Li, Yi; Xue, Wanguo; Ren, Lianzhong; Chen, Yunqi; Chen, Shifu; Liu, Tongze; Jia, Ru; Zhao, Yi; Chai, Chang

    2011-09-01

    China has been implementing regional collaborative medical service (also known as e-health) for >5 years, but is still facing the challenges of bridging different community health information systems (CHISs). The fact that different communities have different systems makes it difficult to share information and data between different CHISs. To explore a solution for addressing this problem, we constructed a demonstration CHIS in Beijing's Dongcheng District. This system is based on the Software-as-a-Service model, in which a central data center is used to store users' health records and to provide different services. This system provides a comprehensive platform combining disease prevention, health protection, medical care, rehabilitation, health education, and family planning. In this article, we first show the challenge of implementing e-health-oriented CHIS in China, then we briefly introduce our solution, and finally we share our experience learned from the modern CHIS implementation practice.

  15. Access to and affordability of healthcare for TB patients in China: issues and challenges

    Institute of Scientific and Technical Information of China (English)

    Shenglan Tang; Lixia Wang; Hong Wang; Daniel P.Chin

    2016-01-01

    This paper introduces the background,aim and objectives of the project entitled "China-the Gates Foundation Collaboration on TB Control in China" that has been underway for many years.It also summarizes the key findings of the nine papers included in this special issue,which used data from the baseline survey of Phase Ⅱ of the project.Data were collected from the survey of TB and MDR-TB patients,from designated hospitals,health insurance agencies and the routine health information systems,as well as key informant interviews and focus group discussions with relevant key stakeholders.Key issues discussed in this series of papers include the uses of TB services and anti-TB medicines and their determining factors related to socio-economic and health systems development;expenditures on TB care and the financial burden incurred on TB patients;and the impact of health insurance schemes implemented in China on financial protection.

  16. A Comprehensive Study about Cloud Computing Security: Issues, Applications and Challenges

    Directory of Open Access Journals (Sweden)

    Sima Ghoflgary

    2014-11-01

    Full Text Available Cloud computing provides facilities for users to save their data or information in servers which are connected through Internet or Intranet. Further, users can run their applications with the help of software provided by cloud computing servers without installing that software in their own personal computers. Since many users access to cloud computing servers for various goals, therefore one of the main problem in this regard is providing security in access, usage, share or running users’ programs by cloud computing sources or servers. This paper attempts to study security issues, applications and its challenges on cloud computing

  17. Mobile Network Data for Public Health: Opportunities and Challenges.

    Science.gov (United States)

    Oliver, Nuria; Matic, Aleksandar; Frias-Martinez, Enrique

    2015-01-01

    The ubiquity of mobile phones worldwide is generating an unprecedented amount of human behavioral data both at an individual and aggregated levels. The study of this data as a rich source of information about human behavior emerged almost a decade ago. Since then, it has grown into a fertile area of research named computational social sciences with a wide variety of applications in different fields such as social networks, urban and transport planning, economic development, emergency relief, and, recently, public health. In this paper, we briefly describe the state of the art on using mobile phone data for public health, and present the opportunities and challenges that this kind of data presents for public health.

  18. Mobile Network Data for Public-Health: Opportunities and Challenges

    Directory of Open Access Journals (Sweden)

    Nuria eOliver

    2015-08-01

    Full Text Available The ubiquity of mobile phones worldwide is generating an unprecedented amount of human behavioral data both at an individual and aggregated levels. The study of this data as a rich source of information about human behavior emerged almost a decade ago. Since then it has grown into a fertile area of research named computational social sciences with a wide variety of applications in different fields such as social networks, urban and transport planning, economic development, emergency relief and, recently, public health. In this paper we briefly describe the state of the art on using mobile phone data for public health, and present the opportunities and challenges that this kind of data presents for public health.

  19. Women and health consequences of natural disasters: Challenge or opportunity?

    Science.gov (United States)

    Sohrabizadeh, Sanaz; Tourani PhD, Sogand; Khankeh, Hamid Reza

    2016-01-01

    Disasters do not affect people equally; the impact of disasters on the lives of women is different from other groups of a community. Women's fundamental rights to health and safety are violated after disasters. The authors of this study aimed to explore various factors of women's health with reference to previous natural disasters in Iran. A qualitative approach using in-depth unstructured interviews and field observations was employed to explore women's health factors in the affected regions. A total of 22 participants affected by disasters, as well as key informants, were interviewed applying the purposeful sampling method. Data were collected in 2014 in three provinces, including East Azerbaijan, Bushehr, and Mazandaran. A content analysis using the Graneheim approach was performed for analyzing the transcribed interviews. Two themes and four categories were extracted from the data. The themes that emerged included psycho-physical effects and women's health status. Physical and psycho-emotional effects and reproductive and environmental health effects were the four emergent categories. The findings implied that managing women's health challenges may result in reducing the distressing effects of disaster. These findings support identification and application of the mechanisms by which women's well-being in physical, mental, reproductive, and environmental aspects can be protected after disasters.

  20. Challenges in dental public health – An overview

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    Allan Kah-Heng Pau

    2012-07-01

    Full Text Available Oral health diseases are common in allregions of the world and their impact on anatomicaland social functioning is widely acknowledged.Their distributions are unequal between and withincountries, with the greatest burden falling ondisadvantaged and socially marginalized populations.The risk factors and social determinants for oral diseaseshave been comprehensively documented, and theevidence base for their prevention is growing. However,decisions on health care are still often made withouta solid grounding in research evidence. Translation ofresearch into policy and practice should be a priority forall. Both community and individual interventions needtailoring to achieve a more equal and person-centeredpreventive focus and reduce any social gradient in health.The major challenges of the future will be to translateknowledge and experiences in oral disease preventionand health promotion into action programmes.The international oral health research community needsto engage further in research capacity building and instrengthening the work so that research is recognized asthe foundation of oral health policy at global level.

  1. Ethical Issues in Measuring Biomarkers in Children’s Environmental Health

    Science.gov (United States)

    Sly, Peter D.; Eskenazi, Brenda; Pronczuk, Jenny; Šrám, Radim; Diaz-Barriga, Fernando; Machin, Diego Gonzalez; Carpenter, David O.; Surdu, Simona; Meslin, Eric M.

    2009-01-01

    Background Studying the impact of environmental exposures is important in children because they are more vulnerable to adverse effects on growth, development, and health. Assessing exposure in children is difficult, and measuring biomarkers is potentially useful. Research measuring biomarkers in children raises a number of ethical issues, some of which relate to children as research subjects and some of which are specific to biomarker research. Objective As an international group with experience in pediatric research, biomarkers, and the ethics of research in children, we highlight the ethical issues of undertaking biomarker research in children in these environments. Discussion Significant issues include undertaking research in vulnerable communities, especially in developing countries; managing community expectations; obtaining appropriate consent to conduct the research; the potential conflicts of obtaining permission from an ethics review board in an economically developed country to perform research in a community that may have different cultural values; returning research results to participants and communities when the researchers are uncertain of how to interpret the results; and the conflicting ethical obligations of maintaining participant confidentiality when information about harm or illegal activities mandate reporting to authorities. Conclusion None of these challenges are insurmountable and all deserve discussion. Pediatric biomarker research is necessary for advancing child health. PMID:19672395

  2. Universal coverage challenges require health system approaches; the case of India.

    Science.gov (United States)

    Duran, Antonio; Kutzin, Joseph; Menabde, Nata

    2014-02-01

    This paper uses the case of India to demonstrate that Universal Health Coverage (UHC) is about not only health financing; personal and population services production issues, stewardship of the health system and generation of the necessary resources and inputs need to accompany the health financing proposals. In order to help policy makers address UHC in India and sort out implementation issues, the framework developed by the World Health Organization (WHO) in the World Health Report 2000 and its subsequent extensions are advocated. The framework includes final goals, generic intermediate objectives and four inter-dependent functions which interact as a system; it can be useful by diagnosing current shortcomings and facilitating the filling up of gaps between functions and goals. Different positions are being defended in India re the preconditions for UHC to succeed. This paper argues that more (public) money will be important, but not enough; it needs to be supplemented with broad interventions at various health system levels. The paper analyzes some of the most important issues in relation to the functions of service production, generation of inputs and the necessary stewardship. It also pays attention to reform implementation, as different from its design, and suggests critical aspects emanating from a review of recent health system reforms. Precisely because of the lack of comparative reference for India, emphasis is made on the need to accompany implementation with analysis, so that the "solutions" ("what to do?", "how to do it?") are found through policy analysis and research embedded into flexible implementation. Strengthening "evidence-to-policy" links and the intelligence dimension of stewardship/leadership as well as accountability during implementation are considered paramount. Countries facing similar challenges to those faced by India can also benefit from the above approaches.

  3. Methods and challenges for the health impact assessment of vaccination programs in Latin America

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    Ana Marli Christovam Sartori

    2015-01-01

    Full Text Available ABSTRACT OBJECTIVE To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. METHODS For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for publication year. Original articles on the health impact assessment of pneumococcal and rotavirus vaccination programs in Latin America and the Caribbean in English, Spanish or Portuguese were included. RESULTS We identified 207 articles. After removing duplicates and assessing eligibility, we reviewed 33 studies, 25 focusing on rotavirus and eight on pneumococcal vaccination programs. The most frequent studies were ecological, with time series analysis or comparing pre- and post-vaccination periods. The main data sources were: health information systems; population-, sentinel- or laboratory-based surveillance systems; statistics reports; and medical records from one or few health care services. Few studies used primary data. Hospitalization and death were the main outcomes assessed. CONCLUSIONS Over the last years, a significant number of health impact assessments of pneumococcal and rotavirus vaccination programs have been conducted in Latin America and the Caribbean. These studies were carried out few years after the programs were implemented, meet the basic methodological requirements and suggest positive health impact. Future assessments should consider methodological issues and challenges arisen in these first studies conducted in the region.

  4. Health challenges in South African automotive companies: Wellness in the workplace

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    Anna Meyer-Weitz

    2015-03-01

    Full Text Available Orientation: In South Africa, workplace programmes in the automotive industry focus predominantly on occupational health and safety and HIV and AIDS. The implementation of focused workplace interventions might be hampered when companies are not convinced that the condition (i.e. HIV and AIDS is the main negative health influencing factor responsible for increased production costs.Research purpose: The study investigated the health influencing conditions perceived to negatively impact company production costs and related interventions.Motivation for the study: Apart from HIV and AIDS, little information is available about the health challenges in the South African workplace and focused HIV and AIDS programmes might only partly respond to the key health challenges of workplaces. The inter-relatedness of various risky lifestyle factors linked to health conditions necessitates a comprehensive health promotion approach.Research approach, design and method: A cross-sectional survey was conducted amongst 74 companies selected through stratified random sampling. Non-parametric tests were conducted to investigate the health influencing factors perceived to impact production costs, the monitoring thereof, extent of containment and the implementation of interventions in terms of company size and ownership.Main findings: The health factors perceived to have a moderate to large impact were HIV and AIDS, smoking, alcohol use, stress, back and neck ache and tuberculosis, also reported to be better monitored and managed by medium and large organisations. Small organisations reported a smaller impact, fewer efforts and less success. HIV and AIDS programmes were more evident in large companies and those with wellness programmes (52%. Workplace programmes enabled better monitoring and managing of impacting health conditions. Smaller organisations were not convinced of the benefits of interventions in addressing health challenges.Practical/managerial implications

  5. Maternal and child health in Brazil: progress and challenges.

    Science.gov (United States)

    Victora, Cesar G; Aquino, Estela M L; do Carmo Leal, Maria; Monteiro, Carlos Augusto; Barros, Fernando C; Szwarcwald, Celia L

    2011-05-28

    (coverage of which expanded to reach the poorest areas of the country through the Family Health Program in the mid-1990s); and implementation of many national and state-wide programmes to improve child health and child nutrition and, to a lesser extent, to promote women's health. Nevertheless, substantial challenges remain, including overmedicalisation of childbirth (nearly 50% of babies are delivered by caesarean section), maternal deaths caused by illegal abortions, and a high frequency of preterm deliveries.

  6. Challenges of mainstreaming: Ayurvedic practice in Delhi Government health institutions.

    Science.gov (United States)

    Mallick, Sharmistha

    2016-03-01

    This paper is an attempt to understand the project of mainstreaming in India's health care system that has started with an aim to bring marginalized and alternative systems of medicine in mainstream. The project has gained much attention with the establishment of Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) in the year 2003, which is now a ministry. It has ushered some positive results in terms of growth of AYUSH hospitals and dispensaries. However, it has also raised challenges around the theory and practice of mainstreaming. With an emphasis on Ayurvedic practice in Delhi Government Health Institutions, this article has tried to analyze some of those challenges and intricacies. Drawing on Weber's theory of bureaucratization and Giddens's theory of structuration, the paper asks what happens to an alternative medical system when it becomes part of the bureaucratic set-up. Along with the questions of structures, it also tries to combine the question of the agency of both patients and doctors considered to be the cornerstone of the Ayurvedic medical system. Although our study recognizes some of the successes of the mainstreaming project, it also underlines the challenges and problems it faces by analyzing three points of view (institutions, doctors, and patients).

  7. Challenges of mainstreaming: Ayurvedic practice in Delhi Government health institutions

    Directory of Open Access Journals (Sweden)

    Sharmistha Mallick

    2016-03-01

    Full Text Available This paper is an attempt to understand the project of mainstreaming in India's health care system that has started with an aim to bring marginalized and alternative systems of medicine in mainstream. The project has gained much attention with the establishment of Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH in the year 2003, which is now a ministry. It has ushered some positive results in terms of growth of AYUSH hospitals and dispensaries. However, it has also raised challenges around the theory and practice of mainstreaming. With an emphasis on Ayurvedic practice in Delhi Government Health Institutions, this article has tried to analyze some of those challenges and intricacies. Drawing on Weber's theory of bureaucratization and Giddens's theory of structuration, the paper asks what happens to an alternative medical system when it becomes part of the bureaucratic set-up. Along with the questions of structures, it also tries to combine the question of the agency of both patients and doctors considered to be the cornerstone of the Ayurvedic medical system. Although our study recognizes some of the successes of the mainstreaming project, it also underlines the challenges and problems it faces by analyzing three points of view (institutions, doctors, and patients.

  8. [Health in Africa, dynamics and socio-territorial challenges].

    Science.gov (United States)

    Amat-Roze, J-M

    2015-02-01

    Because health is the product of a combination of political, economic, social, cultural, technical factors, the values of the indicators of health are an observatory of the African continent and its billion people in all their dimensions. So, the reading of the program of the 9(th) French-speaking international Congress of the Society of Exotic Pathology is significant of the state of Africa in this second decade of the 21(th) century. The age-old infectious plagues go alongside to emergent fevers there, but the program also dedicates a wide time to the chronic pathologies. This kaleidoscope invites to discuss the concept of epidemiological transition chosen by the Congress. What is its meaning when the order of magnitude of the values of the indicators of health was distended never also and became the most contrasted by the world, in all the scales of observation? Which is its meaning when, in Black Africa, unlike the processes observed in the countries which formed the Third World in 1950, the evolution observed for the last five decades is chaotic, made by a succession of advances, by a progress, by blockings, even by walking back, original expression of the health transition, the process which includes the evolution of the health and the answers of States and societies. The geography of the values of indicators shows the socio-territorial dynamics in process, which place societies in more or less protective systems for their health. More than ever, diverse worlds are next to a sum of challenges, of which that to improve the knowledge of the needs for health, in relatively fine scale to avoid generalizations and amalgams, and target priorities of health according to the socio-territorial contexts.

  9. Musings on privacy issues in health research involving disaggregate geographic data about individuals

    Directory of Open Access Journals (Sweden)

    AbdelMalik Philip

    2009-07-01

    Full Text Available Abstract This paper offers a state-of-the-art overview of the intertwined privacy, confidentiality, and security issues that are commonly encountered in health research involving disaggregate geographic data about individuals. Key definitions are provided, along with some examples of actual and potential security and confidentiality breaches and related incidents that captured mainstream media and public interest in recent months and years. The paper then goes on to present a brief survey of the research literature on location privacy/confidentiality concerns and on privacy-preserving solutions in conventional health research and beyond, touching on the emerging privacy issues associated with online consumer geoinformatics and location-based services. The 'missing ring' (in many treatments of the topic of data security is also discussed. Personal information and privacy legislations in two countries, Canada and the UK, are covered, as well as some examples of recent research projects and events about the subject. Select highlights from a June 2009 URISA (Urban and Regional Information Systems Association workshop entitled 'Protecting Privacy and Confidentiality of Geographic Data in Health Research' are then presented. The paper concludes by briefly charting the complexity of the domain and the many challenges associated with it, and proposing a novel, 'one stop shop' case-based reasoning framework to streamline the provision of clear and individualised guidance for the design and approval of new research projects (involving geographical identifiers about individuals, including crisp recommendations on which specific privacy-preserving solutions and approaches would be suitable in each case.

  10. Sexual and reproductive health issues facing Southeast Asian beer promoters: a qualitative pilot study

    Directory of Open Access Journals (Sweden)

    Spitzer Denise L

    2010-07-01

    Full Text Available Abstract Background In Southeast Asia, hundreds of thousands of young rural women migrate from their villages to the larger cities in search of work. Many find employment with beer companies or in the clubs where beer is sold, promoting the sale of beer. Previous research suggests these young migrants are in a highly vulnerable position. This paper will describe the findings of an October 2009 meeting to develop a research agenda on the sexual and reproductive health of beer promoters and a subsequent pilot study of focus groups with beer promoters to review this agenda. Methods Participants of the research meeting representing beer promoters, academics, non-governmental organizations (NGOs, government and the beer industry from Cambodia, Thailand, Laos, and Vietnam collaborated in the development of three key research themes. The themes were verified in focus group discussions with beer promoters organized by local research partners in all four countries. The focus group participants were asked what they felt were the key sexual and reproductive health issues facing them in a non-directive and unstructured manner, and then asked to comment more specifically on the research priorities developed at the meeting. The focus groups were recorded digitally, transcribed, and translated into English. The data were analyzed by coding for common themes and then developing matrices to compare themes between groups. Results The participants of the meeting identified three key research themes: occupational health (including harassment and violence, working conditions, and fair pay, gender and social norms (focusing on the impact of power relations between the genders on women's health, and reproductive health (knowledge and access to reproductive health care services. The participants in the focus groups in all four countries agreed that these were key priorities for them, though the emphasis on the most important issues varied between groups of women

  11. Attitudes of Germans towards distributive issues in the German health system.

    Science.gov (United States)

    Ahlert, Marlies; Pfarr, Christian

    2016-05-01

    Social health care systems are inevitably confronted with the scarcity of resources and the resulting distributional challenges. Since prioritization implies distributional effects, decisions regarding respective rules should take citizens' preferences into account. In this study we concentrate on two distributive issues in the German health system: firstly, we analyze the acceptance of prioritizing decisions concerning the treatment of certain patient groups, in this case patients who all need a heart operation. We focus on the patient criteria smoking behavior, age and whether the patient has or does not have young children. Secondly, we investigate Germans' opinions towards income-dependent health services. The results reveal the strong effects of individuals' attitudes regarding general aspects of the health system on priorities, e.g. that individuals with an unhealthy lifestyle should not be prioritized. In addition, experience of limited access to health services is found to have a strong influence on citizens' attitudes, too. Finally, decisions on different prioritization criteria are found to be not independent.

  12. Issues, Challenges, Causes, Impacts and Utilization of Renewable Energy Sources - Grid Integration

    Directory of Open Access Journals (Sweden)

    Er. Mamatha Sandhu

    2014-03-01

    Full Text Available The renewable energy sources have increased significantly due to environmental issues and fossil fuels elevated cost. Integration of renewable energy sources to utility grid depends on the scale of power generation. Large scale power generations are connected to transmission systems where as small scale distributed power generation is connected to distribution systems. There are certain challenges in the integration of both types of systems directly. Due to this, wind energy has gained a lot of investments from all over the world. However, due to the wind speed‘s uncertain behavior it is difficult to obtain good quality power, since wind speed fluctuations reflect on the voltage and active power output of the electric machine connected to the wind turbine. Solar penetration also changes the voltage profile and frequency response of the system and affects the transmission and distribution systems of utility grid. This paper presents a review in the issues, challenges, causes, impacts and utilization of renewable energy sources (RES - Grid Integration.

  13. Infant nutrition and lifelong health: current perspectives and future challenges.

    Science.gov (United States)

    Robinson, S M

    2015-10-01

    Understanding the role and importance of nutrition in early postnatal life, as an influence on lifelong vulnerability to poor health, is an important part of current research. We need to be able to define optimal patterns of infant feeding, not just to support growth and development in infancy, but also as determinants of later health. To date, much of the focus on the long-term effects of infant nutrition has been on milk feeding, to compare breast and formula feeding and to evaluate the effects of exclusivity, timing and duration of feeding different types of milk in infancy; other aspects of infant feeding such as age at introduction of solid foods and type of weaning diet have received less attention, and relatively little is known about their links to later health. Contemporary data are needed to enable us to move beyond explanation of historical infant feeding data in order to understand and predict health outcomes in future generations. Ongoing and new population studies, that include infants from diverse settings, will be key to providing generalizable data that can be used to define optimal feeding practice. There are some methodological challenges ahead, although significant progress has already been made, and further progress is envisaged in the future. In particular, the opportunity to bring together epidemiological studies and new mechanistic insights that will help identify key aspects of infant nutrition and their causal effects offer great promise both in moving this field forward as well as the potential for health benefits for future generations.

  14. Challenges to translating new media interventions in community practice: a sexual health SMS program case study.

    Science.gov (United States)

    Wright, Cassandra J C; Leinberger, Kaytlyn; Lim, Megan S C

    2016-04-01

    Issue addressed Herein we discuss translational challenges for new media interventions, using the Sexual Health & Youth (SHY) short message service (SMS) project to illustrate particular challenges relating to recruitment and evaluation. Methods Following the delivery of an SMS sexual health program, available documents (progress reports, communications with project staff, ethics submissions and reporting) were analysed thematically to elucidate the barriers to recruitment, implementation and evaluation. Results Despite being framed by evidence-based research, the project had little impact on the intended population. Only 119 of an expected 5100 young people (2%) enrolled to receive SMS messages. Program documents highlighted the difficulty of recruiting participants for new media interventions. Key issues identified in recruitment included under-resourcing, delays waiting to receive ethics approval and challenges of school-based recruitment. Conclusion The minimal impact of the SHY program illustrates the need for improved research translation in the field of new media interventions. It is important that recruitment procedures align with the convenience and appeal of mobile phone-based interventions. So what? New media research is not always easily translated into community settings. Large-scale recruitment requires adequate resourcing and careful planning, even for low-cost mobile interventions. Stronger formative research, documentation and use of partnerships are essential for successful implementation. Researchers must also consider translation in planning and disseminating their work.

  15. Cross-border issues in the development of medical tourism in Malaysia: legal challenges and opportunities.

    Science.gov (United States)

    Nemie, Puteri; Kassim, Jahn

    2009-08-01

    Strategically located at the crossroads of Asia, Malaysia has become one of the key players in the fast-growing and lucrative market for health care services in Asia. Medical travel across international boundaries has been made possible through affordable airfares and the favourable exchange rates of the Malaysian ringgit has contributed to the rise of the "medical tourism phenomenon" where medical travel is combined with visiting popular tourist destinations in Malaysia. Further, competitive medical fees and modern medical facilities have also made Malaysia a popular destination for medical tourists. Nevertheless, the increased number of foreign patients has opened up possibilities of Malaysian health care providers being subjected to malpractice claims and triggering a myriad of cross-border legal issues. Presently, there is no internationally accepted legal framework to regulate medical tourism and issues of legal redress in relation to unsatisfactory provision of treatment across international boundaries. The economic benefits of medical tourism must be based upon a solid legal regulatory framework and strong ethical standards as well as upon high-quality medical and health care services. It is therefore important to assess the existing legal framework affecting the development of medical tourism in Malaysia in order to explore the gaps, deficiencies and possibilities for legal and regulatory reform.

  16. Management and health issues in women with epilepsy - a review.

    Science.gov (United States)

    Salawu, F K; Moruppa, J Y; Danburam, A; Olokoba, A B

    2011-12-01

    Although epilepsy affects men and women equally, there are special implications for women, especially during their childbearing years, and particularly when pregnancy is contemplated. This review summarisesthe complexity and multifaceted nature of health issues affecting women with epilepsy (WWE) in general and epilepsy in women beyond childbearing age. The female sex hormones and their cyclic as well as age-related variations certainly influence seizure activity and epilepsy in women. Catamenial epilepsy is a multifaceted neuroendocrine condition in which seizures are clustered around specific points in the menstrual cycle, most often around perimenstrual or periovulatory period. There are special concerns for women of child bearing years with regard to contraception, pregnancy and teratogenicity that should be considered during counseling and selection of appropriate treatment.Although the majority of pregnant WWE experience normal pregnancies and deliveries, their children have a higher risk of birth defects. Individualised treatment coupling antiepileptic drug use (AED) and the specific phase of impact of the reproductive cycle must be considered in treatment selection. As the number of available treatment options for epilepsy increases, the optimal goal for the general practitioner is to work as a team with obstetricians and gynaecologists, and neurologists in an effort to ensure the best treatment of WWE

  17. Iranian Breast Cancer Bio-Bank: the activity and challenging issues.

    Science.gov (United States)

    Majidzadeh-A, Keivan; Kaviani, Ahmad; Esmaeili, Rezvan; Farahmand, Leila; Shojamoradi, Mohammad Hossein; Zare, Ali Akbar; Eini, Leila; Abbasvandi, Fereshteh; Olfatbakhsh, Asieh; Moazen, Hadi

    2013-03-01

    The information gained from the Human Genome Project has facilitated molecular as well as cellular studies not only to find the origins of Breast Cancer (BC), but also to create novel, and effective treatments. In order to provide an infrastructure for local and international research in this area, Iranian Center for Breast Cancer (ICBC) has established a Bio-Bank (BB) for BC. This article describes the aim, structure, and activities in general, and the challenging issues confronting the bank as a model for the establishment of Bio-Banks in developing countries in particular. The methods employed by the Bank could be explained in the following categories: Blood and Tissue sampling, Preparation and Banking of collected Samples, Clinical and Histopathology data collection, Collaboration Protocol, Challenging issues, and the programs to confront the problems. During the five-year activity of the bank, 110 families were enrolled for genetic counseling, from whom 600 biologic samples were obtained, including 387 blood samples and 213 tissue samples. Of 387 blood samples, 317 (82%) were found to belong to the BC patients and the remaining 70 (18%) belonged to their available relatives. The number of samples increased over the study period partly as a result of the programs designed to confront the problems. During the study period, there were some finished research studies using the samples of BB, and many other studies which are still ongoing. ICBC-BB is a model of biologic sample banking which provides a significant number of biological samples for local and international collaborative research projects regarding molecular and cellular aspects of BC. In establishing the ICBC-BB we have experienced problems and challenges, some general and some local. Some were expected and others not, but we have identified solutions.

  18. Using International Classification of Functioning, Disability and Health to understand challenges in community reintegration of injured veterans.

    Science.gov (United States)

    Resnik, Linda J; Allen, Susan M

    2007-01-01

    This pilot study used the framework of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) to understand the challenges faced by Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans as they reintegrate into the community. We conducted semistructured interviews with 14 injured veterans, 12 caregivers, and 14 clinicians. We used ICF taxonomy to code data and identify issues. We identified challenges in the following ICF domains: learning and applying knowledge; general tasks and demands; communication; mobility; self-care; domestic life; interpersonal interactions, major life areas; and community, social, and civic life. We found many similarities between the challenges faced by veterans with and without polytraumatic injuries, although veterans with polytraumatic injuries faced challenges of greater magnitude. Identifying community reintegration challenges early and promoting reintegration are important mandates for the Department of Veterans Affairs. The findings of this study are useful in understanding the needs of OEF/OIF veterans.

  19. Patient Privacy, Consent, and Identity Management in Health Information Exchange: Issues for the Military Health System

    Science.gov (United States)

    2013-01-01

    infection with HIV/AIDs, and sickle cell anemia by the VHA. There are also myriad state laws regarding disclosure of PHI. The central issue with respect...conducted in a functioning HIO with multiple providers. The studies use either simulated or proxy patient indexes and researchers instead of HIO managers...typically maintained by an HIO. The 10 Patient Privacy, Consent, and Identity Management RLS is an index that indicates only whether health

  20. On the Issues and Challenges of Fiber-Wireless (Fi-Wi Networks

    Directory of Open Access Journals (Sweden)

    Harry Tin Win

    2013-01-01

    Full Text Available The objective of this article is to present various aspects of Fiber-Wireless (Fi-Wi networks, which is a technology of current interest of the researchers. Fiber-wireless technology, known in short as “Fi-Wi,” is a combination of optical-fiber-based network and wireless network. Fi-Wi has recently come forward as one of the emerging future network technologies yet the term is often mixed up with wireless-fidelity (Wi-Fi technology. In fact, Wi-Fi network could be included in a Fi-Wi architecture. Due to the unfamiliarity with the term, “Fi-Wi” and similar sounding commonly known “Wi-Fi,” many students, even academics and practitioners sometimes may not be able to differentiate between these. In the recent years, a good number of works on various issues of Fi-Wi have come out, but an overall survey with the latest advancements in the area is yet to be found. Hence, in this work, we analyze various issues and challenges of implementing Fi-Wi networks in practical scenarios to allow researchers to find future directions of research and general readers to understand the issues better.

  1. Taxation, revenue allocation and fiscal federalism in Nigeria: Issues, challenges and policy options

    Directory of Open Access Journals (Sweden)

    Salami Adeleke

    2011-01-01

    Full Text Available Taxation is one of the most important and easy sources of revenue to any government, as the government possesses inherent power to impose taxes and levies. Nigeria tax system has been weak due largely to inadequate data of the tax base and heavy reliance on oil revenue. With the volatility in oil prices and excruciating impacts of the recent global financial crisis, taxation deserves more attention now than ever before in Nigeria. One issue that is critical to domestic resource mobilization and utilization is the issue of fiscal federalism. Nigeria operates three tiers of government; Federal, State and Local Governments with separate revenue, expenditure, and assigned responsibilities each. However, all decisions including resources are controlled from the centre and the vertical revenue allocations tilt more towards the direction of federal government, contrary to the tenets of federalism the country is practicing. Both vertical and horizontal revenue in Nigeria is engulfed in controversy. The paper presents key issues, trend and challenges of taxation and fiscal federalism in Nigeria. In addition, the paper highlights a number of suggestions that would stimulate increase in tax revenue and guarantee fiscal assignment acceptable to the federal and sub-national government.

  2. Creating virtual communities of practice for learning technology in higher education: issues, challenges and experiences

    Directory of Open Access Journals (Sweden)

    Jacqueline A. Dempster

    2003-12-01

    Full Text Available The need for a Web portal to support the rapidly growing field of learning technology has been well established through a number of national surveys and scoping studies over recent years. The overarching vision has been the provision of a virtual environment to assist in informing and developing professional practice in the use of learning technologies. This paper outlines the issues and challenges in creating such a portal through the experiences of developing the RESULTs Network. In the paper, design and participation issues are considered within the wider context of online and networked approaches to supporting practice and professional development. User participation methodologies and technical developments for RESULTs are described in relation to a review of existing representations of practice and a comprehensive survey amongst the learning technology users' community. An outline of key achievements and experiences is presented, followed by some conclusions regarding the cultural and political issues in creating a viable and sustainable facility and suggestions for possible future direction in national provision.

  3. The development of capability measures in health economics: opportunities, challenges and progress.

    Science.gov (United States)

    Coast, Joanna; Kinghorn, Philip; Mitchell, Paul

    2015-04-01

    Recent years have seen increased engagement amongst health economists with the capability approach developed by Amartya Sen and others. This paper focuses on the capability approach in relation to the evaluative space used for analysis within health economics. It considers the opportunities that the capability approach offers in extending this space, but also the methodological challenges associated with moving from the theoretical concepts to practical empirical applications. The paper then examines three 'families' of measures, Oxford Capability instruments (OxCap), Adult Social Care Outcome Toolkit (ASCOT) and ICEpop CAPability (ICECAP), in terms of the methodological choices made in each case. The paper concludes by discussing some of the broader issues involved in making use of the capability approach in health economics. It also suggests that continued exploration of the impact of different methodological choices will be important in moving forward.

  4. Ethics approval: a challenge for public health researchers in India.

    Science.gov (United States)

    Nagaraja, Sharath Burugina; Menezes, Ritesh G; Zachariah, Rony; Wilson, Nevin

    2015-01-01

    There is increasing impetus, interest and opportunity for people working in public health programmes in India to carry out operational research (OR) around relevant programme issues and then publish that in peer-reviewed publications. These published researches are valuable in analysing, documenting and advocating for locally generated evidence to inform policy and practice. Ethics review and approval is an essential step in the process of OR but is often viewed as a barrier rather than a prerequisite of good practice in OR. Journals and peer reviewers are also increasingly requiring approvals from local institutional ethics committees (IECs).

  5. Partner Country Series: Understanding Energy Challenges in India - Policies, Players and Issues

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    A combination of rapidly increasing energy demand and fuel imports plus growing concern about economic and environmental consequences is generating growing calls for effective and thorough energy governance in India. Numerous policy reforms over the past 20 years have shifted the country’s energy sector from a state-dominated system towards one that is based on market principles. However, with the reform process left unfinished, India now finds itself trapped halfway along the transition to an open and well-performing energy sector. India suffered from the largest power outage ever in late July 2012, affecting nearly half of the population. While this incident highlights the importance of modern and smart energy systems, it indicates that the country is increasingly unable to deliver a secure supply of energy to its population, a quarter of which still lacks access to electricity. Understanding Energy Challenges in India aims to provide an informative and holistic understanding of India’s energy sector to stakeholders in India as well as the broad public. The publication explores in detail the policies, players and issues of the country’s power, coal, oil and gas, renewables and nuclear sectors. It also highlights the key challenges India faces, challenges that must be resolved for the evolution of the fast-growing country’s energy sector towards a sustainable energy future and eventually critical for the prospects of the Indian and global economies.

  6. Toward fisheries sustainability in North America: Issues, challenges, and strategies for action

    Science.gov (United States)

    MacDonald, D.D.; Knudsen, E.E.

    2004-01-01

    Many fisheries in North America are severely depleted and trending downwards. In an effort to find ways of reversing this disturbing situation, the American Fisheries Society and the Sustainable Fisheries Foundation invited leading experts in fisheries science and aquatic resource management to share their thoughts and insights in this book. These experts were asked to identify the factors that are currently impairing our ability to effectively manage fisheries resources and propose creative solutions for addressing the most challenging issues affecting fisheries sustainability. Based on the information that was provided by the experts (i.e., as presented in the earlier chapters of this book), it is apparent that a wide range of human activities are adversely affecting our shared fisheries resources and the aquatic habitats upon which they depend. The most challenging problems stem from causes that are largely beyond the scope of traditional fisheries management (e.g., human population growth, resource consumption patterns, global climate change, broad land-use patterns). It is also apparent that resolution of these challenges will require a new approach to fisheries management - one that effectively integrates economic, social, and environmental interests into a decision-making framework that supports fisheries sustainability. The key strategies for supporting such a transition toward a more holistic and comprehensive approach to managing the human activities that influence fisheries and aquatic resources are summarized in this chapter. ?? 2004 by the American Fisheries Society.

  7. Energy mix and sustainable development: Issues and challenges in Southern Philippines

    Energy Technology Data Exchange (ETDEWEB)

    Osop, Inoray

    2010-09-15

    Southern Philippines utilizes different sources of energy and like any other areas for every increase in energy; major concerns and issues on its sustainable development sprung up. Methods used were quantitative and qualitative measures, experiment, exploratory and descriptive in findings: (1) each of the energy dimensions are compared economic ; On their environment and health of the end users and Social dimensions . The ideal energy mixes based on sustainable development are renewable and some fossil fuels with strict adherence to clean technology since Coal Plants in the country ignores environmental regulations and yet allowed to operate.

  8. Research and development of smart wearable health applications: the challenge ahead.

    Science.gov (United States)

    Lymberis, Andreas

    2004-01-01

    Continuous monitoring of physiological and physical parameters is necessary for the assessment and management of personal health status. It can significantly contribute to the reduction of healthcare cost by avoiding unnecessary hospitalisations and ensuring that those who need urgent care get it sooner. In conjunction with cost-effective telemedicine platforms, ubiquitous health monitoring can significantly contribute to the enhancement of disease prevention and early diagnosis, disease management, treatment and home rehabilitation. Latest developments in the area of micro and nanotechnologies, information processing and wireless communication offer, today, the possibility for minimally (or non) invasive biomedical measurement but also wearable sensing, processing and data communication. Although the systems are being developed to satisfy specific user needs, a number of common critical issues have to be tackled to achieve reliable and acceptable smart health wearable applications e.g. biomedical sensors, user interface, clinical validation, data security and confidentiality, scenarios of use, decision support, user acceptance and business models. Major technological achievements have been realised the last few years. Cutting edge development combining functional clothing and integrated electronics open a new research area and possibilities for body sensing and communicating health parameters. This paper reviews the current status of research and development on smart wearable health systems and applications and discusses the outstanding issues and future challenges.

  9. Implementing the Mental Health Act in Ghana: any challenges ahead?

    Science.gov (United States)

    Doku, V C K; Wusu-Takyi, A; Awakame, J

    2012-12-01

    Ghana successfully passed a Mental Health Act law in March 2012. The passing of the Act was a culmination of a lot of work by various individuals and institutions spanning several decades. Finally there is a raised prospect of the delivery of a better quality mental healthcare and also the protection of human rights of people with mental disorders in Ghana. This paper identifies and describes clusters of related potential problems referred to as 'challenges' involving different aspects of service delivery, which are anticipated to be encountered during the implementation of the law. Finally, it cautions against the risk of allowing the new mental health law to add a new 'legal' burden to a list of perennial 'burdens' including underfunding, serious levels of understaffing and plummeting staff morale, which bisected earlier attempts at implementing a similar law that laid fallow for forty years.

  10. Serious Games for Health: Features, Challenges, Next Steps.

    Science.gov (United States)

    Blumberg, Moderators Fran C; Burke, Lauren C; Hodent, Participants Celia; Evans, Michael A; Lane, H Chad; Schell, Jesse

    2014-10-01

    As articles in this journal have demonstrated over the past 3 years, serious game development continues to flourish as a vehicle for formal and informal health education. How best to characterize a "serious" game remains somewhat elusive in the literature. Many researchers and practitioners view serious games as capitalizing on computer technology and state-of-the-art video graphics as an enjoyable means by which to provide and promote instruction and training, or to facilitate attitude change among its players. We invited four distinguished researchers and practitioners to further discuss with us how they view the characteristics of serious games for health, how those characteristics differ from those for academic purposes, the challenges posed for serious game development among players of different ages, and next steps for the development and empirical examination of the effectiveness of serious games for players' psychological and physical well-being.

  11. SIB health psychology in Brazil: The challenges for working in public health settings.

    Science.gov (United States)

    Spink, Mary-Jane P; Brigagão, Jacqueline M; Menegon, Vera M; Vicentin, Maria-Cristina G

    2016-03-01

    Considering the diversity of theoretical approaches and settings for psychological practice, this editorial provides a background for the articles that have been included in this special issue concerning health psychology in the context of the Brazilian Unified Health System (Sistema Unico de Saude). We addressed issues concerning the national curricular outline for undergraduate training in psychology and historical data on the social movements that led to the creation of the Sistema Unico de Saude and the Psychiatric Reform which created an important area for psychological work absorbing a considerable number of psychologists.

  12. Mobile health requires mobile security: challenges, solutions, and standardization.

    Science.gov (United States)

    Pharow, Peter; Blobel, Bernd

    2008-01-01

    Extended communication and advanced cooperation in a permanently growing healthcare and welfare domain require a well-defined set of security services provided by an interoperable security infrastructure based on international and European standards. Any communication and collaboration procedure requires a purpose. But such legal purpose-binding is definitely not the only aspect to carefully be observed and investigated. More and more, aspects of security, safety, privacy, ethics, and quality reach importance while discussing about future-proof health information systems and health networks - regardless whether local, regional or even pan-European networks. During the course of the current paradigm change from an organization-centered to a process-related and to a person-centered health system, different new technologies including mobile solutions need to be applied in order to meet challenges arising from both legal and technical circumstances. Beside the typical Information and Communication Technology systems and applications, the extended use of modern technologies includes large medical devices like, e.g., MRI and CT but also small devices like sensors worn by a person or included in clothing. Security and safety are on top of the priority list. The paper addresses the identification of some specific aspects like mobile technology and safety when moving both IT and people towards mobile health aiming at increasing citizens and patients awareness, confidence, and acceptance in future mobile care - a world often still beyond the horizon.

  13. The Politico-Economic Challenges of Ghana’s National Health Insurance Scheme Implementation

    Directory of Open Access Journals (Sweden)

    Adam Fusheini

    2016-09-01

    Full Text Available Background National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs as a vehicle to universal health coverage (UHC and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI legislation (ACT 650 in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Methods Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two and Northern (two Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Results Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. Conclusion The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under

  14. The Politico-Economic Challenges of Ghana’s National Health Insurance Scheme Implementation

    Science.gov (United States)

    Fusheini, Adam

    2016-01-01

    Background: National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs) as a vehicle to universal health coverage (UHC) and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS) as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI) legislation (ACT 650) in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Methods: Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two) and Northern (two) Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Results: Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. Conclusion: The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under the NHIS

  15. Public health emergencies and the public health/managed care challenge.

    Science.gov (United States)

    Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

    2002-01-01

    The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

  16. Four perspectives of women's health. Workshop participants talk about women's health issues in four countries. [Malaysia].

    Science.gov (United States)

    Kaur, P

    1994-01-01

    The program officer of the SIEC Project of the Federation of Family Planning Associations, Malaysia (FFPA,M) granted an interview to JOICFP News during JOICFP's IEC Workshop for the Production of Video Script for Women's Health in Tokyo, Japan. FFPA,M provides comprehensive reproductive health services, including family planning services, pap smear screenings, breast examination, annual medical checkups, and premarital and marital counseling for women. Around 50% of married women use family planning. More than 90% of contraceptive users are familiar with at least one family planning method. FFPA,M is focusing on marginalized women. As Malaysia industrializes, rural-urban migration occurs. Young women comprise many of the new factory workers. FFPA,M provides family life education for these women and strives to help them achieve reproductive health and rights. The enthusiasm for women's issues exhibited at the workshop by both male and female participants pleased FFPA,M's program officer.

  17. Economic Issues in the Use of Office Spirometry for Lung Health Assessment

    Directory of Open Access Journals (Sweden)

    Murray Krahn

    2003-01-01

    Full Text Available The National Lung Health Education Program (United States has recently recommended using office spirometry to screen for subclinical lung disease in adult smokers. No published studies evaluate the economic consequences of this recommendation. This review article outlines the issues that must be considered when evaluating the costs and health benefits of office spirometry. Much of the available data on the effectiveness of screening is from studies that included smoking cessation interventions, making it difficult to determine the effects of screening alone. The sensitivity and specificity of screening spirometry are not known, but may not be important in the economic model, because even false positive test results are beneficial if they lead to smoking cessation. Costs to be considered include those of spirometry itself, of implementing and maintaining screening and smoking cessation programs, and of their consequences, ie, reduced morbidity (lower short term health care costs and mortality (perhaps higher long term health care costs. Despite these unique challenges, data are available to perform economic analyses regarding screening spirometry. Such analyses should play a role in future clinical policy making. Even modest quit rates attributable to screening spirometry may result in highly favourable cost effectiveness ratios.

  18. Rethinking global health challenges: towards a 'global compact' for reducing the burden of chronic disease.

    Science.gov (United States)

    Magnusson, R S

    2009-03-01

    Chronic diseases, including cardiovascular disease, diabetes and cancer, are the leading cause of death and disability in both the developed and developing world (excluding sub-Saharan Africa). At present, the global framework for action on chronic disease is strongly 'World Health Organization (WHO)-centric', defined by two WHO initiatives: the WHO Framework Convention on Tobacco Control, and the Global Strategy on Diet, Physical Activity and Health. This paper explores the difficulties of developing a collective response to global health challenges, and draws out some implications for chronic disease. It highlights how political partnerships and improved governance structures, economic processes, and international laws and standards function as three, concurrent pathways for encouraging policy implementation at country level and for building collective commitment to address the transnational determinants of chronic disease. The paper evaluates WHO's initiatives on chronic disease in terms of these pathways, and makes the case for a global compact on chronic disease as a possible structure for advancing WHO's free-standing goal of reducing mortality from chronic diseases by an additional 2% between 2005 and 2015. Beneath this overarching structure, the paper argues that global agencies, donor governments and other global health stakeholders could achieve greater impact by coordinating their efforts within a series of semi-autonomous 'policy channels' or 'workstreams'. These workstreams - including trade and agriculture, consumer health issues and workplace health promotion - could act as focal points for international cooperation, drawing in a wider range of health stakeholders within their areas of comparative advantage.

  19. Reproductive health, and child health and nutrition in India: meeting the challenge

    OpenAIRE

    Paul, Vinod Kumar; Sachdev, Harshpal Singh; Mavalankar, Dileep; Ramachandran, Prema; Sankar, Mari Jeeva; Bhandari, Nita; Sreenivas, Vishnubhatla; Sundararaman, Thiagarajan; Govil, Dipti; Osrin, David; Kirkwood, Betty

    2011-01-01

    India, with a population of more than 1 billion people, has many challenges in improving the health and nutrition of its citizens. Steady declines have been noted in fertility, maternal, infant and child mortalities, and the prevalence of severe manifestations of nutritional deficiencies, but the pace has been slow and falls short of national and Millennium Development Goal targets. The likely explanations include social inequities, disparities in health systems between and within states, and...

  20. ISSUES AND CHALLENGES OF CORPORATE CHANGE INITIATIVES IN SINGAPORE'S SMALL BUSINESS SECTOR

    Directory of Open Access Journals (Sweden)

    Thomas Menkhoff

    2003-01-01

    Full Text Available This paper explores the change propensity of owners of small and medium-sized enterprises (SMEs and associated challenges in the Republic of Singapore. Based on both qualitative interviews and quantitative survey research amongst Singapore's SME owners and change advocates, it identifies several critical issues with regard to the successful management of organizational transitions in small firms: "the need to change", "the mindset of small entrepreneurs", "change management know how" and "the value of external consultancy inputs". The data suggest that awareness building measures and educational efforts are necessary to enable more owners of local SMEs to benefit from change management tools and concepts as well as respective external expertise. Change management training and exposure to "best" (sectoral change management practices and successful projects facilitated by external change agents might help more small entrepreneurs to manage both intra-organizationally and externally induced organizational changes more effectively.

  1. ISSUES ON THE MAIN DEVELOPMENT CHALLENGES DURING THE PERIOD 2014-2020

    Directory of Open Access Journals (Sweden)

    BUȘAN GABRIELA

    2016-10-01

    Full Text Available European funds is one of the most important instruments for addressing major development issues for Romania in the period 2014-2020. These funds must be used on the priorities identified in the framework of the partnership agreement 2014-2020 for Romania. In this paper are presented the main development priorities, which are supported by interventions in the framework of the 11 objectives of the thematic Strategy Europe 2020, in order to strengthen the sustainability of economic operators and improve regional attractiveness; of employment and labour mobility, offering solutions for severe social challenges and combating poverty, especially the underprivileged or marginalized communities or in rural areas; the development of the ICT sector and the transport sector, in order to increase the accessibility of regions of Romania and their attractiveness for investors; promoting energy efficiency, to an economy with low emissions of carbon, environmental protection and adaptation to climate change and settlement governance structural errors.

  2. Perspectives on Learning Analytics: Issues and challenges. Observations from Shane Dawson and Phil Long

    Directory of Open Access Journals (Sweden)

    John Clarke

    2013-04-01

    Full Text Available Analytics is a field of research and practice that aims to reveal new patterns of information through the aggregation of large sets of data held in previously distinct sources drawing on a number of informing disciplines.   This feature details observations sought on learning analytics from two specialists in the field.   Shane Dawson, Deputy Director, Academic Learning Services, University of South Australia, along with Phil Long, Director, Centre for Educational Innovation and Technology, University of Queensland have contributed to a wide-ranging discussion on some of the issues and challenges related to Learning Analytics in higher education in general, and also in relation to its application to first year students and their staff.    

  3. THE NIGERIAN GAS MASTER-PLAN, INVESTMENT OPPORTUNITIES, CHALLENGES, ISSUES AFFECTING POWER SECTOR: AN ANALYSIS

    Directory of Open Access Journals (Sweden)

    R. INGWE

    2014-11-01

    Full Text Available The Nigerian Gas Master-Plan, Investment Opportunities, Challenges, Issues Affecting Power Sector: an Analysis. The objective of this article is to contribute towards understanding of the Nigerian Gas Master Plan (NGMP/Plan and its bifurcations with key socio-economic development factors. I applied the method of discourse to bring to being some points that have hitherto been unknown about the Master-plan and its inter-relationships and bifurcations. Elaborated here are the spectacular gains that have accrued to the Latin American country, Trinidad and Tobago, from its recent development of natural gas resources. This was considered suitable and significant here for highlighting that if such spectacular achievements could be realized from Trinidad and Tobago’s relatively smaller gas deposit (15.3 tcf, probable reserves (8.4 tcf, possible reserves (6.2 tcf would be by far greater considering Nigeria’s larger natural gas reserves (184 tcf wealth as earlier stated. I show that the Plan is well designed relevant to addressing Nigeria’s current development needs generally. It presents potentials for stimulating Nigeria’s economic growth by harnessing the country’s abundant natural gas reserves. The Plan enumerates/ elaborates huge investment opportunities. Some challenges likely to be faced in the implementation/management of the Plan are already being surmounted as recent reports show that some of its key investments have been realized and the required infrastructure are being provided. Regarding the issues in the Master-plan that are likely to affect and are affecting Nigeria’s power sector development, I reckon that they are mostly positive factors due to the way the plan promises to stimulate electricity generation in our country.

  4. Issues and Challenges in Spatial and Temporal Water Allocation in the Nile Delta

    Directory of Open Access Journals (Sweden)

    Wouter Wolters

    2016-04-01

    Full Text Available “Egypt is a gift of the Nile,” wrote Herodotus, and indeed, without the Nile there would be no Egypt as the world knows it. Egypt is mainly dependent on the flow in the Nile River (with an agreed share of 55.5 BCM and it receives about 1.3 BCM rainfall annually (mainly along the north coast. The overall water use efficiency is already high, due to e.g., water scarcity and reuse of drainage water. Egypt’s water resources are managed by the Ministry of Water Resources and Irrigation (MWRI, with agriculture as by far the largest user of irrigation water, with a share of about 85%. The purpose of the paper is to discuss the major issues and challenges in the spatial and temporal allocation of water, in relation to a free cropping pattern and the characteristics of the irrigation system. We conclude that the current world-wide call for “crop-demand-based precision irrigation supply” will not be easily attainable in Egypt. Instead, “water security” in the form of “guaranteed or agreed” water supply may be a preferred water allocation aim for various reasons, including lack of large storage possibilities, impossibility of fine-tuning supplies in the system, and the needed capacity to deal with (future droughts. Although the paper concentrates on technical issues, it is increasingly realized that the challenges are not only of a technical nature and that there is a need for integration of policies as well as a need to establish effective science–business–policy interfaces at the national level.

  5. Mental Health in Developing Countries: Challenges and Opportunities in Introducing Western Mental Health System in Uganda

    Directory of Open Access Journals (Sweden)

    Janice Katherine Kopinak, MHSc, MSc., RN

    2014-12-01

    Full Text Available Background: Despite decades of disagreement among mental health practitioners and researchers in the Western world pertaining to the causation, classification and treatment of mental disorders there is an ongoing push to implement western mental health models in developing countries. Little information exists on the adaptability of western mental health models in developing countries. Method: This paper presents a review of the attempt to implement a western-oriented mental health system into a different culture, specifically a developing country such as Uganda. It draws upon an extensive literature review and the author’s work in Uganda to identify the lessons learned as well as the challenges of introducing a western-oriented mental health system in a totally new cultural milieu. Results: There is recognition by the national government that the challenges faced in mental health services poses serious public health and development concerns. Efforts have and are being made to improve services using the Western model to diagnose and treat, frequently with practitioners who are unfamiliar with the language, values and culture. Conclusions and Global Health Implications: Uganda can continue to implement the Western mental health practice model which emanates from a different cultural base, based on the medical model and whose tenets are currently being questioned, or establish a model based on their needs with small baseline in-country surveys that focus on values, beliefs, resiliency, health promotion and recovery. The latter approach will lead to a more efficient mental health system with improved care, better outcomes and overall mental health services to Ugandan individuals and communities.

  6. Evolution of health coverage in Mexico: evidence of progress and challenges in the Mexican health system.

    Science.gov (United States)

    Urquieta-Salomón, José E; Villarreal, Héctor J

    2016-02-01

    To consolidate an effective and efficient universal health care coverage requires a deep understanding of the challenges faced by the health care system in providing services demanded by population in need. This study analyses the dynamics of health insurance coverage and effective access coverage to some health interventions in Mexico. It examines the evolution of inequalities and heterogeneous performance of the insurance subsystems incorporated under the Mexican health care system. Two types of coverage indicators were selected: health insurance and effective access to preventive health interventions intended for normative population. Data were drawn from National Health and Nutrition Surveys 2006 and 2012. The economic inequality was estimated using the Standardized Concentration Index by household per capita consumption expenditure as socioeconomic-status indicator. Approximately 75% of the population reported being covered by one of the existing insurance schemes, representing a huge step forward from 2006, when as much as 51.62% of the population had no health insurance. About 87% of this growth was attributable to the expansion of Non Contributory Health Insurance whereas 7% emanated from the Social Security subsystem. The results revealed that inequality in access to health insurance was virtually eradicated; however, traces of unequal access persisted in some subpopulations groups. Coverage indicators of effective access showed a slight improvement in the period analysed, but prenatal care and interventions to prevent chronic disease still presented a serious shortage. Furthermore, there was no evidence that inequities in coverage of these interventions have decreased in recent years. The results provided a mixed picture, generalizable to the system as a whole, expansion of insurance status represents one of the most remarkable advances that have not been accompanied by a significant improvement in effective access. In addition, existing inequalities are

  7. Kazakhstan's Environment-Health system, a Big Data challenge

    Science.gov (United States)

    Vitolo, Claudia; Bella Gazdiyeva, Bella; Tucker, Allan; Russell, Andrew; Ali, Maged; Althonayan, Abraham

    2016-04-01

    Kazakhstan has witnessed a remarkable economic development in the past 15 years, becoming an upper-middle-income country. However it is still widely regarded as a developing nation, partially because of its population's low life expectancy which is 5 years below the average in similar economies. The environment is in a rather fragile state, affected by soil, water, air pollution, radioactive contamination and climate change. However, Kazakhstan's government is moving towards clean energy and environmental protection and calling on scientists to help prioritise investments. The British Council-funded "Kazakhstan's Environment-Health Risk Analysis (KEHRA)" project is one of the recently launched initiatives to support Kazakhstan healthier future. The underlying hypothesis of this research is that the above mentioned factors (air/water/soil pollution, etc.) affecting public health almost certainly do not act independently but rather trigger and exacerbate each other. Exploring the environment-health links in a multi-dimensional framework is a typical Big Data problem, in which the volume and variety of the data needed poses technical as well as scientific challenges. In Kazakhstan, the complexities related to managing and analysing Big Data are worsened by a number of obstacles at the data acquisition step: most of the data is not in digital form, spatial and temporal attributes are often ambiguous and the re-use and re-purpose of the information is subject to restrictive licenses and other mechanisms of control. In this work, we document the first steps taken towards building an understanding of the complex environment-health system in Kazakhstan, using interactive visualisation tools to identify and compare hot-spots of pollution and poor health outcomes, Big Data and web technologies to collect, manage and explore available information. In the future, the knowledge acquired will be modelled to develop evidence-based recommendation systems for decision makers in

  8. Emerging zoonoses: the challenge for public health and biodefense.

    Science.gov (United States)

    Murphy, Frederick A

    2008-09-15

    The concept of new and emerging diseases has captured the public interest and has revitalized the public health infectious disease research community. This interest has also resulted in competition for funding and turf wars between animal health and public health scientists and public officials and, in some cases, has delayed and hindered progress toward effective prevention, control and biodefense. There is a dynamic list of outbreaks causing substantial morbidity and mortality in humans and often in the reservoir animal species. Some agents have the potential to grow into major epidemics. There are many determinants that influence the emergence of diseases of concern that require the use of current understanding of the nature of agent persistence and spread. Additional factors that are global must be added to plans for prevention and control. To this complex mix has been added the potential for accidental or malicious release of agents. The nature of emerging infectious agents and their impact is largely unpredictable. Models that strive to predict the dynamics of agents may be useful but can also blind us to increasing disease risks if it does not match a specific model. Field investigations of early events will be critical and should drive prevention and control actions. Many disease agents have developed strategies to overcome extremes of reservoir qualities like population size and density. Every infectious agent spreads easier when its hosts are closer together. Zoonoses must be dealt with at the interface of human and animal health by all available information. Lessons learned from the emergence of and response to agents like West Nile virus, H5N1 avian influenza, SARS and bovine spongiform encephalopathy, the cause of new-variant Creutzfeldt-Jakob disease in humans, must be used to create better plans for response and meet the challenge for public health and biodefense.

  9. Ethical issues in using social media for health and health care research.

    Science.gov (United States)

    McKee, Rebecca

    2013-05-01

    The dramatic growth of social media in recent years has not gone unnoticed in the health sector. Media such as Facebook and Twitter are increasingly being used to disseminate information among health professionals and patients but, more recently, are being seen as a source of data for surveillance and research, for example by tracking public concerns or capturing discourses taking place outside traditional media outlets. This raises ethical issues, in particular the extent to which postings are considered public or private and the right to anonymity of those posting on social media. These issues are not clear cut as social media, by their nature, blur the boundary between public and private. There is a need for further research on the beliefs and expectations of those using social media in relation to how their material might be used in research. In contrast, there are areas where the ethical issues are more clear cut, such as when individuals are active participants in research, where traditional considerations apply.

  10. Evolving the Nation's Energy Infrastructure: A Challenging System Issue for the Twenty-First Century; Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Garrett, B.

    2007-04-01

    Over the next several decades, a profound transformation of the global energy enterprise will occur driven largely by population growth and economic development. How this growing demand for energy is met poses one of the most complex and challenging issues of our time. The current national energy dialogue reflects the challenge in simultaneously considering the social, political, economic, and technical issues as the energy system is defined, technical targets are established, and programs and investments are implemented to meet those technical targets. This paper examines the general concepts and options for meeting this challenge.

  11. India moves towards menstrual hygiene: subsidized sanitary napkins for rural adolescent girls-issues and challenges.

    Science.gov (United States)

    Garg, Rajesh; Goyal, Shobha; Gupta, Sanjeev

    2012-05-01

    The onset of menstruation is one of the most important physiological changes occurring among girls during the adolescent years. Menstruation heralds the onset of physiological maturity in girls. It becomes the part and parcel of their lives until menopause. Apart from personal importance, this phenomenon also has social significance. In India, menstruation is surrounded by myths and misconceptions with a long list of "do's" and "don'ts" for women. Hygiene-related practices of women during menstruation are of considerable importance, as it may increase vulnerability to Reproductive Tract Infections (RTI's). Poor menstrual hygiene is one of the major reasons for the high prevalence of RTIs in the country and contributes significantly to female morbidity. Most of the adolescent girls in villages use rags and old clothes during menstruation, increasing susceptibility to RTI's. Adolescents constitute one-fifths of India's population and yet their sexual health needs remain largely unaddressed in the national welfare programs. Poor menstrual hygiene in developing countries has been an insufficiently acknowledged problem. In June 2010, the Government of India proposed a new scheme towards menstrual hygiene by a provision of subsidized sanitary napkins to rural adolescent girls. But there are various other issues like awareness, availability and quality of napkins, regular supply, privacy, water supply, disposal of napkins, reproductive health education and family support which needs simultaneous attention for promotion of menstrual hygiene. The current article looks at the issue of menstrual hygiene not only from the health point of view, but also considers social and human rights values attached to it.

  12. Evolving legal framework of corporate governance in India – issues and challenges

    Directory of Open Access Journals (Sweden)

    Pankaj Kumar GUPTA

    2014-12-01

    Full Text Available Investors now started considering corporate governance as very essential factor before investment especially in view of the unstable environment in the securities market. It is considered that good corporate governance inspires, strengthens and maintains investor’s confidence by ensuring company’s commitment to higher growth and profits. Corporate Governance has become a major concern for global economies particularly the transition world. Sound corporate governance is extremely important for transition economies for creation of the key institutions, the private corporations, which drive the successful economic transformation to a market based economy, effective allocation of capital and development of financial markets, attracting foreign investment and making a contribution to the process of national development. The Corporate Governance issue has emerged primarily because of the growing importance of corporations in the national economies and their interaction with the international agencies and institutions. This paper presents the current scenario of corporate governance in India, the evolving legal framework and identified the major issues and challenges that need to be addressed to implement an effective system of corporate governance in India.

  13. Challenging Issues on fog forecast with a three-dimensional fog forecast model

    Science.gov (United States)

    Masbou, M.

    2012-12-01

    Fog has a significant impact on economical aspect (traffic management and safety) as well as on environmental issues (fresh water source for the population and the biosphere in arid region). However, reliable fog and visibility forecasts stay challenging issue. Fog is generally a small scale phenomenon which is mostly affected by local advective transport, radiation, topography, vegetation, turbulent mixing at the surface as well as its microphysical structure. In order to consider these intertwined processes, the three-dimensional fog forecast model, COSMO-FOG, with a high vertical resolution with different microphysical complexity has been developed. This model includes a microphysical parameterisation based on the one-dimensional fog forecast model. The implementation of the cloud water droplets as a new prognostic variable allows a detailed definition of the sedimentation processes and the variations in visibility. Moreover, the turbulence scheme, based on a Mellor-Yamada 2.5 order and a closure of a 2nd order has been modified to improve the model behaviour in case of a stable atmosphere structure, occurring typically during night radiative fog episodes. The potential of COSMO-FOG will be presented in some realistic fog situations (flat, bumpy and complex terrain). The fog spatial extension will be compared with MSG satellite products for fog and low cloud. The interplays between dynamical, thermodynamical patterns and the soil-atmosphere interactions will be presented.

  14. A Review on Key Issues and Challenges in Devices Level MEMS Testing

    Directory of Open Access Journals (Sweden)

    Muhammad Shoaib

    2016-01-01

    Full Text Available The present review provides information relevant to issues and challenges in MEMS testing techniques that are implemented to analyze the microelectromechanical systems (MEMS behavior for specific application and operating conditions. MEMS devices are more complex and extremely diverse due to the immersion of multidomains. Their failure modes are distinctive under different circumstances. Therefore, testing of these systems at device level as well as at mass production level, that is, parallel testing, is becoming very challenging as compared to the IC test, because MEMS respond to electrical, physical, chemical, and optical stimuli. Currently, test systems developed for MEMS devices have to be customized due to their nondeterministic behavior and complexity. The accurate measurement of test systems for MEMS is difficult to quantify in the production phase. The complexity of the device to be tested required maturity in the test technique which increases the cost of test development; this practice is directly imposed on the device cost. This factor causes a delay in time-to-market.

  15. Ethical challenges in cluster randomized controlled trials: experiences from public health interventions in Africa and Asia.

    Science.gov (United States)

    Osrin, David; Azad, Kishwar; Fernandez, Armida; Manandhar, Dharma S; Mwansambo, Charles W; Tripathy, Prasanta; Costello, Anthony M

    2009-10-01

    Public health interventions usually operate at the level of groups rather than individuals, and cluster randomized controlled trials (RCTs) are one means of evaluating their effectiveness. Using examples from six such trials in Bangladesh, India, Malawi and Nepal, we discuss our experience of the ethical issues that arise in their conduct. We set cluster RCTs in the broader context of public health research, highlighting debates about the need to reconcile individual autonomy with the common good and about the ethics of public health research in low-income settings in general. After a brief introduction to cluster RCTs, we discuss particular challenges we have faced. These include the nature of - and responsibility for - group consent, and the need for consent by individuals within groups to intervention and data collection. We discuss the timing of consent in relation to the implementation of public health strategies, and the problem of securing ethical review and approval in a complex domain. Finally, we consider the debate about benefits to control groups and the standard of care that they should receive, and the issue of post-trial adoption of the intervention under test.

  16. Approaches and challenges to optimising primary care teams’ electronic health record usage

    Directory of Open Access Journals (Sweden)

    Nancy Pandhi

    2014-07-01

    Full Text Available Background Although the presence of an electronic health record (EHR alone does not ensure high quality, efficient care, few studies have focused on the work of those charged with optimising use of existing EHR functionality.Objective To examine the approaches used and challenges perceived by analysts supporting the optimisation of primary care teams’ EHR use at a large U.S. academic health care system.Methods A qualitative study was conducted. Optimisation analysts and their supervisor were interviewed and data were analysed for themes.Results Analysts needed to reconcile the tension created by organisational mandates focused on the standardisation of EHR processes with the primary care teams’ demand for EHR customisation. They gained an understanding of health information technology (HIT leadership’s and primary care team’s goals through attending meetings, reading meeting minutes and visiting with clinical teams. Within what was organisationally possible, EHR education could then be tailored to fit team needs. Major challenges were related to organisational attempts to standardise EHR use despite varied clinic contexts, personnel readiness and technical issues with the EHR platform. Forcing standardisation upon clinical needs that current EHR functionality could not satisfy was difficult.Conclusions Dedicated optimisation analysts can add value to health systems through playing a mediating role between HIT leadership and care teams. Our findings imply that EHR optimisation should be performed with an in-depth understanding of the workflow, cognitive and interactional activities in primary care.

  17. Methodological challenges in quality of life research among Turkish and Moroccan ethnic minority cancer patients: translation, recruitment and ethical issues.

    Science.gov (United States)

    Hoopman, Rianne; Terwee, Caroline B; Muller, Martin J; Ory, Ferko G; Aaronson, Neil K

    2009-06-01

    The large population of first generation Turkish and Moroccan immigrants who moved to Western Europe in the 1960s and 1970s is now reaching an age at which the incidence of chronic diseases, including cancer, rises sharply. To date, little attention has been paid to the health-related quality of life (HRQOL) of these ethnic minority groups, primarily due to the paucity of well translated and validated measures, but also because of a range of methodological and logistical barriers. The primary objective of this paper is to describe the methodological challenges in conducting HRQOL research among these patient populations, based on experience gained in a project in which four widely used HRQOL questionnaires were translated into Turkish, Moroccan-Arabic and Tarifit, and administered to a sample of 90 Turkish and 79 Moroccan cancer patients in the Netherlands. Problems encountered in translating and administering the questionnaires included achieving semantic equivalence (use of loanwords), use of numerical rating scales, lengthy questions and response scales, and culturally sensitive and/or inappropriate questions. Privacy laws that prohibit hospitals from registering the ethnicity of patients hampered efficient identification of eligible patients. Recruiting patients to studies is often difficult due to low literacy levels, lack of familiarity with and distrust of research, concerns about immigration status, and inaccurate or missing contact information. This can lead to lower response rates than is the case with the population of Dutch cancer patients. Additional ethical issues that arise in such studies concern patients' problems with communicating with their health care providers, their lack of understanding of their diagnosis, treatment and prognosis, and the potential role conflict experienced by bilingual research assistants who may wish or be asked to intervene on the patients' behalf. Practical approaches to resolving these issues are presented.

  18. Occupational Allergic Diseases in Kitchen and Health Care Workers: An Underestimated Health Issue

    Directory of Open Access Journals (Sweden)

    Ugur Bilge

    2013-01-01

    Full Text Available Objective. This study evaluated the frequencies of allergic symptoms and rate of upper respiratory infections during the past year in the general population, kitchen workers (KW and health care workers (HCW. Methods. The European Community Respiratory Health Survey (ECRHS was used to inquire retrospectively about asthma and asthma-like symptoms and the number of treatments required for previous upper respiratory tract infections (URTI: acute pharyngitis, acute sinusitis, etc. during the past year for health care workers, kitchen workers, and members of the general population. Adjusted odds ratios by gender, age, and smoking status were calculated. Results. 579 subjects (186 from the general population, 205 KW, and 188 HCW; 263 females, 316 males participated in the study. Noninfectious (allergic rhinitis was significantly higher in the HCW and KW groups than in the general population (P<0.001. Cumulative asthma was significantly higher only in the HCW group (P<0.05. In addition, the HCW and KW groups had significantly higher risks of ≥2/year URTI (OR: 1.59, 95% CI: 1.07–2.38 versus OR: 1.57, 95% CI: 1.05–2.38 than the general population. Conclusion. Occupational allergic respiratory diseases are an important and growing health issue. Health care providers should become familiar with workplace environments and environmental causes of occupational rhinitis and asthma.

  19. Developing Social Marketing Capacity to Address Health Issues

    Science.gov (United States)

    Whitelaw, S.; Smart, E.; Kopela, J.; Gibson, T.; King, V.

    2011-01-01

    Purpose: Social marketing is increasingly being seen as a potentially effective means of pursuing health education practice generally and within various specific areas such as mental health and wellbeing and more broadly in tackling health inequalities. This paper aims to report and reflect on the authors' experiences of undertaking a health…

  20. The Boston Puerto Rican Health Study, a longitudinal cohort study on health disparities in Puerto Rican adults: challenges and opportunities

    Directory of Open Access Journals (Sweden)

    Collado Bridgette M

    2010-03-01

    Full Text Available Abstract Background The Boston Puerto Rican Health Study is an ongoing longitudinal cohort study designed to examine the role of psychosocial stress on presence and development of allostatic load and health outcomes in Puerto Ricans, and potential modification by nutritional status, genetic variation, and social support. Methods Self-identified Puerto Ricans, aged 45-75 years and residing in the Boston, MA metro area, were recruited through door-to-door enumeration and community approaches. Participants completed a comprehensive set of questionnaires and tests. Blood, urine and salivary samples were extracted for biomarker and genetic analysis. Measurements are repeated at a two-year follow-up. Results A total of 1500 eligible participants completed baseline measurements, with nearly 80% two-year follow-up retention. The majority of the cohort is female (70%, and many have less than 8th grade education (48%, and fall below the poverty level (59%. Baseline prevalence of health conditions is high for this age range: considerable physical (26% and cognitive (7% impairment, obesity (57%, type 2 diabetes (40%, hypertension (69%, arthritis (50% and depressive symptomatology (60%. Conclusions The enrollment of minority groups presents unique challenges. This report highlights approaches to working with difficult to reach populations, and describes some of the health issues and needs of Puerto Rican older adults. These results may inform future studies and interventions aiming to improve the health of this and similar communities.

  1. Broadcast Media Intervention in Mental Health Challenge in Edo State, Nigeria

    Directory of Open Access Journals (Sweden)

    Osakue Stevenson Omoera

    2012-12-01

    Full Text Available n most communities, especially in Africa, people with mental health challenges are denigrated; the society is not sympathetic with sufferers of mental illness. A lot of issues can trigger mental illness. These can be stress (economic stress, social stress, educational stress, etc; hereditary factors; war and aggression; rape; spiritual factors, to mention a few. Therefore, there is the need for understanding and awareness creation among the people as one of the ways of addressing the problem. Methodologically, this study deploys analytical, observation and interview techniques. In doing this, it uses the Edo State, Nigeria scenario to critically reflect, albeit preliminarily, on the interventionist role the broadcast media have played/are playing/should play in creating awareness and providing support systems for mentally challenged persons in urban and rural centres in Nigeria. The study argues that television and radio media are very innovative and their innovativeness can be deployed in the area of putting mental health issue in the public discourse and calling for action.

  2. Challenges and Opportunities for Urban Environmental Health and Sustainability: the HEALTHY-POLIS initiative.

    Science.gov (United States)

    Vardoulakis, Sotiris; Dear, Keith; Wilkinson, Paul

    2016-03-08

    Cities around the world face many environmental health challenges including contamination of air, water and soil, traffic congestion and noise, and poor housing conditions exacerbated by unsustainable urban development and climate change. Integrated assessment of these risks offers opportunities for holistic, low carbon solutions in the urban environment that can bring multiple benefits for public health. The Healthy-Polis consortium aims to protect and promote urban health through multi-disciplinary, policy-relevant research on urban environmental health and sustainability. We are doing this by promoting improved methods of health risk assessment, facilitating international collaboration, contributing to the training of research scientists and students, and engaging with key stakeholders in government, local authorities, international organisations, industry and academia. A major focus of the consortium is to promote and support international research projects coordinated between two or more countries. The disciplinary areas represented in the consortium are many and varied, including environmental epidemiology, modelling and exposure assessment, system dynamics, health impact assessment, multi-criteria decision analysis, and other quantitative and qualitative approaches. This Healthy-Polis special issue presents a range of case studies and reviews that illustrate the need for a systems-based understanding of the urban environment.

  3. Opportunities and challenges for implementing cost accounting systems in the Kenyan health system

    Directory of Open Access Journals (Sweden)

    Elesban Kihuba

    2016-06-01

    Full Text Available Background: Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. Design: We reviewed policy documents, and conducted field observations and semi-structured interviews with key informants in the health sector. We used an adapted Human, Organization and Technology fit (HOT-fit framework to analyze the components and standards of a cost accounting system. Results: Among the opportunities for a viable cost accounting system, we identified a supportive broad policy environment, political will, presence of a national data reporting architecture, good implementation experience with electronic medical records systems, and the availability of patient clinical and resource use data. However, several practical issues need to be considered in the design of the system, including the lack of a framework to guide the costing process, the lack of long-term investment, the lack of appropriate incentives for ground-level staff, and a risk of overburdening the current health management information system. Conclusion: To facilitate the implementation of cost accounting into the health sector, the design of any proposed system needs to remain simple and attuned to the local context.

  4. Opportunities and challenges for implementing cost accounting systems in the Kenyan health system

    Science.gov (United States)

    Kihuba, Elesban; Gheorghe, Adrian; Bozzani, Fiammetta; English, Mike; Griffiths, Ulla K.

    2016-01-01

    Background Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. Design We reviewed policy documents, and conducted field observations and semi-structured interviews with key informants in the health sector. We used an adapted Human, Organization and Technology fit (HOT-fit) framework to analyze the components and standards of a cost accounting system. Results Among the opportunities for a viable cost accounting system, we identified a supportive broad policy environment, political will, presence of a national data reporting architecture, good implementation experience with electronic medical records systems, and the availability of patient clinical and resource use data. However, several practical issues need to be considered in the design of the system, including the lack of a framework to guide the costing process, the lack of long-term investment, the lack of appropriate incentives for ground-level staff, and a risk of overburdening the current health management information system. Conclusion To facilitate the implementation of cost accounting into the health sector, the design of any proposed system needs to remain simple and attuned to the local context. PMID:27357072

  5. Constructing public oral health policies in Brazil: issues for reflection

    Directory of Open Access Journals (Sweden)

    Catharina Leite Matos Soares

    2012-01-01

    Full Text Available This paper addresses the construction of public oral health policies in Brazil by reviewing the available literature. It includes a discussion of the social responses given by the Brazilian State to oral health policies and the relationship of these responses with the ideological oral health movements that have developed globally, and that have specifically influenced oral health policies in Brazil. The influence of these movements has affected a series of hegemonic practices originating from both Market Dentistry and Preventive and Social Dentistry in Brazil. Among the state activities that have been set into motion, the following stand out: the drafting of a law to regulate the fluoridation of the public water supply, and the fluoridation of commercial toothpaste in Brazil; epidemiological surveys to analyze the status of the Brazilian population's oral health; the inclusion of oral health in the Family Health Strategy (Estratégia de Saúde da Família - ESF; the drawing up of the National Oral Health Policy, Smiling Brazil (Brasil Sorridente. From the literature consulted, the progressive expansion of state intervention in oral health policies is observed. However, there remains a preponderance of hegemonic "dental" practices reproduced in the Unified Public Health Service (Sistema Único de Saúde - SUS and the Family Health Strategy.

  6. [Intersectorial actions for health promotion in Family Health Strategy: experiences, challenges, and possibilities].

    Science.gov (United States)

    Silva, Kênia Lara; Rodrigues, Andreza Trevenzoli

    2010-01-01

    Qualitative study with the purpose of analyzing intersectorial actions for health promotion in the context of the Family Health Strategy, identifying experiences, facilitating and restricting factors to the process of building partnerships. Subjects were health managers and informers from social equipment in the territory covered by a local health service in Belo Horizonte/Minas Gerais, Brazil. The results indicate the existence of a wide social network. However, intersectorial health promoting actions are still incipient. Intersectorial actions are faced with the challenge of creating communication spaces that allow the resolution of complex problems. It is concluded that intersectorial actions constitute an innovative strategy which is still under construction, and the paths of which are still being unraveled.

  7. A perspective of health care in the past--insights and challenges for a health care system in the new millennium.

    Science.gov (United States)

    Cicatiello, J S

    2000-01-01

    Health care has been in a state of perpetual change over the past decade. The swirl of activity includes: mergers and acquisitions, downsizing, shortages of nurses, unionizing of physicians, health care cost increases, escalation of pharmaceutical prices, consumerism, managed care, high-tech-low-touch services, the Balanced Budget Act of 1997, declining reimbursement, alternative medicine, Web-based shopping for health care, medicine moving into cyberspace, nanotechnology, advances in digital technology, and a diagnostic boon in high-tech imaging. What this demonstrates is that the broad-based landscape of changes affecting health care in the United States is extensive and incredibly complex. This article provides a perspective of health care in the past, discusses issues and concerns impacting health care today, and articulates some of the challenges and opportunities that are and will continue to shape the future of our health care system in the new millennium.

  8. Promotion of role clarification in the Health Care Team Challenge.

    Science.gov (United States)

    Hudson, C C; Gauvin, S; Tabanfar, R; Poffenroth, A M; Lee, J S; O'Riordan, A L

    2017-01-31

    Interprofessional collaboration has consistently been associated with positive client-care outcomes. Role clarification is one facet of interprofessional collaboration that is thought to be crucial for effective interprofessional team functioning. Given the positive outcomes associated with interprofessional collaboration, educators have begun to integrate formal interprofessional education events into healthcare curricula. The Health Care Team Challenge (HCTC) is a collaborative competition designed to promote interprofessional competencies among students in healthcare fields. The current study empirically investigated whether this event promoted role clarification among participants. Sixteen participants in five healthcare professions (occupational therapy, physiotherapy, clinical psychology, nursing, and medicine) completed two questionnaires to assess role clarification before and after participating in this event. Results indicate that participants' understanding of their own and other professions' roles improved after participating in this team activity. These results suggest that the HCTC is effective in promoting role clarification and collaboration among healthcare students.

  9. Home visitors and child health in England: advances and challenges

    Directory of Open Access Journals (Sweden)

    Sarah Cowley

    2011-12-01

    Full Text Available There is increasing interest in the early years as a focus for reducing health inequalities as well as one that is important for the children themselves. This paper describes the introduction in England of Sure Start Local Programmes, which included home visiting within a community development approach, and an intensive home visiting programme, the Nurse-Family partnership, for disadvantaged teenage mothers. It reflects on changes and challenges in service provision to mothers and their pre-school children in England, explaining that a long tradition of home visiting was, paradoxically, reduced as attention focused on the newer initiatives. This is now being addressed, with attention to a range of evidence based programmes and a specific focus on heath visitor provision.

  10. Emerging arboviruses and public health challenges in Brazil

    Science.gov (United States)

    Lima-Camara, Tamara Nunes

    2016-01-01

    ABSTRACT Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country’s public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country. PMID:27355468

  11. The challenge of gun control for mental health advocates.

    Science.gov (United States)

    Pandya, Anand

    2013-09-01

    Mass shootings, such as the 2012 Newtown massacre, have repeatedly led to political discourse about limiting access to guns for individuals with serious mental illness. Although the political climate after such tragic events poses a considerable challenge to mental health advocates who wish to minimize unsympathetic portrayals of those with mental illness, such media attention may be a rare opportunity to focus attention on risks of victimization of those with serious mental illness and barriers to obtaining psychiatric care. Current federal gun control laws may discourage individuals from seeking psychiatric treatment and describe individuals with mental illness using anachronistic, imprecise, and gratuitously stigmatizing language. This article lays out potential talking points that may be useful after future gun violence.

  12. Emerging arboviruses and public health challenges in Brazil

    Directory of Open Access Journals (Sweden)

    Tamara Nunes Lima-Camara

    2016-01-01

    Full Text Available ABSTRACT Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country’s public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country.

  13. Teacher Time Spent on Student Health Issues and School Nurse Presence

    Science.gov (United States)

    Hill, Nina Jean; Hollis, Marianne

    2012-01-01

    Elementary school teacher time spent on student health issues and the relationship to school nurse services was the focus of this 2-year study. A cross-sectional design was used to survey traditional and exceptional (special needs) classroom teachers about the time they spent on health issues and their perception of school nurse presence. The…

  14. Health care priority setting: principles, practice and challenges

    Directory of Open Access Journals (Sweden)

    Donaldson Cam

    2004-04-01

    Full Text Available Abstract Background Health organizations the world over are required to set priorities and allocate resources within the constraint of limited funding. However, decision makers may not be well equipped to make explicit rationing decisions and as such often rely on historical or political resource allocation processes. One economic approach to priority setting which has gained momentum in practice over the last three decades is program budgeting and marginal analysis (PBMA. Methods This paper presents a detailed step by step guide for carrying out a priority setting process based on the PBMA framework. This guide is based on the authors' experience in using this approach primarily in the UK and Canada, but as well draws on a growing literature of PBMA studies in various countries. Results At the core of the PBMA approach is an advisory panel charged with making recommendations for resource re-allocation. The process can be supported by a range of 'hard' and 'soft' evidence, and requires that decision making criteria are defined and weighted in an explicit manner. Evaluating the process of PBMA using an ethical framework, and noting important challenges to such activity including that of organizational behavior, are shown to be important aspects of developing a comprehensive approach to priority setting in health care. Conclusion Although not without challenges, international experience with PBMA over the last three decades would indicate that this approach has the potential to make substantial improvement on commonly relied upon historical and political decision making processes. In setting out a step by step guide for PBMA, as is done in this paper, implementation by decision makers should be facilitated.

  15. ISSUE OF YOGA ON PHYSICAL AND MENTAL HEALTH

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    Silvia Horváthová

    2016-09-01

    Full Text Available The effect of yoga on human health has long term interest. In this regard, we view the effect on physical health, not only mental, in terms of the sensory input. This paper attempts to present a position on whether yoga affects human health status and limits an increase in lifestyle diseases. In this work, we collect data and use inductive reasoning methods with the aim of generalizing conclusions. Our findings indicate the effect of yoga, not only on mental health, but also in terms of physical health, in particular in reducing obesity. It is concluded that to find a completely healthy person is rare, but with various relaxation techniques of yoga, one can eliminate a variety of ailments and benefit overall in health.

  16. Learning from our apartheid past: human rights challenges for health professionals in contemporary South Africa.

    Science.gov (United States)

    Baldwin-Ragaven, L; London, L; De Gruchy, J

    2000-01-01

    Central to South Africa's democratic transformation have been attempts to understand how and why human rights abuses were common under apartheid. In testimony to the Truth and Reconciliation Commission evidence has emerged of a wide range of past complicity in human rights abuses by health professionals and their organisations. This has presented a major challenge to the health sector to develop ways to operationalize a commitment to human rights in the future. This paper argues that only after a process of self-reflection, both personal and institutional, which enables a thorough and accurate analysis of why things went so wrong, can the health sector effectively move forward. The authors' perspective draws on the submission to the TRC Health Sector Hearings by the Health and Human Rights Project in 1997, which provides a systemic and case-based analysis of the health sector's role in human rights abuses under apartheid. However, human rights responses have to take account of a changing national and global terrain in which human rights issues are no longer as morally absolute as previously encountered, and in which seemingly insuperable resource constraints, inimical economic policies, and the demobilization of civil society, are serious obstacles. Moreover, the politics of transformation has generated expediencies that threaten to rewrite history in ways that fundamentally cheapen human rights. To address this contradiction, the authors propose a set of objectives that places accountability of health professionals in a human rights framework. These objectives are intended to give substance to the main tasks facing the health sector--to develop and infuse the capacity to recognise and integrate both the 'new' and traditional human rights dilemmas, and to effect personal and institutional transformation. A matrix is presented, linking these objectives to key role players in the health sector and identifying activities specific for each role player. As the health

  17. Integration of community health workers into health systems in developing countries: Opportunities and challenges

    Directory of Open Access Journals (Sweden)

    Collins Otieno Asweto

    2016-02-01

    Full Text Available Background: Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health workers (CHWs. It is imperative that health care systems focus on improving access to quality continuous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their effectiveness. Objective: To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing countries. Methods: Six databases were examined for quantitative, qualitative, and mixed-methods studies that included the integration of CHWs, their motivation and supervision, and CHW policy making and implementation in developing countries. Thirty-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programs. Thematic coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was synthesized. Results: CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of health. Important facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management meetings. Sustainable integration of CHWs into the health care system requires the formulation and implementation of polices that support their work, as well as financial and nonfinancial incentives, motivation, collaborative and supportive supervision, and a manageable workload. Conclusions: For sustainable integration of CHWs into health care systems, high-performing health systems with sound governance, adequate financing, well-organized service delivery, and adequate supplies and equipment are essential. Similarly, competent communities could contribute to better CHW performance through sound

  18. ISSUE OF YOGA ON PHYSICAL AND MENTAL HEALTH

    OpenAIRE

    Silvia Horváthová; Iveta Petríková Rosinová

    2016-01-01

    The effect of yoga on human health has long term interest. In this regard, we view the effect on physical health, not only mental, in terms of the sensory input. This paper attempts to present a position on whether yoga affects human health status and limits an increase in lifestyle diseases. In this work, we collect data and use inductive reasoning methods with the aim of generalizing conclusions. Our findings indicate the effect of yoga, not only on mental health, but also in terms of physi...

  19. Conceptualising global health: theoretical issues and their relevance for teaching

    Directory of Open Access Journals (Sweden)

    Rowson Mike

    2012-11-01

    Full Text Available Abstract Background There has long been debate around the definition of the field of education, research and practice known as global health. In this article we step back from attempts at definition and instead ask what current definitions tell us about the evolution of the field, identifying gaps and points of debate and using these to inform discussions of how global health might be taught. Discussion What we now know as global health has its roots in the late 19th century, in the largely colonial, biomedical pursuit of ‘international health’. The twentieth century saw a change in emphasis of the field towards a much broader conceptualisation of global health, encompassing broader social determinants of health and a truly global focus. The disciplinary focus has broadened greatly to include economics, anthropology and political science, among others. There have been a number of attempts to define the new field of global health. We suggest there are three central areas of contention: what the object of knowledge of global health is, the types of knowledge to be used and around the purpose of knowledge in the field of global health. We draw a number of conclusions from this discussion. First, that definitions should pay attention to differences as well as commonalities in different parts of the world, and that the definitions of global health themselves depend to some extent on the position of the definer. Second, global health’s core strength lies in its interdisciplinary character, in particular the incorporation of approaches from outside biomedicine. This approach recognises that political, social and economic factors are central causes of ill health. Last, we argue that definition should avoid inclusion of values. In particular we argue that equity, a key element of many definitions of global health, is a value-laden concept and carries with it significant ideological baggage. As such, its widespread inclusion in the definitions of

  20. Mental Health Issues Facing a Diverse Sample of College Students: Results from the College Student Mental Health Survey

    Science.gov (United States)

    Soet, Johanna; Sevig, Todd

    2006-01-01

    Over the past 5 years there has been increased attention given to mental health issues on college and university campuses across the country. However, few research efforts have been conducted to systematically investigate the mental health of college students. The College Student Mental Health Survey was undertaken as a first step towards gaining…

  1. Health Education Research and Practice Literature on Hispanic Health Issues: Have We Lost Sight of the Largest Minority Population?

    Science.gov (United States)

    Price, James H; Khubchandani, Jagdish

    2016-03-01

    Hispanics constitute the largest racial/ethnic minority population in the United States and are the fastest growing segment of the population. Knowledge about health needs and practices, effective health promotion programs, and health policy making for Hispanics has the potential to improve population health outcomes for this group. Continued research and practice literature will aid in accomplishing these objectives. However, little is known about the extent of health education-related literature available on Hispanic health issues. In this review, we analyzed research and practice publications in all health education-related journals to assess the volume of articles published on Hispanic health issues. We found that the portion of journal articles devoted to Hispanic health issues varied widely among the journals and that there was a very limited emphasis on Hispanic health-related issues. Journal editors and editorial board members may need to be more proactive in soliciting manuscripts on Hispanic health, and our practitioners may have to improve their professional skills and cultural competence in order to work with Hispanic populations to produce research and practice literature that is of adequate quantity and quality to help improve Hispanics' health.

  2. Developing evidence-based ethical policies on the migration of health workers: conceptual and practical challenges

    Directory of Open Access Journals (Sweden)

    Adams Orvill

    2003-10-01

    Full Text Available Abstract It is estimated that in 2000 almost 175 million people, or 2.9% of the world's population, were living outside their country of birth, compared to 100 million, or 1.8% of the total population, in 1995. As the global labour market strengthens, it is increasingly highly skilled professionals who are migrating. Medical practitioners and nurses represent a small proportion of highly skilled workers who migrate, but the loss of health human resources for developing countries can mean that the capacity of the health system to deliver health care equitably is compromised. However, data to support claims on both the extent and the impact of migration in developing countries is patchy and often anecdotal, based on limited databases with highly inconsistent categories of education and skills. The aim of this paper is to examine some key issues related to the international migration of health workers in order to better understand its impact and to find entry points to developing policy options with which migration can be managed. The paper is divided into six sections. In the first, the different types of migration are reviewed. Some global trends are depicted in the second section. Scarcity of data on health worker migration is one major challenge and this is addressed in section three, which reviews and discusses different data sources. The consequences of health worker migration and the financial flows associated with it are presented in section four and five, respectively. To illustrate the main issues addressed in the previous sections, a case study based mainly on the United Kingdom is presented in section six. This section includes a discussion on policies and ends by addressing the policy options from a broader perspective.

  3. Clinical Issues in Mental Health Service Delivery to Refugees.

    Science.gov (United States)

    Gong-Guy, Elizabeth; And Others

    1991-01-01

    Serious limitations exist in the delivery of mental health services to refugees throughout the resettlement process: fragmentation, instability, language barriers, culturally inappropriate treatment methods, and severe staff shortages. Suggested improvements for refugee mental health services emphasize outreach, prevention, treatment approaches,…

  4. Smoking Is a Women's Health Issue Across the Life Cycle.

    Science.gov (United States)

    Holland, Aimee Chism

    2015-01-01

    Many women know about the risks of lung cancer and cardiovascular disease that stem from tobacco use, but many don't realize there are several other potential health consequences of smoking. Nurses should utilize every opportunity to educate women about the various health risks of smoking. Promotion of smoking cessation now may help women prevent numeroushealth problems later.

  5. The Challenges of Conscientious Objection in Health care.

    Science.gov (United States)

    Shanawani, Hasan

    2016-04-01

    Conscientious objection (CO) is the refusal to perform a legal role or responsibility because of personal beliefs. In health care, conscientious objection involves practitioners not providing certain treatments to their patients, based on reasons of morality or "conscience." The development of conscientious objection among providers is complex and challenging. While there may exist good reasons to accommodate COs of clinical providers, the exercise of rights and beliefs of the provider has an impact on a patient's health and/ or their access to care. For this reason, it is incumbent on the provider with a CO to minimize or eliminate the impact of their CO both on the delivery of care to the patients they serve and on the medical system in which they serve patients. The increasing exercise of CO, and its impact on large segments of the population, is made more complex by the provision of government-funded health care benefits by private entities. The result is a blurring of the lines between the public, civic space, where all people and corporate entities are expected to have similar rights and responsibilities, and the private space, where personal beliefs and restrictions are expected to be more tolerated. This paper considers the following questions: (1) What are the allowances or limits of the exercise a CO against the rights of a patient to receive care within accept practice? (2) In a society where there exist "private," personal rights and responsibilities, as well as "civil" or public/shared rights and responsibilities, what defines the boundaries of the public, civil, and private space? (3) As providers and patients face the exercise of CO, what roles, responsibilities, and rights do organizations and institutions have in this interaction?

  6. Clinical issues in mental health service delivery to refugees.

    Science.gov (United States)

    Gong-Guy, E; Cravens, R B; Patterson, T E

    1991-06-01

    Serious limitations exist in the delivery of mental health services to refugees throughout the resettlement process. Having survived harrowing physical and psychological traumas prior to reaching refugee camps, many refugees encounter mental health services in overseas camps that are characterized by fragmentation, instability, language barriers, and severe staff shortages. Refugees requiring mental health intervention after resettlement in the United States confront additional barriers, including frequent misdiagnosis, inappropriate use of interpreters and paraprofessionals, and culturally inappropriate treatment methods. Suggestions for improving mental health services for refugee populations emphasize modifying diagnostic assumptions and treatment approaches, recognizing potential problems associated with using interpreters and paraprofessionals, and examining the role of consultation, prevention, and outreach services in addressing refugee mental health concerns.

  7. Language, culture, and task shifting--an emerging challenge for global mental health.

    Science.gov (United States)

    Swartz, Leslie; Kilian, Sanja; Twesigye, Justus; Attah, Dzifa; Chiliza, Bonginkosi

    2014-01-01

    Language is at the heart of mental health care. Many high-income countries have sophisticated interpreter services, but in low- and middle-income countries there are not sufficient professional services, let alone interpreter services, and task shifting is used. In this article, we discuss this neglected issue in the context of low- and middle-income countries, where task shifting has been suggested as a solution to the problem of scarce mental health resources. The large diversity of languages in low- and middle-income countries, exacerbated by wide-scale migration, has implications for the scale-up of services. We suggest that it would be useful for those who are working innovatively to develop locally delivered mental health programmes in low- and middle-income countries to explore and report on issues of language and how these have been addressed. We need to know more about local challenges, but also about local solutions which seem to work, and for this we need more information from the field than is currently available.

  8. Integrating the issues of global and veterinary public health into the veterinary education curriculum: an Australian perspective.

    Science.gov (United States)

    Fenwick, S G; Robertson, L; Wilks, C R

    2009-08-01

    This article discusses the integration of global and veterinary public health issues into the Australian veterinary curriculum. Formal veterinary education in Australia has a history of over 100 years and veterinarians have played a major role in the control of zoonotic and transboundary diseases for an even longer period. Australia is the largest exporter of red meat and live animals in the world. Therefore, educating veterinarians to promote and ensure food safety and animal welfare is prominent in Australian veterinary curricula. Veterinary degrees are accredited to allow Australian graduates to work professionally overseas, including in the United Kingdom and United States of America, and, in recent years, globalisation of the student body at Australian veterinary schools has occurred. For this reason, an appropriately broad curriculum is required to produce graduates who are able to address challenges in veterinary public health throughout the world. A Public Health University Network has been established to harmonise the veterinary public health curricula at the various veterinary schools and to develop the 'Australian veterinary public health philosophy', with its links to global issues and the 'One World, One Health' concept. Finally, conclusions are drawn on the implications of veterinary public health teaching in Australia and the preparation of Australian graduates for the global profession.

  9. Breast cancer in Mexico: a growing challenge to health and the health system.

    Science.gov (United States)

    Chávarri-Guerra, Yanin; Villarreal-Garza, Cynthia; Liedke, Pedro E R; Knaul, Felicia; Mohar, Alejandro; Finkelstein, Dianne M; Goss, Paul E

    2012-08-01

    Breast cancer is a major public health issue in low-income and middle-income countries. In Mexico, incidence and mortality of breast cancer have risen in the past few decades. Changes in health-care policies in Mexico have incorporated programmes for access to early diagnosis and treatment of this disease. This Review outlines the status of breast cancer in Mexico, regarding demographics, access to care, and strategies to improve clinical outcomes. We identify factors that contribute to the existing disease burden, such as low mammography coverage, poor quality control, limited access to diagnosis and treatment, and insufficient physical and human resources for clinical care.

  10. Challenging Issues for On-orbit Calibration in the VIS and NIR

    Science.gov (United States)

    Xiong, X.; Waluschka, E.; Salomonson, V. V.; Wolfe, R.; Barnes, W.; Guenther, B.

    2004-01-01

    On-orbit calibration of Earth-observing sensors in the VIS and NIR spectral regions is usually performed using the sensors on-board devices such as internal lamp(s) or solar diffuser plate(s) to provide calibration parameters. For sensors with no (or with less reliable) on-board calibrators, lunar calibration or ground validation approaches are often used. Each of these has its own set of problems that need to be fully addressed in order to support high quality on-orbit calibration and characterization. Some science products, such as Ocean color, may impose more stringent requirements that demand greater calibration precision. This paper uses MODIS as an example to illustrate challenging issues involved in VIS and NIR on-orbit calibration. It focuses on the solar diffuser (SD) calibration approach, including the effects due to SD BRF, SD attenuation screen(s), and earthshine. The impact of optics (solar diffuser and scan mirror) on-orbit degradation, including changes in the sensor s response versus scan angle (RVS), on the calibration and subsequent data quality is also discussed.

  11. Forest Ecosystem Services: Issues and Challenges for Biodiversity, Conservation, and Management in Italy

    Directory of Open Access Journals (Sweden)

    Matteo Vizzarri

    2015-05-01

    Full Text Available Although forest ecosystems are fundamental sources of services and global biodiversity, their capacity to maintain these benefits in the future is potentially threatened by anthropogenic impacts such as climate change, land use, and unsustainable management practices. Thus far, studies focusing on forests and their services have gained less attention compared with studies on other biomes. Additionally, management practices may potentially undermine the capacity of forests to sustain biodiversity conservation and services in the future, especially outside protected areas. This study linked the concepts of biodiversity and forest ecosystem services at the national level in Italy. Through a downscaled review, we first analyzed management issues, challenges, and needs within the context of forest ecosystem services. We then carried out a survey on protected areas. The results show that forest biodiversity supports the provision of other services and, hence, needs to be preserved and supported by adaptive management practices. Current research on forest ecosystem services must extend policy trajectories to protected areas (i.e., National Parks as centers of biodiversity and models of the sustainable use of resources.

  12. A missing pillar? Challenges in theorizing and practicing social sustainability: introduction to the special issue

    Directory of Open Access Journals (Sweden)

    Magnus Boström

    2012-01-01

    Full Text Available Since publication of the Brundtland Report in 1987, the notion of sustainable developmenthas come to guide the pursuit of environmental reform by both public and private organizations and to facilitate communication among actors from different societal spheres. It is customary to characterize sustainable development in a familiar typology comprising three pillars: environmental, economic, and social. The relationships among these dimensions are generally assumed to be compatible and mutually supportive. However, previous research has found that when policy makers endorse sustainable development, the social dimension garners less attention and is particularly difficult to realize and operationalize. Recent years though have seen notable efforts among standard setters, planners, and practitioners in various sectors to address the often neglected social aspects of sustainability. Likewise, during the past decade, there have been efforts to develop theoretical frameworks to define and study social sustainability and to empirically investigate it in relation to “sustainability projects,” “sustainability practice,” and “sustainability initiatives.” This introductory article presents the topic and explains some of the challenges of incorporating social sustainability into a broad framework of sustainable development. Also considered is the potential of the social sustainability concept for sustainability projects and planning. This analysis is predicated on the work represented in this special issue and on related initiatives that explicitly discuss the social pillar of sustainable development and its relationship to the other dimensions.

  13. Sexual Abuse of Children: Issues for Social and Health Professionals.

    Science.gov (United States)

    Schultz, Leroy G.; Jones, Preston Jr.

    1983-01-01

    Results of a West Virginia survey of sexual abuse of children challenge popular myths about child molestation. The danger of trauma caused by medical treatment is pointed out, intervention guidelines are provided, and social indicators of acute and chronic molestation are listed. (Author/RH)

  14. Preparation for Community Health Nursing: Issues and Problems.

    Science.gov (United States)

    And Others; White, Caroline

    1980-01-01

    Highlights of a survey of community health nursing agencies and faculty suggest the need for better planning and collaboration between service and education in preparing students for this field. Survey data tables are included. (CT)

  15. Challenges for the Italian Public Health Genomics Task Force

    Directory of Open Access Journals (Sweden)

    Stefania Boccia

    2006-12-01

    Full Text Available

    Dear Sirs,

    In recent years, the results of the Human Genome Project have lead to huge expectations relating to the rapid implementation of its results in the field of prevention.The possibility to provide early detection for those individuals more susceptible to complex diseases, because of their genetic make-up, might theoretically result in individualized primary (e.g., chemoprevention and secondary prevention (e.g., assiduous monitoring programs.

    The issue of an individuals inherited susceptibility to develop complex diseases, however, is much more complicated than it first appears, because of the delicate links between scientific developments, technical applications and ethical considerations. Consequently, besides the framework required for the critical evaluation of genetic testing (analytical validity, clinical validity and clinical utility of the test,we must also consider these three fundamental aspects:

     • From pooled and meta-analyses of genetic association studies, it appears that most of the commonly identified genetic variants (polymorphisms confers a low risk of disease (on average ORs of 1.5, if not lower, which only increases with the interaction of well-known environmental risk factors

    • From preliminary studies, the result from a ‘positive’ genetic testing does not seem to motivate behavioural changes;

    • There is a need for an evidence-based approach to genetic testing that integrates the cost-utility evaluation of each available genetic test [Health Technology Assessment (HTA framework] while considering the weight of the relevant ethical issues.

  16. Theme issue on e-Mental health: a growing field in internet research: Editorial.

    NARCIS (Netherlands)

    Riper, H.; Andersson, G.; Christensen, H.; Cuijpers, P.; Lange, A.; Eysenbach, G.

    2010-01-01

    This theme issue on e-mental health presents 16 articles from leading researchers working on systems and theories related to supporting and improving mental health conditions and mental health care using information and communication technologies. In this editorial, we present the background of this

  17. Ethical issues when using social media for health outside professional relationships.

    Science.gov (United States)

    DeCamp, Matthew

    2015-04-01

    Social media have the potential to revolutionize health and healthcare, but fulfilling this potential requires attention to the ethical issues social media may raise. This article reviews the major ethical issues arising when social media are used for research, public health, mobile health applications, and global health. It focuses on social media use outside fiduciary relationships between healthcare professionals and patients. Emphasis is given to the potential of social media in these contexts, the ethical issues relatively unique to each, and where possible how existing ethical principles and frameworks could help navigate these issues. In some cases social media create the circumstance for particular ethical issues but also facilitate managing them, such as in informed consent for research. In other cases, disagreement exists about whether social media - despite their potential - should be used for certain purposes, such as in public health surveillance (where confidentiality represents a significant ethical concern). In still others, ethical uncertainty exists about how social media will affect ethical issues, such as inequality in global health. As social media technologies continue to develop, identifying and managing the ethical issues they raise will be critical to their success in improving health while preserving fundamental ethical values.

  18. Health information, what happens when there isn't any? Information literacy and the challenges for rare and orphan diseases.

    Science.gov (United States)

    Spring, Hannah

    2014-09-01

    This feature looks at the challenges for information literacy in rare and orphan diseases. In particular, it focuses on the information difficulties faced by those living with a rare condition or awaiting a diagnosis, and also those of the health professionals in charge of their care. The feature also highlights some of the key issues that library and information professionals need to be aware of when providing information support in such circumstances.

  19. Caregiver awareness of reproductive health issues for women with intellectual disabilities

    Directory of Open Access Journals (Sweden)

    Lin Jin-Ding

    2011-01-01

    Full Text Available Abstract Background Limited attention has been paid to the issue of reproductive health as it affects women with intellectual disabilities, despite reproductive health being a vital issue in public health policy for women in the general population. This paper describes caregiver awareness of reproductive health issues relative to women with intellectual disabilities who are being cared for in welfare institutions in Taiwan. Methods The study employed a cross-sectional, questionnaire-based study which recruited 1,152 caregivers (response rate = 71.87% from 32 registered disability welfare institutions in Taiwan. We classified their understanding/awareness of reproductive health issues into four domains: menstrual (1 and menopause (2 issues, sex education (3, and reproductive health services (4. Each domain had five associated yes/no questions and the total score for the four domains was out of a maximum of 20. Data were analyzed using SPSS 15.0 software. Results We found that most of the caregivers were familiar with matters concerning sex education, menopause, and reproductive health services, but they lacked adequate understanding of issues associated with menstruation in women with ID. Many aspects of reproductive health such as "menstrual pain", "age at menarche", "masturbation", "diet during perimenopause", and "publicly available reproductive health services" were issues in which caregivers lacked adequate knowledge and required further instruction. Logistic regression analysis revealed that female caregivers with a university degree, and those who had experience assisting with reproductive health care were more inclined to have higher reproductive health awareness scores than their counterparts. Conclusions This study highlights that service providers should offer appropriate reproductive health education to institutional caregivers, and that more attention be focused on the personal experiences and concerns of intellectually disabled

  20. Behavioral medicine and clinical health psychology: introduction to the special issue.

    Science.gov (United States)

    Christensen, Alan J; Nezu, Arthur M

    2013-04-01

    This issue represents the 4th Journal of Consulting and Clinical Psychology special issue on behavioral medicine and clinical health psychology over the past 4 decades. Recent developments in health care policy, as well as in the maturation of the science, make a special issue in this area particularly timely. This collection includes state of the clinical science reviews, reports of clinical trials, and articles addressing theory and methods in behavioral medicine and clinical health psychology. A multilevel, ecological perspective that considers multiple levels of influences (e.g., cultural influences on behavior-health linkages, individual differences) is salient throughout many of the articles. Our hope is that this sampling of this broad field, and coverage of some key issues and areas, will play a role in stimulating the next 10 years of research, practice, and policy implementation in behavioral medicine and clinical health psychology.

  1. Health, illness, and healing in an uncertain era: challenges from and for medical sociology.

    Science.gov (United States)

    Pescosolido, B A; Kronenfeld, J J

    1995-01-01

    The current situation in health care organizations, among providers and for people, dramatically challenges the "business as usual" roles of medicine, government, insurance companies, the community, and the university. Health care reform marks the first attempt in a century to consider a reconstruction of the social contract between society and medicine. While sociology stands as one of the earliest social sciences to systematically study the health care arena and create a health-focused subfield, there is a perception, not without support, of a desertion of identity from within, an encroachment by other areas from without, and abandonment by the parent discipline. We argue that these situations in medical arenas and in research fields require serious rethinking. The key lies in understanding how these phenomena are related to each other and to larger social forces, and how they offer opportunities, rather than signal limitations, to medical sociologists. We turn to the theoretical tools of sociology to help unravel the complicated challenges that face both policymakers and researchers. After framing these issues in a sociology of knowledge perspective, we use the case of "utilization theory" to illustrate the connections between society and systems of care (as well as studies of them) and to create a future agenda. We end by raising three basic questions: (1) Why is a sociological perspective critical to the understanding of change and reform in health care? (2) Why is medical sociology critical to the survival of the general sociological enterprise? and (3) Why is general sociology critical to the research agenda in medical sociology?

  2. Mental health and the workplace: issues for developing countries

    Directory of Open Access Journals (Sweden)

    Chopra Prem

    2009-02-01

    Full Text Available Abstract The capacity to work productively is a key component of health and emotional well-being. Common Mental Disorders (CMDs are associated with reduced workplace productivity. It is anticipated that this impact is greatest in developing countries. Furthermore, workplace stress is associated with a significant adverse impact on emotional wellbeing and is linked with an increased risk of CMDs. This review will elaborate on the relationship between workplace environment and psychiatric morbidity. The evidence for mental health promotion and intervention studies will be discussed. A case will be developed to advocate for workplace reform and research to improve mental health in workplaces in developing countries in order to improve the wellbeing of employees and workplace productivity.

  3. Child marriage: a silent health and human rights issue.

    Science.gov (United States)

    Nour, Nawal M

    2009-01-01

    Marriages in which a child under the age of 18 years is involved occur worldwide, but are mainly seen in South Asia, Africa, and Latin America. A human rights violation, child marriage directly impacts girls' education, health, psychologic well-being, and the health of their offspring. It increases the risk for depression, sexually transmitted infection, cervical cancer, malaria, obstetric fistulas, and maternal mortality. Their offspring are at an increased risk for premature birth and, subsequently, neonatal or infant death. The tradition, driven by poverty, is perpetuated to ensure girls' financial futures and to reinforce social ties. One of the most effective methods of reducing child marriage and its health consequences is mandating that girls stay in school.

  4. Health of issues of whey proteins: 2. Weight management

    NARCIS (Netherlands)

    Schaafsma, G.

    2006-01-01

    The increasing prevalence in many countries of people with overweight and obesity is undoubtedly one of the biggest threats to public health. Dietary proteins, because of their positive effects on satiation/ satiety, may help to reduce energy intake and promote a healthy body composition with less b

  5. Health Management Information System utilization in Pakistan: challenges, pitfalls and the way forward.

    Science.gov (United States)

    Qazi, Muhammad Suleman; Ali, Moazzam

    2011-12-01

    Use of data generated through the Health Management Information System (HMIS) in decision making has been facing various challenges ever since its inception in Pakistan. This descriptive qualitative study attempts to explore the perceptions of health managers to identify the status and issues in use of HMIS. Overall 26 managers (all men, ages ranging from 26 to 49 years; selected from federal level (2), provincial (4) and seven selected districts (20) from all four provinces) were interviewed face to face. The respondents identified a number of hurdles resulting in non-use, misuse and disuse of data. These included limited scope of HMIS, dubious data quality, political motives behind demand of data and an element of corruption in data reporting etc. A great deal of political and administrative will is required to institutionalize transparency in decision making in health management and HMIS is an important tool for doing so. Appropriate legislation and regulations are needed to create a conducive policy environment that would help in changing the existing decision making culture. The effective use of information requires that besides capacity development of district health managers in understanding and use of data, the higher level decision makers are provided with relevant data timely and in an easily understandable form along with the recommended actions pertinent to this data.

  6. Reproductive health, and child health and nutrition in India: meeting the challenge.

    Science.gov (United States)

    Paul, Vinod Kumar; Sachdev, Harshpal Singh; Mavalankar, Dileep; Ramachandran, Prema; Sankar, Mari Jeeva; Bhandari, Nita; Sreenivas, Vishnubhatla; Sundararaman, Thiagarajan; Govil, Dipti; Osrin, David; Kirkwood, Betty

    2011-01-22

    India, with a population of more than 1 billion people, has many challenges in improving the health and nutrition of its citizens. Steady declines have been noted in fertility, maternal, infant and child mortalities, and the prevalence of severe manifestations of nutritional deficiencies, but the pace has been slow and falls short of national and Millennium Development Goal targets. The likely explanations include social inequities, disparities in health systems between and within states, and consequences of urbanisation and demographic transition. In 2005, India embarked on the National Rural Health Mission, an extraordinary effort to strengthen the health systems. However, coverage of priority interventions remains insufficient, and the content and quality of existing interventions are suboptimum. Substantial unmet need for contraception remains, adolescent pregnancies are common, and access to safe abortion is inadequate. Increases in the numbers of deliveries in institutions have not been matched by improvements in the quality of intrapartum and neonatal care. Infants and young children do not get the health care they need; access to effective treatment for neonatal illness, diarrhoea, and pneumonia shows little improvement; and the coverage of nutrition programmes is inadequate. Absence of well functioning health systems is indicated by the inadequacies related to planning, financing, human resources, infrastructure, supply systems, governance, information, and monitoring. We provide a case for transformation of health systems through effective stewardship, decentralised planning in districts, a reasoned approach to financing that affects demand for health care, a campaign to create awareness and change health and nutrition behaviour, and revision of programmes for child nutrition on the basis of evidence. This agenda needs political commitment of the highest order and the development of a people's movement.

  7. Neighbourhood social capital: measurement issues and associations with health outcomes.

    Science.gov (United States)

    Mackenbach, J D; Lakerveld, J; van Lenthe, F J; Kawachi, I; McKee, M; Rutter, H; Glonti, K; Compernolle, S; De Bourdeaudhuij, I; Feuillet, T; Oppert, J-M; Nijpels, G; Brug, J

    2016-01-01

    We compared ecometric neighbourhood scores of social capital (contextual variation) to mean neighbourhood scores (individual and contextual variation), using several health-related outcomes (i.e. self-rated health, weight status and obesity-related behaviours). Data were analysed from 5,900 participants in the European SPOTLIGHT survey. Factor analysis of the 13-item social capital scale revealed two social capital constructs: social networks and social cohesion. The associations of ecometric and mean neighbourhood-level scores of these constructs with self-rated health, weight status and obesity-related behaviours were analysed using multilevel regression analyses, adjusted for key covariates. Analyses using ecometric and mean neighbourhood scores, but not mean neighbourhood scores adjusted for individual scores, yielded similar regression coefficients. Higher levels of social network and social cohesion were not only associated with better self-rated health, lower odds of obesity and higher fruit consumption, but also with prolonged sitting and less transport-related physical activity. Only associations with transport-related physical activity and sedentary behaviours were associated with mean neighbourhood scores adjusted for individual scores. As analyses using ecometric scores generated the same results as using mean neighbourhood scores, but different results when using mean neighbourhood scores adjusted for individual scores, this suggests that the theoretical advantage of the ecometric approach (i.e. teasing out individual and contextual variation) may not be achieved in practice. The different operationalisations of social network and social cohesion were associated with several health outcomes, but the constructs that appeared to represent the contextual variation best were only associated with two of the outcomes.

  8. When health systems are barriers to health care: challenges faced by uninsured Mexican kidney patients.

    Directory of Open Access Journals (Sweden)

    Ciara Kierans

    Full Text Available BACKGROUND: Chronic Kidney Disease disproportionately affects the poor in Low and Middle Income Countries (LMICs. Mexico exemplifies the difficulties faced in supporting Renal Replacement Therapy (RRT and providing equitable patient care, despite recent attempts at health reform. The objective of this study is to document the challenges faced by uninsured, poor Mexican families when attempting to access RRT. METHODS: The article takes an ethnographic approach, using interviewing and observation to generate detailed accounts of the problems that accompany attempts to secure care. The study, based in the state of Jalisco, comprised interviews with patients, their caregivers, health and social care professionals, among others. Observations were carried out in both clinical and social settings. RESULTS: In the absence of organised health information and stable pathways to renal care, patients and their families work extraordinarily hard and at great expense to secure care in a mixed public-private healthcare system. As part of this work, they must navigate challenging health and social care environments, negotiate treatments and costs, resource and finance healthcare and manage a wide range of formal and informal health information. CONCLUSIONS: Examining commonalities across pathways to adequate healthcare reveals major failings in the Mexican system. These systemic problems serve to reproduce and deepen health inequalities. A system, in which the costs of renal care are disproportionately borne by those who can least afford them, faces major difficulties around the sustainability and resourcing of RRTs. Attempts to increase access to renal therapies, therefore, need to take into account the complex social and economic demands this places on those who need access most. This paper further shows that ethnographic studies of the concrete ways in which healthcare is accessed in practice provide important insights into the plight of CKD patients and so

  9. Incorporating intersectionality theory into population health research methodology: challenges and the potential to advance health equity.

    Science.gov (United States)

    Bauer, Greta R

    2014-06-01

    Intersectionality theory, developed to address the non-additivity of effects of sex/gender and race/ethnicity but extendable to other domains, allows for the potential to study health and disease at different intersections of identity, social position, processes of oppression or privilege, and policies or institutional practices. Intersectionality has the potential to enrich population health research through improved validity and greater attention to both heterogeneity of effects and causal processes producing health inequalities. Moreover, intersectional population health research may serve to both test and generate new theories. Nevertheless, its implementation within health research to date has been primarily through qualitative research. In this paper, challenges to incorporation of intersectionality into population health research are identified or expanded upon. These include: 1) confusion of quantitative terms used metaphorically in theoretical work with similar-sounding statistical methods; 2) the question of whether all intersectional positions are of equal value, or even of sufficient value for study; 3) distinguishing between intersecting identities, social positions, processes, and policies or other structural factors; 4) reflecting embodiment in how processes of oppression and privilege are measured and analysed; 5) understanding and utilizing appropriate scale for interactions in regression models; 6) structuring interaction or risk modification to best convey effects, and; 7) avoiding assumptions of equidistance or single level in the design of analyses. Addressing these challenges throughout the processes of conceptualizing and planning research and in conducting analyses has the potential to improve researchers' ability to more specifically document inequalities at varying intersectional positions, and to study the potential individual- and group-level causes that may drive these observed inequalities. A greater and more thoughtful incorporation

  10. Personalized medicine and the role of health economics and outcomes research: issues, applications, emerging trends, and future research.

    Science.gov (United States)

    O'Donnell, John C

    2013-01-01

    The decade since the completion of the sequencing of the human genome has witnessed significant advances in the incorporation of genomic information in diagnostic, treatment, and reimbursement practices. Indeed, as case in point, there are now several dozen commercially available genomic tests routinely applied across a wide range of disease states in predictive or prognostic applications. Moreover, many involved in the advancement of personalized medicine would view emerging approaches to stratify patients in meaningful ways beyond genomic information as a signal of the progress made. Yet despite these advances, there remains a general sense of dissatisfaction about the progress of personalized medicine in terms of its contribution to the drug development process, to the efficiency and effectiveness of health care delivery, and ultimately to the provision of the right treatment to the right patient at the right time. Academicians, payers, and manufacturers alike are struggling not only with how to embed the new insights that personalized medicine promises but also with the fundamental issues of application in early drug development, implications for health technology assessment, new demands on traditional health economic and outcomes research methods, and implications for reimbursement and access. In fact, seemingly prosaic issues such as the definition and composition of the term "personalized medicine" are still unresolved. Regardless of these issues, practitioners are increasingly compelled to find practical solutions to the challenges and opportunities presented by the evolving face of personalized medicine today. Accordingly, the articles comprising this Special Issue offer applied perspectives geared toward professionals and policymakers in the field grappling with developing, assessing, implementing, and reimbursing personalized medicine approaches. Starting with a framework with which to characterize personalized medicine, this Special Issue proceeds to

  11. Dublin Ireland: a city addressing challenging water supply, management, and governance issues

    Directory of Open Access Journals (Sweden)

    Mary Kelly-Quinn

    2014-12-01

    Full Text Available The population of Dublin City and its suburbs currently stands at 1.3 million and is projected to reach 2.1 million by 2022. There is pressure on its water supply system (inadequate catchment sources, ageing infrastructure including treatment facilities, and distribution network with little or no spare capacity despite Ireland's relatively high rainfall that is well distributed throughout the year; albeit the greatest rainfall occurs in the west and southwest and at some remove from Dublin. The current governance approach to addressing the projected water supply deficit relies heavily on a combination of identifying new supply sources to secure the long-term water supply needs of the city together with an intense drive toward achieving "demand-side" reduced usage and conservation targets in accordance with EU benchmarks for various individual and sectoral users. This potentially emerging crisis of water scarcity in Dublin, with drivers including population growth, greater industrial and institutional demands, migration, and climate change, has generated one of the most significant public water works projects proposed in Irish history, which is to abstract raw water from the Shannon River Basin in the midland region and, following treatment, pump it to a storage reservoir in a cut-away bog before piping to the Greater Dublin Area. The preparations for this scheme have brought to the forefront some longstanding Irish water resources governance issues and challenges. This provides a unique opportunity and imperative at this time to take a more comprehensive look at the decision-making process in this regard, one done in the context of new European and national policies requiring incorporation of integrated planning to sustain ecosystem services, water resources management, water services management, and flood defense principles, and one taking account of the current unprecedented state of flux in which water resources management institutions in

  12. Academic Accommodations for Postsecondary Students with Mental Health Disabilities in Ontario, Canada: A Review of the Literature and Reflections on Emerging Issues

    Science.gov (United States)

    Condra, Mike; Dineen, Mira; Gills, Helen; Jack-Davies, Anita; Condra, Eleanor

    2015-01-01

    An increasing number of students with mental health disabilities (MHDs) are enrolling at Canadian colleges and universities. This review examines the challenges and complexities of meeting the unique needs of these students at Ontario's postsecondary institutions, with a specific focus on the issue of academic accommodations. These complexities…

  13. Global Challenges in People-Centered E-Health.

    Science.gov (United States)

    Quintana, Yuri; Safran, Charles

    2015-01-01

    People-centered health care seeks an active role for the patient while empowering all other members of the health care team. By promoting greater patient responsibility and optimal usage, patient-centered health care leads to improved health outcomes, quality of life and optimal value for health care investment. This paper reviews some definitions of people-centered health care and various e-health approaches around the world used to implement this vision. The barriers and enablers to implementation this type of approach are explored. This paper provides a proposed research agenda for future implementations of people-centered e-health.

  14. Inequality in Human Resources for Health: Measurement Issues.

    Science.gov (United States)

    Speybroeck, Niko; Paraje, Guillermo; Prasad, Amit; Goovaerts, Pierre; Ebener, Steeve; Evans, David B

    2012-04-01

    This article discusses options to allow comparative analysis of inequalities in the distribution of health workers (HWs) across and within countries using a single summary measure of the distribution. Income inequality generally is measured across individuals, but inequalities in the dispersion of HWs must use geographical areas or population groupings as units of analysis. The article first shows how this change of observational unit creates a resolution problem for various inequality indices and then tests how sensitive a simple ratio measure of the distribution of HWs is to changes in resolution. This ratio of inequality is illustrated first with the global distribution of HWs and then with its distributions within Indonesia. The resolution problem is not solved through this new approach, and indicators of inequalities of access to HWs or health services more generally appear not to be comparable across countries. Investigating geographical inequalities over time in one setting is possible but only if the units of analysis remain the same over time.

  15. Sleep Health Issues for Children with FASD: Clinical Considerations

    Directory of Open Access Journals (Sweden)

    James E. Jan

    2010-01-01

    Full Text Available This article describes the combined clinical experience of a multidisciplinary group of professionals on the sleep disturbances of children with fetal alcohol spectrum disorders (FASD focusing on sleep hygiene interventions. Such practical and comprehensive information is not available in the literature. Severe, persistent sleep difficulties are frequently associated with this condition but few health professionals are familiar with both FASD and sleep disorders. The sleep promotion techniques used for typical children are less suitable for children with FASD who need individually designed interventions. The types, causes, and adverse effects of sleep disorders, the modification of environment, scheduling and preparation for sleep, and sleep health for their caregivers are discussed. It is our hope that parents and also researchers, who are interested in the sleep disorders of children with FASD, will benefit from this presentation and that this discussion will stimulate much needed evidence-based research.

  16. Forced migration: health and human rights issues among refugee populations.

    Science.gov (United States)

    Lori, Jody R; Boyle, Joyceen S

    2015-01-01

    Undocumented migration is a global phenomenon that is manifest in diverse contexts. In this article, we examine the situations that precipitate the movement of large numbers of people across several African countries, producing a unique type of undocumented migrant--the refugee. These refugee movements impact already fragile African health care systems and often involve human rights violations that are of particular concern, such as gender-based violence and child soldiers. We use examples from several countries in sub-Saharan Africa, including the Democratic Republic of the Congo, Rwanda, Liberia, Sierra Leone, and Mozambique. Drawing on key documents from the United Nations High Commissioner for Refugees, current research, and our personal international experiences, we provide an overview of forced migration and discuss implications and opportunities for nurses to impact research, practice, and policy related to refugee health.

  17. Inequity in child health as a global issue.

    Science.gov (United States)

    Waterston, Tony

    2003-09-01

    Poverty, violence, lack of education, abuse and exploitation, and refugee status are among the primary determinants of the health of children worldwide. There are 1.3 billion people living on less than 1 US dollars per day. Half the world's population, 3 billion people, live on less than 1.30 US dollars per day. Of the 4.4 billion people who live in developing countries, 60% lack access to sanitation, 33% lack clean water, 20% have no health care, and 20% do not have enough dietary energy and protein.(1) The world's 225 richest people have a combined wealth equivalent to the annual income of the poorest 2.5 billion people, nearly half of the world's population.(1) This article describes a number of the social, political, and environmental factors impacting children in the developing (southern hemisphere) world and how these are affected by actions taken in the developed (northern hemisphere) world.

  18. Rights to safe motherhood and newborn health: ethical issues.

    Science.gov (United States)

    Milliez, Jacques

    2009-08-01

    Worldwide, one woman dies every minute as a result of being pregnant. This statistic highlights the denial of women's rights to safe motherhood in many parts of the world, particularly in low-resource countries where 98% all maternal deaths occur. The majority of pregnant women die because they deliver unattended by a properly trained birth professional. According to the 1948 Universal Declaration of Human Rights, every woman has the right to a standard of living adequate for the health and well-being of herself and her family, including medical care. The principle of moral philosophy supporting women's rights to safe motherhood may be difficult to implement. Philanthropy is diverted by other competing needs, such as HIV prevention and treatment, or provision of urgent food supplies. Equity is denied because women's health is too often set as a low priority. Utilitarianism advocates that safe motherhood is an investment of societal shared interest.

  19. A residents' program for educating adolescents about mental health issues.

    Science.gov (United States)

    Coverdale, J H; Battaglia, J; Bushong, C P

    1991-09-01

    This paper describes a school-based program in which psychiatry residents educate adolescents about a variety of mental health topics. Adolescents responded positively to the program and were principally concerned about drugs, depression, suicide, and family problems. Residents also liked presenting in the schools. Participation in this program allowed residents to learn about agency consultation and secondary prevention. Possibilities for program expansion are discussed.

  20. Ethics issues in scientific data and service provision: evidence and challenges for the European Plate Observing System (EPOS)

    Science.gov (United States)

    Cocco, Massimo; Freda, Carmela; Haslinger, Florian; Consortium, Epos

    2016-04-01

    monitor planet Earth is rapidly evolving through the development of new sensor technology and we can deliver this information with increasing rapidity, integrate it, provide solutions to scientific challenges and furnish essential information for decision makers. EPOS is aware that the research promoted by its data and service provision can have a profound influence on the environment, human health and wellbeing, economic development, national security, and other facets of human societies. For these reasons EPOS must address Ethics issues associated with the exploitation of its achievements involving security issues, use and misuse of data, environmental protection and risk communication. The EPOS community feels the obligation to adopt a responsible conduct, both within the scientific community and in the broader society, exploring the implications of open provisioning of data and services, up to imposing justified constraints. This requires that contributing to the DDSS provision cannot be simply limited to activities fostering the capacity (i.e., ability) to access scientific products, but must promote the creation of capabilities (i.e., conscious use of data) and the functioning (i.e., activities constitutive of a scientist's being) to access and use scientific products in an ethically consistent way. We will present and discuss Ethics issues envisaged in EPOS, focusing on the most relevant for its implementation phase: protection of personal data, misuse of data, communication, and societal impact.

  1. Tobacco industry issues management organizations: Creating a global corporate network to undermine public health

    Directory of Open Access Journals (Sweden)

    Malone Ruth E

    2008-01-01

    Full Text Available Abstract Background The global tobacco epidemic claims 5 million lives each year, facilitated by the ability of transnational tobacco companies to delay or thwart meaningful tobacco control worldwide. A series of cross-company tobacco industry "issues management organizations" has played an important role in coordinating and implementing common strategies to defeat tobacco control efforts at international, national, and regional levels. This study examines the development and enumerates the activities of these organizations and explores the implications of continuing industry cooperation for global public health. Methods Using a snowball sampling strategy, we collected documentary data from tobacco industry documents archives and assembled them into a chronologically organized case study. Results The International Committee on Smoking Issues (ICOSI was formed in 1977 by seven tobacco company chief executives to create common anti-tobacco control strategies and build a global network of regional and national manufacturing associations. The organization's name subsequently changed to INFOTAB. The multinational companies built the organization rapidly: by 1984, it had 69 members operating in 57 countries. INFOTAB material, including position papers and "action kits" helped members challenge local tobacco control measures and maintain tobacco-friendly environments. In 1992 INFOTAB was replaced by two smaller organizations. The Tobacco Documentation Centre, which continues to operate, distributes smoking-related information and industry argumentation to members, some produced by cross-company committees. Agro-Tobacco Services, and now Hallmark Marketing Services, assists the INFOTAB-backed and industry supported International Tobacco Growers Association in advancing claims regarding the economic importance of tobacco in developing nations. Conclusion The massive scale and scope of this industry effort illustrate how corporate interests, when

  2. RFID technology in health environment opportunities and challenges for modern cancer care.

    Science.gov (United States)

    Safdari, Reza; Maserat, Elham; Maserat, Elnaz

    2012-01-01

    Cancers are significant contributors to the mortality and health care expenditures. Cancer can be reduced and monitored by new information technology. Radio frequency identification or RFID is a wireless identification technology. The use of this technology can be employed for identifying and tracking clinical staff, patients, supplies, medications and equipments. RFID can trace and manage chemotherapy drugs. There are different types of RFID. Implantable RFID allowing a chip to be embedded under the skin and that store the cancer patient's identifier. These are concerns about applications of RFID. Privacy, security and legal issues are key problems. This paper describes capabilities, benefits and confidentiality aspects in radio frequency identification systems and solutions for overcoming challenges.

  3. Post-apartheid challenges: household access and use of health care in South Africa.

    Science.gov (United States)

    Gilson, Lucy; McIntyre, Di

    2007-01-01

    Since 1994 the South African government has placed equity at the heart of its health policy goals. However, there has as yet been surprisingly little assessment of the success of policies in reducing inequity. This article provides insights on these issues by applying the Affordability Ladder conceptual framework in synthesizing evidence drawn from a series of household surveys and studies undertaken between 1992 and 2003. These data suggest that, despite policy efforts, inequities in access and utilization between socioeconomic groups remain. Underlying challenges include worsening community perceptions of the quality of publicly provided care and the influence of insurance status on utilization patterns. Further and more detailed evaluation of household-level policy impacts requires both improvements in the quality of South African survey data, particularly in enhancing consistency in survey design over time, and more detailed, focused studies.

  4. National Association of School Nurses ISSUE BRIEF: School Health Nurse's Role in Education: Privacy Standards for Student Health Records

    Science.gov (United States)

    Pohlman, Katherine; Schwab, Nadine

    2003-01-01

    This article is a reprint of the National Association of School Nurses' "Issue Brief" on Privacy Standards for Student Health Records. It distinguishes between the Family Education Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act (HI-PAA), clarifies which of these laws governs the privacy of student health…

  5. Security And Privacy Issues in Health Monitoring Systems: eCare@Home Case Study

    DEFF Research Database (Denmark)

    Wearing, Thomas; Dragoni, Nicola

    2016-01-01

    of sensitive data these systems deal with and expose to the external world, security and privacy issues are surpris-ingly not taken into consideration. The aim of this paper is to raise some key security and privacy issues that home health monitor systems should face with. The analysis is based on a real world...

  6. An update on environmental, health and safety issues of interest to the photovoltaic industry

    Energy Technology Data Exchange (ETDEWEB)

    Moskowitz, P.D.; Viren, J.; Fthenakis, V.M.

    1992-08-01

    There is growing interest in the environmental, health, and safety issues related to new photovoltaic technologies as they approach commercialization. Such issues include potential toxicity of II--VI compounds; the impacts of new environmental regulations on module manufacturers; and, the need for recycling of spent modules and manufacturing wastes. This paper will review these topics. 20 refs.

  7. An update on environmental, health and safety issues of interest to the photovoltaic industry

    Energy Technology Data Exchange (ETDEWEB)

    Moskowitz, P.D.; Viren, J.; Fthenakis, V.M.

    1992-01-01

    There is growing interest in the environmental, health, and safety issues related to new photovoltaic technologies as they approach commercialization. Such issues include potential toxicity of II--VI compounds; the impacts of new environmental regulations on module manufacturers; and, the need for recycling of spent modules and manufacturing wastes. This paper will review these topics. 20 refs.

  8. Public Health Ethics, Legitimacy, and the Challenges of Industrial Wind Turbines: The Case of Ontario, Canada

    Science.gov (United States)

    Shain, Martin

    2011-01-01

    While industrial wind turbines (IWTs) clearly raise issues concerning threats to the health of a few in contrast to claimed health benefits to many, the trade-off has not been fully considered in a public health framework. This article reviews public health ethics justifications for the licensing and installation of IWTs. It concludes that the…

  9. Perceived challenges for adopting the Personal Health Record (PHR) at Ministry of National Guard Health Affairs (MNGHA)- Riyadh

    OpenAIRE

    ,

    2016-01-01

    Background The Personal Health Record (PHR) is an electronic record that allows patients to maintain, manage and access their health information in one secure location. However, despite these potential capabilities, the adoption rate of the PHR has been slow due to various challenges. Objectives This study, being the first of its kind in Saudi Arabia, investigates the perceived barriers and /or challenges for PHR adoption in the Ministry of National Guard Health Affairs (MNGHA). The study exp...

  10. Confusion, Crisis, and Opportunity: Professional School Counselors' Role in Responding to Student Mental Health Issues

    Science.gov (United States)

    Walley, Cynthia; Grothaus, Tim; Craigen, Laurie

    2009-01-01

    With the array of challenges facing today's youth, school counselors are in a unique position to recognize and respond to the diverse mental health needs of students. After a brief examination of the challenges and some promising responses, this article will consider the use of advocacy, collaboration, and professional development to aid school…

  11. Has donor prioritization of HIV/AIDS displaced aid for other health issues?

    Science.gov (United States)

    Shiffman, Jeremy

    2008-03-01

    Advocates for many developing-world health and population issues have expressed concern that the high level of donor attention to HIV/AIDS is displacing funding for their own concerns. Even organizations dedicated to HIV/AIDS prevention and treatment have raised this issue. However, the issue of donor displacement has not been evaluated empirically. This paper attempts to do so by considering donor funding for four historically prominent health agendas--HIV/AIDS, population, health sector development and infectious disease control--over the years 1992 to 2005. The paper employs funding data from the Organization for Economic Cooperation and Development's (OECD) Development Assistance Committee, supplemented by data from other sources. Several trends indicate possible displacement effects, including HIV/AIDS' rapidly growing share of total health aid, a concurrent global stagnation in population aid, the priority HIV/AIDS control receives in US funding, and HIV/AIDS aid levels in several sub-Saharan African states that approximate or exceed the entirety of their national health budgets. On the other hand, aggregate donor funding for health and population quadrupled between 1992 and 2005, allowing for funding growth for some health issues even as HIV/AIDS acquired an increasingly prominent place in donor health agendas. Overall, the evidence indicates that displacement is likely occurring, but that aggregate increases in global health aid may have mitigated some of the crowding-out effects.

  12. Access to health services in Western Newfoundland, Canada: Issues, barriers and recommendations emerging from a community-engaged research project

    Directory of Open Access Journals (Sweden)

    Janelle Hippe

    2014-06-01

    Full Text Available Research indicates that people living in rural and remote areas of Canada face challenges to accessing health services. This article reports on a community-engaged research project conducted by investigators at Memorial University of Newfoundland in collaboration with the Rural Secretariat Regional Councils and Regional Partnership Planners for the Corner Brook–Rocky Harbour and Stephenville–Port aux Basques Rural Secretariat Regions of Newfoundland and Labrador. The aim of this research was to gather information on barriers to accessing health services, to identify solutions to health services’ access issues and to inform policy advice to government on enhancing access to health services. Data was collected through: (1 targeted distribution of a survey to communities throughout the region, and (2 informal ‘kitchen table’ discussions to discuss health services’ access issues. A total of 1049 surveys were collected and 10 kitchen table discussions were held. Overall, the main barriers to care listed in the survey included long wait times, services not available in the area and services not available at time required. Other barriers noted by survey respondents included transportation problems, financial concerns, no medical insurance coverage, distance to travel and weather conditions. Some respondents reported poorer access to maternal/child health and breast and cervical screening services and a lack of access to general practitioners, pharmacy services, dentists and nurse practitioners. Recommendations that emerged from this research included improving the recruitment of rural physicians, exploring the use of nurse practitioners, assisting individuals with travel costs,  developing specialist outreach services, increasing use of telehealth services and initiating additional rural and remote health research. Keywords: rural, remote, healthcare, health services, social determinants of health

  13. Scientific integrity: critical issues in environmental health research

    Directory of Open Access Journals (Sweden)

    Merlo Domenico

    2008-01-01

    Full Text Available Abstract Environmental health research is a relatively new scientific area with much interdisciplinary collaboration. Regardless of which human population is included in field studies (e.g., general population, working population, children, elderly, vulnerable sub-groups, etc. their conduct must guarantee well acknowledged ethical principles. These principles, along with codes of conduct, are aimed at protecting study participants from research-related undesired effects and guarantee research integrity. A central role is attributed to the need for informing potential participants (i.e., recruited subjects who may be enrolled in a study, obtaining their written informed consent to participate, and making them aware of their right to refuse to participate at any time and for any reason. Data protection is also required and communication of study findings must respect participant's willingness to know or not know. This is specifically relevant for studies including biological markers and/or storing biological samples that might be analysed years later to tackle research objectives that were specified and communicated to participants at the time of recruitment or that may be formulated after consent was obtained. Integrity is central to environmental health research searching for causal relations. It requires open communication and trust and any violation (i.e., research misconduct, including fabrication or falsification of data, plagiarism, conflicting interests, etc. may endanger the societal trust in the research community as well as jeopardize participation rates in field projects.

  14. Scientific integrity: critical issues in environmental health research.

    Science.gov (United States)

    Merlo, Domenico Franco; Vahakangas, Kirsi; Knudsen, Lisbeth E

    2008-06-05

    Environmental health research is a relatively new scientific area with much interdisciplinary collaboration. Regardless of which human population is included in field studies (e.g., general population, working population, children, elderly, vulnerable sub-groups, etc.) their conduct must guarantee well acknowledged ethical principles. These principles, along with codes of conduct, are aimed at protecting study participants from research-related undesired effects and guarantee research integrity. A central role is attributed to the need for informing potential participants (i.e., recruited subjects who may be enrolled in a study), obtaining their written informed consent to participate, and making them aware of their right to refuse to participate at any time and for any reason. Data protection is also required and communication of study findings must respect participant's willingness to know or not know. This is specifically relevant for studies including biological markers and/or storing biological samples that might be analysed years later to tackle research objectives that were specified and communicated to participants at the time of recruitment or that may be formulated after consent was obtained.Integrity is central to environmental health research searching for causal relations. It requires open communication and trust and any violation (i.e., research misconduct, including fabrication or falsification of data, plagiarism, conflicting interests, etc.) may endanger the societal trust in the research community as well as jeopardize participation rates in field projects.

  15. [Excessive Internet use and Internet addiction: emerging public health issues.].

    Science.gov (United States)

    Coniglio, Maria Anna; Muni, Viviana; Giammanco, Giuseppe; Pignato, Sarina

    2007-01-01

    A survey was performed among students of various faculties at the University of Catania (Italy) to examine the health effects of excessive Internet use and behaviour patterns of Internet dependency. Three hundred students were recruited through a non probabilistic quota sampling method and were asked to complete a questionnaire aimed at identifying attitudes and behaviours regarding Internet use, and the psychological and physical consequences of excessive use of the Internet. The most relevant findings that emerged from student responses regard: emotional dependency on the Internet (5% of students believe that Internet facilitates social relationships, 4% experiences euphoric feelings or excitement while on-line, 1% consider the Internet as a way of escaping from real life), the excessive amount of time spent on-line (8%) and the inability to end an on-line session(8%), lying to family members to conceal the nature of involvement with the Internet (3%), giving up sports (2%) or meals (1%), the negative impact on school grades (3%), lack of sleep (4%), and physical health problems such as backache (2%), arm or wrist pain (2%), vision disturbances (6%).

  16. Oral health in Brazil: the challenges for dental health care models.

    Science.gov (United States)

    Chaves, Sônia Cristina Lima

    2012-01-01

    This paper discusses adult oral health in Brazil according to three perspectives: 1) the available epidemiological evidence about the population's oral-health-related epidemiological situation, especially adults and the elderly population, in relation to two high prevalence oral injuries (dental caries and tooth loss), 2) the main health care models for dealing with this situation, by analyzing the related historical processes in order to reveal the likely social, political and epidemiological implications of the different models, and 3) lastly, the possible challenges to Brazilian dentistry or collective oral health in overcoming these obstacles. The main results of the study indicate that, from an epidemiological point of view, Brazil is undergoing a transition in dental caries and tooth loss, which is not yet reflected in the profile of the elderly, but which is tentatively evidenced in young adults. Tooth loss remains high. Certain aspects of society's economic and political superstructure have an important impact on oral health indicators and existing inequalities. Oral health care models have a relative importance and must not be neglected. Vestiges of ideological movements, like preventive medicine, may explain the current impasse in collective oral health practices, such as the preeminence of Finalized Treatment (FT) in clinics and of preventive care in schools fostered by community-based programs. It is therefore important to develop conceptual, theoretical reflections and to increase the objects of intervention, their purposes and their modus operandi. The practice of dentistry according to these alternative models is still being constructed. New studies related to the different formats of these new practices are recommended.

  17. Dolphin Watching in the Southern Tañon Strait Protected Seascape, Philippines: Issues and Challenges

    Directory of Open Access Journals (Sweden)

    Lemnuel V. Aragones

    2013-12-01

    Full Text Available Dolphin watching is a growing economic activity in the southern Tañon Strait Protected Seascape (TSPS, the Philippines, an area that is also heavily exploited by fisheries. In order to examine the issues and challenges in this growing industry, we monitored relevant information regarding cetacean watching, conducted focus group discussions (FGDs and educational seminar-workshops for various local stakeholders from 2004 to 2006, and followed these up from 2008-2012. From 9 May to 16 August 2004, we conducted structured interviews to determine the perceptions of cetacean-watching tourists (CWTs and assess the level of local knowledge of f ishers and non-fishers (NFs regarding marine mammals and environmental management in this area. Ninety f ive (95 CWTs, 100 local fishers, and 64 NFs were interviewed. Sixty seven percent (n=64 of the CWTs believed that the overall quality of tours was impressive primarily because they were able to watch, at reasonable costs, large groups of dolphins in close proximity and in an almost pristine environment. The majority of CWTs (~91% felt that there is a need to develop a ‘Special Management Plan’ (SMP for the southern TSPS focusing on cetaceans and their habitats. The increasing number of dolphin watching boats, heavy exploitation of f ishing ground, misperception of local f ishers that cetaceans are competitors with f isheries, and lack of a SMP or a Management Plan per se for TSPS warranted the facilitation of a participatory management process to protect the cetaceans and their habitats.This study has shown that even with only preliminary results, survey interviews of key stakeholders in combination with FGDs and seminar-workshop could be critical in facilitating a participatory management process. In the case of the TSPS, this par ticipatory approach led to the formation of the Tañon Strait Association of Dolphin and Whale Watching Operators, Inc. (TaSADoWWI, and eventual development of cetacean

  18. Psicologia e saúde: desafios atuais Psychology and health: recent challenges

    Directory of Open Access Journals (Sweden)

    Fernando González Rey

    1997-01-01

    Full Text Available Este artigo apresenta e discute diferentes desafios que a psicologia tem que enfrentar em seus estudos sobre assuntos relacionados com a saúde, que, sobre o ponto de vista do autor, são impossíveis de desenvolver com os estudos atuais sobre saúde e psicologia clínica. O autor enfatiza desafios concretos: o primeiro que é colocado está relacionado com a elaboração teórica do conceito de saúde, que tem sido praticamente ignorado na literatura psicológica, a qual tem se centrado no problema da doença. Neste sentido, o autor propõe abandonar a definição de saúde em termos de normalidade, equilíbrio ou ausência de sintomas. Para este propósito, o autor utiliza o conceito de distress e o explica com diferente enquadramento teórico, levando em conta sua complexa constituição subjetiva e social no curso da vida do sujeito. O outro desafio coloca a necessidade de incluir o problema da saúde entre outros já desenvolvidos pelas psicologias social e educacional, enfatizando a importância de um estudo intradisciplinar do problema da saúde em psicologia.This paper presents and discusses different challenges that psychology has to face in its approach to health issues, which, from my point of view, are impossible to develop within the current approaches to health and clinical psychology. I emphasize concrete challenges: the first deals with the theoretical elaboration of the concept of health, which has been practically ignored in the psychological literature that focus mostly on the matter of disease. In this sense, I propose to abandon the definition of health in terms of normality, equilibrium, or absence of symptoms. For this purpose, I take the concept of distress and explain it within a different theoretical framework, taking into account its complex subjective and social constitution on the subject’s life course. The other challenges relate to the need to include the matter of health among those developed by social and

  19. Fragile X premutation in women: recognizing the health challenges beyond primary ovarian insufficiency.

    Science.gov (United States)

    Hoyos, Luis R; Thakur, Mili

    2016-12-19

    Fragile X premutation carriers have 55-200 CGG repeats in the 5' untranslated region of the FMR1 gene. Women with this premutation face many physical and emotional challenges in their life. Approximately 20% of these women will develop fragile X-associated primary ovarian insufficiency (FXPOI). In addition, they suffer from increased rates of menstrual dysfunction, diminished ovarian reserve, reduction in age of menopause, infertility, dizygotic twinning, and risk of having an offspring with a premutation or full mutation. Consequent chronic hypoestrogenism may result in impaired bone health and increased cardiovascular risk. Neuropsychiatric issues include risk of developing fragile X-associated tremor/ataxia syndrome, neuropathy, musculoskeletal problems, increased prevalence of anxiety, depression, and sleep disturbances independent of the stress of raising an offspring with fragile X syndrome and higher risk of postpartum depression. Some studies have reported a higher prevalence of thyroid abnormalities and hypertension in these women. Reproductive health providers play an important role in the health supervision of women with fragile X premutation. Awareness of these risks and correlation of the various manifestations could help in early diagnosis and coordination of care and services for these women and their families. This paper reviews current evidence regarding the possible conditions that may present in women with premutation-sized repeats beyond FXPOI.

  20. Ethical challenges and how to develop ethics support in primary health care.

    Science.gov (United States)

    Lillemoen, Lillian; Pedersen, Reidar

    2013-02-01

    Ethics support in primary health care has been sparser than in hospitals, the need for ethics support is probably no less. We have, however, limited knowledge about how to develop ethics support that responds to primary health-care workers' needs. In this article, we present a survey with a mixture of closed- and open-ended questions concerning: How frequent and how distressed various types of ethical challenges make the primary health-care workers feel, how important they think it is to deal with these challenges better and what kind of ethics support they want. Five primary health-care institutions participated. Ethical challenges seem to be prominent and common. Most frequently, the participants experienced ethical challenges related to scarce resources and lack of knowledge and skills. Furthermore, ethical challenges related to communication and decision making were common. The participants welcomed ethics support responding to their challenges and being integrated in their daily practices.

  1. Allostatic Load: Single Parents, Stress-Related Health Issues, and Social Care

    Science.gov (United States)

    Johner, Randy L.

    2007-01-01

    This article explores the possible relationships between allostatic load (AL) and stress-related health issues in the low-income single-parent population, using both a population health perspective (PHP) and a biological framework. A PHP identifies associations among such factors as gender, income, employment, and social support and their…

  2. Maquila Workers’ Health: Basic Issues, What is Known, and a Pilot Study in Nicaragua

    Directory of Open Access Journals (Sweden)

    Luis Blanco R.

    2008-09-01

    Full Text Available Occupational health issues identified in maquilas include respiratory, musculoskeletal, psychological problems, and accidents. This study identifies the basic health issues, as well as the sources and investigational methods needed for drafting health standards for maquilas. It sets out conceptual guidelines, suggesting general methodological strategies appropriate for studies of workers’ health and its determinants in the maquiladora sector. The conceptual-methodological model is based on 1 a review of relevant studies, 2 a mixed methods pilot feasibility study within the community of workers and social actors of a textile maquila in Nicaragua, and 3 the conceptual-methodological integration of a literature review with the results of the pilot study. The main issues identified are the organization of work, health, governmental regulation, family and gender, infrastructure and environment. Methodological recommendations focus on the principle of triangulation; the use of anonymous questionnaires and focus groups to examine specific issues; individual interviews with management personnel and members of the community; and the value of family members as key informers on the impact on family, environment and community. Observation of actual work procedures is ideal but not always possible. A joint health and safety committee and a health services unit would be key instruments in the prevention of accidents and illness and in health promotion and care.

  3. New smart materials to address issues of structural health monitoring.

    Energy Technology Data Exchange (ETDEWEB)

    Chaplya, Pavel Mikhail

    2004-12-01

    Nuclear weapons and their storage facilities may benefit from in-situ structural health monitoring systems. Appending health-monitoring functionality to conventional materials and structures has been only marginally successful. The purpose of this project was to evaluate feasibility of a new smart material that includes self-sensing health monitoring functions similar to that of a nervous system of a living organism. Reviews of current efforts in the fields of heath-monitoring, nanotechnology, micro-electromechanical systems (MEMS), and wireless sensor networks were conducted. Limitations of the current nanotechnology methods were identified and new approaches were proposed to accelerate the development of self-sensing materials. Wireless networks of MEMS sensors have been researched as possible prototypes of self-sensing materials. Sensor networks were also examined as enabling technologies for dense data collection techniques to be used for validation of numerical methods and material parameter identification. Each grain of the envisioned material contains sensors that are connected in a dendritic manner similar to networks of neurons in a nervous system. Each sensor/neuron can communicate with the neighboring grains. Both the state of the sensor (on/off) and the quality of communication signal (speed/amplitude) should indicate not only a presence of a structural defect but the nature of the defect as well. For example, a failed sensor may represent a through-grain crack, while a lost or degraded communication link may represent an inter-granular crack. A technology to create such material does not exist. While recent progress in the fields of MEMS and nanotechnology allows to envision these new smart materials, it is unrealistic to expect creation of self-sensing materials in the near future. The current state of MEMS, nanotechnology, communication, sensor networks, and data processing technologies indicates that it will take more than ten years for the

  4. Transition to Adult Health Care for Adolescents with Spina Bifida: Research Issues

    Science.gov (United States)

    Sawyer, Susan M.; Macnee, Sarah

    2010-01-01

    The increasing survival of children and young people with congenital disabilities such as spina bifida (SB) provides a challenge to health care systems globally about how best to respond to the multitude of health, developmental, and psychosocial needs of those affected by this complex disorder across the lifespan, not just in childhood and…

  5. Challenges for Novice School Leaders: Facing Today's Issues in School Administration

    Science.gov (United States)

    Beam, Andrea P.; Claxton, Russell L.; Smith, Samuel J.

    2016-01-01

    Challenges for novice school leaders evolve as information is managed differently and as societal and regulatory expectations change. This study addresses unique challenges faced by practicing school administrators (n = 159) during their first three years in a school leadership position. It focuses on their perceptions, how perceptions of present…

  6. Challenging Assumptions: Teaching, Documenting, Producing and Negotiating "Health"

    Science.gov (United States)

    Herrick, Clare

    2010-01-01

    As "health" climbs academic, policy, commercial, non-profit and societal agendas, it has become increasingly subject to scrutiny by geographers. Yet, while health geographers may explore the discursive production, operationalization, deployment and management of health; the role of pedagogical practices has been repeatedly overlooked…

  7. Obesity and Depression : An Intertwined Public Health Challenge

    NARCIS (Netherlands)

    Nigatu, Yeshambel Tesfa

    2015-01-01

    Obesity and depression are widespread public health problems. Both problems often coexist, and can affect an individual’s health and productivity. We examine in this thesis the prospective association between obesity and depression, and their separate and combined effects on work and health outcomes

  8. Poverty and elimination of urban health disparities: challenge and opportunity.

    Science.gov (United States)

    Thomas, Stephen B; Quinn, Sandra Crouse

    2008-01-01

    The aim of this article is to examine the intersection of race and poverty, two critical factors fueling persistent racial and ethnic health disparities among urban populations. From the morass of social determinants that shape the health of racial and ethnic communities in our urban centers, we will offer promising practices and potential solutions to eliminating racial and ethnic health disparities.

  9. Environmental Sanitation Crisis: More than just a health issue

    Directory of Open Access Journals (Sweden)

    Peter A. Harvey

    2008-01-01

    Full Text Available The global environmental sanitation crisis cannot be denied: well over a century after the sanitary revolution in 19th century Europe, 40% of the world’s population still lacks access to improved sanitation. Important lessons from the past must be applied today if the crisis is to be averted. Sanitation has suffered from a lack of prioritization for as long as it has remained the poor relation to water supply. The International Year of Sanitation 2008 provides an opportunity to separate the two and give sanitation the emphasis it requires. The economic argument for sanitation must be articulated and non-health incentives for improved sanitation exploited. Environmental sanitation results in a multitude of socio-economic benefits and can contribute positively to all the Millennium Development Goals. Community-led bottom-up approaches, rather than supply-led or technology-driven approaches, are most effective in increasing and sustaining access to sanitation but need to be implemented at scale. Targeted strategies for urban and school sanitation are also required. Evidence-based advocacy can help develop the political will that is now needed to ensure sufficient public sector investment, leadership, legislation and regulation to ensure that the fundamental human right of access to sanitation is realized.

  10. Fundamental modeling issues on benchmark structure for structural health monitoring

    Institute of Scientific and Technical Information of China (English)

    LI HuaJun; ZHANG Min; WANG JunRong; HU Sau-Lon James

    2009-01-01

    The IASC-ASCE Structural Health Monitoring Task Group developed a series of benchmark problems,and participants of the benchmark study were charged with using a 12-degree-of-freedom (DOF) shear building as their identification model. The present article addresses improperness, including the parameter and modeling errors, of using this particular model for the intended purpose of damage detection, while the measurements of damaged structures are synthesized from a full-order finite-element model. In addressing parameter errors, a model calibration procedure is utilized to tune the mass and stiffness matrices of the baseline identification model, and a 12-DOF shear building model that preserves the first three modes of the full-order model is obtained. Sequentially, this calibrated model is employed as the baseline model while performing the damage detection under various damage scenarios. Numerical results indicate that the 12-DOF shear building model is an over-simplified identification model, through which only idealized damage situations for the benchmark structure can be detected. It is suggested that a more sophisticated 3-dimensional frame structure model should be adopted as the identification model, if one intends to detect local member damages correctly.

  11. Occupational health issues in marine and freshwater research

    Directory of Open Access Journals (Sweden)

    Courtenay Glenn

    2012-03-01

    Full Text Available Abstract Marine and freshwater scientists are potentially exposed to a wide variety of occupational hazards. Depending on the focus of their research, risks may include animal attacks, physiological stresses, exposure to toxins and carcinogens, and dangerous environmental conditions. Many of these hazards have been investigated amongst the general population in their recreational use of the environment; however, very few studies have specifically related potential hazards to occupational exposure. For example, while the incidence of shark and crocodile attacks may invoke strong emotions and the occupational risk of working with these animals is certainly real, many more people are stung by jellyfish or bitten by snakes or dogs each year. Furthermore, a large proportion of SCUBA-related injuries and deaths are incurred by novice or uncertified divers, rather than professional divers using aquatic environments. Nonetheless, marine and freshwater research remains a potentially risky occupation, and the likelihood of death, injury and long-term health impacts still needs to be seriously considered.

  12. Fundamental modeling issues on benchmark structure for structural health monitoring

    Institute of Scientific and Technical Information of China (English)

    HU; Sau-Lon; James

    2009-01-01

    The IASC-ASCE Structural Health Monitoring Task Group developed a series of benchmark problems, and participants of the benchmark study were charged with using a 12-degree-of-freedom (DOF) shear building as their identification model. The present article addresses improperness, including the parameter and modeling errors, of using this particular model for the intended purpose of damage detec- tion, while the measurements of damaged structures are synthesized from a full-order finite-element model. In addressing parameter errors, a model calibration procedure is utilized to tune the mass and stiffness matrices of the baseline identification model, and a 12-DOF shear building model that preserves the first three modes of the full-order model is obtained. Sequentially, this calibrated model is employed as the baseline model while performing the damage detection under various damage scenarios. Numerical results indicate that the 12-DOF shear building model is an over-simplified identification model, through which only idealized damage situations for the benchmark structure can be detected. It is suggested that a more sophisticated 3-dimensional frame structure model should be adopted as the identification model, if one intends to detect local member damages correctly.

  13. Health and safety issues pertaining to genetically modified foods.

    Science.gov (United States)

    Goodyear-Smith, F

    2001-08-01

    Genetic modification involves the insertion of genes from other organisms (within or between species) into host cells to select for desirable qualities. Potential benefits of GM foods include increased nutritional value; reduced allergenicity; pest and disease-resistance; and enhanced processing value. Possible detrimental outcomes include producing foods with novel toxins, allergens or reduced nutritional value, and development of antibiotic resistance or herbicide-resistant weeds. Benefits to individuals or populations need to be weighed against adverse health and environmental risks, and may differ between developing and Westernised countries. Whether testing and monitoring should exceed requirements for conventional foods is under debate. While not necessarily scientifically justifiable, consumer concerns have resulted in Australian and New Zealand requirements to label foods containing GM-produced proteins. Dissatisfied consumer advocacy groups are calling for all foods involving GM technology to be labelled, irrelevant of whether the final product contains novel protein. Goals to improve the quantity, quality and safety of foods are laudable; however, the primary aim of the bio-food industry is financial gain. GM foods may be as safe as conventional foods but public distrust runs high. It is important that discussion is informed by science and that claims of both benefits and risks are evidence-based, to ensure that the process is driven neither by the vested interest of the bio-technical multinational companies on the one hand, nor ill-informed public fears on the other.

  14. Music therapy in cardiac health care: current issues in research.

    Science.gov (United States)

    Hanser, Suzanne B

    2014-01-01

    Music therapy is a service that has become more prevalent as an adjunct to medical practice-as its evidence base expands and music therapists begin to join the cardiology team in every phase of care, from the most serious cases to those maintaining good heart health. Although applications of music medicine, primarily listening to short segments of music, are capable of stabilizing vital signs and managing symptoms in the short-term, music therapy interventions by a qualified practitioner are showing promise in establishing deeper and more lasting impact. On the basis of mind-body approaches, stress/coping models, the neuromatrix theory of pain, and entrainment, music therapy capitalizes on the ability of music to affect the autonomic nervous system. Although only a limited number of randomized controlled trials pinpoint the efficacy of specific music therapy interventions, qualitative research reveals some profound outcomes in certain individuals. A depth of understanding related to the experience of living with a cardiovascular disease can be gained through music therapy approaches such as nonverbal music psychotherapy and guided imagery and music. The multifaceted nature of musical responsiveness contributes to strong individual variability and must be taken into account in the development of research protocols for future music therapy and music medicine interventions. The extant research provides a foundation for exploring the many potential psychosocial, physiological, and spiritual outcomes of a music therapy service for cardiology patients.

  15. Emerging arboviruses and public health challenges in Brazil.

    Science.gov (United States)

    Lima-Camara, Tamara Nunes

    2016-06-27

    Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country's public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country. RESUMO A modificação do ambiente por ações antrópicas, o crescimento urbano desordenado, o processo de globalização do intercâmbio internacional e as mudanças climáticas são alguns fatores que vêm facilitando a emergência e disseminação de doenças infecciosas humanas transmitidas por vetores. Este comentário aborda a recente entrada de três arbovírus no Brasil, Chikungunya (CHIKV), West Nile (WNV) e Zika (ZIKV), com enfoque nos desafios para a Saúde Pública do País. Transmitidos por mosquitos vetores amplamente distribuídos no território nacional e associados ao homem, a população brasileira encontra-se exposta à infecção por esses três arbovírus. Na ausência de vacina eficaz e tratamento específico, são importantes a manutenção e integração de uma vigilância entomológica e epidemiológica contínua, a fim de direcionarmos métodos de controle e prevenção contra essas arboviroses no País.

  16. Challenges and Opportunities of Implementing District-based Health Information System in Ethiopia

    DEFF Research Database (Denmark)

    Mengiste, Shegaw Anagaw

    2005-01-01

    of sustainable and scalable district-based health information system in the context of Primary Health Care (PHC) sector in Ethiopia were identified. Human resource, infrastructure, and HIS related problems are the main challenges hindering the implementation of sustainable and scalable district-based health......This paper has analyzed the challenges of sustainability and scalability of HIS. The empirical analysis was conducted in a backward and disadvantaged region of Ethiopia. An ongoing process of HISP (Health Information System Program) was addressed and the main challenges in the implementation...... information systems in the region....

  17. Aboriginal-mainstream partnerships: exploring the challenges and enhancers of a collaborative service arrangement for Aboriginal clients with substance use issues

    Directory of Open Access Journals (Sweden)

    Taylor Kate P

    2013-01-01

    Full Text Available Abstract Background Partnerships between different health services are integral to addressing the complex health needs of vulnerable populations. In Australia, partnerships between Aboriginal1 community controlled and mainstream services can extend health care options and improve the cultural safety of services. However, although government funding supports such collaborations, many factors can cause these arrangements to be tenuous, impacting the quality of health care received. Research was undertaken to explore the challenges and enhancers of a government initiated service partnership between an Aboriginal Community Controlled alcohol and drug service and three mainstream alcohol rehabilitation and support services. Methods Sixteen staff including senior managers (n=5, clinical team leaders (n=5 and counsellors (n=6 from the four services were purposively recruited and interviewed. Interviews were semi-structured and explored staff experience of the partnership including the client intake and referral process, shared client care, inter-service communication and ways of working. Results & discussion Communication issues, partner unfamiliarity, ‘mainstreaming’ of Aboriginal funding, divergent views regarding staff competencies, client referral issues, staff turnover and different ways of working emerged as issues, emphasizing the challenges of working with a population with complex issues in a persistent climate of limited resourcing. Factors enhancing the partnership included adding a richness and diversity to treatment possibilities and opportunities to explore different, more culturally appropriate ways of working. Conclusion While the literature strongly advises partnerships be suitably mature before commencing service delivery, the reality of funding cycles may require partnerships become operational before relationships are adequately consolidated. Allowing sufficient time and funding for both the operation and relational aspects of a

  18. Health in the 5th 5-years Development Plan of Iran: Main Challenges, General Policies and Strategies

    Directory of Open Access Journals (Sweden)

    N Rostamigooran

    2013-01-01

    Full Text Available Access to the right to the highest attainable level of health is a constitutional right that obliges governments and other players to take step to increase all individuals’ chances of obtaining good health. At the least, health and education are two crucial requirements for this as well. Iran's vision 2025 is going to lead the country to a developed state with the highest rank of economic, scientific and technological status in the region. Enjoying health, welfare, food security, social security, equal opportunities, etc, are also considered as part of characteristics of Iranian society in 2025. Although health system of Iran has many achievements in providing health services specially for the poor following the Islamic Revolution of 1979, but the evidences gathered to develop the 5th 5-years economical, social and cultural plan (5th5YDP:2011-2015, listed a variety of main challenges in stewardship, financing, resources generation and service provision functions of the existing health system. Thus, to overcome the main challenges, about 11% of general policies of 5th5YDP are directly address health related issues with emphasizing on healthy human and comprehensive health approach with considering: Integration of policy making, planning, evaluation, supervision and public financing; Developing both quantity and quality of health insurance system and reducing out-of-pocket expenditures for health services to 30% by the end of the 5th plan. The strategies of 5th5YDP adopted by the parliament as an Act will change the health system fundamentally through tuning the main drivers; so, its implementation needs brave leaders, capable managers, motivated technical staff and social mobilization.

  19. Free-trade agreements: challenges for global health.

    Science.gov (United States)

    Ribeiro, Helena

    2015-01-01

    In this study new free-trade agreements are discussed, which are based on the breaking down of tariff and technical barriers and normally exclude most of the poorest countries in the world. Considering the current context of economic globalization and its health impacts, seven controversial points of these treaties and their possible implications for global public health are presented, mainly regarding health equity and other health determinants. Finally, this research proposes a greater social and health professionals participation in the formulation and discussion of these treaties, and a deeper insertion of Brazil in this important international agenda.

  20. New smart materials to address issues of structural health monitoring.

    Energy Technology Data Exchange (ETDEWEB)

    Chaplya, Pavel Mikhail

    2004-12-01

    Nuclear weapons and their storage facilities may benefit from in-situ structural health monitoring systems. Appending health-monitoring functionality to conventional materials and structures has been only marginally successful. The purpose of this project was to evaluate feasibility of a new smart material that includes self-sensing health monitoring functions similar to that of a nervous system of a living organism. Reviews of current efforts in the fields of heath-monitoring, nanotechnology, micro-electromechanical systems (MEMS), and wireless sensor networks were conducted. Limitations of the current nanotechnology methods were identified and new approaches were proposed to accelerate the development of self-sensing materials. Wireless networks of MEMS sensors have been researched as possible prototypes of self-sensing materials. Sensor networks were also examined as enabling technologies for dense data collection techniques to be used for validation of numerical methods and material parameter identification. Each grain of the envisioned material contains sensors that are connected in a dendritic manner similar to networks of neurons in a nervous system. Each sensor/neuron can communicate with the neighboring grains. Both the state of the sensor (on/off) and the quality of communication signal (speed/amplitude) should indicate not only a presence of a structural defect but the nature of the defect as well. For example, a failed sensor may represent a through-grain crack, while a lost or degraded communication link may represent an inter-granular crack. A technology to create such material does not exist. While recent progress in the fields of MEMS and nanotechnology allows to envision these new smart materials, it is unrealistic to expect creation of self-sensing materials in the near future. The current state of MEMS, nanotechnology, communication, sensor networks, and data processing technologies indicates that it will take more than ten years for the