WorldWideScience

Sample records for complex health problems

  1. Level of satisfaction of older persons with their general practitioner and practice: role of complexity of health problems.

    Directory of Open Access Journals (Sweden)

    Antonius J Poot

    Full Text Available BACKGROUND: Satisfaction is widely used to evaluate and direct delivery of medical care; a complicated relationship exists between patient satisfaction, morbidity and age. This study investigates the relationships between complexity of health problems and level of patient satisfaction of older persons with their general practitioner (GP and practice. METHODS AND FINDINGS: This study is embedded in the ISCOPE (Integrated Systematic Care for Older Persons study. Enlisted patients aged ≥75 years from 59 practices received a written questionnaire to screen for complex health problems (somatic, functional, psychological and social. For 2664 randomly chosen respondents (median age 82 years; 68% female information was collected on level of satisfaction (satisfied, neutral, dissatisfied with their GP and general practice, and demographic and clinical characteristics including complexity of health problems. Of all participants, 4% was dissatisfied with their GP care, 59% neutral and 37% satisfied. Between these three categories no differences were observed in age, gender, country of birth or education level. The percentage of participants dissatisfied with their GP care increased from 0.4% in those with 0 problem domains to 8% in those with 4 domains, i.e. having complex health problems (p<0.001. Per additional health domain with problems, the risk of being dissatisfied increased 1.7 times (95% CI 1.4-2.14; p<0.001. This was independent of age, gender, and demographic and clinical parameters (adjusted OR 1.4, 95% CI 1.1-1.8; p = 0.021. CONCLUSION: In older persons, dissatisfaction with general practice is strongly correlated with rising complexity of health problems, independent of age, demographic and clinical parameters. It remains unclear whether complexity of health problems is a patient characteristic influencing the perception of care, or whether the care is unable to handle the demands of these patients. Prospective studies are needed to

  2. Level of satisfaction of older persons with their general practitioner and practice: role of complexity of health problems.

    Science.gov (United States)

    Poot, Antonius J; den Elzen, Wendy P J; Blom, Jeanet W; Gussekloo, Jacobijn

    2014-01-01

    Satisfaction is widely used to evaluate and direct delivery of medical care; a complicated relationship exists between patient satisfaction, morbidity and age. This study investigates the relationships between complexity of health problems and level of patient satisfaction of older persons with their general practitioner (GP) and practice. This study is embedded in the ISCOPE (Integrated Systematic Care for Older Persons) study. Enlisted patients aged ≥75 years from 59 practices received a written questionnaire to screen for complex health problems (somatic, functional, psychological and social). For 2664 randomly chosen respondents (median age 82 years; 68% female) information was collected on level of satisfaction (satisfied, neutral, dissatisfied) with their GP and general practice, and demographic and clinical characteristics including complexity of health problems. Of all participants, 4% was dissatisfied with their GP care, 59% neutral and 37% satisfied. Between these three categories no differences were observed in age, gender, country of birth or education level. The percentage of participants dissatisfied with their GP care increased from 0.4% in those with 0 problem domains to 8% in those with 4 domains, i.e. having complex health problems (ppatient characteristic influencing the perception of care, or whether the care is unable to handle the demands of these patients. Prospective studies are needed to investigate the causal associations between care organization, patient characteristics, indicators of quality, and patient perceptions.

  3. Environmental problems in the nuclear weapons complex

    International Nuclear Information System (INIS)

    Fultz, K.O.

    1989-04-01

    This paper provide the authors' views on the environmental problems facing the Department of Energy. Testimony is based on a large body of work, over 50 reports and testimonies since 1981, on environmental, safety, and health aspects of DOE's nuclear weapons complex. This work has shown that the complex faces a wide variety of serious problem areas including aging facilities, safety concerns which have shut down DOE's production reactors, and environmental cleanup

  4. How Health Care Complexity Leads to Cooperation and Affects the Autonomy of Health Care Professionals

    NARCIS (Netherlands)

    Molleman, Eric; Broekhuis, Manda; Stoffels, Renee; Jaspers, Frans

    2008-01-01

    Health professionals increasingly face patients with complex health problems and this pressurizes them to cooperate. The authors have analyzed how the complexity of health care problems relates to two types of cooperation: consultation and multidisciplinary teamwork (MTW). Moreover, they have

  5. Applications of systems thinking and soft operations research in managing complexity from problem framing to problem solving

    CERN Document Server

    2016-01-01

    This book captures current trends and developments in the field of systems thinking and soft operations research which can be applied to solve today's problems of dynamic complexity and interdependency. Such ‘wicked problems’ and messes are seemingly intractable problems characterized as value-laden, ambiguous, and unstable, that resist being tamed by classical problem solving. Actions and interventions associated with this complex problem space can have highly unpredictable and unintended consequences. Examples of such complex problems include health care reform, global climate change, transnational serious and organized crime, terrorism, homeland security, human security, disaster management, and humanitarian aid. Moving towards the development of solutions to these complex problem spaces depends on the lens we use to examine them and how we frame the problem. It will be shown that systems thinking and soft operations research has had great success in contributing to the management of complexity. .

  6. Zoonoses, One Health and complexity: wicked problems and constructive conflict.

    Science.gov (United States)

    Waltner-Toews, David

    2017-07-19

    Infectious zoonoses emerge from complex interactions among social and ecological systems. Understanding this complexity requires the accommodation of multiple, often conflicting, perspectives and narratives, rooted in different value systems and temporal-spatial scales. Therefore, to be adaptive, successful and sustainable, One Health approaches necessarily entail conflicts among observers, practitioners and scholars. Nevertheless, these integrative approaches have, both implicitly and explicitly, tended to marginalize some perspectives and prioritize others, resulting in a kind of technocratic tyranny. An important function of One Health approaches should be to facilitate and manage those conflicts, rather than to impose solutions.This article is part of the themed issue 'One Health for a changing world: zoonoses, ecosystems and human well-being'. © 2017 The Authors.

  7. On duty all the time: Health and quality of life among immigrant parents caring for a child with complex health needs

    OpenAIRE

    Kvarme, Lisbeth Gravdal; Albertini Früh, Elena; Brekke, Idunn; Gardsjord, Ragnhild; Halvorsrud, Liv; Lidén, Hilde

    2016-01-01

    Aims and objectives: To provide knowledge about how immigrant parents of children with complex health needs manage their family lives and how this affects their own health and quality of life. Background: Caregivers of children with complex health needs have additional risk for general health problems and mental health problems and immigrant parents may be more vulnerable to mental distress and failing health and quality of life. Results: Immigrant parents of children with complex health need...

  8. Child Obesity and Mental Health: A Complex Interaction.

    Science.gov (United States)

    Small, Leigh; Aplasca, Alexis

    2016-04-01

    Prevalence rates of childhood obesity have risen steeply over the last 3 decades. Given the increased national focus, the frequency of this clinical problem, and the multiple mental health factors that coexist with it, make obesity a public health concern. The complex relationships between mental health and obesity serve to potentiate the severity and interdependency of each. The purpose of this review is to create a contextual connection for the 2 conditions as outlined by the research literature and consider treatment options that affect both health problems. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Qubit Complexity of Continuous Problems

    National Research Council Canada - National Science Library

    Papageorgiou, A; Traub, J. F

    2005-01-01

    .... The authors show how to obtain the classical query complexity for continuous problems. They then establish a simple formula for a lower bound on the qubit complexity in terms of the classical query complexity...

  10. Towards a Unified Theory of Health-Disease: I. Health as a complex model-object

    Directory of Open Access Journals (Sweden)

    Naomar Almeida-Filho

    2013-06-01

    Full Text Available Theory building is one of the most crucial challenges faced by basic, clinical and population research, which form the scientific foundations of health practices in contemporary societies. The objective of the study is to propose a Unified Theory of Health-Disease as a conceptual tool for modeling health-disease-care in the light of complexity approaches. With this aim, the epistemological basis of theoretical work in the health field and concepts related to complexity theory as concerned to health problems are discussed. Secondly, the concepts of model-object, multi-planes of occurrence, modes of health and disease-illness-sickness complex are introduced and integrated into a unified theoretical framework. Finally, in the light of recent epistemological developments, the concept of Health-Disease-Care Integrals is updated as a complex reference object fit for modeling health-related processes and phenomena.

  11. Making mobility-related disability better: a complex response to a complex problem.

    Science.gov (United States)

    Rockwood, Kenneth

    2012-10-15

    Mobility disability in older adults can arise from single system problems, such as discrete musculoskeletal injury. In frail older adults, however, mobility disability is part of a complex web of problems. The approach to their rehabilitation must take that complexity into account, as is reported by Fairhall et al. First, their overall health state must be assessed, which is achieved by a comprehensive geriatric assessment. The assessment can show how a particular patient came to be disabled, so that an individualized care plan can be worked out. Whether this approach works in general can be evaluated by looking at group differences in mean mobility test scores. Knowing whether it has worked in the individual patient requires an individualized measure. This is because not every patient starts from the same point, and not every patient achieves success by aiming for the same goal. For one patient, walking unassisted for three metres would be a triumph; for another it would be a tragedy. Unless we understand the complexity of the needs of frail older adults, we will neither be able to treat them effectively nor evaluate our efforts sensibly.Please see related article http://www.biomedcentral.com/1741-7015/10/120.

  12. Improving the Quality of Home Health Care for Children With Medical Complexity.

    Science.gov (United States)

    Nageswaran, Savithri; Golden, Shannon L

    2017-08-01

    The objectives of this study are to describe the quality of home health care services for children with medical complexity, identify barriers to delivering optimal home health care, and discuss potential solutions to improve home health care delivery. In this qualitative study, we conducted 20 semistructured in-depth interviews with primary caregivers of children with medical complexity, and 4 focus groups with 18 home health nurses. During an iterative analysis process, we identified themes related to quality of home health care. There is substantial variability between home health nurses in the delivery of home health care to children. Lack of skills in nurses is common and has serious negative health consequences for children with medical complexity, including hospitalizations, emergency room visits, and need for medical procedures. Inadequate home health care also contributes to caregiver burden. A major barrier to delivering optimal home health care is the lack of training of home health nurses in pediatric care and technology use. Potential solutions for improving care include home health agencies training nurses in the care of children with medical complexity, support for nurses in clinical problem solving, and reimbursement for training nurses in pediatric home care. Caregiver-level interventions includes preparation of caregivers about: providing medical care for their children at home and addressing problems with home health care services. There are problems in the quality of home health care delivered to children with medical complexity. Training nurses in the care of children with medical complexity and preparing caregivers about home care could improve home health care quality. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  13. Problems in creating enviroment and health protection systems

    International Nuclear Information System (INIS)

    Vorob'ev, E.I.; Reznichenko, V.Yu.

    1981-01-01

    The problems in creating environmental and health protection systems are considered with relation to development of nuclear energetics facilities. A problem of transition from the system of detection and observation to the uniform system of environment and health protection and control is set. The objectives and problems of such a system are analyzed and the basic principles of their construction are outlined. A system conception for a fuel energetic complex is described. Usefulness of such systems in solving problems of sites of industrial objects including nuclear power industrial objects, of removal of these objects from service and etc. is shown. New requirements to medical-biological investigations on designing of such a system are discussed [ru

  14. Critical complexity in environmental health practice: simplify and complexify

    Directory of Open Access Journals (Sweden)

    Keune Hans

    2012-06-01

    Full Text Available Abstract The magic word ‘complexity’ has been buzzing around in science, policy and society for quite some time now. There seems to be a common feel for a ‘new way’ of doing things, for overcoming the limits of tradition. From the combined perspective of critical complexity thinking and environment and health practice we want to contribute to the development of alternative routines that may help overcome the limitations of traditional environment and health science. On the one hand traditional environment and health science is too self-confident with respect to potential scientific insight in environment and health problems: complexity condemns us to limited and ambiguous knowledge and the need for simplification. A more modest attitude would be more realistic from that point of view. On the other hand from a problem solving perspective more boldness is required. Waiting for Godot (perfect undisputed knowledge will not help us with respect to the challenges posed to society by environment and health problems. A sense of urgency is legitimate: the paralysis by traditional analysis should be resolved. Nevertheless this sense of urgency should not withhold us from investing in the problem solving quality of our endeavour; quality takes time, fastness from a quality perspective often leads us to a standstill. We propose the concept of critical complexification of environment and health practice that will enable the integration of relevant actors and factors in a pragmatic manner. We will illustrate this with practical examples and especially draw attention to the practical complexities involved, confronting us not only with fundamental questions, but also with fundamental challenges.

  15. Making mobility-related disability better: a complex response to a complex problem

    Directory of Open Access Journals (Sweden)

    Rockwood Kenneth

    2012-10-01

    Full Text Available Abstract Mobility disability in older adults can arise from single system problems, such as discrete musculoskeletal injury. In frail older adults, however, mobility disability is part of a complex web of problems. The approach to their rehabilitation must take that complexity into account, as is reported by Fairhall et al. First, their overall health state must be assessed, which is achieved by a comprehensive geriatric assessment. The assessment can show how a particular patient came to be disabled, so that an individualized care plan can be worked out. Whether this approach works in general can be evaluated by looking at group differences in mean mobility test scores. Knowing whether it has worked in the individual patient requires an individualized measure. This is because not every patient starts from the same point, and not every patient achieves success by aiming for the same goal. For one patient, walking unassisted for three metres would be a triumph; for another it would be a tragedy. Unless we understand the complexity of the needs of frail older adults, we will neither be able to treat them effectively nor evaluate our efforts sensibly. Please see related article http://www.biomedcentral.com/1741-7015/10/120

  16. A case-based, problem-based learning approach to prepare master of public health candidates for the complexities of global health.

    Science.gov (United States)

    Leon, Juan S; Winskell, Kate; McFarland, Deborah A; del Rio, Carlos

    2015-03-01

    Global health is a dynamic, emerging, and interdisciplinary field. To address current and emerging global health challenges, we need a public health workforce with adaptable and collaborative problem-solving skills. In the 2013-2014 academic year, the Hubert Department of Global Health at the Rollins School of Public Health-Emory University launched an innovative required core course for its first-year Master of Public Health students in the global health track. The course uses a case-based, problem-based learning approach to develop global health competencies. Small teams of students propose solutions to these problems by identifying learning issues and critically analyzing and synthesizing new information. We describe the course structure and logistics used to apply this approach in the context of a large class and share lessons learned.

  17. Innovative Use of the Law to Address Complex Global Health Problems Comment on "The Legal Strength of International Health Instruments - What It Brings toGlobal Health Governance?"

    Science.gov (United States)

    Walls, Helen L; Ooms, Gorik

    2017-05-20

    Addressing the increasingly globalised determinants of many important problems affecting human health is a complex task requiring collective action. We suggest that part of the solution to addressing intractable global health issues indeed lies with the role of new legal instruments in the form of globally binding treaties, as described in the recent article of Nikogosian and Kickbusch. However, in addition to the use of international law to develop new treaties, another part of the solution may lie in innovative use of existing legal instruments. A 2015 court ruling in The Hague, which ordered the Dutch government to cut greenhouse gas emissions by at least 25% within five years, complements this perspective, suggesting a way forward for addressing global health problems that critically involves civil society and innovative use of existing domestic legal instruments. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  18. Geological Factors and Health Problems

    Directory of Open Access Journals (Sweden)

    Francisco Prieto García

    2013-06-01

    Full Text Available Geological factors, such as damages, can cause health determinants in people, which were a little-studied and if they have been raised on occasion, usually referred to no communicable diseases. The aim of this work, which is a more or less updated bibliography, has been to develop a holistic idea for a better understanding of a problem and force latent or potential risk that they can carry and consider scientific basis infectious diseases especially complex.  In essence, the focus of ecosystem health that should be considered in terrestrial ecosystems. It also provides the basic elements for the development of new research in this field.

  19. Generalist solutions to complex problems: generating practice-based evidence--the example of managing multi-morbidity.

    Science.gov (United States)

    Reeve, Joanne; Blakeman, Tom; Freeman, George K; Green, Larry A; James, Paul A; Lucassen, Peter; Martin, Carmel M; Sturmberg, Joachim P; van Weel, Chris

    2013-08-07

    A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases) is a product of the design of health care systems which define health care need on the basis of disease status. So does the solution lie in an alternative model of healthcare? Strengthening generalist practice has been proposed as part of the solution to tackling multi-morbidity. Generalism is a professional philosophy of practice, deeply known to many practitioners, and described as expertise in whole person medicine. But generalism lacks the evidence base needed by policy makers and planners to support service redesign. The challenge is to fill this practice-research gap in order to critically explore if and when generalist care offers a robust alternative to management of this complex problem. We need practice-based evidence to fill this gap. By recognising generalist practice as a 'complex intervention' (intervening in a complex system), we outline an approach to evaluate impact using action-research principles. We highlight the implications for those who both commission and undertake research in order to tackle this problem. Answers to the complex problem of multi-morbidity won't come from doing more of the same. We need to change systems of care, and so the systems for generating evidence to support that care. This paper contributes to that work through outlining a process for generating practice-based evidence of generalist solutions to the complex problem of person-centred care for people with multi-morbidity.

  20. How does maternal oxytocin influence children's mental health problem and maternal mental health problem?

    Science.gov (United States)

    Tse, Wai S; Siu, Angela F Y; Wong, Tracy K Y

    2017-12-01

    This study aims to explore the interrelationship among maternal oxytocin (OT) responsiveness, maternal mental health, maternal parenting behavior, and mental health of children under a free-play interaction. 61 mother-child dyads were recruited for the study. Maternal mental health problem and parenting self-efficacy were measured using self-reported questionnaires. The mental health problems of children were also evaluated using a mother-reported questionnaire. Furthermore, salivary OT was collected before and after a standardized 10min free-play interaction. Parenting behaviors, including eye gaze and touch, were measured during the free-play interaction. Maternal OT responsiveness was significantly associated with less maternal mental health problem, touch frequency, and mental health problem of children but not with parenting self-efficacy. In the multivariate linear regression analysis that considers maternal OT responsiveness and maternal and children's mental health problems, maternal OT responsiveness was not associated with the mental health problems of children. This result suggested that maternal mental health problem played a mediational role between maternal OT responsiveness and the mental health problem of children. Results supported the assertion that maternal OT responsiveness contributed to the increased risk of maternal mental health problems and, subsequently, the risk of mental health problems of their children. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Inequalities in South African health care: Part I. The problem ...

    African Journals Online (AJOL)

    This exposition analyses and contextualises the complex problem of structural inequality in South African health care. Socio-econornic conditions, racial divisions and geographical location are isolated as the main determinants of inequality in the provision, allocation and distribution of health care; the prevailing inequalities ...

  2. Complex saddle points and the sign problem in complex Langevin simulation

    International Nuclear Information System (INIS)

    Hayata, Tomoya; Hidaka, Yoshimasa; Tanizaki, Yuya

    2016-01-01

    We show that complex Langevin simulation converges to a wrong result within the semiclassical analysis, by relating it to the Lefschetz-thimble path integral, when the path-integral weight has different phases among dominant complex saddle points. Equilibrium solution of the complex Langevin equation forms local distributions around complex saddle points. Its ensemble average approximately becomes a direct sum of the average in each local distribution, where relative phases among them are dropped. We propose that by taking these phases into account through reweighting, we can solve the wrong convergence problem. However, this prescription may lead to a recurrence of the sign problem in the complex Langevin method for quantum many-body systems.

  3. On duty all the time: health and quality of life among immigrant parents caring for a child with complex health needs.

    Science.gov (United States)

    Gravdal Kvarme, Lisbeth; Albertini-Früh, Elena; Brekke, Idunn; Gardsjord, Ragnhild; Halvorsrud, Liv; Liden, Hilde

    2016-02-01

    To provide knowledge about how immigrant parents of children with complex health needs manage their family lives and how this affects their own health and quality of life. Caregivers of children with complex health needs have additional risk for general health problems and mental health problems and immigrant parents may be more vulnerable to mental distress and failing health and quality of life. This qualitative study used an exploratory design with individual and focus group interviews. Data collection and analysis followed phenomenological hermeneutic guidelines. Individual and group interviews with 27 parents: 18 mothers and 9 fathers from Pakistan, Poland and Vietnam. Immigrant parents of children with complex health needs experience their own health and quality of life challenges. They described the burden of dealing with their child's needs and special care, which affects their sleep and physical and mental health. Single mothers are particularly vulnerable. Parents reported positive and negative effects of their caregiving experience that may affect their health and quality of life. Mothers were the primary caregivers and reported more health problems than did fathers. The lack of respite care, social networks and support impacted maternal health. Immigrant parents struggle to access resources for their child with complex health needs. Hospital nurses, schools and community health care can play a valuable role in supporting the parents of children with complex health needs. It is important that parents are informed about their rights and receive a coordinator and interdisciplinary group to ensure that their needs are met with assistance and respite care. That maternal health was worse in this sample implies that health care professionals should pay more attention to reducing stress among these caregivers. © 2016 John Wiley & Sons Ltd.

  4. Association between Psychopathology and Physical Health Problems among Youth in Residential Treatment

    Science.gov (United States)

    Nelson, Timothy D.; Smith, Tori R.; Duppong Hurley, Kristin; Epstein, Michael H.; Thompson, Ronald W.; Tonniges, Thomas F.

    2013-01-01

    Youth in residential treatment settings often present with a complex combination of mental and physical health problems. Despite an emerging literature documenting significant associations between mental health and physical health, the relationship between these two areas of functioning has not been systematically examined in youth presenting to…

  5. Complex Sequencing Problems and Local Search Heuristics

    NARCIS (Netherlands)

    Brucker, P.; Hurink, Johann L.; Osman, I.H.; Kelly, J.P.

    1996-01-01

    Many problems can be formulated as complex sequencing problems. We will present problems in flexible manufacturing that have such a formulation and apply local search methods like iterative improvement, simulated annealing and tabu search to solve these problems. Computational results are reported.

  6. Common ground, complex problems and decision making

    NARCIS (Netherlands)

    Beers, P.J.; Boshuizen, H.P.A.; Kirschner, P.A.; Gijselaers, W.H.

    2006-01-01

    Organisations increasingly have to deal with complex problems. They often use multidisciplinary teams to cope with such problems where different team members have different perspectives on the problem, different individual knowledge and skills, and different approaches on how to solve the problem.

  7. Wellbeing and resilience: mechanisms of transmission of health and risk in parents with complex mental health problems and their offspring--The WARM Study.

    Science.gov (United States)

    Harder, Susanne; Davidsen, Kirstine; MacBeth, Angus; Lange, Theis; Minnis, Helen; Andersen, Marianne Skovsager; Simonsen, Erik; Lundy, Jenna-Marie; Nyström-Hansen, Maja; Trier, Christopher Høier; Røhder, Katrine; Gumley, Andrew

    2015-12-09

    The WARM study is a longitudinal cohort study following infants of mothers with schizophrenia, bipolar disorder, depression and control from pregnancy to infant 1 year of age. Children of parents diagnosed with complex mental health problems including schizophrenia, bipolar disorder and depression, are at increased risk of developing mental health problems compared to the general population. Little is known regarding the early developmental trajectories of infants who are at ultra-high risk and in particular the balance of risk and protective factors expressed in the quality of early caregiver-interaction. We are establishing a cohort of pregnant women with a lifetime diagnosis of schizophrenia, bipolar disorder, major depressive disorder and a non-psychiatric control group. Factors in the parents, the infant and the social environment will be evaluated at 1, 4, 16 and 52 weeks in terms of evolution of very early indicators of developmental risk and resilience focusing on three possible environmental transmission mechanisms: stress, maternal caregiver representation, and caregiver-infant interaction. The study will provide data on very early risk developmental status and associated psychosocial risk factors, which will be important for developing targeted preventive interventions for infants of parents with severe mental disorder. NCT02306551, date of registration November 12, 2014.

  8. The Process of Solving Complex Problems

    Science.gov (United States)

    Fischer, Andreas; Greiff, Samuel; Funke, Joachim

    2012-01-01

    This article is about Complex Problem Solving (CPS), its history in a variety of research domains (e.g., human problem solving, expertise, decision making, and intelligence), a formal definition and a process theory of CPS applicable to the interdisciplinary field. CPS is portrayed as (a) knowledge acquisition and (b) knowledge application…

  9. Obesity, Complexity, and the Role of the Health System

    OpenAIRE

    Frood, Sarah; Johnston, Lee M.; Matteson, Carrie L.; Finegood, Diane T.

    2013-01-01

    As obesity continues to increase throughout the world, there is still no well-defined solution to the issue. Reducing obesity poses a significant challenge for the health care system because it is a complex problem with numerous interconnections and elements. The complexity of obesity challenges traditional primary care practices that have been structured to address simple or less complicated conditions. Systems thinking provides a way forward for clinicians that are discouraged or overwhelme...

  10. Solving Complex Problems to Create Charter Extension Options

    DEFF Research Database (Denmark)

    Tippmann, Esther; Nell, Phillip Christopher

    undertaken by 29 subsidiary units supports our hypotheses, demonstrating that these activities are a means to systematically reduce inherent problem solving biases. This study contributes to problem solving theory, the literature on headquarters’ roles in complex organizations, as well as the literature......This study examines subsidiary-driven problem solving processes and their potential to create advanced solutions for charter extension options. Problem solving theory suggests that biases in problem formulation and solution search can confine problem solving potential. We thus argue that balanced...... solution search, or activities to reconcile the need for some solution features to be locally-tailored while others can be internationally standardized, mediates the relationships between problem complexity/headquarters involvement and the capacity to create advanced solutions. An analysis of 67 projects...

  11. Is Disability a Health Problem?

    Directory of Open Access Journals (Sweden)

    Malcolm MacLachlan

    2013-12-01

    Full Text Available We welcome Andrew Haig's critique of our paper, "Disability & Health: A research agenda" in Social Inclusion. Our paper sought to identify research priorities to better understand, provide enhanced services and a better quality of life for people with disabilities, particularly in relation to their health and wellbeing. Haig's critique makes several important points that deserve serious consideration. His comments reflect a view of the relationship between disability and health which is different from the one we have espoused. Specifically, Haig argues that (a disability is a health problem, (b medical rehabilitation should be separated from Community Based Rehabilitation (CBR, and (c the evidence base for medical rehabilitation is much stronger than for CBR. We address each of these points below arguing that while some types of disability clearly result from health problems; often disability is not experienced as a health problem; and sometimes, disability in interaction with restricted access is the cause of health problems.

  12. Trajectories of mental health problems in children of parents with mental health problems: results of the BELLA study.

    Science.gov (United States)

    Plass-Christl, Angela; Otto, Christiane; Klasen, Fionna; Wiegand-Grefe, Silke; Barkmann, Claus; Hölling, Heike; Schulte-Markwort, Michael; Ravens-Sieberer, Ulrike

    2017-11-24

    Children of parents with mental health problems (CPM) have an increased risk for behavioral and psychological problems. This study investigated the age- and gender-specific course as well as predictors of mental health problems in CPM using the longitudinal data (baseline 1- and 2-year follow-ups) of a German general population sample from the BELLA study. Children and adolescents aged 11-17 years (at baseline) who had a parent with mental health problems (n = 325) were analyzed. The mental health problems of the children were assessed by the self-reported version of the strengths and difficulties questionnaire (SDQ). We used individual growth modeling to investigate the age- and gender-specific course, and the effects of risk as well as personal, familial and social protective factors on self-reported mental health problems in CPM. Additionally, data were examined differentiating internalizing and externalizing mental health problems in CPM. Results indicated that female compared to male CPM showed increasing mental health problems with increasing age. Mental health problems in CPM were associated with lower self-efficacy, worse family climate and less social competence over time. Internalizing problems were associated with lower self-efficacy, less social competence and more severe parental mental health problems. Externalizing problems were associated with lower self-efficacy, worse family climate and lower social competence. The main limitations of the study are the short time period (2 years) covered and the report of mental health problems by only one parent. Our findings should be considered in the development of treatment and prevention programs for mental health problems in CPM.

  13. Finding practical solutions to complex problems: IDRC's fifth annual ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-04-15

    Apr 15, 2016 ... English · Français ... Finding practical solutions to complex problems: IDRC's fifth annual ... “IDRC staff share a common goal with the researchers they work with – to find low-cost, down-to-earth solutions to complex problems ...

  14. Workplace bullying and subsequent health problems.

    Science.gov (United States)

    Nielsen, Morten Birkeland; Magerøy, Nils; Gjerstad, Johannes; Einarsen, Ståle

    2014-07-01

    Cross-sectional studies demonstrate that exposure to bullying in the workplace is positively correlated with self-reported health problems. However, these studies do not provide a basis to draw conclusions on the extent to which bullying leads to increased health problems or whether health problems increase the risk of being bullied. To provide better indications of a causal relationship, knowledge from prospective studies on the association between bullying in the workplace and health outcomes is therefore summarised. We conducted a systematic literature review of original articles from central literature databases on longitudinal associations between bullying in the workplace and health. Average associations between bullying and health outcomes are calculated using meta-analysis. A consistent finding across the studies is that exposure to bullying is significantly positively related to mental health problems (OR =1.68; 95% KI 1.35-2.09) and somatic symptoms (OR = 1.77; 95% KI 1.41-2.22) over time. Mental health problems are also associated with subsequent exposure to bullying (OR = 1.74; 95% KI 1.44-2.12). Bullying is positively related to mental health problems and somatic symptoms. The association between mental health problems and subsequent bullying indicates a self-reinforcing process between mental health and bullying. The methodological quality of the studies that were conducted is relatively sound. However, based on the existing knowledge base there are no grounds for conclusions regarding an unambiguous causal relationship between bullying and health.

  15. Preparing new nurses with complexity science and problem-based learning.

    Science.gov (United States)

    Hodges, Helen F

    2011-01-01

    Successful nurses function effectively with adaptability, improvability, and interconnectedness, and can see emerging and unpredictable complex problems. Preparing new nurses for complexity requires a significant change in prevalent but dated nursing education models for rising graduates. The science of complexity coupled with problem-based learning and peer review contributes a feasible framework for a constructivist learning environment to examine real-time systems data; explore uncertainty, inherent patterns, and ambiguity; and develop skills for unstructured problem solving. This article describes a pilot study of a problem-based learning strategy guided by principles of complexity science in a community clinical nursing course. Thirty-five senior nursing students participated during a 3-year period. Assessments included peer review, a final project paper, reflection, and a satisfaction survey. Results were higher than expected levels of student satisfaction, increased breadth and analysis of complex data, acknowledgment of community as complex adaptive systems, and overall higher level thinking skills than in previous years. 2011, SLACK Incorporated.

  16. Quantum complexity of graph and algebraic problems

    International Nuclear Information System (INIS)

    Doern, Sebastian

    2008-01-01

    This thesis is organized as follows: In Chapter 2 we give some basic notations, definitions and facts from linear algebra, graph theory, group theory and quantum computation. In Chapter 3 we describe three important methods for the construction of quantum algorithms. We present the quantum search algorithm by Grover, the quantum amplitude amplification and the quantum walk search technique by Magniez et al. These three tools are the basis for the development of our new quantum algorithms for graph and algebra problems. In Chapter 4 we present two tools for proving quantum query lower bounds. We present the quantum adversary method by Ambainis and the polynomial method introduced by Beals et al. The quantum adversary tool is very useful to prove good lower bounds for many graph and algebra problems. The part of the thesis containing the original results is organized in two parts. In the first part we consider the graph problems. In Chapter 5 we give a short summary of known quantum graph algorithms. In Chapter 6 to 8 we study the complexity of our new algorithms for matching problems, graph traversal and independent set problems on quantum computers. In the second part of our thesis we present new quantum algorithms for algebraic problems. In Chapter 9 to 10 we consider group testing problems and prove quantum complexity bounds for important problems from linear algebra. (orig.)

  17. Quantum complexity of graph and algebraic problems

    Energy Technology Data Exchange (ETDEWEB)

    Doern, Sebastian

    2008-02-04

    This thesis is organized as follows: In Chapter 2 we give some basic notations, definitions and facts from linear algebra, graph theory, group theory and quantum computation. In Chapter 3 we describe three important methods for the construction of quantum algorithms. We present the quantum search algorithm by Grover, the quantum amplitude amplification and the quantum walk search technique by Magniez et al. These three tools are the basis for the development of our new quantum algorithms for graph and algebra problems. In Chapter 4 we present two tools for proving quantum query lower bounds. We present the quantum adversary method by Ambainis and the polynomial method introduced by Beals et al. The quantum adversary tool is very useful to prove good lower bounds for many graph and algebra problems. The part of the thesis containing the original results is organized in two parts. In the first part we consider the graph problems. In Chapter 5 we give a short summary of known quantum graph algorithms. In Chapter 6 to 8 we study the complexity of our new algorithms for matching problems, graph traversal and independent set problems on quantum computers. In the second part of our thesis we present new quantum algorithms for algebraic problems. In Chapter 9 to 10 we consider group testing problems and prove quantum complexity bounds for important problems from linear algebra. (orig.)

  18. Condition of Health Problems in The District Health Offi ce Parigi Moutong Central Sulawesi Province, Efforts in Response of Health Problem

    Directory of Open Access Journals (Sweden)

    Ahmad Erlan

    2016-01-01

    Full Text Available Background: District Parigi Moutong, Central Sulawesi Province is one of the Regional District Health Problems. Ranking Public Health Development Index Parigi Moutong to the level of Central Sulawesi was ranked 6 out of 9 districts/cities, while at the national level comes out to 320 of 440 districts/cities in Indonesia. The purpose of this study is to provide a picture of the health problems in Parigi Moutong. In more detail the objectives are observed after the implementation of such interventions and Booster Kalakarya prevention efforts in the area of health problems. Methods: The study is qualitative observational study of participatory design. Samples were taken by using purposive sampling to conduct in-depth interviews and document searches. Results: The results of in-depth interviews obtained information of some constraints inthe implementation of health programs, ie no actions/movements that were signifi cant in the response to the problem. Infant mortality in 2012, registered 7 cases. Substitution head of the health center too fast. This happens because the head of the health center has held PTT doctor working period of one year, which resulted in problems in sustainability programs in health centers. Internal monthly meeting at the Department of Health and the District Health Offi ce with the entire health center no. Effort or movement to address the problems associated Regional Health Problems has not be percieved. Conclusions: Implementation of Regional Booster Kalakarya and Health Troubled make changes to the head of health policy by forming groups Conscious Movement IHC and revitalization partnership TBA and midwives who are increasing numbers toddlersweighing scope and aid delivery by health personnel.

  19. Modeling the Structure and Complexity of Engineering Routine Design Problems

    NARCIS (Netherlands)

    Jauregui Becker, Juan Manuel; Wits, Wessel Willems; van Houten, Frederikus J.A.M.

    2011-01-01

    This paper proposes a model to structure routine design problems as well as a model of its design complexity. The idea is that having a proper model of the structure of such problems enables understanding its complexity, and likewise, a proper understanding of its complexity enables the development

  20. Solving Complex Problems: A Convergent Approach to Cognitive Load Measurement

    Science.gov (United States)

    Zheng, Robert; Cook, Anne

    2012-01-01

    The study challenged the current practices in cognitive load measurement involving complex problem solving by manipulating the presence of pictures in multiple rule-based problem-solving situations and examining the cognitive load resulting from both off-line and online measures associated with complex problem solving. Forty-eight participants…

  1. On the complexity of container stowage planning problems

    DEFF Research Database (Denmark)

    Tierney, Kevin; Pacino, Dario; Jensen, Rune Møller

    2014-01-01

    The optimization of container ship and depot operations embeds the kk-shift problem, in which containers must be stowed in stacks such that at most kk containers must be removed in order to reach containers below them. We first solve an open problem introduced by Avriel et al. (2000) by showing...... that changing from uncapacitated to capacitated stacks reduces the complexity of this problem from NP-complete to polynomial. We then examine the complexity of the current state-of-the-art abstraction of container ship stowage planning, wherein containers and slots are grouped together. To do this, we define...... the hatch overstow problem, in which a set of containers are placed on top of the hatches of a container ship such that the number of containers that are stowed on hatches that must be accessed is minimized. We show that this problem is NP-complete by a reduction from the set-covering problem, which means...

  2. Health Problems of Mentally Disabled Individuals

    Directory of Open Access Journals (Sweden)

    Hatice Yildirim Sari

    2010-04-01

    Full Text Available Mentally disabled individuals are at risk of health problems. In fact, health problems are more frequent in mentally disabled individuals than in the general population and mentally disabled individuals less frequently use health care facilities. It has been shown that mentally disabled individuals frequently have nutritional problems. They may suffer from low weight, malnutrition, high weight, pica, iron and zinc deficiencies and absorption and eating disorders. Activities can be limited due to motor disability and restricted movements. Depending on insufficient liquid intake and dietary fiber, constipation can be frequent. Another problem is sleep disorders such as irregular sleep hours, short sleep, waking up at night and daytime sleepiness. Visual-hearing losses, epilepsy, motor disability, hepatitis A infection and poor oral hygiene are more frequent in mentally disabled children than in the general population. The mentally disabled have limited health care facilities, poorer health status than the general population and difficulties in demanding for health care and expressing health problems. Therefore, they should be provided with more health promotion services. [TAF Prev Med Bull 2010; 9(2.000: 145-150

  3. Generalist solutions to complex problems: generating practice-based evidence - the example of managing multi-morbidity

    NARCIS (Netherlands)

    Reeve, J.; Blakeman, T.; Freeman, G.K.; Green, L.A.; James, P.A.; Lucassen, P.L.; Martin, C.M.; Sturmberg, J.P.; Weel, C. van

    2013-01-01

    BACKGROUND: A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet

  4. Correcting environmental problems facing the nuclear weapons complex

    International Nuclear Information System (INIS)

    Rezendes, V.S.

    1990-06-01

    This report discusses DOE's efforts to correct the environmental problems facing the nuclear weapons complex. It focuses on three main points. First, the weapons complex faces a variety of serious and costly environmental problems. Second, during the past year, DOE has made some important changes to its organization that should help change its management focus from one that emphasizes materials production to one that more clearly focuses on environmental concerns. Third, because resolution of DOE's environmental problems will require considerable resources during a period of budgetary constraints, it is imperative that DOE have internal controls in place to ensure that resources are spent efficiently

  5. Non-commutative cryptography and complexity of group-theoretic problems

    CERN Document Server

    Myasnikov, Alexei; Ushakov, Alexander

    2011-01-01

    This book is about relations between three different areas of mathematics and theoretical computer science: combinatorial group theory, cryptography, and complexity theory. It explores how non-commutative (infinite) groups, which are typically studied in combinatorial group theory, can be used in public-key cryptography. It also shows that there is remarkable feedback from cryptography to combinatorial group theory because some of the problems motivated by cryptography appear to be new to group theory, and they open many interesting research avenues within group theory. In particular, a lot of emphasis in the book is put on studying search problems, as compared to decision problems traditionally studied in combinatorial group theory. Then, complexity theory, notably generic-case complexity of algorithms, is employed for cryptanalysis of various cryptographic protocols based on infinite groups, and the ideas and machinery from the theory of generic-case complexity are used to study asymptotically dominant prop...

  6. Operationalization of biopsychosocial case complexity in general health care : the INTERMED project

    NARCIS (Netherlands)

    de Jonge, P; Huyse, FJ; Slaets, JPJ; Sollner, W; Stiefel, FC

    Objective: Lack of operationalization of the biopsychosocial model hinders its effective application to the increasingly prevalent problems of comorbidities in clinical presentations. Here, we describe the INTERMED, an instrument to assess biopsychosocial case complexity in general health care, and

  7. Case study method and problem-based learning: utilizing the pedagogical model of progressive complexity in nursing education.

    Science.gov (United States)

    McMahon, Michelle A; Christopher, Kimberly A

    2011-08-19

    As the complexity of health care delivery continues to increase, educators are challenged to determine educational best practices to prepare BSN students for the ambiguous clinical practice setting. Integrative, active, and student-centered curricular methods are encouraged to foster student ability to use clinical judgment for problem solving and informed clinical decision making. The proposed pedagogical model of progressive complexity in nursing education suggests gradually introducing students to complex and multi-contextual clinical scenarios through the utilization of case studies and problem-based learning activities, with the intention to transition nursing students into autonomous learners and well-prepared practitioners at the culmination of a nursing program. Exemplar curricular activities are suggested to potentiate student development of a transferable problem solving skill set and a flexible knowledge base to better prepare students for practice in future novel clinical experiences, which is a mutual goal for both educators and students.

  8. Explicitly solvable complex Chebyshev approximation problems related to sine polynomials

    Science.gov (United States)

    Freund, Roland

    1989-01-01

    Explicitly solvable real Chebyshev approximation problems on the unit interval are typically characterized by simple error curves. A similar principle is presented for complex approximation problems with error curves induced by sine polynomials. As an application, some new explicit formulae for complex best approximations are derived.

  9. Cybersecurity vulnerabilities in medical devices: a complex environment and multifaceted problem

    Directory of Open Access Journals (Sweden)

    Williams PAH

    2015-07-01

    Full Text Available Patricia AH Williams, Andrew J Woodward eHealth Research Group and Security Research Institute, Edith Cowan University, Perth, WA, Australia Abstract: The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat. Keywords: cybersecurity, security, safety, wireless, risk, medical devices

  10. Using mHealth technologies to improve the identification of behavioral health problems in urban primary care settings.

    Science.gov (United States)

    Staeheli, Martha; Aseltine, Robert H; Schilling, Elizabeth; Anderson, Daren; Gould, Bruce

    2017-01-01

    Behavioral health disorders remain under recognized and under diagnosed among urban primary care patients. Screening patients for such problems is widely recommended, yet is challenging to do in a brief primary care encounter, particularly for this socially and medically complex patient population. In 2013, intervention patients at an urban Connecticut primary clinic were screened for post-traumatic stress disorder, depression, and risky drinking (n = 146) using an electronic tablet-based screening tool. Screening data were compared to electronic health record data from control patients (n = 129) to assess differences in the prevalence of behavioral health problems, rates of follow-up care, and the rate of newly identified cases in the intervention group. Results from logistic regressions indicated that both groups had similar rates of disorder at baseline. Patients in the intervention group were five times more likely to be identified with depression (p Post-traumatic stress disorder was virtually unrecognized among controls but was observed in 23% of the intervention group (p behavioral health problems identified in the intervention group were new cases. Follow-up rates were significantly higher in the intervention group relative to controls, but were low overall. This tablet-based electronic screening tool identified significantly higher rates of behavioral health disorders than have been previously reported for this patient population. Electronic risk screening using patient-reported outcome measures offers an efficient approach to improving the identification of behavioral health problems and improving rates of follow-up care.

  11. Exploring the role of GIS during community health assessment problem solving: experiences of public health professionals

    Directory of Open Access Journals (Sweden)

    Scotch Matthew

    2006-09-01

    Full Text Available Abstract Background A Community health assessment (CHA involves the use of Geographic Information Systems (GIS in conjunction with other software to analyze health and population data and perform numerical-spatial problem solving. There has been little research on identifying how public health professionals integrate this software during typical problem solving scenarios. A better understanding of this is needed to answer the "What" and the "How". The "What" identifies the specific software being used and the "How" explains the way they are integrated together during problem solving steps. This level of understanding will highlight the role of GIS utilization during problem solving and suggest to developers how GIS can be enhanced to better support data analysis during community health assessment. Results An online survey was developed to identify the information technology used during CHA analysis. The tasks were broken down into steps and for our analysis these steps were categorized by action: Data Management/Access, Data Navigation, Geographic Comparison, Detection of Spatial Boundaries, Spatial Modelling, and Ranking Analysis. 27 CHA professionals completed the survey, with the majority of participants (14 being from health departments. Statistical software (e.g. SPSS was the most popular software for all but one of the types of steps. For this step (detection of spatial boundaries, GIS was identified as the most popular technology. Conclusion Most CHA professionals indicated they use statistical software in conjunction with GIS. The statistical software appears to drive the analysis, while GIS is used primarily for simple spatial display (and not complex spatial analysis. This purpose of this survey was to thoroughly examine into the process of problem solving during community health assessment data analysis and to gauge how GIS is integrated with other software for this purpose. These findings suggest that GIS is used more for spatial

  12. New complex variable meshless method for advection—diffusion problems

    International Nuclear Information System (INIS)

    Wang Jian-Fei; Cheng Yu-Min

    2013-01-01

    In this paper, an improved complex variable meshless method (ICVMM) for two-dimensional advection—diffusion problems is developed based on improved complex variable moving least-square (ICVMLS) approximation. The equivalent functional of two-dimensional advection—diffusion problems is formed, the variation method is used to obtain the equation system, and the penalty method is employed to impose the essential boundary conditions. The difference method for two-point boundary value problems is used to obtain the discrete equations. Then the corresponding formulas of the ICVMM for advection—diffusion problems are presented. Two numerical examples with different node distributions are used to validate and inestigate the accuracy and efficiency of the new method in this paper. It is shown that ICVMM is very effective for advection—diffusion problems, and has a good convergent character, accuracy, and computational efficiency

  13. Problem analysis: application in the development of market strategies for health care organizations.

    Science.gov (United States)

    Martin, J

    1988-03-01

    The problem analysis technique is an approach to understanding salient customer needs that is especially appropriate under complex market conditions. The author demonstrates the use of the approach in segmenting markets and conducting competitive analysis for positioning strategy decisions in health care.

  14. Ordinal optimization and its application to complex deterministic problems

    Science.gov (United States)

    Yang, Mike Shang-Yu

    1998-10-01

    We present in this thesis a new perspective to approach a general class of optimization problems characterized by large deterministic complexities. Many problems of real-world concerns today lack analyzable structures and almost always involve high level of difficulties and complexities in the evaluation process. Advances in computer technology allow us to build computer models to simulate the evaluation process through numerical means, but the burden of high complexities remains to tax the simulation with an exorbitant computing cost for each evaluation. Such a resource requirement makes local fine-tuning of a known design difficult under most circumstances, let alone global optimization. Kolmogorov equivalence of complexity and randomness in computation theory is introduced to resolve this difficulty by converting the complex deterministic model to a stochastic pseudo-model composed of a simple deterministic component and a white-noise like stochastic term. The resulting randomness is then dealt with by a noise-robust approach called Ordinal Optimization. Ordinal Optimization utilizes Goal Softening and Ordinal Comparison to achieve an efficient and quantifiable selection of designs in the initial search process. The approach is substantiated by a case study in the turbine blade manufacturing process. The problem involves the optimization of the manufacturing process of the integrally bladed rotor in the turbine engines of U.S. Air Force fighter jets. The intertwining interactions among the material, thermomechanical, and geometrical changes makes the current FEM approach prohibitively uneconomical in the optimization process. The generalized OO approach to complex deterministic problems is applied here with great success. Empirical results indicate a saving of nearly 95% in the computing cost.

  15. Advice Complexity of the Online Search Problem

    DEFF Research Database (Denmark)

    Clemente, Jhoirene; Hromkovič, Juraj; Komm, Dennis

    2016-01-01

    the minimum amount of information needed in order to achieve a certain competitive ratio. We design an algorithm that reads $b$ bits of advice and achieves a competitive ratio of (M/m)^{1/(2^b+1)} where M and m are the maximum and minimum price in the input. We also give a matching lower bound. Furthermore......The online search problem is a fundamental problem in finance. The numerous direct applications include searching for optimal prices for commodity trading and trading foreign currencies. In this paper, we analyze the advice complexity of this problem. In particular, we are interested in identifying......, we compare the power of advice and randomization for this problem....

  16. Quantum trajectories in complex space: One-dimensional stationary scattering problems

    International Nuclear Information System (INIS)

    Chou, C.-C.; Wyatt, Robert E.

    2008-01-01

    One-dimensional time-independent scattering problems are investigated in the framework of the quantum Hamilton-Jacobi formalism. The equation for the local approximate quantum trajectories near the stagnation point of the quantum momentum function is derived, and the first derivative of the quantum momentum function is related to the local structure of quantum trajectories. Exact complex quantum trajectories are determined for two examples by numerically integrating the equations of motion. For the soft potential step, some particles penetrate into the nonclassical region, and then turn back to the reflection region. For the barrier scattering problem, quantum trajectories may spiral into the attractors or from the repellers in the barrier region. Although the classical potentials extended to complex space show different pole structures for each problem, the quantum potentials present the same second-order pole structure in the reflection region. This paper not only analyzes complex quantum trajectories and the total potentials for these examples but also demonstrates general properties and similar structures of the complex quantum trajectories and the quantum potentials for one-dimensional time-independent scattering problems

  17. Associations between work-related stress in late midlife, educational attainment, and serious health problems in old age: a longitudinal study with over 20 years of follow-up.

    Science.gov (United States)

    Nilsen, Charlotta; Andel, Ross; Fors, Stefan; Meinow, Bettina; Darin Mattsson, Alexander; Kåreholt, Ingemar

    2014-08-27

    People spend a considerable amount of time at work over the course of their lives, which makes the workplace important to health and aging. However, little is known about the potential long-term effects of work-related stress on late-life health. This study aims to examine work-related stress in late midlife and educational attainment in relation to serious health problems in old age. Data from nationally representative Swedish surveys were used in the analyses (n = 1,502). Follow-up time was 20-24 years. Logistic regressions were used to examine work-related stress (self-reported job demands, job control, and job strain) in relation to serious health problems measured as none, serious problems in one health domain, and serious problems in two or three health domains (complex health problems). While not all results were statistically significant, high job demands were associated with higher odds of serious health problems among women but lower odds of serious health problems among men. Job control was negatively associated with serious health problems. The strongest association in this study was between high job strain and complex health problems. After adjustment for educational attainment some of the associations became statistically nonsignificant. However, high job demands, remained related to lower odds of serious problems in one health domain among men, and low job control remained associated with higher odds of complex health problems among men. High job demands were associated with lower odds of complex health problems among men with low education, but not among men with high education, or among women regardless of level of education. The results underscore the importance of work-related stress for long-term health. Modification to work environment to reduce work stress (e.g., providing opportunities for self-direction/monitoring levels of psychological job demands) may serve as a springboard for the development of preventive strategies to improve public

  18. Addressing complex design problems through inductive learning

    OpenAIRE

    Hanna, S.

    2012-01-01

    Optimisation and related techniques are well suited to clearly defined problems involving systems that can be accurately simulated, but not to tasks in which the phenomena in question are highly complex or the problem ill-defined. These latter are typical of architecture and particularly creative design tasks, which therefore currently lack viable computational tools. It is argued that as design teams and construction projects of unprecedented scale are increasingly frequent, this is just whe...

  19. [The dimension of the paradigm of complexity in health systems].

    Science.gov (United States)

    Fajardo-Ortiz, Guillermo; Fernández-Ortega, Miguel Ángel; Ortiz-Montalvo, Armando; Olivares-Santos, Roberto Antonio

    2015-01-01

    This article presents elements to better understand health systems from the complety paradigm, innovative perspective that offers other ways in the conception of the scientific knowledge prevalent away from linear, characterized by the arise of emerging dissociative and behaviors, based on the intra and trans-disciplinarity concepts such knowledges explain and understand in a different way what happens in the health systems with a view to efficiency and effectiveness. The complexity paradigm means another way of conceptualizing the knowledge, is different from the prevalent epistemology, is still under construction does not separate, not isolated, is not reductionist, or fixed, does not solve the problems, but gives other bases to know them and study them, is a different strategy, a perspective that has basis in the systems theory, informatics and cybernetics beyond traditional knowledge, the positive logics, the newtonian physics and symmetric mathematics, in which everything is centered and balanced, joint the "soft sciences and hard sciences", it has present the Social Determinants of Health and organizational culture. Under the complexity paradigm the health systems are identified with the following concepts: entropy, neguentropy, the thermodynamic second law, attractors, chaos theory, fractals, selfmanagement and self-organization, emerging behaviors, percolation, uncertainty, networks and robusteness; such expressions open new possibilities to improve the management and better understanding of the health systems, giving rise to consider health systems as complex adaptive systems. Copyright © 2015. Published by Masson Doyma México S.A.

  20. Oral health problems and mortality

    Directory of Open Access Journals (Sweden)

    Jung Ki Kim

    2013-06-01

    Conclusion: Individual oral health conditions—tooth loss, root caries, and periodontal disease—were not related to mortality when sociodemographic, health, and/or health behavioral factors were considered, and there was no differential pattern between the three conditions. Multiple oral health problems were associated with a higher risk of dying.

  1. Quality of life of people with mental health problems: a synthesis of qualitative research.

    Science.gov (United States)

    Connell, Janice; Brazier, John; O'Cathain, Alicia; Lloyd-Jones, Myfanwy; Paisley, Suzy

    2012-11-22

    To identify the domains of quality of life important to people with mental health problems. A systematic review of qualitative research undertaken with people with mental health problems using a framework synthesis. We identified six domains: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; and hope and hopelessness. Firstly, symptoms or 'ill-being' were an intrinsic aspect of quality of life for people with severe mental health problems. Additionally, a good quality of life was characterised by the feeling of being in control (particularly of distressing symptoms), autonomy and choice; a positive self-image; a sense of belonging; engagement in meaningful and enjoyable activities; and feelings of hope and optimism. Conversely, a poor quality life, often experienced by those with severe mental health difficulties, was characterized by feelings of distress; lack of control, choice and autonomy; low self-esteem and confidence; a sense of not being part of society; diminished activity; and a sense of hopelessness and demoralization. Generic measures fail to address the complexity of quality of life measurement and the broad range of domains important to people with mental health problems.

  2. Quality of life of people with mental health problems: a synthesis of qualitative research

    Directory of Open Access Journals (Sweden)

    Connell Janice

    2012-11-01

    Full Text Available Abstract Purpose To identify the domains of quality of life important to people with mental health problems. Method A systematic review of qualitative research undertaken with people with mental health problems using a framework synthesis. Results We identified six domains: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; and hope and hopelessness. Firstly, symptoms or ‘ill-being’ were an intrinsic aspect of quality of life for people with severe mental health problems. Additionally, a good quality of life was characterised by the feeling of being in control (particularly of distressing symptoms, autonomy and choice; a positive self-image; a sense of belonging; engagement in meaningful and enjoyable activities; and feelings of hope and optimism. Conversely, a poor quality life, often experienced by those with severe mental health difficulties, was characterized by feelings of distress; lack of control, choice and autonomy; low self-esteem and confidence; a sense of not being part of society; diminished activity; and a sense of hopelessness and demoralization. Conclusions Generic measures fail to address the complexity of quality of life measurement and the broad range of domains important to people with mental health problems.

  3. Knowledge based method for solving complexity in design problems

    NARCIS (Netherlands)

    Vermeulen, B.

    2007-01-01

    The process of design aircraft systems is becoming more and more complex, due to an increasing amount of requirements. Moreover, the knowledge on how to solve these complex design problems becomes less readily available, because of a decrease in availability of intellectual resources and reduced

  4. Fluid leadership: inviting diverse inputs to address complex problems

    OpenAIRE

    Moir, Sylvia

    2016-01-01

    Approved for public release; distribution is unlimited History is replete with examples of misapplied leadership strategies. When singular methods are used to solve multifaceted problems, negative results are often the consequence. Complex issues in a complex environment require complex perspectives; the homeland security enterprise (HSE) needs leaders who can adapt their leadership styles according to emerging environments. Furthermore, the diverse agencies within the HSE must work togeth...

  5. Understanding the determinants of problem-solving behavior in a complex environment

    Science.gov (United States)

    Casner, Stephen A.

    1994-01-01

    It is often argued that problem-solving behavior in a complex environment is determined as much by the features of the environment as by the goals of the problem solver. This article explores a technique to determine the extent to which measured features of a complex environment influence problem-solving behavior observed within that environment. In this study, the technique is used to determine how complex flight deck and air traffic control environment influences the strategies used by airline pilots when controlling the flight path of a modern jetliner. Data collected aboard 16 commercial flights are used to measure selected features of the task environment. A record of the pilots' problem-solving behavior is analyzed to determine to what extent behavior is adapted to the environmental features that were measured. The results suggest that the measured features of the environment account for as much as half of the variability in the pilots' problem-solving behavior and provide estimates on the probable effects of each environmental feature.

  6. Solving complex problems a handbook

    CERN Document Server

    Schönwandt, Walter; Grunau, Jens; Utz, Jürgen; Voermanek, Katrin

    2014-01-01

    When you're planning something big, problems appear rather quickly. We hear of them on a daily basis. The bigger or more complex a task, the more we have to deal with complicated, multidisciplinary task formulations. In many cases it is architecture, including urban and spatial planning, but also politics and all types of organizational forms, irrespective of whether they are public authorities or private enterprises, which are expected to deliver functional solutions for such challenges. This is precisely where this book is helpful. It introduces a methodology for developing target-specific,

  7. Developing an agent-based model on how different individuals solve complex problems

    Directory of Open Access Journals (Sweden)

    Ipek Bozkurt

    2015-01-01

    Full Text Available Purpose: Research that focuses on the emotional, mental, behavioral and cognitive capabilities of individuals has been abundant within disciplines such as psychology, sociology, and anthropology, among others. However, when facing complex problems, a new perspective to understand individuals is necessary. The main purpose of this paper is to develop an agent-based model and simulation to gain understanding on the decision-making and problem-solving abilities of individuals. Design/Methodology/approach: The micro-level analysis modeling and simulation paradigm Agent-Based Modeling Through the use of Agent-Based Modeling, insight is gained on how different individuals with different profiles deal with complex problems. Using previous literature from different bodies of knowledge, established theories and certain assumptions as input parameters, a model is built and executed through a computer simulation. Findings: The results indicate that individuals with certain profiles have better capabilities to deal with complex problems. Moderate profiles could solve the entire complex problem, whereas profiles within extreme conditions could not. This indicates that having a strong predisposition is not the ideal way when approaching complex problems, and there should always be a component from the other perspective. The probability that an individual may use these capabilities provided by the opposite predisposition provides to be a useful option. Originality/value: The originality of the present research stems from how individuals are profiled, and the model and simulation that is built to understand how they solve complex problems. The development of the agent-based model adds value to the existing body of knowledge within both social sciences, and modeling and simulation.

  8. The public health aspects of complex emergencies and refugee situations.

    Science.gov (United States)

    Toole, M J; Waldman, R J

    1997-01-01

    Populations affected by armed conflict have experienced severe public health consequences mediated by population displacement, food scarcity, and the collapse of basic health services, giving rise to the term complex humanitarian emergencies. These public health effects have been most severe in underdeveloped countries in Africa, Asia, and Latin America. Refugees and internally displaced persons have experienced high mortality rates during the period immediately following their migration. In Africa, crude mortality rates have been as high as 80 times baseline rates. The most common causes of death have been diarrheal diseases, measles, acute respiratory infections, and malaria. High prevalences of acute malnutrition have contributed to high case fatality rates. In conflict-affected European countries, such as the former Yugoslavia, Georgia, Azerbaijan, and Chechnya, war-related injuries have been the most common cause of death among civilian populations; however, increased incidence of communicable diseases, neonatal health problems, and nutritional deficiencies (especially among the elderly) have been documented. The most effective measures to prevent mortality and morbidity in complex emergencies include protection from violence; the provision of adequate food rations, clean water and sanitation; diarrheal disease control; measles immunization; maternal and child health care, including the case management of common endemic communicable diseases; and selective feeding programs, when indicated.

  9. Complex network problems in physics, computer science and biology

    Science.gov (United States)

    Cojocaru, Radu Ionut

    There is a close relation between physics and mathematics and the exchange of ideas between these two sciences are well established. However until few years ago there was no such a close relation between physics and computer science. Even more, only recently biologists started to use methods and tools from statistical physics in order to study the behavior of complex system. In this thesis we concentrate on applying and analyzing several methods borrowed from computer science to biology and also we use methods from statistical physics in solving hard problems from computer science. In recent years physicists have been interested in studying the behavior of complex networks. Physics is an experimental science in which theoretical predictions are compared to experiments. In this definition, the term prediction plays a very important role: although the system is complex, it is still possible to get predictions for its behavior, but these predictions are of a probabilistic nature. Spin glasses, lattice gases or the Potts model are a few examples of complex systems in physics. Spin glasses and many frustrated antiferromagnets map exactly to computer science problems in the NP-hard class defined in Chapter 1. In Chapter 1 we discuss a common result from artificial intelligence (AI) which shows that there are some problems which are NP-complete, with the implication that these problems are difficult to solve. We introduce a few well known hard problems from computer science (Satisfiability, Coloring, Vertex Cover together with Maximum Independent Set and Number Partitioning) and then discuss their mapping to problems from physics. In Chapter 2 we provide a short review of combinatorial optimization algorithms and their applications to ground state problems in disordered systems. We discuss the cavity method initially developed for studying the Sherrington-Kirkpatrick model of spin glasses. We extend this model to the study of a specific case of spin glass on the Bethe

  10. Hypertension – a public health problem

    Directory of Open Access Journals (Sweden)

    Zélia Maria de Sousa Araújo Santos

    2011-12-01

    years(1.The problem related to treatment adhesion is complex. A series of factorsinfluence this process: biological characteristics (sex, age, race/color and familyhistory, social and cultural issues (civil status, years of schooling, income,profession, origin and religion; as well as the experience of the person with thedisease and its treatment; relationship with health care professionals; family support;and access to health care systems linked to updated public health policies(2.The lack of adhesion to treatment is an important challenge for theimplementation of policies for this population, possibly being responsible for theincrease in social costs with work absence, license for health treatment, and earlyretirement. On the other hand, the adhesion to treatment means the decrease oftreatment cost, and the possibility to integrate or reintegrate those in treatmentinto society. In addition, it reduces the morbimortality taxes by cardiovascular andcerebrovascular diseases related to hypertension.The population, mainly the most vulnerable to hypertension, needs to increaseits knowledge regarding hypertension risk factors in order to adhere to treatment andcontrol measures. The intermediation of this process should mainly be done troughhealth education, due its ability to capacitate and transform individuals, turningthem independent, based on informed knowledge regarding their health, in taking their own decisions regarding their body, and undertaking,or not, healthier behaviors.Education is the main action implemented by theprimary care, as it allows health promotion. Like this, it canbe admitted that the follow-up of a person with hypertension,together with family care, and implementation of educationalactions, will allow adhesion to therapeutic conducts in orderto control hypertension, as well as others conducts, whichwill promote health to individuals and families.The idea of health promotion relates itself tothe surrounding reality, as updated healthy policies

  11. Solving complex band structure problems with the FEAST eigenvalue algorithm

    Science.gov (United States)

    Laux, S. E.

    2012-08-01

    With straightforward extension, the FEAST eigenvalue algorithm [Polizzi, Phys. Rev. B 79, 115112 (2009)] is capable of solving the generalized eigenvalue problems representing traveling-wave problems—as exemplified by the complex band-structure problem—even though the matrices involved are complex, non-Hermitian, and singular, and hence outside the originally stated range of applicability of the algorithm. The obtained eigenvalues/eigenvectors, however, contain spurious solutions which must be detected and removed. The efficiency and parallel structure of the original algorithm are unaltered. The complex band structures of Si layers of varying thicknesses and InAs nanowires of varying radii are computed as test problems.

  12. Complex multiplication and lifting problems

    CERN Document Server

    Chai, Ching-Li; Oort, Frans

    2013-01-01

    Abelian varieties with complex multiplication lie at the origins of class field theory, and they play a central role in the contemporary theory of Shimura varieties. They are special in characteristic 0 and ubiquitous over finite fields. This book explores the relationship between such abelian varieties over finite fields and over arithmetically interesting fields of characteristic 0 via the study of several natural CM lifting problems which had previously been solved only in special cases. In addition to giving complete solutions to such questions, the authors provide numerous examples to illustrate the general theory and present a detailed treatment of many fundamental results and concepts in the arithmetic of abelian varieties, such as the Main Theorem of Complex Multiplication and its generalizations, the finer aspects of Tate's work on abelian varieties over finite fields, and deformation theory. This book provides an ideal illustration of how modern techniques in arithmetic geometry (such as descent the...

  13. Side effects of problem-solving strategies in large-scale nutrition science: towards a diversification of health.

    Science.gov (United States)

    Penders, Bart; Vos, Rein; Horstman, Klasien

    2009-11-01

    Solving complex problems in large-scale research programmes requires cooperation and division of labour. Simultaneously, large-scale problem solving also gives rise to unintended side effects. Based upon 5 years of researching two large-scale nutrigenomic research programmes, we argue that problems are fragmented in order to be solved. These sub-problems are given priority for practical reasons and in the process of solving them, various changes are introduced in each sub-problem. Combined with additional diversity as a result of interdisciplinarity, this makes reassembling the original and overall goal of the research programme less likely. In the case of nutrigenomics and health, this produces a diversification of health. As a result, the public health goal of contemporary nutrition science is not reached in the large-scale research programmes we studied. Large-scale research programmes are very successful in producing scientific publications and new knowledge; however, in reaching their political goals they often are less successful.

  14. What are the health needs, familial and social problems of Thai migrants in a local community in Australia? A focus group study.

    Science.gov (United States)

    Vatcharavongvan, Pasitpon; Hepworth, Julie; Lim, Joanne; Marley, John

    2014-02-01

    This study explored the health needs, familial and social problems of Thai migrants in a local community in Brisbane, Australia. Five focus groups with Thai migrants were conducted. The qualitative data were examined using thematic content analysis that is specifically designed for focus group analysis. Four themes were identified: (1) positive experiences in Australia, (2) physical health problems, (3) mental health problems, and (4) familial and social health problems. This study revealed key health needs related to chronic disease and mental health, major barriers to health service use, such as language skills, and facilitating factors, such as the Thai Temple. We concluded that because the health needs, familial and social problems of Thai migrants were complex and culture bound, the development of health and community services for Thai migrants needs to take account of the ways in which Thai culture both negatively impacts health and offer positive solutions to problems.

  15. Reentry challenges facing women with mental health problems.

    Science.gov (United States)

    Visher, Christy A; Bakken, Nicholas W

    2014-01-01

    Women entering the correctional system represent a population at high risk for mental health and the body of research on the mental health needs of women offenders is growing. These mental health problems pose challenges for women at every stage of the criminal justice process, from arrest to incarceration to community reentry and reintegration. In this article, we examined mental health status among a sample of 142 women leaving confinement and the role that mental health problems played in shaping their reentry outcomes using data collected between 2002 and 2005 in Houston, Texas. In the year after leaving prison, women with mental health problems reported poorer health, more hospitalizations, more suicidal thoughts, greater difficulties securing housing and employment, more involvement in criminal behavior, and less financial support from family than women with no indication of mental health problems. However, mental health status did not increase the likelihood of substance use relapse or reincarceration. The article concludes with a discussion of recommendations for improved policy and practice.

  16. Using mHealth technologies to improve the identification of behavioral health problems in urban primary care settings

    OpenAIRE

    Staeheli, Martha; Aseltine, Robert H; Schilling, Elizabeth; Anderson, Daren; Gould, Bruce

    2017-01-01

    Introduction: Behavioral health disorders remain under recognized and under diagnosed among urban primary care patients. Screening patients for such problems is widely recommended, yet is challenging to do in a brief primary care encounter, particularly for this socially and medically complex patient population. Methods: In 2013, intervention patients at an urban Connecticut primary clinic were screened for post-traumatic stress disorder, depression, and risky drinking (n?=?146) using an elec...

  17. [Health and social problems in the aged].

    Science.gov (United States)

    Grujić, V; Martinov-Cvejin, M; Ac-Nikolić, E

    1997-01-01

    This study reviews data from a poll conducted in three municipalities of Vojvodina on health and social problems of 60-year old and older people (n = 104). Poverty and illness are the main two problems aged people have to deal with, whereas exhaustion, pains, moving around with difficulty, poor vision, heart and breathing problems, as well as cardiovascular diseases and diseases of the musculoskeletal system are the most frequent health problems. Socializing is poor in the old age. Every third aged person visits nobody, while every fifth aged person is visited by nobody. About 3% of examinees describe their relationships with children as negative. That is why it is necessary to organize a health care of the aged which should maintain health and functional abilities into the old age with adequate social care of both closed and open type as long as possible.

  18. Online Information Search Performance and Search Strategies in a Health Problem-Solving Scenario.

    Science.gov (United States)

    Sharit, Joseph; Taha, Jessica; Berkowsky, Ronald W; Profita, Halley; Czaja, Sara J

    2015-01-01

    Although access to Internet health information can be beneficial, solving complex health-related problems online is challenging for many individuals. In this study, we investigated the performance of a sample of 60 adults ages 18 to 85 years in using the Internet to resolve a relatively complex health information problem. The impact of age, Internet experience, and cognitive abilities on measures of search time, amount of search, and search accuracy was examined, and a model of Internet information seeking was developed to guide the characterization of participants' search strategies. Internet experience was found to have no impact on performance measures. Older participants exhibited longer search times and lower amounts of search but similar search accuracy performance as their younger counterparts. Overall, greater search accuracy was related to an increased amount of search but not to increased search duration and was primarily attributable to higher cognitive abilities, such as processing speed, reasoning ability, and executive function. There was a tendency for those who were younger, had greater Internet experience, and had higher cognitive abilities to use a bottom-up (i.e., analytic) search strategy, although use of a top-down (i.e., browsing) strategy was not necessarily unsuccessful. Implications of the findings for future studies and design interventions are discussed.

  19. Health Problems at School

    Science.gov (United States)

    ... the Word Shop AAP Find a Pediatrician Ages & Stages Prenatal Baby Toddler Preschool Gradeschool Fitness Nutrition Puberty School Teen Young Adult Healthy Children > Ages & Stages > Gradeschool > School > Health Problems at School Ages & Stages ...

  20. Health Behaviour and Body Mass Index Among Problem Gamblers

    DEFF Research Database (Denmark)

    Holst Algren, Maria; Ekholm, Ola; Davidsen, Michael

    2015-01-01

    Problem gambling is a serious public health issue. The objective of this study was to investigate whether past year problem gamblers differed from non-problem gamblers with regard to health behaviour and body mass index (BMI) among Danes aged 16 years or older. Data were derived from the Danish...... pattern and obesity was higher among problem gamblers than among non-problem gamblers. The associations found in this study remained significant after adjustment for sex, age, educational and cohabiting status as well as other risk factors. Our findings highlight the presence of a potential, public health...... Health and Morbidity Surveys in 2005 and 2010. Past year problem gambling was defined using the lie/bet questionnaire. Logistic regression analyses were used to examine the association between past year problem gambling and health behaviour and BMI. Problem gambling was associated with unhealthy...

  1. Complexity and Health Coaching: Synergies in Nursing

    Directory of Open Access Journals (Sweden)

    Gail J. Mitchell

    2013-01-01

    Full Text Available Health care professionals are increasingly aware that persons are complex and live in relation with other complex human communities and broader systems. Complex beings and systems are living and evolving in nonlinear ways through a process of mutual influence. Traditional standardized approaches in chronic disease management do not address these non-linear linkages and the meaning and changes that impact day-to-day life and caring for self and family. The RN health coach role described in this paper addresses the complexities and ambiguities for persons living with chronic illness in order to provide person-centered care and support that are unique and responsive to the context of persons’ lives. Informed by complexity thinking and relational inquiry, the RN health coach is an emergent innovation of creative action with community and groups that support persons as they shape their health and patterns of living.

  2. Probing problems and priorities in oral health (care) among community dwelling elderly in the Netherlands: a mixed method study

    NARCIS (Netherlands)

    Everaars, B.; Jerković-Ćosić, K.; van der Putten, G.J.; van der Heijden, G.J.M.G.

    2015-01-01

    Background: Complex dentitions and decline in adequate oral hygiene in elderly may lead to poor oral health. This may have impact on their general health, wellbeing and quality of life. With increased longevity, the problems and needs in oral health of community dwelling elderly lead to changes in

  3. Travel-related health problems in Japanese travelers.

    Science.gov (United States)

    Mizuno, Yasutaka; Kudo, Koichiro

    2009-09-01

    Although the number of Japanese individuals traveling abroad has increased steadily, reaching approximately 17.3 million in 2007, the incidence of various travel-related health problems in Japan remains unknown. The travel-related health problems of Japanese travelers returning to Japan from abroad are analyzed by assessing the records. Data were collected retrospectively on returning travelers who visited the authors' travel clinic during the period from January 2005 through to December 2006 with any health problem acquired overseas. A total of 345 patients were included in this study (200 male, 145 female; average age, 34+/-12.3 years). Reasons for travel included leisure (45.8%); business (39.1%); visiting friends and relatives or accompanying other travelers (8.7%); volunteering (3.8%); and long stays in order to study or live (2.6%). The most visited destination was Asia (n=260), followed by Africa (n=105). The most commonly reported health problems were gastro-intestinal infections (39.1%), followed by respiratory tract infections (16.2%), animal bites (8.1%), and skin problems (5.8%). Together, malaria and dengue accounted for 10% of diagnoses in 125 febrile patients (36.2%). Although the profile of travel-related health problems in Japanese travelers is similar to that of Western travelers, the characteristics of travel were quite different. Therefore Japanese travel advice should be tailored to suit the Japanese traveler.

  4. Immigrants' use of primary health care services for mental health problems.

    Science.gov (United States)

    Straiton, Melanie; Reneflot, Anne; Diaz, Esperanza

    2014-08-13

    Equity in health care across all social groups is a major goal in health care policy. Immigrants may experience more mental health problems than natives, but we do not know the extent to which they seek help from primary health care services. This study aimed to determine a) the rate immigrants use primary health care services for mental health problems compared with Norwegians and b) the association between length of stay, reason for immigration and service use among immigrants. National register data covering all residents in Norway and all consultations with primary health care services were used. We conducted logistic regression analyses to compare Norwegians' with Polish, Swedish, German, Pakistani and Iraqi immigrants' odds of having had a consultation for a mental health problem (P-consultation). After accounting for background variables, all immigrants groups, except Iraqi men had lower odds of a P-consultation than their Norwegian counterparts. A shorter length of stay was associated with lower odds of a P-consultation. Service use varies by country of origin and patterns are different for men and women. There was some evidence of a possible 'healthy migrant worker' effect among the European groups. Together with previous research, our findings however, suggest that Iraqi women and Pakistanis in particular, may experience barriers in accessing care for mental health problems.

  5. Maternal problem drinking and child mental health

    NARCIS (Netherlands)

    Husky, M.M.; Keyes, K.M.; Hamilton, A.; Stragalinou, A.; Pez, O.; Kuijpers, R.C.W.M.; Lesinskiene, S.; Mihova, Z.; Otten, R.; Kovess-Masfety, V.

    2017-01-01

    Background: Offspring of individuals with alcohol use disorders have been shown to have elevated risk for mental health problems. Objectives: To examine the association between maternal problem drinking and child mental health as assessed by three informants in three European countries. Methods:

  6. Developing a case mix classification for child and adolescent mental health services: the influence of presenting problems, complexity factors and service providers on number of appointments.

    Science.gov (United States)

    Martin, Peter; Davies, Roger; Macdougall, Amy; Ritchie, Benjamin; Vostanis, Panos; Whale, Andy; Wolpert, Miranda

    2017-09-01

    Case-mix classification is a focus of international attention in considering how best to manage and fund services, by providing a basis for fairer comparison of resource utilization. Yet there is little evidence of the best ways to establish case mix for child and adolescent mental health services (CAMHS). To develop a case mix classification for CAMHS that is clinically meaningful and predictive of number of appointments attended and to investigate the influence of presenting problems, context and complexity factors and provider variation. We analysed 4573 completed episodes of outpatient care from 11 English CAMHS. Cluster analysis, regression trees and a conceptual classification based on clinical best practice guidelines were compared regarding their ability to predict number of appointments, using mixed effects negative binomial regression. The conceptual classification is clinically meaningful and did as well as data-driven classifications in accounting for number of appointments. There was little evidence for effects of complexity or context factors, with the possible exception of school attendance problems. Substantial variation in resource provision between providers was not explained well by case mix. The conceptually-derived classification merits further testing and development in the context of collaborative decision making.

  7. Analogy as a strategy for supporting complex problem solving under uncertainty.

    Science.gov (United States)

    Chan, Joel; Paletz, Susannah B F; Schunn, Christian D

    2012-11-01

    Complex problem solving in naturalistic environments is fraught with uncertainty, which has significant impacts on problem-solving behavior. Thus, theories of human problem solving should include accounts of the cognitive strategies people bring to bear to deal with uncertainty during problem solving. In this article, we present evidence that analogy is one such strategy. Using statistical analyses of the temporal dynamics between analogy and expressed uncertainty in the naturalistic problem-solving conversations among scientists on the Mars Rover Mission, we show that spikes in expressed uncertainty reliably predict analogy use (Study 1) and that expressed uncertainty reduces to baseline levels following analogy use (Study 2). In addition, in Study 3, we show with qualitative analyses that this relationship between uncertainty and analogy is not due to miscommunication-related uncertainty but, rather, is primarily concentrated on substantive problem-solving issues. Finally, we discuss a hypothesis about how analogy might serve as an uncertainty reduction strategy in naturalistic complex problem solving.

  8. Particle swarm as optimization tool in complex nuclear engineering problems

    International Nuclear Information System (INIS)

    Medeiros, Jose Antonio Carlos Canedo

    2005-06-01

    Due to its low computational cost, gradient-based search techniques associated to linear programming techniques are being used as optimization tools. These techniques, however, when applied to multimodal search spaces, can lead to local optima. When finding solutions for complex multimodal domains, random search techniques are being used with great efficacy. In this work we exploit the swarm optimization algorithm search power capacity as an optimization tool for the solution of complex high dimension and multimodal search spaces of nuclear problems. Due to its easy and natural representation of high dimension domains, the particle swarm optimization was applied with success for the solution of complex nuclear problems showing its efficacy in the search of solutions in high dimension and complex multimodal spaces. In one of these applications it enabled a natural and trivial solution in a way not obtained with other methods confirming the validity of its application. (author)

  9. Survey of Applications of Complex Event Processing (CEP in Health Domain

    Directory of Open Access Journals (Sweden)

    Nadeem Mahmood

    2017-12-01

    Full Text Available It is always difficult to manipulate the production of huge amount of data which comes from multiple sources and to extract meaningful information to make appropriate decisions. When data comes from various input resources, to get required streams of events form this complex input network, the one of the strong functionality of Business Intelligence (BI the Complex Event Processing (CEP is the appropriate solution for the above mention problems. Real time processing, pattern matching, stream processing, big data management, sensor data processing and many more are the application areas of CEP. Health domain itself is a multi-dimension domain such as hospital supply chain, OPD management, disease diagnostic, In-patient, out-patient management, and emergency care etc. In this paper, the main focus is to discuss the application areas of Complex Event Processing (CEP in health domain by using sensor device, such that how CEP manipulate health data set events coming from sensor devices such as blood pressure, heart rate, fall detection, sugar level, temperature or any other vital signs and how this systems respond to these events as quickly as possible. Different existing models and application using CEP are discussed and summarized according to different characteristics.

  10. Simulation Gaming as a Social Development Instrument : Dealing with Complex Problems

    NARCIS (Netherlands)

    Klievink, B.; Janssen, M.

    Improving public service delivery is a very complex domain and the complexity is difficult to grasp by stakeholders having various degree of knowledge and involvement. An emergent and promising method for dealing with complex problems is simulation gaming, which can be used to capitalize the

  11. SCHOOL VIOLENCE: A COMPLEX PROBLEM

    Directory of Open Access Journals (Sweden)

    María del Rosario Ayala-Carrillo

    2015-07-01

    Full Text Available School violence is one type of violence that reflects the breakdown of current society. It is impossible to speak of school violence as an isolated phenomenon without establishing nexuses between public and private life, between collective and individual behaviors, between family and community aspects, without making reference to differences in gender and the life stories of those who are the aggressors or the victims, and without considering the patriarchal culture and interpersonal relationships. When all these factor are interrelated, they make the problem of violence a very complex one that requires us to know the different factors in order to understand it and deal with it.

  12. Children's Mental Health: Problems and Services. Background Paper.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Office of Technology Assessment.

    This background paper on children's mental health indicates that less than one-third of the children who have mental health problems receive treatment. Types of mental health problems are discussed, including intellectual, developmental, behavior, emotional, psychophysiological, and adjustment disorders. Enviromental risk factors of poverty and…

  13. The simplicity complex: exploring simplified health messages in a complex world.

    Science.gov (United States)

    Zarcadoolas, Christina

    2011-09-01

    A challenge in individual and public health at the start of the 21st century is to effectively communicate health and science information about disease and complex emergencies. The low health literacy of millions of adults in the USA has been referred to as a 'silent killer'. A popular approach to improving health communication and health promotion to low health literate consumers has been to simplify the language of health information. The expected result has been that individuals and groups will better understand information and will then make informed decisions about their health and behaviors. This expectation has grown to include the belief that the public will be better prepared to take appropriate action in complex natural and man-made emergencies. Demonstrating the efficacy of this approach remains, in large part, uninvestigated. And it is becoming more evident that health literacy itself is complex and multifaceted. This article applies linguistic and sociolinguistic models in order to better articulate the role of simplification in health communication and health promotion. Focusing on two models from sociolinguistics-pragmatics and text theory-the article discusses their usefulness in rethinking message simplification. The discussion proposes that a richer, more theory-based understanding of text structures and functions, along with other powerful constructs, including cultural appropriateness, relevancy and context, are needed to close the gaps between health messages, health messengers and patients/the public. The article concludes by making recommendations for future study to empirically test the strengths and limitations of these models and constructs.

  14. Responding to families with complex needs: a national survey of child and family health nurses.

    Science.gov (United States)

    Rossiter, Chris; Schmied, Virginia; Kemp, Lynn; Fowler, Cathrine; Kruske, Sue; Homer, Caroline S E

    2017-02-01

    The aim of this study was to explore the extent to which Australian child and family health nurses work with families with complex needs and how their practice responds to the needs of these families. Many families with young children face challenges to their parenting capacity, potentially placing their children at risk of poorer developmental outcomes. Nurses increasingly work with families with mental health problems, trauma histories and/or substance dependence. Universal child health services must respond effectively to these challenges, to address health inequalities and to promote the best outcomes for all children and families. The descriptive study used cross-sectional data from the first national survey of child and family health nurses in Australia, conducted during 2011. Survey data reported how often, where and how child and family health nurses worked with families with complex needs and their confidence in nursing tasks. Many, but not all, of the 679 respondents saw families with complex needs in their regular weekly caseload. Child and family health nurses with diverse and complex caseloads reported using varied approaches to support their clients. They often undertook additional professional development and leadership roles compared with nurses who reported less complex caseloads. Most respondents reported high levels of professional confidence. For health services providing universal support and early intervention for families at risk, the findings underscore the importance of appropriate education, training and support for child and family health professionals. The findings can inform the organization and delivery of services for families in Australia and internationally. © 2016 John Wiley & Sons Ltd.

  15. Structuring and assessing large and complex decision problems using MCDA

    DEFF Research Database (Denmark)

    Barfod, Michael Bruhn

    This paper presents an approach for the structuring and assessing of large and complex decision problems using multi-criteria decision analysis (MCDA). The MCDA problem is structured in a decision tree and assessed using the REMBRANDT technique featuring a procedure for limiting the number of pair...

  16. Dependability problems of complex information systems

    CERN Document Server

    Zamojski, Wojciech

    2014-01-01

    This monograph presents original research results on selected problems of dependability in contemporary Complex Information Systems (CIS). The ten chapters are concentrated around the following three aspects: methods for modelling of the system and its components, tasks ? or in more generic and more adequate interpretation, functionalities ? accomplished by the system and conditions for their correct realization in the dynamic operational environment. While the main focus is on theoretical advances and roadmaps for implementations of new technologies, a?much needed forum for sharing of the bes

  17. Influence of Child Factors on Health-Care Professionals' Recognition of Common Childhood Mental-Health Problems.

    Science.gov (United States)

    Burke, Delia A; Koot, Hans M; de Wilde, Amber; Begeer, Sander

    Early recognition of childhood mental-health problems can help minimise long-term negative outcomes. Recognition of mental-health problems, needed for referral and diagnostic evaluation, is largely dependent on health-care professionals' (HCPs) judgement of symptoms presented by the child. This study aimed to establish whether HCPs recognition of mental-health problems varies as a function of three child-related factors (type of problem, number of symptoms, and demographic characteristics). In an online survey, HCPs ( n  = 431) evaluated a series of vignettes describing children with symptoms of mental-health problems. Vignettes varied by problem type (Attention-Deficit/Hyperactivity Disorder (ADHD), Generalised Anxiety Disorder (GAD), Autism Spectrum Disorder (ASD), Conduct Disorder (CD) and Major Depressive Disorder), number of symptoms presented (few and many), and child demographic characteristics (ethnicity, gender, age and socio-economic status (SES)). Results show that recognition of mental-health problems varies by problem type, with ADHD best recognised and GAD worst. Furthermore, recognition varies by the number of symptoms presented. Unexpectedly, a child's gender, ethnicity and family SES did not influence likelihood of problem recognition. These results are the first to reveal differences in HCPs' recognition of various common childhood mental-health problems. HCPs in practice should be advised about poor recognition of GAD, and superior recognition of ADHD, if recognition of all childhood mental-health problems is to be equal.

  18. Addressing Complex Challenges through Adaptive Leadership: A Promising Approach to Collaborative Problem Solving

    Science.gov (United States)

    Nelson, Tenneisha; Squires, Vicki

    2017-01-01

    Organizations are faced with solving increasingly complex problems. Addressing these issues requires effective leadership that can facilitate a collaborative problem solving approach where multiple perspectives are leveraged. In this conceptual paper, we critique the effectiveness of earlier leadership models in tackling complex organizational…

  19. Health-related quality of life among children with mental health problems: a population-based approach

    Directory of Open Access Journals (Sweden)

    Dey Michelle

    2012-06-01

    Full Text Available Abstract Background Children with mental health problems have been neglected in health-related quality of life (HRQOL studies. Therefore, the aims of the current study were 1 to assess the influence of the presence of mental or physical health problems on HRQOL; and 2 to analyze the effects of item overlap between mental health problems and HRQOL-measurements. Methods Proxy- and self-rated HRQOL (KIDSCREEN-27 of children 9–14 years old was assessed across children with mental health problems (n = 535, children with physical health problems (n = 327, and healthy controls (n = 744. Multiple linear regression analyses were conducted with health status, severity of symptoms, status of medication use, gender and nationality as independent, and HRQOL scores as dependent variables. The effects of item overlap were analyzed by repeating regression analyses while excluding those HRQOL items that contextually overlapped the most frequently-occurring mental health problem (attention deficits. Results Severity of symptoms was the strongest predictor of reduced HRQOL. However, all other predictors (except for the status of medication use also contributed to the prediction of some HRQOL scores. Controlling for item overlap did not meaningfully alter the results. Conclusions When children with different health constraints are compared, the severity of their particular health problems should be considered. Furthermore, item overlap seems not to be a major problem when the HRQOL of children with mental health problems is studied. Hence, HRQOL assessments are useful to gather information that goes beyond the clinical symptoms of a health problem. This information can, for instance, be used to improve clinical practice.

  20. Bangladesh women report postpartum health problems.

    Science.gov (United States)

    Goodburn, L

    1994-02-01

    The Bangladesh Rural Advancement Committee conducted operational research in Bangladesh to examine postpartum health problems. Researchers conducted focus groups, indepth interviews, and observation. More than 40% of the postpartum women had a delivery-related health problem by 2 weeks after delivery. 52% had signs or symptoms of anemia. Body needs after pregnancy, lactation, and blood loss during delivery exacerbate the nutritional anemia common to Bangladeshi women. 17% of the postpartum women had signs of infections. More than 50% had severe malnutrition, worsened by food taboos during the postpartum period. 60% of infant deaths occur in the neonatal period. The mortality risk is elevated in low birth weight (LBW) infants. In this study, more than 50% of the newborns were LBW infants. Many Bangladeshi mothers discard the colostrum and begin breast feeding several days after delivery. 11% of the postpartum women had breast problem (e.g., cracked nipples). Women believed that susceptibility to evil spirits accounted for their being more vulnerable to health problems during the postpartum. They feared leaving the household. These findings show a need for home visits to provide valuable postpartum care.

  1. PROBLEMS AND PROSPECTS OF SAFEGUARDING HEALTH ...

    African Journals Online (AJOL)

    observes that problems of safeguarding health values and right to health in ... through organized strategies and new approaches deliberately instituted to ... conceptions of a group about what is bad, undesirable and improper towards their ...

  2. Separate and combined effects of anxiety, depression and problem drinking on subjective health among black, hispanic and non-hispanic white men

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2014-01-01

    Conclusions: Although separate effects of anxiety and problem drinking were similar among race and ethnic groups, race and ethnicity seemed to modify the combined effects of different mental health problems. These results warrant further exploration of these complex links.

  3. arXiv Spin models in complex magnetic fields: a hard sign problem

    CERN Document Server

    de Forcrand, Philippe

    2018-01-01

    Coupling spin models to complex external fields can give rise to interesting phenomena like zeroes of the partition function (Lee-Yang zeroes, edge singularities) or oscillating propagators. Unfortunately, it usually also leads to a severe sign problem that can be overcome only in special cases; if the partition function has zeroes, the sign problem is even representation-independent at these points. In this study, we couple the N-state Potts model in different ways to a complex external magnetic field and discuss the above mentioned phenomena and their relations based on analytic calculations (1D) and results obtained using a modified cluster algorithm (general D) that in many cases either cures or at least drastically reduces the sign-problem induced by the complex external field.

  4. How Cognitive Style and Problem Complexity Affect Preservice Agricultural Education Teachers' Abilities to Solve Problems in Agricultural Mechanics

    Science.gov (United States)

    Blackburn, J. Joey; Robinson, J. Shane; Lamm, Alexa J.

    2014-01-01

    The purpose of this experimental study was to determine the effects of cognitive style and problem complexity on Oklahoma State University preservice agriculture teachers' (N = 56) ability to solve problems in small gasoline engines. Time to solution was operationalized as problem solving ability. Kirton's Adaption-Innovation Inventory was…

  5. Shift work-related health problems in

    Directory of Open Access Journals (Sweden)

    S. Khavaji

    2010-04-01

    Full Text Available Background and aimsShift work is a major feature of working life that affects diverse aspects of human life. The main purposes of this study were to investigate shift work-related health problems and their risk factors among workers of "12-hour shift" schedule.MethodsThis cross-sectional study was carried out at 8 petrochemical industries in Asalooyeh area. Study population consisted of 1203 workers including 549 shift worker (46% and 654 day worker (54%. Data on personal details, shift schedule and adverse effects of shift work werecollected by anonymous questionnaire. Statistical analyses were performed using SPSS, version 11.5. The level of significance was set at 5%.ResultsAlthough, the results showed that health problems among shift workers was more prevalent than day workers, but the differences were just significant in gastrointestinal and musculoskeletal disorders (p<0.05. Multiple linear regressions indicated that in addition to shift working, other variants such as long work hours, type of employment, second job, number of children and job title were associated with health problems.ConclusionPrevalence rates of gastrointestinal and musculoskeletal problems among shift workers were significantly higher than that of day workers. Although, working in shift system was the main significant factor associated with the reported problems, but other demographic andwork variables were also found to have association.

  6. The Similar Structures and Control Problems of Complex Systems

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    In this paper, the naturally evolving complex systems, such as biotic and social ones, are considered. Focusing on their structures, a feature is noteworthy, i.e., the similarity in structures. The relations between the functions and behaviors of these systems and their similar structures will be studied. Owing to the management of social systems and the course of evolution of biotic systems may be regarded as control processes, the researches will be within the scope of control problems. Moreover, since it is difficult to model for biotic and social systems, it will start with the control problems of complex systems, possessing similar structures, in engineering.The obtained results show that for either linear or nonlinear systems and for a lot of control problemssimilar structures lead to a series of simplifications. In general, the original system may be decomposed into reduced amount of subsystems with lower dimensions and simpler structures. By virtue of such subsystems, the control problems of original system can be solved more simply.At last, it turns round to observe the biotic and social systems and some analyses are given.

  7. Complex problems require complex solutions: the utility of social quality theory for addressing the Social Determinants of Health

    Directory of Open Access Journals (Sweden)

    Ward Paul R

    2011-08-01

    Full Text Available Abstract Background In order to improve the health of the most vulnerable groups in society, the WHO Commission on Social Determinants of Health (CSDH called for multi-sectoral action, which requires research and policy on the multiple and inter-linking factors shaping health outcomes. Most conceptual tools available to researchers tend to focus on singular and specific social determinants of health (SDH (e.g. social capital, empowerment, social inclusion. However, a new and innovative conceptual framework, known as social quality theory, facilitates a more complex and complete understanding of the SDH, with its focus on four domains: social cohesion, social inclusion, social empowerment and socioeconomic security, all within the same conceptual framework. This paper provides both an overview of social quality theory in addition to findings from a national survey of social quality in Australia, as a means of demonstrating the operationalisation of the theory. Methods Data were collected using a national random postal survey of 1044 respondents in September, 2009. Multivariate logistic regression analysis was conducted. Results Statistical analysis revealed that people on lower incomes (less than $45000 experience worse social quality across all of the four domains: lower socio-economic security, lower levels of membership of organisations (lower social cohesion, higher levels of discrimination and less political action (lower social inclusion and lower social empowerment. The findings were mixed in terms of age, with people over 65 years experiencing lower socio-economic security, but having higher levels of social cohesion, experiencing lower levels of discrimination (higher social inclusion and engaging in more political action (higher social empowerment. In terms of gender, women had higher social cohesion than men, although also experienced more discrimination (lower social inclusion. Conclusions Applying social quality theory allows

  8. Children with mental versus physical health problems: differences in perceived disease severity, health care service utilization and parental health literacy.

    Science.gov (United States)

    Dey, Michelle; Wang, Jen; Jorm, Anthony Francis; Mohler-Kuo, Meichun

    2015-03-01

    To compare children with mental and physical health problems regarding (1) perceived disease severity; (2) the impact of their condition on their families; (3) their utilization of health care services (including satisfaction with care); and (4) parents' health literacy about their child's condition and its treatment. Furthermore, we examined whether parents' health literacy differs between types of mental health condition. Parental reports about their 9- to 14-year-old children with mental (n = 785) or physical health problems (n = 475) were analyzed from the population-based National Survey of Children with Special Health Care Needs in Switzerland. Mental health problems were perceived as being more severe (p mental health problem mentioned having a particular person or place to contact if they needed information or advice regarding the child's condition (p = 0.004) and were satisfied with the health care services their child received (p mental health problems vs. parents of children with physical health problems (OR in the adjusted model = 1.92; 95 % CI 1.47-2.50; p mental health problem (although only a trend was observable for internalizing problems). The large impact of children's mental health conditions on themselves and their families might be reduced by adapting the provision of health care and by increasing parents' health literacy.

  9. Thinking about complexity in health: A systematic review of the key systems thinking and complexity ideas in health.

    Science.gov (United States)

    Rusoja, Evan; Haynie, Deson; Sievers, Jessica; Mustafee, Navonil; Nelson, Fred; Reynolds, Martin; Sarriot, Eric; Swanson, Robert Chad; Williams, Bob

    2018-01-30

    As the Sustainable Development Goals are rolled out worldwide, development leaders will be looking to the experiences of the past to improve implementation in the future. Systems thinking and complexity science (ST/CS) propose that health and the health system are composed of dynamic actors constantly evolving in response to each other and their context. While offering practical guidance for steering the next development agenda, there is no consensus as to how these important ideas are discussed in relation to health. This systematic review sought to identify and describe some of the key terms, concepts, and methods in recent ST/CS literature. Using the search terms "systems thinkin * AND health OR complexity theor* AND health OR complex adaptive system* AND health," we identified 516 relevant full texts out of 3982 titles across the search period (2002-2015). The peak number of articles were published in 2014 (83) with journals specifically focused on medicine/healthcare (265) and particularly the Journal of Evaluation in Clinical Practice (37) representing the largest number by volume. Dynamic/dynamical systems (n = 332), emergence (n = 294), complex adaptive system(s) (n = 270), and interdependent/interconnected (n = 263) were the most common terms with systems dynamic modelling (58) and agent-based modelling (43) as the most common methods. The review offered several important conclusions. First, while there was no core ST/CS "canon," certain terms appeared frequently across the reviewed texts. Second, even as these ideas are gaining traction in academic and practitioner communities, most are concentrated in a few journals. Finally, articles on ST/CS remain largely theoretical illustrating the need for further study and practical application. Given the challenge posed by the next phase of development, gaining a better understanding of ST/CS ideas and their use may lead to improvements in the implementation and practice of the Sustainable Development

  10. Who should be responsible for supporting individuals with mental health problems? A critical literature review.

    Science.gov (United States)

    Pope, Megan A; Malla, Ashok K; Iyer, Srividya N

    2018-05-01

    Individuals with mental health problems have many support needs that are often inadequately met; however, perceptions of who should be responsible for meeting these needs have been largely unexplored. Varying perceptions may influence whether, how, and to what extent relevant stakeholders support individuals with mental health problems. To critically evaluate the literature to determine who different stakeholders believe should be responsible for supporting individuals with mental health problems, what factors shape these perceptions, and how they relate to one another. A critical literature review was undertaken. Following an extensive literature search, the conceptual contributions of relevant works were critically evaluated. A concept map was created to build a conceptual framework of the topic. Views of individual versus societal responsibility for need provision and health; the morality of caring; and attributions of responsibility for mental illness offered valuable understandings of the review questions. Creating a concept map revealed that various interrelated factors may influence perceptions of responsibility. Varying perceptions of who should be responsible for supporting individuals with mental health problems may contribute to unmet support needs among this group. Our critical review helps build a much-needed conceptual framework of factors influencing perceptions of responsibility. Such a framework is essential as these views iteratively shape and reflect the complex divisions of mental healthcare roles and responsibilities. Understanding these perceptions can help define relevant stakeholders' roles more clearly, which can improve mental health services and strengthen stakeholder accountability.

  11. Solution of a Complex Least Squares Problem with Constrained Phase.

    Science.gov (United States)

    Bydder, Mark

    2010-12-30

    The least squares solution of a complex linear equation is in general a complex vector with independent real and imaginary parts. In certain applications in magnetic resonance imaging, a solution is desired such that each element has the same phase. A direct method for obtaining the least squares solution to the phase constrained problem is described.

  12. Developing, delivering and evaluating primary mental health care: the co-production of a new complex intervention.

    Science.gov (United States)

    Reeve, Joanne; Cooper, Lucy; Harrington, Sean; Rosbottom, Peter; Watkins, Jane

    2016-09-06

    Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area in to quality improvement changes on the ground. BounceBack was a service development innovation project which sought to examine this issue through the implementation and evaluation in a primary care setting of a novel complex intervention. The project was a collaboration between a local mental health charity, an academic unit, and GP practices. The aim was to translate the charity's model of care into practice-based evidence describing delivery and impact. Normalisation Process Theory (NPT) was used to support the implementation of the new model of primary mental health care into six GP practices. An integrated process evaluation evaluated the process and impact of care. Implementation quickly stalled as we identified problems with the described model of care when applied in a changing and variable primary care context. The team therefore switched to using the NPT framework to support the systematic identification and modification of the components of the complex intervention: including the core components that made it distinct (the consultation approach) and the variable components (organisational issues) that made it work in practice. The extra work significantly reduced the time available for outcome evaluation. However findings demonstrated moderately successful implementation of the model and a suggestion of hypothesised changes in outcomes. The BounceBack project demonstrates the development of a complex intervention from practice. It highlights the use of Normalisation Process Theory to support development, and not just implementation, of a complex intervention; and describes the use of the research process in the generation of practice-based evidence. Implications for future translational complex intervention research supporting practice change

  13. Sepsis is a preventable public health problem.

    Science.gov (United States)

    Kempker, Jordan A; Wang, Henry E; Martin, Greg S

    2018-05-06

    There is a paradigm shift happening for sepsis. Sepsis is no longer solely conceptualized as problem of individual patients treated in emergency departments and intensive care units but also as one that is addressed as public health issue with population- and systems-based solutions. We offer a conceptual framework for sepsis as a public health problem by adapting the traditional model of primary, secondary, and tertiary prevention.

  14. Tracing the development of complex problems and the methods of its information support

    International Nuclear Information System (INIS)

    Belenki, A.; Ryjov, A.

    1999-01-01

    This article is dedicated to the development of a technology for information monitoring of complex problems such as IAEA safeguards tasks. The main purpose of this technology is to create human-machine systems for monitoring problems with complex subject areas such as political science, social science, business, ecology and etc. (author)

  15. Information Technology in Complex Health Services

    Science.gov (United States)

    Southon, Frank Charles Gray; Sauer, Chris; Dampney, Christopher Noel Grant (Kit)

    1997-01-01

    Abstract Objective: To identify impediments to the successful transfer and implementation of packaged information systems through large, divisionalized health services. Design: A case analysis of the failure of an implementation of a critical application in the Public Health System of the State of New South Wales, Australia, was carried out. This application had been proven in the United States environment. Measurements: Interviews involving over 60 staff at all levels of the service were undertaken by a team of three. The interviews were recorded and analyzed for key themes, and the results were shared and compared to enable a continuing critical assessment. Results: Two components of the transfer of the system were considered: the transfer from a different environment, and the diffusion throughout a large, divisionalized organization. The analyses were based on the Scott-Morton organizational fit framework. In relation to the first, it was found that there was a lack of fit in the business environments and strategies, organizational structures and strategy-structure pairing as well as the management process-roles pairing. The diffusion process experienced problems because of the lack of fit in the strategy-structure, strategy-structure-management processes, and strategy-structure-role relationships. Conclusion: The large-scale developments of integrated health services present great challenges to the efficient and reliable implementation of information technology, especially in large, divisionalized organizations. There is a need to take a more sophisticated approach to understanding the complexities of organizational factors than has traditionally been the case. PMID:9067877

  16. Assessment of occupational hazards, health problems and safety ...

    African Journals Online (AJOL)

    Background: Petrol station attendants encounter several hazards and health problems while working. This study was conducted to determine the ... Hazards reported included inhalation of petrol fumes 145 (67.4%), confrontation from customers 112 (52.1%) and noise 98 (45.6%). Health problems reported included ...

  17. Prognosis and continuity of child mental health problems from preschool to primary school: results of a four-year longitudinal study.

    Science.gov (United States)

    Beyer, Thomas; Postert, Christian; Müller, Jörg M; Furniss, Tilman

    2012-08-01

    In a four-year longitudinal study, changes in and continuity of behavioral and emotional problems were examined in 814 subjects from kindergarten to primary school. Mental health problems were assessed by means of the Child Behavior Checklist (CBCL). The distribution of the CBCL broadband groups revealed a high level of continuity of internalizing symptoms over the four-year period and a shift from externalizing symptoms at baseline towards a combination of internalizing and externalizing symptoms at follow-up. The presence of mental health problems at follow-up was correlated with gender (higher amongst boys), pre-existing mental health problems at baseline, and separation or divorce of the parents, but not with single-family status or the age and educational level of the mother. The increasing number of children with a combination of internalizing and externalizing symptoms demonstrates the increasing complexity of child mental health problems in the developmental span from preschool age to school age.

  18. Advice Complexity of the Online Induced Subgraph Problem

    DEFF Research Database (Denmark)

    Komm, Dennis; Královič, Rastislav; Královič, Richard

    2016-01-01

    of the input can influence the solution quality. We evaluate the information in a quantitative way by considering the best possible advice of given size that describes the unknown input. Using a result from Boyar et al. we give a tight trade-off relationship stating that, for inputs of length n, roughly n...... subgraph problem, preemption does not significantly help by giving a lower bound of Omega(n/(c^2\\log c)) on the bits of advice that are needed to obtain competitive ratio c, where c is any increasing function bounded from above by \\sqrt{n/\\log n}. We also give a linear lower bound for c close to 1....... these problems by investigating a generalized problem: for an arbitrary but fixed hereditary property, find some maximal induced subgraph having the property. We investigate this problem from the point of view of advice complexity, i.e. we ask how some additional information about the yet unrevealed parts...

  19. Data Mining and Complex Problems: Case Study in Composite Materials

    Science.gov (United States)

    Rabelo, Luis; Marin, Mario

    2009-01-01

    Data mining is defined as the discovery of useful, possibly unexpected, patterns and relationships in data using statistical and non-statistical techniques in order to develop schemes for decision and policy making. Data mining can be used to discover the sources and causes of problems in complex systems. In addition, data mining can support simulation strategies by finding the different constants and parameters to be used in the development of simulation models. This paper introduces a framework for data mining and its application to complex problems. To further explain some of the concepts outlined in this paper, the potential application to the NASA Shuttle Reinforced Carbon-Carbon structures and genetic programming is used as an illustration.

  20. Parent-reported Mental Health Problems and Mental Health Services Use in South Australian School-aged Children

    Directory of Open Access Journals (Sweden)

    Jing Wu

    2016-09-01

    Full Text Available Background:Monitoring and reporting childhood mental health problems and mental health services utilization over time provide important information to identify mental health related issues and to guide early intervention. This paper aims to describe the recent prevalence of parent-reported mental health problems among South Australian (SA children; to identify mental health problems associated characteristics; and to describe mental health services utilization and its related characteristics among this population. Methods:Parent-reported mental health problems were assessed against the first item of the Strength and Difficulties Questionnaire. School-aged children were randomly sampled monthly and data were collected using a surveillance system between 2005 and 2015. Associations between mental health problems and various factors were analysed using univariable analysis and multivariable logistic regression modelling. Results:Prevalence of parent-reported mental health problems among children was 9.1% and 9.3% for children aged 5 to 11 years and children aged 12 to 15 years, respectively. No change in prevalence was observed during the past decade. Mental health problems were associated with male sex, long-term illness or pain, negative school experiences, not living with biological parents, and living in a rental dwelling. Less than half (48.7% of the children with mental health problems received professional help. An increasing trend was found in mental health services utilisation among children aged 5 to 15 years. Utilization of mental health services was associated with male sex, older age, long-term illness or pain, and feeling unhappy at school. Conclusion:This study reports the prevalence of parent-reported mental and mental health services utilisation among SA school-aged children. Identified characteristics associated with mental health problems and mental health services utilisation provide useful information for the planning of

  1. Complexity of hierarchically and 1-dimensional periodically specified problems

    Energy Technology Data Exchange (ETDEWEB)

    Marathe, M.V.; Hunt, H.B. III; Stearns, R.E.; Radhakrishnan, V.

    1995-08-23

    We study the complexity of various combinatorial and satisfiability problems when instances are specified using one of the following specifications: (1) the 1-dimensional finite periodic narrow specifications of Wanke and Ford et al. (2) the 1-dimensional finite periodic narrow specifications with explicit boundary conditions of Gale (3) the 2-way infinite1-dimensional narrow periodic specifications of Orlin et al. and (4) the hierarchical specifications of Lengauer et al. we obtain three general types of results. First, we prove that there is a polynomial time algorithm that given a 1-FPN- or 1-FPN(BC)specification of a graph (or a C N F formula) constructs a level-restricted L-specification of an isomorphic graph (or formula). This theorem along with the hardness results proved here provides alternative and unified proofs of many hardness results proved in the past either by Lengauer and Wagner or by Orlin. Second, we study the complexity of generalized CNF satisfiability problems of Schaefer. Assuming P {ne} PSPACE, we characterize completely the polynomial time solvability of these problems, when instances are specified as in (1), (2),(3) or (4). As applications of our first two types of results, we obtain a number of new PSPACE-hardness and polynomial time algorithms for problems specified as in (1), (2), (3) or(4). Many of our results also hold for O(log N) bandwidth bounded planar instances.

  2. Physical health problems in adults with Prader-Willi syndrome.

    Science.gov (United States)

    Sinnema, Margje; Maaskant, Marian A; van Schrojenstein Lantman-de Valk, Henny M J; van Nieuwpoort, I Caroline; Drent, Madeleine L; Curfs, Leopold M G; Schrander-Stumpel, Constance T R M

    2011-09-01

    Prader-Willi syndrome (PWS) is a genetic disorder which is characterized by severe hypotonia and feeding problems in early infancy. In later childhood and adolescence, this is followed by hyperphagia and extreme obesity if the diet is not strictly controlled. Data on physical health problems in adults with PWS are scarce. We report on the prevalence of physical health problems in a Dutch cohort of adults with PWS in relation to age, BMI, and genetic subtype. Participants (n = 102) were retrieved via the Dutch Prader-Willi Parent Association and through physicians specializing in persons with intellectual disabilities (ID). Details regarding physical health problem spanning the participants' lifespan were collected from caretakers through semi-structured interviews. Cardiovascular problems included diabetes mellitus, hypertension, and cerebrovascular accidents. Respiratory infections were frequent in adulthood. In males, cryptorchidism was almost universal, for which 28/48 males had a history of surgery, mostly orchidopexy. None of the women had a regular menstrual cycle. Sixteen individuals had a diagnosis of osteoporosis. Spinal deformation, hip dysplasia, and foot abnormalities were common. Skinpicking, leg edema, and erysipelas were frequent dermatological problems. The findings in our group support the notion that the prevalence of physical health problems is underestimated. This underscores the importance of developing monitoring programs which would help to recognize physical health problems at an early stage. Copyright © 2011 Wiley-Liss, Inc.

  3. Problem Gambling Among Ontario Students: Associations with Substance Abuse, Mental Health Problems, Suicide Attempts, and Delinquent Behaviours.

    Science.gov (United States)

    Cook, Steven; Turner, Nigel E; Ballon, Bruce; Paglia-Boak, Angela; Murray, Robert; Adlaf, Edward M; Ilie, Gabriela; den Dunnen, Wendy; Mann, Robert E

    2015-12-01

    This paper describes gambling problems among Ontario students in 2009 and examines the relationship between gambling problems and substance use problems, mental health problem indicators, and delinquent behaviors. Data were derived from the Ontario Student Drug Use and Health Survey of Ontario students in grades 7-12. Gambling problems were measured as 2 or more of 6 indicators of problem gambling. In total 2.8% of the students surveyed endorsed two or more of the problem gambling items. The odds of problem gamblers reporting mental distress was 4.2 times higher than the rest of the sample and the odds of problem gamblers reporting a suicide attempt were 17.8 times greater than the rest of the sample. In addition compared to the rest of the students, delinquent behaviors were also more common among problem gamblers, including theft (OR = 14.5), selling marijuana (OR = 19.6), gang fights (OR = 11.3) and carrying a handgun (OR = 11.2). In a multivariate analysis, substance-use problems, mental health problems, and the participation in a variety of delinquent behaviors remained significantly associated with youth problem gambling behavior. Students who report problem gambling behaviors show increased substance abuse, mental health, and delinquency/criminal problems that are similar to those seen among adult problem gamblers. The association between these problems suggests that these problems could be addressed in a unified manner.

  4. Disclosure of minor mental health problems: an exploratory theoretical study.

    Science.gov (United States)

    Williams, B; Healy, D

    2001-07-01

    The aim of this study was to explore people's experiences, concerns and beliefs about disclosing minor mental health problems by focusing on the ways in which such disclosures are interpreted. Approximately half of people with mental health problems do not seek help. The decision to consult represents just one aspect of the process of revealing one's illness to others. People with mental health problems are known to be reluctant to reveal the existence of those problems through fear of how others might then view them. A qualitative approach was employed. In-depth interviews were carried out with 47 users and nonusers of community mental health services. Interviews were tape-recorded, transcribed and analysed. The data suggest that when people reveal minor mental health problems others interpret these in relation to a number of perceived contextual factors. These include perceptions of the severity and duration of any possible causes, the inner 'strength' of the person, the expected ability of the person to either solve or suppress the experience, and the form and context of the expression itself. The data presented included individuals who were seeking help for relatively 'minor' mental health problems (primarily depression and anxiety) and individuals who had no current mental health problems but routinely managed expressions of their own emotions. Throughout the data there appeared to be no distinct difference between these two groups other than one of the severity of psychological experience. The key elements involved in the interpretation of people's expressions of sadness were essentially the same as those involved in the interpretation of expressions of depression. An appreciation of these contextual factors influencing the interpretation and disclosure of minor mental health problems may aid the development of more person-centred mental health services and inform the content of health education in the mental health field.

  5. Health behaviour changes and onset of chronic health problems in later life

    Directory of Open Access Journals (Sweden)

    Marijke Veenstra

    2012-11-01

    Full Text Available Objectives: To assess five-year changes in health behaviours in later life and associations with onset of chronic health problems. The results may inform policy and interventions to promote healthy life years in ageing populations.Methods: Data are derived from the Norwegian study on Life-course, Ageing and Generation (NorLAG, a five-year (2002-2007 panel survey comprising a nation wide community sample. The present analyses include a sample of 1,019 respondents aged 60 years and older. Five-year changes in smoking, alcohol use, physical exercise and Body Mass Index (BMI are assessed according to prevalent and incident chronic health problems. Multivariate logistic analyses of “healthy” behavioural changes are conducted.Results: A total of 453 respondents (45% reported at least one chronic condition and 13% (N=133 reported onset of chronic conditions in the course of the past five years. Over a five-year period, there was an overall reduction in smoking rates and a decrease in regular physical activity. Alcohol consumption in older people slightly increased over time, but the incidence of chronic health problems tended to reduce alcohol intake. Older persons experiencing chronic health problems were less likely to initiate physical activity.Conclusions: The results provide limited support for the assumption that the onset of a chronic health condition triggers improved health behaviours. This suggests that the health care system could do more in targeting a potential “window of opportunity” for individuals to adopt new healthy behaviours in later life.

  6. Understanding global health governance as a complex adaptive system.

    Science.gov (United States)

    Hill, Peter S

    2011-01-01

    The transition from international to global health reflects the rapid growth in the numbers and nature of stakeholders in health, as well as the constant change embodied in the process of globalisation itself. This paper argues that global health governance shares the characteristics of complex adaptive systems, with its multiple and diverse players, and their polyvalent and constantly evolving relationships, and rich and dynamic interactions. The sheer quantum of initiatives, the multiple networks through which stakeholders (re)configure their influence, the range of contexts in which development for health is played out - all compound the complexity of this system. This paper maps out the characteristics of complex adaptive systems as they apply to global health governance, linking them to developments in the past two decades, and the multiple responses to these changes. Examining global health governance through the frame of complexity theory offers insight into the current dynamics of governance, and while providing a framework for making meaning of the whole, opens up ways of accessing this complexity through local points of engagement.

  7. Systems thinking and complexity: considerations for health promoting schools.

    Science.gov (United States)

    Rosas, Scott R

    2017-04-01

    The health promoting schools concept reflects a comprehensive and integrated philosophy to improving student and personnel health and well-being. Conceptualized as a configuration of interacting, interdependent parts connected through a web of relationships that form a whole greater than the sum of its parts, school health promotion initiatives often target several levels (e.g. individual, professional, procedural and policy) simultaneously. Health promoting initiatives, such as those operationalized under the whole school approach, include several interconnected components that are coordinated to improve health outcomes in complex settings. These complex systems interventions are embedded in intricate arrangements of physical, biological, ecological, social, political and organizational relationships. Systems thinking and characteristics of complex adaptive systems are introduced in this article to provide a perspective that emphasizes the patterns of inter-relationships associated with the nonlinear, dynamic and adaptive nature of complex hierarchical systems. Four systems thinking areas: knowledge, networks, models and organizing are explored as a means to further manage the complex nature of the development and sustainability of health promoting schools. Applying systems thinking and insights about complex adaptive systems can illuminate how to address challenges found in settings with both complicated (i.e. multi-level and multisite) and complex aspects (i.e. synergistic processes and emergent outcomes). © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Investigating the Effect of Complexity Factors in Stoichiometry Problems Using Logistic Regression and Eye Tracking

    Science.gov (United States)

    Tang, Hui; Kirk, John; Pienta, Norbert J.

    2014-01-01

    This paper includes two experiments, one investigating complexity factors in stoichiometry word problems, and the other identifying students' problem-solving protocols by using eye-tracking technology. The word problems used in this study had five different complexity factors, which were randomly assigned by a Web-based tool that we developed. The…

  9. Conceptual and procedural knowledge community college students use when solving a complex science problem

    Science.gov (United States)

    Steen-Eibensteiner, Janice Lee

    2006-07-01

    A strong science knowledge base and problem solving skills have always been highly valued for employment in the science industry. Skills currently needed for employment include being able to problem solve (Overtoom, 2000). Academia also recognizes the need for effectively teaching students to apply problem solving skills in clinical settings. This thesis investigates how students solve complex science problems in an academic setting in order to inform the development of problem solving skills for the workplace. Students' use of problem solving skills in the form of learned concepts and procedural knowledge was studied as students completed a problem that might come up in real life. Students were taking a community college sophomore biology course, Human Anatomy & Physiology II. The problem topic was negative feedback inhibition of the thyroid and parathyroid glands. The research questions answered were (1) How well do community college students use a complex of conceptual knowledge when solving a complex science problem? (2) What conceptual knowledge are community college students using correctly, incorrectly, or not using when solving a complex science problem? (3) What problem solving procedural knowledge are community college students using successfully, unsuccessfully, or not using when solving a complex science problem? From the whole class the high academic level participants performed at a mean of 72% correct on chapter test questions which was a low average to fair grade of C-. The middle and low academic participants both failed (F) the test questions (37% and 30% respectively); 29% (9/31) of the students show only a fair performance while 71% (22/31) fail. From the subset sample population of 2 students each from the high, middle, and low academic levels selected from the whole class 35% (8/23) of the concepts were used effectively, 22% (5/23) marginally, and 43% (10/23) poorly. Only 1 concept was used incorrectly by 3/6 of the students and identified as

  10. Anxiety and health problems related to air travel.

    Science.gov (United States)

    McIntosh, I B; Swanson, V; Power, K G; Raeside, F; Dempster, C

    1998-12-01

    A significant proportion of air travelers experience situational anxiety and physical health problems. Take-off and landing are assumed to be stressful, but anxiety related to other aspects of the air travel process, anxiety coping strategies, and in-flight health problems have not previously been investigated. We aimed to investigate frequency of perceived anxiety at procedural stages of air travel, individual strategies used to reduce such anxiety, and frequency of health problems on short-haul and long-haul flights. A questionnaire measuring the occurrence and frequency of the above was administered to two samples of intending travelers during a 3 month period to: (a) 138 travel agency clients, and (b) 100 individuals attending a hospital travel clinic. Of the 238 respondents, two thirds were women. Take-off and landing were a perceived source of anxiety for about 40% of respondents, flight delays for over 50%, and customs and baggage reclaim for a third of individuals. Most frequent anxiety-reduction methods included alcohol and cigarette use, and distraction or relaxation techniques. Physical health problems related to air travel were common, and there was a strong relationship between such problems and frequency of anxiety. Travel agency clients reported more anxiety but not more physical health symptoms overall than travel clinic clients. Women reported greater air-travel anxiety, and more somatic symptoms than men. Significant numbers of air travelers report perceived anxiety related to aspects of travel, and this is associated with health problems during flights. Airlines and travel companies could institute specific measures, including improved information and communication, to reassure clients and thereby diminish anxiety during stages of air-travel. Medical practitioners and travel agencies should also be aware of the potential stresses of air travel and the need for additional information and advice.

  11. Assessment of Occupational Hazards, Health Problems and Safety ...

    African Journals Online (AJOL)

    UNIBEN

    Background: Petrol station attendants encounter several hazards and health problems while working. This study was conducted to determine the occupational hazards, health ..... engineering conference on sustainable ... Industrial Health.

  12. Complexity: a potential paradigm for a health promotion discipline.

    Science.gov (United States)

    Tremblay, Marie-Claude; Richard, Lucie

    2014-06-01

    Health promotion underpins a distancing from narrow, simplifying health approaches associated with the biomedical model. However, it has not yet succeeded in formally establishing its theoretical, epistemological and methodological foundations on a single paradigm. The complexity paradigm, which it has yet to broach head-on, might provide it with a disciplinary matrix in line with its implicit stances and basic values. This article seeks to establish complexity's relevance as a paradigm that can contribute to the development of a health promotion discipline. The relevance of complexity is justified primarily by its matching with several implicit epistemological and methodological/theoretical stances found in the cardinal concepts and principles of health promotion. The transcendence of ontological realism and determinism as well as receptiveness in respect of the reflexivity that complexity encompasses are congruent with the values of social justice, participation, empowerment and the concept of positive health that the field promotes. Moreover, from a methodological and theoretical standpoint, complexity assumes a holistic, contextual and transdisciplinary approach, toward which health promotion is tending through its emphasis on ecology and interdisciplinary action. In a quest to illustrate our position, developmental evaluation is presented as an example of practice stemming from a complexity paradigm that can be useful in the evaluation of health promotion initiatives. In short, we argue that it would be advantageous for health promotion to integrate this paradigm, which would provide it with a formal framework appropriate to its purposes and concerns.

  13. Social problem solving ability predicts mental health among undergraduate students.

    Science.gov (United States)

    Ranjbar, Mansour; Bayani, Ali Asghar; Bayani, Ali

    2013-11-01

    The main objective of this study was predicting student's mental health using social problem solving- ability. In this correlational. descriptive study, 369 (208 female and 161 male) from, Mazandaran University of Medical Science were selected through stratified random sampling method. In order to collect the data, the social problem solving inventory-revised and general health questionnaire were used. Data were analyzed through SPSS-19, Pearson's correlation, t test, and stepwise regression analysis. Data analysis showed significant relationship between social problem solving ability and mental health (P Social problem solving ability was significantly associated with the somatic symptoms, anxiety and insomnia, social dysfunction and severe depression (P social problem solving ability and mental health.

  14. Radon: A health problem and a communication problem

    International Nuclear Information System (INIS)

    Johnson, R.H.

    1992-01-01

    The US Environmental Protection Agency (USEPA) is making great efforts to alert the American public to the potential health risks of radon in homes. The news media have widely publicized radon as a problem; state and local governments are responding to public alarms; and hundreds of radon open-quotes expertsclose quotes are now offering radon detection and mitigation services. Apparently, USEPA's communication program is working, and the public is becoming increasingly concerned with radon. But are they concerned with radon as a open-quotes healthclose quotes problem in the way USEPA intended? The answer is yes, partly. More and more, however, the concerns are about home resale values. Many homebuyers are now deciding whether to buy on the basis of a single radon screening measurement, comparing it with USEPA's action guide of 4 pCi L -1 . They often conclude that 3.9 is OK, but 4.1 is not. Here is where the communication problems begin. The public largely misunderstands the significance of USEPA's guidelines and the meaning of screening measurements. Seldom does anyone inquire about the quality of the measurements, or the results of USEPA performance testing? Who asks about the uncertainty of lifetime exposure assessments based on a 1-hour, 1-day, 3-day, or even 30-day measurement? Who asks about the uncertainty of USEPA's risk estimates? Fortunately, an increasing number of radiation protection professions are asking such questions. They find that USEPA's risk projections are based on many assumptions which warrant further evaluation, particularly with regard to the combined risks of radon and cigarette-smoking. This is the next communication problem. What are these radiation professions doing to understand the bases for radon health-risk projections? Who is willing to communicate a balanced perspective to the public? Who is willing to communicate the uncertainty and conservatism in radon measurements and risk estimates?

  15. Modal and Mixed Specifications: Key Decision Problems and their Complexities

    DEFF Research Database (Denmark)

    Antonik, Adam; Huth, Michael; Larsen, Kim Guldstrand

    2010-01-01

    , and whether all implementations of one specification are implementations of another one. For each of these decision problems we investigate the worst-case computational complexity for the modal and mixed case. We show that the first decision problem is EXPTIME-complete for modal as well as for mixed......Modal and mixed transition systems are specification formalisms that allow mixing of over- and under-approximation. We discuss three fundamental decision problems for such specifications: whether a set of specifications has a common implementation, whether a sole specification has an implementation...... specifications. We prove that the second decision problem is EXPTIME-complete for mixed specifications (while it is known to be trivial for modal ones). The third decision problem is furthermore demonstrated to be EXPTIME-complete for mixed specifications....

  16. Palestinian mothers' perceptions of child mental health problems and services

    Science.gov (United States)

    THABET, ABDEL AZIZ; EL GAMMAL, HOSSAM; VOSTANIS, PANOS

    2006-01-01

    The aim of this study was to explore Palestinian mothers' perceptions of child mental health problems and their understanding of their causes; to determine Palestinian mothers' awareness of existing services and sources of help and support; to identify professionals in the community whom Palestinian mothers would consult if their child had mental health problems; and to establish their views on ways of increasing awareness of child mental health issues and services. Checklists exploring the above issues were completed by 249 Palestinian mothers living in refugee camps in the Gaza Strip. Palestinian mothers equally perceived emotional, behavioural and psychotic symptoms as suggestive of mental ill health in childhood. Mothers perceived multiple causes of child mental health problems, including family problems, parental psychiatric illness and social adversity. A substantial proportion (42.6%) had knowledge of local child mental health care services. Overall, mothers preferred Western over traditional types of treatment, and were keen to increase mental health awareness within their society. Despite a different cultural tradition, Palestinian mothers appear open to a range of services and interventions for child mental health problems. As in other non-Western societies, child mental health service provision should be integrated with existing primary health care, schools, and community structures. PMID:16946953

  17. Solving the three-body Coulomb breakup problem using exterior complex scaling

    Energy Technology Data Exchange (ETDEWEB)

    McCurdy, C.W.; Baertschy, M.; Rescigno, T.N.

    2004-05-17

    Electron-impact ionization of the hydrogen atom is the prototypical three-body Coulomb breakup problem in quantum mechanics. The combination of subtle correlation effects and the difficult boundary conditions required to describe two electrons in the continuum have made this one of the outstanding challenges of atomic physics. A complete solution of this problem in the form of a ''reduction to computation'' of all aspects of the physics is given by the application of exterior complex scaling, a modern variant of the mathematical tool of analytic continuation of the electronic coordinates into the complex plane that was used historically to establish the formal analytic properties of the scattering matrix. This review first discusses the essential difficulties of the three-body Coulomb breakup problem in quantum mechanics. It then describes the formal basis of exterior complex scaling of electronic coordinates as well as the details of its numerical implementation using a variety of methods including finite difference, finite elements, discrete variable representations, and B-splines. Given these numerical implementations of exterior complex scaling, the scattering wave function can be generated with arbitrary accuracy on any finite volume in the space of electronic coordinates, but there remains the fundamental problem of extracting the breakup amplitudes from it. Methods are described for evaluating these amplitudes. The question of the volume-dependent overall phase that appears in the formal theory of ionization is resolved. A summary is presented of accurate results that have been obtained for the case of electron-impact ionization of hydrogen as well as a discussion of applications to the double photoionization of helium.

  18. The meaning and experience of work in the context of severe and enduring mental health problems: an interpretative phenomenological analysis.

    Science.gov (United States)

    Blank, Alison; Harries, Priscilla; Reynolds, Frances

    2013-01-01

    Research into mental health and employment has indicated that work holds multiple meanings for people with mental health problems. This paper reports findings from a phenomenological study which aimed to understand the complexity of these meanings by exploration of the perspectives of one individual who was considering returning to work. Data were gathered through a series of three interviews carried out over a period of 18 months. Three themes were identified - Beliefs and Values about Work, Working with a Mental Health Problem, and Planning for the Future. Analysis and interpretation facilitated understandings of what work represented for the participant. What this study has contributed to the evidence base is a deeper understanding of the multiple meanings of work, and the varied roles that work may play in contributing to meaning and quality of life for people with mental health problems.

  19. Proposing a health promotion framework to address gambling problems in Australian Indigenous communities.

    Science.gov (United States)

    Fogarty, Marisa; Coalter, Nicola; Gordon, Ashley; Breen, Helen

    2018-02-01

    Gambling impacts affect Australian Indigenous families and communities in diverse and complex ways. Indigenous people throughout Australia engage in a broad range of regulated and unregulated gambling activities. Challenges in this area include the complexities that come with delivering services and programmes between the most remote regions, to highly populated towns and cities of Australia. There is little knowledge transfer between states and territories in Australia and no conceptual understanding or analysis of what constitutes 'best practice' in gambling service delivery for Indigenous people, families and communities. This article reviews health promotion approaches used in Australia, with a particular focus on Indigenous and gambling-based initiatives. Contributing to this review is an examination of health promotion strategies used in Indigenous gambling service delivery in the Northern Territory, New South Wales and Western Australia, demonstrating diversity and innovation in approaches. The article concludes by emphasizing the potential value of adopting health promotion strategies to underpin programme and service delivery for addressing gambling problems in Australian Indigenous communities. However, success is contingent on robust, evidence-based programme design, implementation and evaluation that adhere to health promotion principles. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Is Principled Pragmatism a Viable Framework for Addressing Complex Problems?

    Science.gov (United States)

    Islam, S.

    2017-12-01

    Complex water problems are connected with many competing and often conflicting values, interests, and tools. These problems can't be addressed through simply applying dogmatic principles or a deal-making pragmatic approach. Because these problems are interconnected and interdependent, a final solution can't be pre-specified. Any intervention to a complex problem requires attention to both principles and pragmatism. Strict adherence to principles without pragmatism is often not actionable; pure pragmatism exercised without guiding principles is not sustainable. In a colloquial sense, pragmatism is often taken to suggest practical, opportunistic, and expedient approaches at the expense of principles. This perception appears to be rooted in the dichotomy between "being pragmatic" and "being ideological". The notion of principled pragmatism attempts to get away from this duality by focusing on how to make ideas clear and actionable. In other words, how to connect our thoughts to action given the context, constraints, and capacity. Principled pragmatism - rooted in equity and sustainability as guiding principles for water management - approach attempts to synthesize symbolic aspirations with realistic assessment to chart a trajectory of actionable subset of implementable solutions. Case studies from the Ganges Basin will show the utility of principled pragmatism for water management in a changing world.

  1. Caregiver perceptions of mental health problems and treatment utilisation in siblings of children with mental health problems.

    Science.gov (United States)

    Ma, Nylanda; Furber, Gareth; Roberts, Rachel; Winefield, Helen

    2016-01-01

    Siblings of children with mental health problems (MHPs) have been found to have higher rates of psychopathology and impaired psychosocial functioning compared to control children. It is not yet known how these siblings are managed within the clinical service context (e.g., are they assessed for mental health problems? Do they receive appropriate psychological treatment?). The following brief report describes a pilot study which aimed to explore (a) the rate of caregiver-identified MHPs in siblings and (b) the proportion of siblings receiving psychiatric or psychosocial treatment or support (i.e., treatment utilisation). Eighty-five caregivers of children receiving treatment at CAMHS were interviewed about the mental health and treatment utilisation of their siblings. The findings revealed a high rate of caregiver-identified MHPs in siblings (34.1%) and a high rate of treatment utilisation (85.7%). The findings suggest that, for the vast majority, when siblings of children with MHPs are identified by their caregivers as having MHPs, they are receiving some kind of support and treatment. Implications for mental health service costs are discussed and recommendations for future research are outlined.

  2. Influence of Child Factors on Health-Care Professionals' Recognition of Common Childhood Mental-Health Problems

    NARCIS (Netherlands)

    Burke, Delia A; Koot, Hans M; de Wilde, Amber; Begeer, Sander

    2016-01-01

    Early recognition of childhood mental-health problems can help minimise long-term negative outcomes. Recognition of mental-health problems, needed for referral and diagnostic evaluation, is largely dependent on health-care professionals' (HCPs) judgement of symptoms presented by the child. This

  3. Adjustment and mental health problem in prisoners

    Directory of Open Access Journals (Sweden)

    Sudhinta Sinha

    2010-01-01

    Full Text Available Background : "Crime" is increasing day by day in our society not only in India but also all over the world. In turn, the number of prisoners is also increasing at the same rate. They remain imprisoned for a long duration or in some cases for the whole life. Living in a prison for long time becomes difficult for all inmates. So they often face adjustment and mental health problems. Recent findings suggest that mental illness rate in prison is three times higher than in the general population. Objective: The aim of the present study was to investigate the adjustment and the mental health problem and its relation in the prisoners. Materials and Methods : In the present study, 37 male prisoners of district jail of Dhanbad District of Jharkhand were selected on purposive sampling basis. Each prisoner was given specially designed Performa - Personal Data Sheet, General Health Questionnaire-12 and Bell Adjustment Inventory. Appropriate statistical tools were used to analyze the data. Results: The results obtained showed poor adjustment in social and emotional areas on the adjustment scale. The study also revealed a significant association between adjustment and mental health problem in the prisoners. Conclusion: The prisoners were found to have poor social and emotional adjustment which has strong association with their mental health.

  4. Performance of community health workers:situating their intermediary position within complex adaptive health systems

    OpenAIRE

    Kok, Maryse. C; Broerse, Jacqueline E.W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

    2017-01-01

    Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors. This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income countries. It examines their unique intermediary position between the communities they serve and actors in the health sector, and the complexity of the health systems in which they operate. The assessment...

  5. Mental health problem in HIV/AIDS patients

    Science.gov (United States)

    Camellia, V.

    2018-03-01

    People with HIV positive have risk increased mental health problem than the general population. It associated with psychosocial factors, direct neurological effects of the HIV infection and medication. Overall it can make increased morbidity and mortality in HIV positive patients. The more common mental problem in HIV/AIDS people is dementia, delirium, depression, and mania, suicide, psychotic, sleep problem. Both psychopharmacologic and psychotherapeutic treatment strategies often indicate.

  6. Oral health and oral health risk behaviour in children with and without externalising behaviour problems.

    Science.gov (United States)

    Staberg, M; Norén, J G; Gahnberg, L; Ghaderi, A; Kadesjö, C; Robertson, A

    2018-05-15

    This was to study children with early detected externalising behaviour problems compared to matched controls regarding oral health, oral health risk behaviour and the parental evaluation of the child's oral health and dental care. Children aged 10-13 years and with externalising behaviour problems, were compared to matched controls. Behavioural characteristics were based on the Strength and Difficulties Questionnaire. The children and their parents completed questionnaires regarding dental fear, tooth brushing, dietary habits and evaluation of oral health and dental care. Data on dental caries risk assessments, caries, behaviour management problems and dental trauma were obtained from dental files. There were no differences in caries prevalence in children with early detected externalising behaviour problems, compared to controls. However, the former group consumed more sweet drinks when thirsty and brushed their teeth fewer than twice daily; they also had more dental trauma in both dentitions and a higher risk range for dental fear, compared to controls. This study points out potential oral health risk factors in children with early-detected externalising behaviour problems. Although no difference in caries prevalence was observed, externalising behaviour may affect oral health. Therefore, dental professionals should support the families and the children to preserve dental health by offering increased prophylactic measures. There were no differences between children with externalising behaviour problems, compared with controls, regarding the parent evaluation of their child's dental health. However, more parents in the study group evaluated the dental care as poor or not functioning.

  7. Health Problems and Health Care Seeking Behaviour of Rohingya Refugees

    OpenAIRE

    Masud, Abdullah Al; Ahmed, Md. Shahoriar; Sultana, Mst. Rebeka; Alam, S. M. Iftekhar; Kabir, Russell; Arafat, S. M. Yasir; Papadopoulos, Konstantinos

    2017-01-01

    Abstract Background: Rohingya refugees are one of the most vulnerable group due to lack of health care system, personal hygiene, shelter, sanitation and violence. Aim: The present study aims to find out the health problems and health care seeking behavior of rohingya refugee peoples, to identify the socio-demographic information for such exposure group in relation to age, sex, occupation, living areas, to explore the patient's physical, emotional, perceptions, attitudes and environmen...

  8. Identification of effective visual problem solving strategies in a complex visual domain

    NARCIS (Netherlands)

    Van Meeuwen, Ludo; Jarodzka, Halszka; Brand-Gruwel, Saskia; Kirschner, Paul A.; De Bock, Jeano; Van Merriënboer, Jeroen

    2018-01-01

    Students in complex visual domains must acquire visual problem solving strategies that allow them to make fast decisions and come up with good solutions to real-time problems. In this study, 31 air traffic controllers at different levels of expertise (novice, intermediate, expert) were confronted

  9. Diversity in sexual health: problems and dilemmas.

    NARCIS (Netherlands)

    Rademakers, J.; Mouthaan, I.; Neef, M. de

    2005-01-01

    The increase in migrant populations in western Europe has led to specific problems and dilemmas in the area of sexual and reproductive health and service provision. In general, these problems and dilemmas can be divided into four categories: (1) epidemiology of diseases and risk factors; (2)

  10. Diversity in sexual health: Problems and dilemmas

    NARCIS (Netherlands)

    Rademakers, J.; Mouthaan, I.; Neef, M. de

    2005-01-01

    The increase in migrant populations in western Europe has led to specific problems and dilemmas in the area of sexual and reproductive health and service provision. In general, these problems and dilemmas can be divided into four categories: (1) epidemiology of diseases and risk factors; (2)

  11. DOE's efforts to correct environmental problems of the nuclear weapons complex

    International Nuclear Information System (INIS)

    Rezendes, V.S.

    1990-03-01

    This report focuses on four main issues: the environmental problems at DOE's nuclear weapons complex, recent changes in DOE's organizational structure, DOE's 1991 budget request, and the need for effective management systems. This report concludes that the environmental problems are enormous and will take decades to resolve. Widespread contamination can be found at many DOE sites, and the full extent of the environmental problems is unknown. DOE has taken several steps during the past year to better deal with these problems, including making organizational improvements and requesting additional funds for environmental restoration and waste management activities

  12. OCCUPATIONAL HEALTH WITH SPECIAL REFERENCE TO LUNG PROBLEMS

    Directory of Open Access Journals (Sweden)

    Mihir Kumar

    2015-11-01

    Full Text Available INTRODCUTION: WHO’s definition of Physical, social and mental well - being is explained below. A positive mental health state indicates that the individual enjoys his routine; there are no undue conflicts. Health reiteration become s more imperative than health maintenanc e, where society’s responsibility is paramount. Health economics enables us to examine the burden caused by illness. In India, 620 million people live in rural area; only 9% of every one billion populatio n is covered under health schemes. Only 2% of GDP is spent on health, where the recommended percentage is 5%. In addition to this only 5% of annual family income is spent on curative health care. In the recent past rapid deterioration in the quality of environment has over - burdened the health problem. Occu pational Health is one of the environmental health sciences, concerned broadly with the health effects of work and of working conditions. Occupational illnesses and injuries have long been a preventable blight to health. A part from occupational diseases t here are some hazards which will impair health of employees in industries. Workers in every Occupation are faced with a multitude of hazards in the work place. Ronald Blake has classified occupational hazards into the following four categories. The most pr essing environmental health problems today, in terms of death and illness worldwide are those associated with poor households and communities in the development countries. According to WHO and the World Bank, environmental improvement at the household and community level would make the greatest difference for global health. This Article also focuses on the lung disease mainly occurring du e to hazards caused by the patient occupation. A good number of diseases like COAD, asthma and pneumoconiosis afflict the concerned population. Discussion has been made in threadbare about these problems in this article

  13. Fluid Ability (Gf and Complex Problem Solving (CPS

    Directory of Open Access Journals (Sweden)

    Patrick Kyllonen

    2017-07-01

    Full Text Available Complex problem solving (CPS has emerged over the past several decades as an important construct in education and in the workforce. We examine the relationship between CPS and general fluid ability (Gf both conceptually and empirically. A review of definitions of the two factors, prototypical tasks, and the information processing analyses of performance on those tasks suggest considerable conceptual overlap. We review three definitions of CPS: a general definition emerging from the human problem solving literature; a more specialized definition from the “German School” emphasizing performance in many-variable microworlds, with high domain-knowledge requirements; and a third definition based on performance in Minimal Complex Systems (MCS, with fewer variables and reduced knowledge requirements. We find a correlation of 0.86 between expert ratings of the importance of CPS and Gf across 691 occupations in the O*NET database. We find evidence that employers value both Gf and CPS skills, but CPS skills more highly, even after controlling for the importance of domain knowledge. We suggest that this may be due to CPS requiring not just cognitive ability but additionally skill in applying that ability in domains. We suggest that a fruitful future direction is to explore the importance of domain knowledge in CPS.

  14. Some Health Problems Among Working Children In Zagzig City ...

    African Journals Online (AJOL)

    Background: Children's increased vulnerability puts them at a high risk of work related health problems. Objectives: 1) identifying the characteristics of the child labor, work perceptions and job satisfaction among working children in Zagazig City 2) determining some health problems among them, 3) determining the ...

  15. Health problems among sawmill workers in Abakaliki and workplace ...

    African Journals Online (AJOL)

    Introduction: Sawmill workers are exposed to hazards and subsequent health problems. A workplace risk assessment and risk control measures will reduce morbidity and mortality. The objectives of this study are to identify health problems and carry out a workplace risk assessment among sawmill workers in Abakaliki.

  16. Role of physical activity in preventing mental health problems

    NARCIS (Netherlands)

    Bernaards, C.

    2006-01-01

    Mental health problems are a major concern to employers, employees and occupational health professionals in the Netherlands. Employees developing these problems often have to take long-term leave from work, which may lead to disability. About a third of the total disability inflow is due to

  17. Assessment of computer-related health problems among post-graduate nursing students.

    Science.gov (United States)

    Khan, Shaheen Akhtar; Sharma, Veena

    2013-01-01

    The study was conducted to assess computer-related health problems among post-graduate nursing students and to develop a Self Instructional Module for prevention of computer-related health problems in a selected university situated in Delhi. A descriptive survey with co-relational design was adopted. A total of 97 samples were selected from different faculties of Jamia Hamdard by multi stage sampling with systematic random sampling technique. Among post-graduate students, majority of sample subjects had average compliance with computer-related ergonomics principles. As regards computer related health problems, majority of post graduate students had moderate computer-related health problems, Self Instructional Module developed for prevention of computer-related health problems was found to be acceptable by the post-graduate students.

  18. Studies on hepatic lipidosis and coinciding health and fertility problems of high-producing dairy cows using the "Utrecht fatty liver model of dairy cows". A review.

    Science.gov (United States)

    Geelen, M J H; Wensing, T

    2006-09-01

    Fatty liver or hepatic lipidosis is a major metabolic disorder of high-producing dairy cows that occurs rather frequently in early lactation and is associated with decreased health, production and fertility. A background section of the review explores reasons why high-producing dairy cows are prone to develop fatty liver post partum. Hepatic lipidosis and coinciding health and fertility problems seriously endanger profitability and longevity of the dairy cow. Results from a great number of earlier epidemiological and clinical studies made it clear that a different approach was needed for elucidation of pathogenesis and etiology of this complex of health problems. There was a need for an adequate animal model in which hepatic lipidosis and production, health and fertility problems could be provoked under controlled conditions. It was hypothesized that overconditioning ante partum and feed restriction post partum might induce lipolysis in adipose tissue and triacylglycerol accumulation in the liver following calving. This consideration formed the basis for the experiments, which resulted in the "Utrecht fatty liver model of dairy cows". In this model, post partum triacylglycerol-lipidosis as well as the whole complex of health and fertility problems are induced under well-controlled conditions. The experimental protocol based on this hypothesis produced in all cases (10 feeding trials with over 150 dairy cattle) the intended result, i.e. all experimental cows developed post partum higher hepatic triacylglycerol concentrations than did control cows. The model was evaluated in biochemical, clinical pathology, immunological, clinical and fertility terms. It turned out that in this model, post partum triacylglycerol-lipidosis as well as the whole complex of health and fertility problems were induced under well-controlled conditions.

  19. Contextualising eating problems in individual diet counselling

    DEFF Research Database (Denmark)

    Kristensen, Søren Tange; Køster, Allan

    2014-01-01

    Health professionals consider diet to be a vital component in managing weight, chronic diseases and the overall promotion of health. This article takes the position that the complexity and contextual nature of individual eating problems needs to be addressed in a more systematic and nuanced way...... than is usually the case in diet counselling, motivational interviewing and health coaching. We suggest the use of narrative practice as a critical and context-sensitive counselling approach to eating problems. Principles of externalisation and co-researching are combined within a counselling framework...... sessions, exploration of the complex structures of food and eating with the client can provide agency by helping them navigate within the context of the problem. We also exemplify why a reflexive and critical approach to the way health is perceived by clients should be an integrated part of diet...

  20. Contextualising eating problems in individual diet counselling.

    Science.gov (United States)

    Kristensen, Søren T; Køster, Allan

    2014-05-01

    Health professionals consider diet to be a vital component in managing weight, chronic diseases and the overall promotion of health. This article takes the position that the complexity and contextual nature of individual eating problems needs to be addressed in a more systematic and nuanced way than is usually the case in diet counselling, motivational interviewing and health coaching. We suggest the use of narrative practice as a critical and context-sensitive counselling approach to eating problems. Principles of externalisation and co-researching are combined within a counselling framework that employs logistic, social and discursive eating problems as analytic categories. Using cases from a health clinic situated at the Metropolitan University College in Copenhagen, we show that even if the structural conditions associated with eating problems may not be solvable through individual counselling sessions, exploration of the complex structures of food and eating with the client can provide agency by helping them navigate within the context of the problem. We also exemplify why a reflexive and critical approach to the way health is perceived by clients should be an integrated part of diet counselling.

  1. Child outcomes of home-visiting for families with complex and multiple problems

    NARCIS (Netherlands)

    van Assen, Arend; Dickscheit, Jana; Post, Wendy; Grietens, Hans

    2016-01-01

    Introduction Families with complex and multiple problems are faced with an accumulation of problems across multiple areas of life. Furthermore, these families are often considered to be ‘difficult to treat’. Children and teenagers growing up in these families are exposed to an accumulation of risks

  2. Fluid Ability (Gf) and Complex Problem Solving (CPS)

    OpenAIRE

    Patrick Kyllonen; Cristina Anguiano Carrasco; Harrison J. Kell

    2017-01-01

    Complex problem solving (CPS) has emerged over the past several decades as an important construct in education and in the workforce. We examine the relationship between CPS and general fluid ability (Gf) both conceptually and empirically. A review of definitions of the two factors, prototypical tasks, and the information processing analyses of performance on those tasks suggest considerable conceptual overlap. We review three definitions of CPS: a general definition emerging from the human pr...

  3. Beyond Psychometrics: The Difference between Difficult Problem Solving and Complex Problem Solving

    Directory of Open Access Journals (Sweden)

    Jens F. Beckmann

    2017-10-01

    Full Text Available In this paper we argue that a synthesis of findings across the various sub-areas of research in complex problem solving and consequently progress in theory building is hampered by an insufficient differentiation of complexity and difficulty. In the proposed framework of person, task, and situation (PTS, complexity is conceptualized as a quality that is determined by the cognitive demands that the characteristics of the task and the situation impose. Difficulty represents the quantifiable level of a person’s success in dealing with such demands. We use the well-documented “semantic effect” as an exemplar for testing some of the conceptual assumptions derived from the PTS framework. We demonstrate how a differentiation between complexity and difficulty can help take beyond a potentially too narrowly defined psychometric perspective and subsequently gain a better understanding of the cognitive mechanisms behind this effect. In an empirical study a total of 240 university students were randomly allocated to one of four conditions. The four conditions resulted from contrasting the semanticity level of the variable labels used in the CPS system (high vs. low and two instruction conditions for how to explore the CPS system’s causal structure (starting with the assumption that all relationships between variables existed vs. starting with the assumption that none of the relationships existed. The variation in the instruction aimed at inducing knowledge acquisition processes of either (1 systematic elimination of presumptions, or (2 systematic compilation of a mental representation of the causal structure underpinning the system. Results indicate that (a it is more complex to adopt a “blank slate” perspective under high semanticity as it requires processes of inhibiting prior assumptions, and (b it seems more difficult to employ a systematic heuristic when testing against presumptions. In combination, situational characteristics, such as the

  4. Social comparison as a mediator between health problems and subjective health evaluations.

    NARCIS (Netherlands)

    Van der Zee, K.I.; Buunk, Abraham (Bram); Sanderman, R.

    The role of social comparison in mediating the relation between 'objective' health status and subjective health evaluations was examined. In a random population sample (N = 361) it was shown that health problems were related to psychological distress, which in turn induced a downward comparison

  5. Tackling complexities in understanding the social determinants of health: the contribution of ethnographic research.

    Science.gov (United States)

    Bandyopadhyay, Mridula

    2011-11-25

    The complexities inherent in understanding the social determinants of health are often not well-served by quantitative approaches. My aim is to show that well-designed and well-conducted ethnographic studies have an important contribution to make in this regard. Ethnographic research designs are a difficult but rigorous approach to research questions that require us to understand the complexity of people's social and cultural lives. I draw on an ethnographic study to describe the complexities of studying maternal health in a rural area in India. I then show how the lessons learnt in that setting and context can be applied to studies done in very different settings. I show how ethnographic research depends for rigour on a theoretical framework for sample selection; why immersion in the community under study, and rapport building with research participants, is important to ensure rich and meaningful data; and how flexible approaches to data collection lead to the gradual emergence of an analysis based on intense cross-referencing with community views and thus a conclusion that explains the similarities and differences observed. When using ethnographic research design it can be difficult to specify in advance the exact details of the study design. Researchers can encounter issues in the field that require them to change what they planned on doing. In rigorous ethnographic studies, the researcher in the field is the research instrument and needs to be well trained in the method. Ethnographic research is challenging, but nevertheless provides a rewarding way of researching complex health problems that require an understanding of the social and cultural determinants of health.

  6. Workaholism and mental health problems among municipal middle managers in Norway.

    Science.gov (United States)

    Midje, Hilde H; Nafstad, Ingunn T; Syse, Jonn; Torp, Steffen

    2014-10-01

    To provide empirical knowledge about the antecedents and outcomes of workaholism among municipal middle managers within the framework of the job demands-resources model. We used a self-administered questionnaire to collect cross-sectional data (n = 118) on job demands, job resources, work engagement, workaholism, and mental health problems. Workaholism correlated positively with both work engagement and mental health problems. Job demands affected workaholism and mental health problems more strongly than did job resources. The results indicate that workaholism does not mediate the effects of certain work characteristics on mental health problems, but rather that workaholics create excessive job demands that harm their health. Preventing workaholism should be a central concern of municipal stakeholders because workaholic behavior among middle managers may harm organizational performance and employee health and middle managers' own health.

  7. Life satisfaction and mental health problems (18 to 35 years).

    Science.gov (United States)

    Fergusson, D M; McLeod, G F H; Horwood, L J; Swain, N R; Chapple, S; Poulton, R

    2015-08-01

    Previous research has found that mental health is strongly associated with life satisfaction. In this study we examine associations between mental health problems and life satisfaction in a birth cohort studied from 18 to 35 years. Data were gathered during the Christchurch Health and Development Study, which is a longitudinal study of a birth cohort of 1265 children, born in Christchurch, New Zealand, in 1977. Assessments of psychiatric disorder (major depression, anxiety disorder, suicidality, alcohol dependence and illicit substance dependence) using DSM diagnostic criteria and life satisfaction were obtained at 18, 21, 25, 30 and 35 years. Significant associations (p life satisfaction and the psychiatric disorders major depression, anxiety disorder, suicidality, alcohol dependence and substance dependence. After adjustment for non-observed sources of confounding by fixed effects, statistically significant associations (p life satisfaction and major depression, anxiety disorder, suicidality and substance dependence. Overall, those reporting three or more mental health disorders had mean life satisfaction scores that were nearly 0.60 standard deviations below those without mental health problems. A structural equation model examined the direction of causation between life satisfaction and mental health problems. Statistically significant (p life satisfaction and mental health problems. After adjustment for confounding, robust and reciprocal associations were found between mental health problems and life satisfaction. Overall, this study showed evidence that life satisfaction influences mental disorder, and that mental disorder influences life satisfaction.

  8. Complex analogues of real problems

    DEFF Research Database (Denmark)

    Esdahl-Schou, Rune

    This thesis will be a mix of different problems in number theory. As such it is split into two natural parts. The rst part focuses on normal numbers and construction of numbers that are normal to a given complex base. It is written in the style of a thorough and introductory paper on that subject....... Certain classical theorems are stated without proof but with a reference instead, though usually a proof is given. This part of the thesis represents the pinnacle of the authors work during the first two years of his PhD study. The work presented is greatly inspired by the work of Madritsch, Thuswaldner...... and Tichy in [Madritsch et al., 2008] and [Madritsch, 2008] and contains a generalisation of the main theorem in [Madritsch, 2008]. The second part of the thesis focuses on Diophantine approximation, mainly on a famous conjecture by Schmidt from the 1980s. This conjecture was solved by Badziahin, Pollington...

  9. The Meaning and Predictive Value of Self-rated Mental Health among Persons with a Mental Health Problem.

    Science.gov (United States)

    McAlpine, Donna D; McCreedy, Ellen; Alang, Sirry

    2018-06-01

    Self-rated health is a valid measure of health that predicts quality of life, morbidity, and mortality. Its predictive value reflects a conceptualization of health that goes beyond a traditional medical model. However, less is known about self-rated mental health (SRMH). Using data from the Medical Expenditure Panel Survey ( N = 2,547), we examine how rating your mental health as good-despite meeting criteria for a mental health problem-predicts outcomes. We found that 62% of people with a mental health problem rated their mental health positively. Persons who rated their mental health as good (compared to poor) had 30% lower odds of having a mental health problem at follow-up. Even without treatment, persons with a mental health problem did better if they perceived their mental health positively. SRMH might comprise information beyond the experience of symptoms. Understanding the unobserved information individuals incorporate into SRMH will help us improve screening and treatment interventions.

  10. The Complex Relationship Between Diet And Health.

    Science.gov (United States)

    Bleich, Sara N; Jones-Smith, Jessica; Wolfson, Julia A; Zhu, Xiaozhou; Story, Mary

    2015-11-01

    The relationship between food and health is complex. Everyone needs food to live, but too little food, too much food, or the wrong type of food has negative consequences for health. To increase understanding of this relationship, we describe trends and patterns in food-related diseases among both adults and children. Using an ecological framework, we then describe why food intake is complex with a discussion of three broad levels--macro (including policy and social-cultural norms), local community, and individual environments--and their relationship to food consumption. Given the strong relationship between an individual's food choice and his or her surrounding environment, we end with examples of policy responses that aim to help people overcome environmental disincentives toward healthy eating. Finding ways to make eating healthfully easier and affordable for all populations is essential to shifting the average American diet toward one that promotes health. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Relationships between interpersonal trauma, symptoms of posttraumatic stress disorder, and other mental health problems in girls in compulsory residential care

    NARCIS (Netherlands)

    Leenarts, Laura E. W.; Vermeiren, Robert R. J. M.; van de Ven, Peter M.; Lodewijks, Henny P. B.; Doreleijers, Theo A. H.; Lindauer, Ramón J. L.

    2013-01-01

    This cross-sectional study examined the relationships (using structural equation modeling) between exposure to early-onset interpersonal trauma, symptoms of posttraumatic stress disorder (PTSD), symptoms of complex PTSD, and other mental health problems. The participants were 92 girls recruited from

  12. Cognitive Behaviour Therapy for Adolescent Offenders with Mental Health Problems in Custody

    Science.gov (United States)

    Mitchell, Paul; Smedley, Kirsty; Kenning, Cassandra; McKee, Amy; Woods, Debbie; Rennie, Charlotte E.; Bell, Rachel V.; Aryamanesh, Mitra; Dolan, Mairead

    2011-01-01

    Many studies have identified high levels of mental health problems among adolescents in custody and there is increasing evidence that mental health problems in this population are associated with further offending and mental health problems into adulthood. Despite recent improvements in mental health provision within custodial settings there is…

  13. [Economic problems in military public health].

    Science.gov (United States)

    Petrov, G M; Moretskiĭ, A A

    2000-03-01

    There are discussed the problems of military treatment and prophylactic institution (TPI) functioning under conditions of market reform of Russian public health. Main marketing concepts in military health are determined and some recommendations on work improvement in TPI of the Armed Forces in the system of obligatory medical insurance are presented, granting population paid medical services. It is necessary to form a new type of director--military and medical manager.

  14. Perceived school safety is strongly associated with adolescent mental health problems.

    Science.gov (United States)

    Nijs, Miesje M; Bun, Clothilde J E; Tempelaar, Wanda M; de Wit, Niek J; Burger, Huibert; Plevier, Carolien M; Boks, Marco P M

    2014-02-01

    School environment is an important determinant of psychosocial function and may also be related to mental health. We therefore investigated whether perceived school safety, a simple measure of this environment, is related to mental health problems. In a population-based sample of 11,130 secondary school students, we analysed the relationship of perceived school safety with mental health problems using multiple logistic regression analyses to adjust for potential confounders. Mental health problems were defined using the clinical cut-off of the self-reported Strengths and Difficulties Questionnaire. School safety showed an exposure-response relationship with mental health problems after adjustment for confounders. Odds ratios increased from 2.48 ("sometimes unsafe") to 8.05 ("very often unsafe"). The association was strongest in girls and young and middle-aged adolescents. Irrespective of the causal background of this association, school safety deserves attention either as a risk factor or as an indicator of mental health problems.

  15. College Students: Mental Health Problems and Treatment Considerations.

    Science.gov (United States)

    Pedrelli, Paola; Nyer, Maren; Yeung, Albert; Zulauf, Courtney; Wilens, Timothy

    2015-10-01

    Attending college can be a stressful time for many students. In addition to coping with academic pressure, some students have to deal with the stressful tasks of separation and individuation from their family of origin while some may have to attend to numerous work and family responsibilities. In this context, many college students experience the first onset of mental health and substance use problems or an exacerbation of their symptoms. Given the uniqueness of college students, there is a need to outline critical issues to consider when working with this population. In this commentary, first, the prevalence of psychiatric and substance use problems in college students and the significance of assessing age of onset of current psychopathology are described. Then, the concerning persistent nature of mental health problems among college students and its implications are summarized. Finally, important aspects of treatment to consider when treating college students with mental health problems are outlined, such as the importance of including parents in the treatment, communicating with other providers, and employing of technology to increase adherence. It is concluded that, by becoming familiar with the unique problems characteristic of the developmental stage and environment college students are in, practitioners will be able to better serve them.

  16. Complex Problem Solving in Teams: The Impact of Collective Orientation on Team Process Demands.

    Science.gov (United States)

    Hagemann, Vera; Kluge, Annette

    2017-01-01

    Complex problem solving is challenging and a high-level cognitive process for individuals. When analyzing complex problem solving in teams, an additional, new dimension has to be considered, as teamwork processes increase the requirements already put on individual team members. After introducing an idealized teamwork process model, that complex problem solving teams pass through, and integrating the relevant teamwork skills for interdependently working teams into the model and combining it with the four kinds of team processes (transition, action, interpersonal, and learning processes), the paper demonstrates the importance of fulfilling team process demands for successful complex problem solving within teams. Therefore, results from a controlled team study within complex situations are presented. The study focused on factors that influence action processes, like coordination, such as emergent states like collective orientation, cohesion, and trust and that dynamically enable effective teamwork in complex situations. Before conducting the experiments, participants were divided by median split into two-person teams with either high ( n = 58) or low ( n = 58) collective orientation values. The study was conducted with the microworld C3Fire, simulating dynamic decision making, and acting in complex situations within a teamwork context. The microworld includes interdependent tasks such as extinguishing forest fires or protecting houses. Two firefighting scenarios had been developed, which takes a maximum of 15 min each. All teams worked on these two scenarios. Coordination within the team and the resulting team performance were calculated based on a log-file analysis. The results show that no relationships between trust and action processes and team performance exist. Likewise, no relationships were found for cohesion. Only collective orientation of team members positively influences team performance in complex environments mediated by action processes such as

  17. Complex Problems in Entrepreneurship Education: Examining Complex Problem-Solving in the Application of Opportunity Identification

    Directory of Open Access Journals (Sweden)

    Yvette Baggen

    2017-01-01

    Full Text Available In opening up the black box of what entrepreneurship education (EE should be about, this study focuses on the exploration of relationships between two constructs: opportunity identification (OI and complex problem-solving (CPS. OI, as a domain-specific capability, is at the core of entrepreneurship research, whereas CPS is a more domain-general skill. On a conceptual level, there are reasons to believe that CPS skills can help individuals to identify potential opportunities in dynamic and nontransparent environments. Therefore, we empirically investigated whether CPS relates to OI among 113 masters students. Data is analyzed using multiple regressions. The results show that CPS predicts the number of concrete ideas that students generate, suggesting that having CPS skills supports the generation of detailed, potential business ideas of good quality. The results of the current study suggest that training CPS, as a more domain-general skill, could be a valuable part of what should be taught in EE.

  18. Information Seeking When Problem Solving: Perspectives of Public Health Professionals.

    Science.gov (United States)

    Newman, Kristine; Dobbins, Maureen; Yost, Jennifer; Ciliska, Donna

    2017-04-01

    Given the many different types of professionals working in public health and their diverse roles, it is likely that their information needs, information-seeking behaviors, and problem-solving abilities differ. Although public health professionals often work in interdisciplinary teams, few studies have explored their information needs and behaviors within the context of teamwork. This study explored the relationship between Canadian public health professionals' perceptions of their problem-solving abilities and their information-seeking behaviors with a specific focus on the use of evidence in practice settings. It also explored their perceptions of collaborative information seeking and the work contexts in which they sought information. Key Canadian contacts at public health organizations helped recruit study participants through their list-servs. An electronic survey was used to gather data about (a) individual information-seeking behaviors, (b) collaborative information-seeking behaviors, (c) use of evidence in practice environments, (d) perceived problem-solving abilities, and (e) demographic characteristics. Fifty-eight public health professionals were recruited, with different roles and representing most Canadian provinces and one territory. A significant relationship was found between perceived problem-solving abilities and collaborative information-seeking behavior (r = -.44, p public health professionals take a shared, active approach to problem solving, maintain personal control, and have confidence, they are more likely collaborate with others in seeking information to complete a work task. Administrators of public health organizations should promote collaboration by implementing effective communication and information-seeking strategies, and by providing information resources and retrieval tools. Public health professionals' perceived problem-solving abilities can influence how they collaborate in seeking information. Educators in public health

  19. Help-seeking for early childhood mental health problems

    OpenAIRE

    Oh, Elizabeth

    2017-01-01

    Children's mental health has significant implications for functioning across home, school, and community settings. The infant to preschool years has been found to be a crucial stage in a child’s development. As such, problems that arise during these years are likely to impact a child’s social and emotional development if no treatment is sought. Childhood mental health problems affect up to almost one quarter of children globally (Belfer, 2008; Canino, Bird, Rubio-Stipec, & Bravo, 1995; Egger ...

  20. Mental Health Problems and Related Factors in Ecuadorian College Students

    Directory of Open Access Journals (Sweden)

    Claudia Torres

    2017-05-01

    Full Text Available Although the mental health problems of college students have been the subject of increasing research, there are no studies about its prevalence in Ecuadorian college students. The aim of this study was to determine the mental health problems and their associated factors in Ecuadorian freshmen university students. A sample of 1092 students (53.7% women; mean age = 18.3 years were recruited from the Technical Particular University of Loja (Ecuador. Socio-demographic, academic, and clinical characteristics were gathered, as well as information on the participants’ mental health through a number of mental health screens. Prevalence of positive screens was 6.2% for prevalence of major depressive episodes, 0.02% for generalized anxiety disorders, 2.2% for panic disorders, 32.0% for eating disorders, 13.1% for suicidal risk. Mental health problems were significantly associated with sex, area of study, self-esteem, social support, personality and histories of mental health problems. The findings offer a starting point for identifying useful factors to target prevention and intervention strategies aimed at university students.

  1. Mental Health Problems and Related Factors in Ecuadorian College Students.

    Science.gov (United States)

    Torres, Claudia; Otero, Patricia; Bustamante, Byron; Blanco, Vanessa; Díaz, Olga; Vázquez, Fernando L

    2017-05-15

    Although the mental health problems of college students have been the subject of increasing research, there are no studies about its prevalence in Ecuadorian college students. The aim of this study was to determine the mental health problems and their associated factors in Ecuadorian freshmen university students. A sample of 1092 students (53.7% women; mean age = 18.3 years) were recruited from the Technical Particular University of Loja (Ecuador). Socio-demographic, academic, and clinical characteristics were gathered, as well as information on the participants' mental health through a number of mental health screens. Prevalence of positive screens was 6.2% for prevalence of major depressive episodes, 0.02% for generalized anxiety disorders, 2.2% for panic disorders, 32.0% for eating disorders, 13.1% for suicidal risk. Mental health problems were significantly associated with sex, area of study, self-esteem, social support, personality and histories of mental health problems. The findings offer a starting point for identifying useful factors to target prevention and intervention strategies aimed at university students.

  2. Self-recognition of mental health problems in a rural Australian sample.

    Science.gov (United States)

    Handley, Tonelle E; Lewin, Terry J; Perkins, David; Kelly, Brian

    2018-04-19

    Although mental health literacy has increased in recent years, mental illness is often under-recognised. There has been little research conducted on mental illness in rural areas; however, this can be most prominent in rural areas due to factors such as greater stigma and stoicism. The aim of this study is to create a profile of those who are most and least likely to self-identify mental health problems among rural residents with moderate- to-high psychological distress. Secondary analysis of a longitudinal postal survey. Rural and remote New South Wales, Australia. Four-hundred-and-seventy-two community residents. Participants completed the K10 Psychological Distress Scale, as well as the question 'In the past 12 months have you experienced any mental health problems?' The characteristics of those who reported moderate/high distress scores were explored by comparing those who did and did not experience mental health problems recently. Of the 472 participants, 319 (68%) with moderate/high distress reported a mental health problem. Reporting a mental health problem was higher among those with recent adverse life events or who perceived more stress from life events while lower among those who attributed their symptoms to a physical cause. Among a rural sample with moderate/high distress, one-third did not report a mental health problem. Results suggest a threshold effect, whereby mental health problems are more likely to be acknowledged in the context of additional life events. Ongoing public health campaigns are necessary to ensure that symptoms of mental illness are recognised in the multiple forms that they take. © 2018 National Rural Health Alliance Ltd.

  3. Persistence of mental health problems and needs in a college student population.

    Science.gov (United States)

    Zivin, Kara; Eisenberg, Daniel; Gollust, Sarah E; Golberstein, Ezra

    2009-10-01

    Cross-sectional studies indicate a high prevalence of mental health problems among college students, but there are fewer longitudinal data on these problems and related help-seeking behavior. We conducted a baseline web-based survey of students attending a large public university in fall 2005 and a two-year follow-up survey in fall 2007. We used brief screening instruments to measure symptoms of mental disorders (anxiety, depression, eating disorders), as well as self-injury and suicidal ideation. We estimated the persistence of these mental health problems between the two time points, and determined to what extent students with mental health problems perceived a need for or used mental health services (medication or therapy). We conducted logistic regression analyses examining how baseline predictors were associated with mental health and help-seeking two years later. Over half of students suffered from at least one mental health problem at baseline or follow-up. Among students with at least one mental health problem at baseline, 60% had at least one mental health problem two years later. Among students with a mental health problem at both time points, fewer than half received treatment between those time points. Mental health problems are based on self-report to brief screens, and the sample is from a single university. These findings indicate that mental disorders are prevalent and persistent in a student population. While the majority of students with probable disorders are aware of the need for treatment, most of these students do not receive treatment, even over a two-year period.

  4. The Streaming Complexity of Cycle Counting, Sorting by Reversals, and Other Problems

    DEFF Research Database (Denmark)

    Verbin, Elad; Yu, Wei

    2011-01-01

    -way. By designing reductions from BHH, we prove lower bounds for the streaming complexity of approximating the sorting by reversal distance, of approximately counting the number of cycles in a 2-regular graph, and of other problems. For example, here is one lower bound that we prove, for a cycle-counting problem...

  5. Managing interoperability and complexity in health systems.

    Science.gov (United States)

    Bouamrane, M-M; Tao, C; Sarkar, I N

    2015-01-01

    In recent years, we have witnessed substantial progress in the use of clinical informatics systems to support clinicians during episodes of care, manage specialised domain knowledge, perform complex clinical data analysis and improve the management of health organisations' resources. However, the vision of fully integrated health information eco-systems, which provide relevant information and useful knowledge at the point-of-care, remains elusive. This journal Focus Theme reviews some of the enduring challenges of interoperability and complexity in clinical informatics systems. Furthermore, a range of approaches are proposed in order to address, harness and resolve some of the many remaining issues towards a greater integration of health information systems and extraction of useful or new knowledge from heterogeneous electronic data repositories.

  6. Parentification, Stress, and Problem Behavior of Adolescents who have a Parent with Mental Health Problems.

    Science.gov (United States)

    Van Loon, Linda M A; Van de Ven, Monique O M; Van Doesum, Karin T M; Hosman, Clemens M H; Witteman, Cilia L M

    2017-03-01

    When adolescents live with a parent with mental illness, they often partly take over the parental role. Little is known about the consequences of this so-called parentification on the adolescents' internalizing and externalizing problems. This survey study examined this effect cross-sectionally and longitudinally in a sample of 118 adolescents living with a parent suffering from mental health problems. In addition, the study examined a possible indirect effect via perceived stress. Path analyses were used to examine the direct associations between parentification and problem behavior as well as the indirect relations via perceived stress. The results showed that parentification was associated with both internalizing and externalizing problems cross-sectionally, but it predicted only internalizing problems 1 year later. An indirect effect of parentification on adolescent internalizing and externalizing problems via perceived stress was found, albeit only cross-sectionally. These findings imply that parentification can be stressful for adolescents who live with a parent with mental health problems, and that a greater awareness of parentification is needed to prevent adolescents from developing internalizing problems. © 2015 Family Process Institute.

  7. Complexity or Meaning in Health Professional Education and Practice?

    Science.gov (United States)

    Lowe, Wendy Anne

    2014-01-01

    Objectives: Discourses of complexity have entered health professional education. This paper explores the meaning of complexity by asking how health professionals are educated and some of the consequences of that education. Design: A qualitative study was carried out drawing on reflexivity, discourse analysis and grounded methodology. Setting: Two…

  8. Health brokers : How can they help deal with the wickedness of public health problems?

    NARCIS (Netherlands)

    Van Rinsum, C.E.; Gerards, S.M.P.L.; Rutten, G.J.M.; Van De Goor, L.A.M.; Kremers, S.P.J.

    Background The role of health broker is a relatively new one in public health. Health brokers aim to create support for efforts to optimise health promotion in complex or even “wicked” public health contexts by facilitating intersectoral collaborations and by exchanging knowledge with different

  9. Understanding and quantifying cognitive complexity level in mathematical problem solving items

    Directory of Open Access Journals (Sweden)

    SUSAN E. EMBRETSON

    2008-09-01

    Full Text Available The linear logistic test model (LLTM; Fischer, 1973 has been applied to a wide variety of new tests. When the LLTM application involves item complexity variables that are both theoretically interesting and empirically supported, several advantages can result. These advantages include elaborating construct validity at the item level, defining variables for test design, predicting parameters of new items, item banking by sources of complexity and providing a basis for item design and item generation. However, despite the many advantages of applying LLTM to test items, it has been applied less often to understand the sources of complexity for large-scale operational test items. Instead, previously calibrated item parameters are modeled using regression techniques because raw item response data often cannot be made available. In the current study, both LLTM and regression modeling are applied to mathematical problem solving items from a widely used test. The findings from the two methods are compared and contrasted for their implications for continued development of ability and achievement tests based on mathematical problem solving items.

  10. Is blended learning and problem-based learning course design suited to develop future public health leaders? An explorative European study.

    Science.gov (United States)

    Könings, Karen D; de Jong, Nynke; Lohrmann, Christa; Sumskas, Linas; Smith, Tony; O'Connor, Stephen J; Spanjers, Ingrid A E; Van Merriënboer, Jeroen J G; Czabanowska, Katarzyna

    2018-01-01

    Public health leaders are confronted with complex problems, and developing effective leadership competencies is essential. The teaching of leadership is still not common in public health training programs around the world. A reconceptualization of professional training is needed and can benefit from innovative educational approaches. Our aim was to explore learners' perceptions of the effectiveness and appeal of a public health leadership course using problem-based, blended learning methods that used virtual learning environment technologies. In this cross-sectional evaluative study, the Self-Assessment Instrument of Competencies for Public Health Leaders was administered before and after an online, blended-learning, problem-based (PBL) leadership course. An evaluation questionnaire was also used to measure perceptions of blended learning, problem-based learning, and tutor functioning among 19 public health professionals from The Netherlands ( n  = 8), Lithuania ( n  = 5), and Austria ( n  = 6).Participants showed overall satisfaction and knowledge gains related to public health leadership competencies in six of eight measured areas, especially Political Leadership and Systems Thinking. Some perceptions of blended learning and PBL varied between the institutions. This might have been caused by lack of experience of the educational approaches, differing professional backgrounds, inexperience of communicating in the online setting, and different expectations towards the course. Blended, problem-based learning might be an effective way to develop leadership competencies among public health professionals in international and interdisciplinary context.

  11. A Real-Life Case Study of Audit Interactions--Resolving Messy, Complex Problems

    Science.gov (United States)

    Beattie, Vivien; Fearnley, Stella; Hines, Tony

    2012-01-01

    Real-life accounting and auditing problems are often complex and messy, requiring the synthesis of technical knowledge in addition to the application of generic skills. To help students acquire the necessary skills to deal with these problems effectively, educators have called for the use of case-based methods. Cases based on real situations (such…

  12. The Effect of Social Trust on Citizens’ Health Risk Perception in the Context of a Petrochemical Industrial Complex

    Directory of Open Access Journals (Sweden)

    Vicente Tortosa-Edo

    2013-01-01

    Full Text Available Perceived risk of environmental threats often translates into psychological stress with a wide range of effects on health and well-being. Petrochemical industrial complexes constitute one of the sites that can cause considerable pollution and health problems. The uncertainty around emissions results in a perception of risk for citizens residing in neighboring areas, which translates into anxiety and physiological stress. In this context, social trust is a key factor in managing the perceived risk. In the case of industrial risks, it is essential to distinguish between trust in the companies that make up the industry, and trust in public institutions. In the context of a petrochemical industrial complex located in the port of Castellón (Spain, this paper primarily discusses how trust — both in the companies located in the petrochemical complex and in the public institutions — affects citizens’ health risk perception. The research findings confirm that while the trust in companies negatively affects citizens’ health risk perception, trust in public institutions does not exert a direct and significant effect. Analysis also revealed that trust in public institutions and health risk perception are essentially linked indirectly (through trust in companies.

  13. The Effect of Social Trust on Citizens’ Health Risk Perception in the Context of a Petrochemical Industrial Complex

    Science.gov (United States)

    López-Navarro, Miguel Ángel; Llorens-Monzonís, Jaume; Tortosa-Edo, Vicente

    2013-01-01

    Perceived risk of environmental threats often translates into psychological stress with a wide range of effects on health and well-being. Petrochemical industrial complexes constitute one of the sites that can cause considerable pollution and health problems. The uncertainty around emissions results in a perception of risk for citizens residing in neighboring areas, which translates into anxiety and physiological stress. In this context, social trust is a key factor in managing the perceived risk. In the case of industrial risks, it is essential to distinguish between trust in the companies that make up the industry, and trust in public institutions. In the context of a petrochemical industrial complex located in the port of Castellón (Spain), this paper primarily discusses how trust—both in the companies located in the petrochemical complex and in the public institutions—affects citizens’ health risk perception. The research findings confirm that while the trust in companies negatively affects citizens’ health risk perception, trust in public institutions does not exert a direct and significant effect. Analysis also revealed that trust in public institutions and health risk perception are essentially linked indirectly (through trust in companies). PMID:23337129

  14. Social problem solving ability predicts mental health among undergraduate students

    Directory of Open Access Journals (Sweden)

    Mansour Ranjbar

    2013-01-01

    Methods : In this correlational- descriptive study, 369 (208 female and 161 male from, Mazandaran University of Medical Science were selected through stratified random sampling method. In order to collect the data, the social problem solving inventory-revised and general health questionnaire were used. Data were analyzed through SPSS-19, Pearson′s correlation, t test, and stepwise regression analysis. Results : Data analysis showed significant relationship between social problem solving ability and mental health (P < 0.01. Social problem solving ability was significantly associated with the somatic symptoms, anxiety and insomnia, social dysfunction and severe depression (P < 0.01. Conclusions: The results of our study demonstrated that there is a significant correlation between social problem solving ability and mental health.

  15. Redundant interferometric calibration as a complex optimization problem

    Science.gov (United States)

    Grobler, T. L.; Bernardi, G.; Kenyon, J. S.; Parsons, A. R.; Smirnov, O. M.

    2018-05-01

    Observations of the redshifted 21 cm line from the epoch of reionization have recently motivated the construction of low-frequency radio arrays with highly redundant configurations. These configurations provide an alternative calibration strategy - `redundant calibration' - and boost sensitivity on specific spatial scales. In this paper, we formulate calibration of redundant interferometric arrays as a complex optimization problem. We solve this optimization problem via the Levenberg-Marquardt algorithm. This calibration approach is more robust to initial conditions than current algorithms and, by leveraging an approximate matrix inversion, allows for further optimization and an efficient implementation (`redundant STEFCAL'). We also investigated using the preconditioned conjugate gradient method as an alternative to the approximate matrix inverse, but found that its computational performance is not competitive with respect to `redundant STEFCAL'. The efficient implementation of this new algorithm is made publicly available.

  16. Political Limits to the Processing of Policy Problems

    Directory of Open Access Journals (Sweden)

    Peter J. May

    2013-07-01

    Full Text Available This contribution addresses political limits to the processing of policy problems in the United States. Our foci are the forces that limit policymakers' attention to different aspects of problems and how this affects the prospects for problem resolution. We theorize about three sets of forces: interest engagement, linkages among relevant institutions for policymaking, and partisan conflict. We show how the interplay of these forces limits efforts to address complex problems. Based on secondary accounts, we consider these underlying dynamics for ten complex problems. These include the thorny problems of the financial crisis, climate change, and health care; the persistent problems of K-12 education, drug abuse, and food safety; and the looming problems associated with critical infrastructure, the obesity epidemic, ocean health, and terrorism and extreme events. From these accounts we identify different patterns that we label fractured, allied, bureaucratic, and anemic policymaking.

  17. Upper estimates of complexity of algorithms for multi-peg Tower of Hanoi problem

    Directory of Open Access Journals (Sweden)

    Sergey Novikov

    2007-06-01

    Full Text Available There are proved upper explicit estimates of complexity of lgorithms: for multi-peg Tower of Hanoi problem with the limited number of disks, for Reve's puzzle and for $5$-peg Tower of Hanoi problem with the free number of disks.

  18. Problems of development of Kuzbass fuel power-engineering complex

    International Nuclear Information System (INIS)

    Mazikin, V.P.; Razumnyak, N.L.; Shatirov, S.V.; Gladyshev, G.P.

    2000-01-01

    Problems of Kuzbass fuel and energy complex development, bituminous and brown coal being its main resource, are discussed. Balance reserves of bituminous coal in Kuzbass are estimated as 59 bln. tons, which makes up 29% of the world and nearly 60% of bituminous coal reserves in Russia. Dynamics of price rise in reference to energy-grade coal of Kuzbass is analyzed. The structure of the Kuzbass energy system is considered and characteristics of its major state district electric power plants and heat and power generating plants are provided. Water-coal and water-black oil fuels are od interest for Kuzbass energy production as alternative source of energy. Special attention is paid to environmental problems of coal concentration [ru

  19. Legionnaires' Disease: a Problem for Health Care Facilities

    Science.gov (United States)

    ... Clips Legionnaires’ Disease A problem for health care facilities Language: English (US) Español (Spanish) Recommend on Facebook ... drinking. Many people being treated at health care facilities, including long-term care facilities and hospitals, have ...

  20. Mental, physical and social health problems of call centre workers

    Directory of Open Access Journals (Sweden)

    P Bhuyar

    2008-01-01

    Full Text Available Background: Call centre workers in BPO face unique occupational hazards - mental, physical and psychosocial. Material & Method: A sample 100 call centre workers of both sexes and from two cities Pune and Mumbai were surveyed by both qualitative and quantitative methods for the above health problems. Results: A high proportion of workers faced sleep disturbances and associated mental stress and anxiety. Sleep disturbance and anxiety was significantly more in international call centres compared to domestic. There was also disturbance in circadian rhythms due to night shift. Physical problems such as musculoskeletal disorders, obesity, eye, and hearing problems were also present. Psychosocial problems included disruption in family life, use of tobacco and alcohol, and faulty eating habits. Conclusion: Better personal management, health education and more research is indicated to study the health problems in this emerging occupation.

  1. Long-term effects of the Family Bereavement Program on spousally bereaved parents: Grief, mental health problems, alcohol problems, and coping efficacy.

    Science.gov (United States)

    Sandler, Irwin; Tein, Jenn-Yun; Cham, Heining; Wolchik, Sharlene; Ayers, Tim

    2016-08-01

    This study reports on the findings from a 6-year follow-up of a randomized trial of the Family Bereavement Program (FBP) on the outcomes for spousally bereaved parents. Spousally bereaved parents (N = 131) participated in the trial in which they were randomly assigned to receive the FBP (N = 72) or literature control (N = 59). Parents were assessed at four time points: pretest, posttest, and 11-month and 6-year follow-up. They reported on mental health problems, grief, and parenting at all four time periods. At the 6-year follow-up, parents reported on additional measures of persistent complex bereavement disorder, alcohol abuse problems, and coping efficacy. Bereaved parents in the FBP as compared to those in the literature control had lower levels of symptoms of depression, general psychiatric distress, prolonged grief, and alcohol problems, and higher coping efficacy (for mothers) at the 6-year follow-up. Multiple characteristics of the parent (e.g., gender, age, and baseline mental health problems) and of the spousal death (e.g., cause of death) were tested as moderators of program effects on each outcome, but only 3 of 45 tests of moderation were significant. Latent growth modeling found that the effects of the FBP on depression, psychiatric distress, and grief occurred immediately following program participation and were maintained over 6 years. Mediation analysis found that improvement in positive parenting partially mediated program effects to reduce depression and psychiatric distress, but had an indirect effect to higher levels of grief at the 6-year follow-up. Mediation analysis also found that improved parenting at the 6-year follow-up was partially mediated by program effects to reduce depression and that program effects to increase coping efficacy at the 6-year follow-up was partially mediated through reduced depression and grief and improved parenting. FBP reduced mental health problems, prolonged grief, and alcohol abuse, and increased coping

  2. Co-occurrence of substance use related and mental health problems in the Finnish social and health care system.

    Science.gov (United States)

    Kuussaari, Kristiina; Hirschovits-Gerz, Tanja

    2016-03-01

    Many studies have noted that substance abuse and mental health problems often occur simultaneously. The aim of the work reported here was to study the co-occurrence of mental health problems and problems related to substance use in a sample of clients visiting the Finnish social and health care services for issues related to substance use. We collected background information on the clients and considered the parts of the treatment system in which these clients were treated. Survey data on intoxicant-related cases in the Finnish health care and social services were gathered on a single day in 2011. During the 24 hours of data collection, all intoxicant-related cases were reported and data were obtained for 11,738 intoxicant-related cases. In this analysis we took into account the clients' background variables, mental health variables, information on the treatment type and the main reasons for the client being in treatment. The χ(2) test, Fisher's exact test and binary logistic regression analysis were used. Half of the visiting clients had both substance use related and mental health problems. The strongest factors associated with the co-occurrence of substance use related and mental health problems were female sex, younger age and single marital status. Clients with co-occurring problems were more often treated in the health care services, whereas clients with only substance use related problems were primarily treated in specialized services for the treatment of substance abuse. It is important to identify clients with co-occurring substance use related and mental health problems. In this study, half of the clients presenting to the Finnish social and health care treatment system had both these problems. © 2015 the Nordic Societies of Public Health.

  3. Guidelines and Recommendations for Developing Interactive eHealth Apps for Complex Messaging in Health Promotion.

    Science.gov (United States)

    Heffernan, Kayla Joanne; Chang, Shanton; Maclean, Skye Tamara; Callegari, Emma Teresa; Garland, Suzanne Marie; Reavley, Nicola Jane; Varigos, George Andrew; Wark, John Dennis

    2016-02-09

    The now ubiquitous catchphrase, "There's an app for that," rings true owing to the growing number of mobile phone apps. In excess of 97,000 eHealth apps are available in major app stores. Yet the effectiveness of these apps varies greatly. While a minority of apps are developed grounded in theory and in conjunction with health care experts, the vast majority are not. This is concerning given the Hippocratic notion of "do no harm." There is currently no unified formal theory for developing interactive eHealth apps, and development is especially difficult when complex messaging is required, such as in health promotion and prevention. This paper aims to provide insight into the creation of interactive eHealth apps for complex messaging, by leveraging the Safe-D case study, which involved complex messaging required to guide safe but sufficient UV exposure for vitamin D synthesis in users. We aim to create recommendations for developing interactive eHealth apps for complex messages based on the lessons learned during Safe-D app development. For this case study we developed an Apple and Android app, both named Safe-D, to safely improve vitamin D status in young women through encouraging safe ultraviolet radiation exposure. The app was developed through participatory action research involving medical and human computer interaction researchers, subject matter expert clinicians, external developers, and target users. The recommendations for development were created from analysis of the development process. By working with clinicians and implementing disparate design examples from the literature, we developed the Safe-D app. From this development process, recommendations for developing interactive eHealth apps for complex messaging were created: (1) involve a multidisciplinary team in the development process, (2) manage complex messages to engage users, and (3) design for interactivity (tailor recommendations, remove barriers to use, design for simplicity). This research has

  4. Health professionals' advice for breastfeeding problems: not good enough!

    Science.gov (United States)

    Amir, Lisa H; Ingram, Jennifer

    2008-09-11

    Jane Scott and colleagues have recently published a paper in the International Breastfeeding Journal showing that health professionals are still giving harmful advice to women with mastitis. We see the management of mastitis as an illustration of health professionals' management of wider breastfeeding issues. If health professionals don't know how to manage this common problem, how can they be expected to manage less common conditions such as a breast abscess or nipple/breast candidiasis? There is an urgent need for more clinical research into breastfeeding problems and to improve the education of health professionals to enable them to promote breastfeeding and support breastfeeding women.

  5. Health professionals' advice for breastfeeding problems: Not good enough!

    Directory of Open Access Journals (Sweden)

    Amir Lisa H

    2008-09-01

    Full Text Available Abstract Jane Scott and colleagues have recently published a paper in the International Breastfeeding Journal showing that health professionals are still giving harmful advice to women with mastitis. We see the management of mastitis as an illustration of health professionals' management of wider breastfeeding issues. If health professionals don't know how to manage this common problem, how can they be expected to manage less common conditions such as a breast abscess or nipple/breast candidiasis? There is an urgent need for more clinical research into breastfeeding problems and to improve the education of health professionals to enable them to promote breastfeeding and support breastfeeding women.

  6. Determining the Effects of Cognitive Style, Problem Complexity, and Hypothesis Generation on the Problem Solving Ability of School-Based Agricultural Education Students

    Science.gov (United States)

    Blackburn, J. Joey; Robinson, J. Shane

    2016-01-01

    The purpose of this experimental study was to assess the effects of cognitive style, problem complexity, and hypothesis generation on the problem solving ability of school-based agricultural education students. Problem solving ability was defined as time to solution. Kirton's Adaption-Innovation Inventory was employed to assess students' cognitive…

  7. Implementation of exterior complex scaling in B-splines to solve atomic and molecular collision problems

    International Nuclear Information System (INIS)

    McCurdy, C William; MartIn, Fernando

    2004-01-01

    B-spline methods are now well established as widely applicable tools for the evaluation of atomic and molecular continuum states. The mathematical technique of exterior complex scaling has been shown, in a variety of other implementations, to be a powerful method with which to solve atomic and molecular scattering problems, because it allows the correct imposition of continuum boundary conditions without their explicit analytic application. In this paper, an implementation of exterior complex scaling in B-splines is described that can bring the well-developed technology of B-splines to bear on new problems, including multiple ionization and breakup problems, in a straightforward way. The approach is demonstrated for examples involving the continuum motion of nuclei in diatomic molecules as well as electronic continua. For problems involving electrons, a method based on Poisson's equation is presented for computing two-electron integrals over B-splines under exterior complex scaling

  8. Childhood constipation as an emerging public health problem.

    Science.gov (United States)

    Rajindrajith, Shaman; Devanarayana, Niranga Manjuri; Crispus Perera, Bonaventure Jayasiri; Benninga, Marc Alexander

    2016-08-14

    Functional constipation (FC) is a significant health problem in children and contrary to common belief, has serious ramifications on the lives of children and their families. It is defined by the Rome criteria which encourage the use of multiple clinical features for diagnosis. FC in children has a high prevalence (0.7%-29%) worldwide, both in developed and developing countries. Biopsychosocial risk factors such as psychological stress, poor dietary habits, obesity and child maltreatment are commonly identified predisposing factors for FC. FC poses a significant healthcare burden on the already overstretched health budgets of many countries in terms of out-patient care, in-patient care, expenditure for investigations and prescriptions. Complications are common and range from minor psychological disturbances, to lower health-related quality of life. FC in children also has a significant impact on families. Many paediatric clinical trials have poor methodological quality, and drugs proved to be useful in adults, are not effective in relieving symptoms in children. A significant proportion of inadequately treated children have similar symptoms as adults. These factors show that constipation is an increasing public health problem across the world with a significant medical, social and economic impact. This article highlights the potential public health impact of FC and the possibility of overcoming this problem by concentrating on modifiable risk factors rather than expending resources on high cost investigations and therapeutic modalities.

  9. Complex Problem Solving in Teams: The Impact of Collective Orientation on Team Process Demands

    Science.gov (United States)

    Hagemann, Vera; Kluge, Annette

    2017-01-01

    Complex problem solving is challenging and a high-level cognitive process for individuals. When analyzing complex problem solving in teams, an additional, new dimension has to be considered, as teamwork processes increase the requirements already put on individual team members. After introducing an idealized teamwork process model, that complex problem solving teams pass through, and integrating the relevant teamwork skills for interdependently working teams into the model and combining it with the four kinds of team processes (transition, action, interpersonal, and learning processes), the paper demonstrates the importance of fulfilling team process demands for successful complex problem solving within teams. Therefore, results from a controlled team study within complex situations are presented. The study focused on factors that influence action processes, like coordination, such as emergent states like collective orientation, cohesion, and trust and that dynamically enable effective teamwork in complex situations. Before conducting the experiments, participants were divided by median split into two-person teams with either high (n = 58) or low (n = 58) collective orientation values. The study was conducted with the microworld C3Fire, simulating dynamic decision making, and acting in complex situations within a teamwork context. The microworld includes interdependent tasks such as extinguishing forest fires or protecting houses. Two firefighting scenarios had been developed, which takes a maximum of 15 min each. All teams worked on these two scenarios. Coordination within the team and the resulting team performance were calculated based on a log-file analysis. The results show that no relationships between trust and action processes and team performance exist. Likewise, no relationships were found for cohesion. Only collective orientation of team members positively influences team performance in complex environments mediated by action processes such as

  10. Complex Problem Solving in Teams: The Impact of Collective Orientation on Team Process Demands

    Directory of Open Access Journals (Sweden)

    Vera Hagemann

    2017-09-01

    Full Text Available Complex problem solving is challenging and a high-level cognitive process for individuals. When analyzing complex problem solving in teams, an additional, new dimension has to be considered, as teamwork processes increase the requirements already put on individual team members. After introducing an idealized teamwork process model, that complex problem solving teams pass through, and integrating the relevant teamwork skills for interdependently working teams into the model and combining it with the four kinds of team processes (transition, action, interpersonal, and learning processes, the paper demonstrates the importance of fulfilling team process demands for successful complex problem solving within teams. Therefore, results from a controlled team study within complex situations are presented. The study focused on factors that influence action processes, like coordination, such as emergent states like collective orientation, cohesion, and trust and that dynamically enable effective teamwork in complex situations. Before conducting the experiments, participants were divided by median split into two-person teams with either high (n = 58 or low (n = 58 collective orientation values. The study was conducted with the microworld C3Fire, simulating dynamic decision making, and acting in complex situations within a teamwork context. The microworld includes interdependent tasks such as extinguishing forest fires or protecting houses. Two firefighting scenarios had been developed, which takes a maximum of 15 min each. All teams worked on these two scenarios. Coordination within the team and the resulting team performance were calculated based on a log-file analysis. The results show that no relationships between trust and action processes and team performance exist. Likewise, no relationships were found for cohesion. Only collective orientation of team members positively influences team performance in complex environments mediated by action processes

  11. [Parental beliefs and child-rearing attitudes and mental health problems among schoolchildren].

    Science.gov (United States)

    Vitolo, Ymara Lúcia Camargo; Fleitlich-Bilyk, Bacy; Goodman, Robert; Bordin, Isabel Altenfelder Santos

    2005-10-01

    To verify the prevalence and identify the risk factors related to mental health problems among schoolchildren and its possible association with the beliefs and educational attitudes of parents/caretakers. Cross-sectional study with a stratified probabilistic sample (n=454) of first to third-graders from public and private schools in Southeastern Brazil. Standardized instruments were administered to parents/caretakers by trained interviewers, including screening questionnaires for mental health problems among children and parents/caretakers; a questionnaire on beliefs and attitudes; and a questionnaire for socio-economic status. Chi-square tests and logistic regression models were used for statistical analysis. We found 35.2% prevalence of clinical/borderline cases among students. Parents/caretakers that believed in corporal punishment as a child-rearing method used physical aggression towards their children more frequently (64.8%). Logistic regression models showed that the act of hitting the child with a belt was associated to conduct problems and to overall mental health problems among schoolchildren in the presence of other risk factors: child gender (male), parents/caretakers with mental health problems, and adverse socioeconomic conditions. The high prevalence of mental health problems among schoolchildren and its association with child-rearing methods and mental health problems among parents/caretakers indicate the need for psycho-educational interventions aimed to reduce physical abuse and mental health problems in childhood.

  12. Acute pesticide poisoning--a global public health problem

    DEFF Research Database (Denmark)

    Konradsen, Flemming

    2007-01-01

    Acute pesticide poisoning has become a major public health problem worldwide, following the intensification of agriculture and the promotion of agro-chemicals in low and middle income countries, with more than 300,000 deaths each year. The easy availability of highly toxic pesticides in the homes...... of farming communities has made pesticides the preferred means of suicide with an extremely high case fatality. Similarly, the extensive use of pesticides exposes the community to both long-term and acute occupational health problems. A concerted effort is urgently needed to address the situation....

  13. Recruitment strategies for caregivers of children with mental health problems.

    Science.gov (United States)

    Oruche, Ukamaka M; Gerkensmeyer, Janis E; Austin, Joan K; Perkins, Susan M; Scott, Eric; Lindsey, Laura M; Mullins, Kristen

    2012-01-01

    The aim of this study was to describe strategies for recruiting participants into an intervention study that focused on improving problem-solving skills in caregivers of children with mental health problems. Caregivers of children with mental health problems report feeling physically and psychologically overwhelmed and have high rates of depression because of the demands of caregiving. Research on the needs of these caregivers and interventions to ameliorate their stress is needed. However, recruiting this population can be particularly difficult because of the stigma of mental illness. Available literature on recruitment of caregivers of persons with physical illness cannot be transferred to caregivers of children with mental health problems because of the different caregiving situations. There is a need to identify effective recruitment strategies to reduce cost and answer research questions. Clinical nurse specialists have the skills to facilitate the recruitment of research participants. We revised and expanded health system referrals, community outreach, and recruiting advertisement (ads). When these strategies did not increase recruitment, radio ads were used. The Andersen's Behavioral Model of Health Services Utilization was selected as a guiding framework. Radio ads were the most effective strategy for recruiting caregivers of children with mental health problems for this study. Recruitment was ultimately successful because we were flexible and made decisions consistent with the Andersen's Behavioral Model of Health Services Utilization. Clinical nurse specialists who study this population of caregivers should really consider the use of radio ads and systematically track which recruitment strategies lead to the greatest number of participants screened, eligible, and enrolled into studies.

  14. Association between school bullying levels/types and mental health problems among Taiwanese adolescents.

    Science.gov (United States)

    Yen, Cheng-Fang; Yang, Pinchen; Wang, Peng-Wei; Lin, Huang-Chi; Liu, Tai-Ling; Wu, Yu-Yu; Tang, Tze-Chun

    2014-04-01

    Few studies have compared the risks of mental health problems among the adolescents with different levels and different types of bullying involvement experiences. Bullying involvement in 6,406 adolescents was determined through use of the Chinese version of the School Bullying Experience Questionnaire. Data were collected regarding the mental health problems, including depression, suicidality, insomnia, general anxiety, social phobia, alcohol abuse, inattention, and hyperactivity/impulsivity. The association between experiences of bullying involvement and mental health problems was examined. The risk of mental health problems was compared among those with different levels/types of bullying involvement. The results found that being a victim of any type of bullying and being a perpetrator of passive bullying were significantly associated with all kinds of mental health problems, and being a perpetrator of active bullying was significantly associated with all kinds of mental health problems except for general anxiety. Victims or perpetrators of both passive and active bullying had a greater risk of some dimensions of mental health problems than those involved in only passive or active bullying. Differences in the risk of mental health problems were also found among adolescents involved in different types of bullying. This difference in comorbid mental health problems should be taken into consideration when assessing adolescents involved in different levels/types of bullying. © 2014.

  15. Health problems of newly arrived migrants and refugees in Europe.

    Science.gov (United States)

    Pavli, Androula; Maltezou, Helena

    2017-07-01

    The number of migrants and refugees in Europe in the past few years has increased dramatically due to war, violence or prosecutions in their homeland. Migration may affect physical, mental and social health. The objective of this article is to assess migrants and refugees' health problems, and to recommend appropriate interventions. A PubMed search of published articles on health problems of newly arrived migrants and refugees was conducted from 2003 through 2016, focusing on the current refugee crisis in Europe. In addition to communicable diseases, such as respiratory, gastrointestinal and dermatologic infections, non-communicable diseases, including chronic conditions, mental and social problems, account for a significant morbidity burden in newly arrived migrants and refugees. Vaccine-preventable diseases are also of outmost importance. The appropriate management of newly arrived refugees and migrants' health problems is affected by barriers to access to health care including legal, communication, cultural and bureaucratic difficulties. There is diversity and lack of integration regarding health care provision across Europe due to policy differences between health care systems and social services. There is a notable burden of communicable and non-communicable diseases among newly arrived migrants and refugees. Provision of health care at reception and temporary centres should be integrated and provided by a multidisciplinary team Appropriate health care of migrants and refugees could greatly enhance their health and social status which will benefit also the host countries at large. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  16. Adolescent health problems in India: A review from 2001 to 2015

    Directory of Open Access Journals (Sweden)

    Punyatoya Bej

    2015-12-01

    Full Text Available Adolescence is a period in which all the habits and behaviour like high risk behaviour, substance abuse and eating habits develop that have lifelong impact. In India, programmes have been launched to address all the problems faced during adolescent period, still then adolescents are facing problems. In this review the problems faced by Indian adolescents were highlighted from the past 14 years’ studies. The studies were searched from 2001 to 2015 from Pub Med, Google scholar and other community medicine and public health related journals. The problems included were sexual health and teenage pregnancy, problems related to menstruation, illicit drugs, tobacco and alcohol use. Anaemia, eating problems, obesity, behavioural problems and oral health among adolescent were also reviewed. Nineteen abstracts and 52 full texts were available. Sexual health knowledge among adolescent varies from 41% to poor. Knowledge about sexually transmitted diseases and sexuality is less. Prevalence of dysmenorrhoea varies from 67.2% to 56.15% among adolescent girls. Prevalence of tobacco use varies from 25.1 to 12%. Prevalence of obesity varies from 3.4% to 0.35% and overweight varies from 5.5% to 5.84%. Prevalence of anaemia varies from 29% to 41.1%. Adolescents are facing depressive problems, physical fights, worry and loneliness. Prevalence of depression varies from 18.4% to 13.3%. Prevalence of dental problems varies from 18.2 to 41%. The review revealed that adolescents in India are facing problems of sexually transmitted infections, dysmenorrhea, tobacco and alcohol use, depression, physical fights, worry, loneliness and oral health problems. This needs a participation of family, community and government to resolve the issue.

  17. Understanding the complexity of biopsychosocial factors in the public health epidemic of overweight and obesity

    OpenAIRE

    Rosenbaum, Diane L; White, Kamila S

    2016-01-01

    Obesity is a complex and multifaceted public health problem. This commentary reflects on a new theoretical model of obesity (i.e. Homeostatic Theory of Obesity proposed by Marks), and calls for additional research to examine biopsychosocial factors that may be of importance in developing interventions that promote long-term maintenance of weight loss and in developing obesity prevention programs. Furthermore, we discuss the role of socioeconomic factors in obesity and call for interdisciplina...

  18. Psychosocial and Mental Health Problems of Older People in Postearthquake Nepal.

    Science.gov (United States)

    Adhikari, Ramesh P; Upadhaya, Nawaraj; Paudel, Sasmita; Pokhrel, Ruja; Bhandari, Nagendra; Cole, Laura; Koirala, Suraj

    2017-03-01

    To identify community perceptions on psychosocial and mental health problems of older people in postearthquake situation in Nepal. A qualitative methodology was adopted to explore the experience and opinions of older people, social workers, school teachers, health workers, and nongovernmental organization workers on the psychosocial and mental health problems of older people in Nepal, using key informant interviews. Major local vocabulary for older peoples' psychosocial and mental health problems were "bichalan" (variation in mood and feeling), "ekohoro" (becoming single minded), "athmabiswasko kami" (low self-esteem), and "bina karan rune" (crying without any reason). The major causes attributed to older people's problems were physical injury, disability, family conflict, and economic problems. Forgetfulness, tiredness, loss of concentration, restlessness, and isolation were observed in older people since the 2015 earthquake. The findings suggest that earthquake had negative impact on older people's psychosocial well-being; however, little support or treatment options have been made available to these individuals. The tailor-made community-based psychosocial and mental health programs for older people are needed.

  19. What Do Employers Pay for Employees' Complex Problem Solving Skills?

    Science.gov (United States)

    Ederer, Peer; Nedelkoska, Ljubica; Patt, Alexander; Castellazzi, Silvia

    2015-01-01

    We estimate the market value that employers assign to the complex problem solving (CPS) skills of their employees, using individual-level Mincer-style wage regressions. For the purpose of the study, we collected new and unique data using psychometric measures of CPS and an extensive background questionnaire on employees' personal and work history.…

  20. Mental health problems in deaf and severely hard of hearing children and adolescents : findings on prevalence, pathogenesis and clinical complexities, and implications for prevention, diagnosis and intervention

    NARCIS (Netherlands)

    Gent, Tiejo van

    2012-01-01

    The aim of this thesis is to expand the knowledge of mental health problems with deaf and severely hard of hearing children and adolescents in the following domains: 1. The prevalence of mental health problems; 2. Specific intra- and interpersonal aspects of pathogenesis; 3. characteristics of the

  1. Perception of primary school teachers to school children's mental health problems in Southwest Ethiopia.

    Science.gov (United States)

    Kerebih, Habtamu; Abrha, Hailay; Frank, Reiner; Abera, Mubarek

    2016-11-12

    Teachers perception of child mental health problems and their attitude to school-based mental health services helps in designing early intervention strategies aimed at promoting the service. However, little is known in this regard among primary school teachers in Ethiopia. Therefore, this study assessed perceptions and attitude of primary school teachers to child mental health problem and school-based mental health programs in Jimma town, southwest Ethiopia in 2013. A cross-sectional study design was implemented among 568 primary school teachers in Jimma town, from 1 to 30 October 2013. Perceptions and attitude of teachers to children with mental health problems and school mental health related information were assessed using a structured self- administered questionnaire. About 40% of teachers recognized the list of psychopathology items presented to them as child mental health problems while 54.4% of them rated child mental health problem as severe. Externalizing behaviors were perceived as the most severe problems. Teaching experience and teaching in public schools were significantly associated with the perception of severe type of child mental health problems. About 95% of teachers acknowledged that school-based mental health programs are important but limited availability was reported. Despite the high problem severity ratings, teachers' perception of the psychopathology as a mental health problem in children was low. There was also a favorable attitude on the importance and the need of school-based child mental health programs. Thus, creating mental health awareness for teachers and establishing school mental health services to intervene in child mental health problem is crucial.

  2. Child labor and childhood behavioral and mental health problems in ...

    African Journals Online (AJOL)

    Objective: The objectives of this study are to estimate the prevalence and describe the nature of behavioral and mental health problems, as well as child abuse, nutritional problems, gross physical illness and injury among child laborers aged 8 to 15 years in Ethiopia. However, only the behavioral and mental health ...

  3. Medicines counterfeiting is a complex problem: a review of key challenges across the supply chain.

    Science.gov (United States)

    Tremblay, Michael

    2013-02-01

    The paper begins by asking why there is a market for counterfeit medicines, which in effect creates the problem of counterfeiting itself. Contributing factors include supply chain complexity and the lack of whole-systems thinking. These two underpin the author's view that counterfeiting is a complex (i.e. wicked) problem, and that corporate, public policy and regulatory actions need to be mindful of how their actions may be causal. The paper offers a problem-based review of key components of this complexity, viz., the knowledge end-users/consumers have of medicines; whether restrictive information policies may hamper information provision to patients; the internet's direct access to consumers; internet-enabled distribution of unsafe and counterfeit medicines; whether the internet is a parallel and competitive supply chain to legitimate routes; organised crime as an emerging medicines manufacturer and supplier and whether substandard medicines is really the bigger problem. Solutions respect the perceived complexity of the supply chain challenges. The paper identifies the need to avoid technologically-driven solutions, calling for 'technological agnosticism'. Both regulation and public policy need to reflect the dynamic nature of the problem and avoid creating perverse incentives; it may be, for instance, that medicines pricing and reimbursement policies, which affect consumer/patient access may act as market signals to counterfeiters, since this creates a cash market in cheaper drugs.

  4. Conceptualizing childhood health problems using survey data: a comparison of key indicators

    Directory of Open Access Journals (Sweden)

    Miller Anton R

    2007-12-01

    Full Text Available Abstract Background Many definitions are being used to conceptualize child health problems. With survey data, commonly used indicators for identifying children with health problems have included chronic condition checklists, measures of activity limitations, elevated service use, and health utility thresholds. This study compares these different indicators in terms of the prevalence rates elicited, and in terms of how the subgroups identified differ. Methods Secondary data analyses used data from the National Longitudinal Survey of Children and Youth, which surveyed a nationally representative sample of Canadian children (n = 13,790. Descriptive analyses compared healthy children to those with health problems, as classified by any of the key indicators. Additional analyses examined differences between subgroups of children captured by a single indicator and those described as having health problems by multiple indicators. Results This study demonstrates that children captured by any of the indicators had poorer health than healthy children, despite the fact that over half the sample (52.2% was characterized as having a health problem by at least one indicator. Rates of child ill health differed by indicator; 5.6% had an activity limitation, 9.2% exhibited a severe health difficulty, 31.7% reported a chronic condition, and 36.6% had elevated service use. Further, the four key indicators captured different types of children. Indicator groupings differed on child and socio-demographic factors. Compared to children identified by more than one indicator, those identified only by the severe health difficulty indicator displayed more cognitive problems (p Conclusion We provide information useful to researchers when selecting indicators from survey data to identify children with health problems. Researchers and policy makers need to be aware of the impact of such definitions on prevalence rates as well as on the composition of children classified as

  5. The development of the Quality Indicator for Rehabilitative Care (QuIRC) : a measure of best practice for facilities for people with longer term mental health problems

    NARCIS (Netherlands)

    Killaspy, Helen; White, Sarah; Wright, Christine; Taylor, Tatiana L.; Turton, Penny; Schuetzwohl, Matthias; Schuster, Mirjam; Cervilla, Jorge A.; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Adamowski, Tomasz; Ploumpidis, Dimitri; Gonidakis, Fragiskos; Caldas-de-Almeida, Jose; Cardoso, Graca; King, Michael B.

    2011-01-01

    Background: Despite the progress over recent decades in developing community mental health services internationally, many people still receive treatment and care in institutional settings. Those most likely to reside longest in these facilities have the most complex mental health problems and are at

  6. Health and environmental effects of complex chemical mixtures: proceedings

    Energy Technology Data Exchange (ETDEWEB)

    1985-01-01

    The Office of Health and Environmental Research (OHER) of the Department of Energy supports a broad long-term research program on human health and environmental effects from potential exposure to energy-related complex chemical mixtures. The program seeks basic mechanistic data on the effects of complex mixtures at the cellular, molecular, and whole animal levels to aid in predicting human health effects and seeks ecological data on biological and physical transformations in the mixtures, concentrations of the mixtures in various compartments of the environment, and potential routes for human exposure to these mixtures (e.g., food chain). On June 17-18, 1985, OHER held its First Annual Technical Meeting on the Complex Chemical Mixtures Program in Chicago, IL. The primary purpose of the meeting was to enable principal investigators to report the research status and accomplishments of ongoing complex chemical mixture studies supported by OHER. To help focus future research directions round table discussions were conducted.

  7. Feeling hindered by health problems and functional capacity at 60 years and above.

    Science.gov (United States)

    Fagerström, Cecilia; Holst, Göran; Hallberg, Ingalill R

    2007-01-01

    It is common to use activities of daily living (ADL) rating scales to identify the impact of health problems such as diseases, impaired eyesight or hearing on daily life. However, for various reasons people with health problems might feel hindered in daily life before limitations in ability to perform ADL have occurred. In addition, there is sparse knowledge of what makes people feel hindered by health problems in relation to their ADL capacity. The aim was to investigate feeling hindered by health problems among 1297 people aged 60-89 living at home in relation to ADL capacity, health problems, life satisfaction, self-esteem, and social and financial resources, using a self-reported questionnaire, including questions from Older Americans' Resources and Services schedule (OARS), Rosenberg's self-esteem and Life Satisfaction Index Z (LSIZ). People feeling greatly hindered by health problems rarely had anyone who could help when they needed support, had lower life satisfaction and self-esteem than those not feeling hindered. Feeling hindered by health problems appeared to take on a different meaning depending on ADL capacity, knowledge that seems essential to include when accomplishing health promotion and rehabilitation interventions, especially at the early stages of reduced ADL capacity.

  8. Mental health problems in adolescents with cochlear implants: Peer problems persist after controlling for additional handicaps

    Directory of Open Access Journals (Sweden)

    Maria eHuber

    2015-07-01

    Full Text Available The aims of the present multi-center study were to investigate the extent of mental health problems in adolescents with a hearing loss and cochlear implants (CIs in comparison to normal hearing (NH peers and to investigate possible relations between the extent of mental health problems of young CI users and hearing variables, such as age at implantation, or functional gain of CI. The survey included 140 adolescents with CI (mean age = 14.7, SD = 1.5 years and 140 NH adolescents (mean age = 14.8, SD = 1.4 years, their parents and teachers. Participants were matched by age, gender and social background. Within the CI group, 35 adolescents were identified as risk cases due to possible and manifest additional handicaps, and 11 adolescents were non-classifiable. Mental health problems were assessed with the Strengths and Difficulties Questionnaire (SDQ in the versions Self, Parent, and Teacher. The CI group showed significantly more Peer Problems than the NH group. When the CI group was split into a risk-group (35 risk cases and 11 non-classifiable persons and a non-risk group (n = 94, increased peer problems were perceived in both CI subgroups by adolescents themselves. However, no further differences between the CI non-risk group and the NH group were observed in any rater. The CI-risk group showed significantly more hyperactivity compared to the NH group and more hyperactivity and conduct problems compared to the CI non-risk group. Cluster analyses confirmed that there were significantly more adolescents with high problems in the CI-risk group compared to the CI non-risk group and the NH group. Adolescents with CI, who were able to understand speech in noise had significantly less difficulties compared to constricted CI users. Parents, teachers, and clinicians should be aware that CI users with additionally special needs may have mental health problems. However, peer problems were also experienced by CI adolescents without additional handicaps

  9. Complex health service needs for people who are homeless.

    Science.gov (United States)

    Moore, Gaye; Manias, Elizabeth; Gerdtz, Marie Frances

    2011-11-01

    Homeless people face many challenges in accessing and utilising health services to obtain psychosocial supports offered in hospital and community settings. The complex nature of health issues is compounded by lack of accessibility to services and lack of appropriate and safe housing. To examine the perceptions and experiences of homeless people in relation to their health service needs as well as those of service providers involved with their care. A purposive sampling approach was undertaken with a thematic framework analysis of semi-structured interviews. Participants. Interviews were undertaken with 20 homeless people who accessed the emergency department in an acute hospital in Melbourne, Australia and 27 service providers involved in hospital and community care. Six key themes were identified from interviews: complexity of care needs, respect for homeless people and co-workers, engagement as a key strategy in continued care, lack of after-hour services, lack of appropriate accommodation and complexity of services. Findings revealed the complex and diverse nature of health concerns in homeless people. The demand on hospital services continues to increase and unless government policies take into consideration the psychosocial demands of the communities most vulnerable people efforts to divert hospital demand will continue to fail.

  10. Conceptual measurement framework for help-seeking for mental health problems

    Directory of Open Access Journals (Sweden)

    Rickwood D

    2012-12-01

    Full Text Available Debra Rickwood, Kerry ThomasFaculty of Health, University of Canberra, ACT, AustraliaBackground: Despite a high level of research, policy, and practice interest in help-seeking for mental health problems and mental disorders, there is currently no agreed and commonly used definition or conceptual measurement framework for help-seeking.Methods: A systematic review of research activity in the field was undertaken to investigate how help-seeking has been conceptualized and measured. Common elements were used to develop a proposed conceptual measurement framework.Results: The database search revealed a very high level of research activity and confirmed that there is no commonly applied definition of help-seeking and no psychometrically sound measures that are routinely used. The most common element in the help-seeking research was a focus on formal help-seeking sources, rather than informal sources, although studies did not assess a consistent set of professional sources; rather, each study addressed an idiosyncratic range of sources of professional health and community care. Similarly, the studies considered help-seeking for a range of mental health problems and no consistent terminology was applied. The most common mental health problem investigated was depression, followed by use of generic terms, such as mental health problem, psychological distress, or emotional problem. Major gaps in the consistent measurement of help-seeking were identified.Conclusion: It is evident that an agreed definition that supports the comparable measurement of help-seeking is lacking. Therefore, a conceptual measurement framework is proposed to fill this gap. The framework maintains that the essential elements for measurement are: the part of the help-seeking process to be investigated and respective time frame, the source and type of assistance, and the type of mental health concern. It is argued that adopting this framework will facilitate progress in the field by

  11. Stillbirths: What Can Be Done To Confront An Invisible Public Health Problem In Pakistan?

    Science.gov (United States)

    Shaikh, Babar Tasneem; Hafeez, Assad; Hamid, Saima

    2017-01-01

    Pakistan has been ranked highest and appears worst in stillbirths' rate according to the recent global estimates. Reasons could be manifold; socio-cultural, health system related country specific, and some of these of course déjà vu, i.e., the biomedical causes. Yet, a fresh stocktaking is necessary to understand the complex phenomenon in a country, awfully affected by this menace. Maternal, neonatal and child health program needs to be informed and geared up toward addressing the actual reasons behind this heavy toll of stillbirths in Pakistan. Maternal health indicators would never be improved, if the issue of stillbirths is not stalled at the earliest. Besides known medical reasons, this account attempts to document the health systems related factors, and more so the social determinants behind the whole scenario, so that appropriate and customized interventions could be suggested, developed and implemented. This paper will be a piece of evidence for policy corridors, program managers, development partners, non-governmental organizations, public health institutions, students, and researchers to enhance their understanding of a major public health problem, and to recognize the strengths and opportunities in the health system of Pakistan to cope with this challenge.

  12. Poor Pre-Pregnancy and Antepartum Mental Health Predicts Postpartum Mental Health Problems among US Women: A Nationally Representative Population-Based Study

    Science.gov (United States)

    Witt, Whitney P.; Wisk, Lauren E.; Cheng, Erika R.; Hampton, John M.; Creswell, Paul; Hagen, Erika W.; Spear, Hilary A.; Maddox, Torsheika; DeLeire, Thomas

    2011-01-01

    Purpose Mental health problems disproportionately affect women, particularly during childbearing years. However, there is a paucity of research on the determinants of postpartum mental health problems using representative US populations. Taking a life course perspective, we determined the potential risk factors for postpartum mental health problems, with a particular focus on the role of mental health before and during pregnancy. Methods We examined data on 1,863 mothers from eleven panels of the 1996-2006 Medical Expenditure Panel Survey (MEPS). Poor postpartum mental health was defined using self-reports of mental health conditions, symptoms of mental health conditions, or global mental health ratings of “fair” or “poor.” Results 9.5% of women reported experiencing postpartum mental health problems, with over half of these women reporting a history of poor mental health. Poor pre-pregnancy mental health and poor antepartum mental health both independently increased the odds of having postpartum mental health problems. Staged multivariate analyses revealed that poor antepartum mental health attenuated the relationship between pre-pregnancy and postpartum mental health problems. Additionally, significant disparities exist in women's report of postpartum mental health status. Conclusions While poor antepartum mental health is the strongest predictor of postpartum mental health problems, pre-pregnancy mental health is also important. Accordingly, health care providers should identify, treat, and follow women with a history of poor mental health, as they are particularly susceptible to postpartum mental health problems. This will ensure that women and their children are in the best possible health and mental health during the postpartum period and beyond. PMID:21349740

  13. Some Mobile Phone Associated Health Problems Among Mobile ...

    African Journals Online (AJOL)

    Background: Although mobile telecommunications deliver enormous benefit to society, there are concerns whether its electric and magnetic field emissions are linked with cancer or other health hazards. Objectives: 1) determining some of the mobile phone(Mph) associated health problems. 2) identifying some of the risk ...

  14. Learning about Complex Multi-Stakeholder Issues: Assessing the Visual Problem Appraisal

    NARCIS (Netherlands)

    Witteveen, L.M.; Put, M.; Leeuwis, C.

    2010-01-01

    This paper presents an evaluation of the visual problem appraisal (VPA) learning environment in higher education. The VPA has been designed for the training of competences that are required in complex stakeholder settings in relation to sustainability issues. The design of VPA incorporates a

  15. Health problems associated with international business travel. A critical review of the literature.

    Science.gov (United States)

    Rogers, H L; Reilly, S M

    2000-08-01

    1. Few studies examine the travel related health problems of international business travelers (IBTs). Research exists for other travelers, such as tourists, which begins to help clinicians understand the potential health problems faced by IBTs. 2. A review of the literature reveals 36% to 54% of travelers experience physical health problems such as traveler's diarrhea, insomnia, respiratory problems, and skin problems; 6% to 18% report accidents and injuries while abroad. 3. Psychosocial data are equally limited, but support the idea that IBTs may experience stress, anxiety, culture shock, and adjustment problems while overseas. 4. Multiple factors likely contribute to the physical and psychosocial health experiences of IBTs. The historical lack of data for this population of workers combined with the trend towards globalization confirm the need for further study from an occupational health perspective.

  16. School Nurses' Perceived Prevalence and Competence to Address Student Mental Health Problems

    Science.gov (United States)

    Stephan, Sharon H.; Connors, Elizabeth H.

    2013-01-01

    Due to under-identification of student mental health problems and limited specialty mental health providers in schools, school nurses are often faced with identifying and addressing student mental health needs. This exploratory study assessed prevalence and types of student mental health problems encountered by school nurses, as well as their…

  17. A qualitative study of health care providers' perceptions and experiences of working together to care for children with medical complexity (CMC).

    Science.gov (United States)

    Altman, Lisa; Zurynski, Yvonne; Breen, Christie; Hoffmann, Tim; Woolfenden, Susan

    2018-01-31

    Children with medical complexity (CMC) have a wide range of long term health problems and disabilities that have an adverse impact on their quality of life. They have high levels of family identified health care needs and health care utilisation. There is no Australian literature on the experiences of health care providers working in the Australian tertiary, secondary and primary health care system, whilst managing CMC. This information is essential to inform the design of integrated health care systems for these children. We address this knowledge gap by exploring the perceptions and experiences of health care providers on the provision of health care for CMC aged 0 to 18 years. A qualitative research study was undertaken. Stakeholder forums, group and individual in depth interviews were undertaken using a semi-structured interview guide. The stakeholder forums were audio recorded and transcribed verbatim. Field notes of the stakeholder forums, group and individual interviews were taken. Inductive thematic analysis was undertaken to identify key themes. One hundred and three providers took part in the stakeholder forums and interviews across 3 local health districts, a tertiary paediatric hospital network, and primary health care organisations. Providers expressed concern regarding family capacity to negotiate the system, which was impacted by the medical complexity of the children and psychosocial complexity of their families. Lack of health care provider capacity in terms of their skills, time and availability to manage CMC was also a key problem. These issues occurred within a health system that had impaired capacity in terms of fragmentation of care and limited communication among health care providers. When designing integrated care models for CMC, it is essential to understand and address the challenges experienced by their health care providers. This requires adequate training of providers, additional resources and time for coordination of care, improved

  18. Health and participation problems in older adults with long-term disability.

    Science.gov (United States)

    Hilberink, Sander R; van der Slot, Wilma M A; Klem, Martijn

    2017-04-01

    More attention and understanding of the health and participation problems of adults with early and later onset disabilities in the Netherlands is needed. To explore health/participation problems and unmet needs in adults aged ≥40 years with long-term disabilities and their relationship with the time of onset. Participants were recruited in the Netherlands through newsletters and social media to participate in a web-based questionnaire. The questionnaire assessed background characteristics, (change in) health/participation problems, and unmet needs. Spearman's rho was used to examine the relationships with time of onset. Of the 163 survey respondents, 42% acquired their disability before age 25 years and reported fatigue (77%), walking problems (66%), and pain (59%). In 21% of the respondents with early-onset disability fatigue, pain and depressive feelings co-occurred. Early-onset disability correlated with joint deformities, pain and anxiety. Participation problems included loss of income and fewer social activities. Early-onset correlated with the need for more information about diagnosis and prognosis. People aged over 40 years with long-term disability have significant and increasing health and participation problems. Adults with early-onset disability are more likely to have health or participation problems than adults with late-onset disability. Early identification is needed for preventive care and access to specialized services that focus on improving and maintaining physical symptoms, energy management, and participation. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Home care assistants’ perspectives on detecting mental health problems and promoting mental health among community-dwelling seniors with multimorbidity

    Science.gov (United States)

    Grundberg, Åke; Hansson, Anna; Religa, Dorota; Hillerås, Pernilla

    2016-01-01

    Introduction Elderly people with multiple chronic conditions, or multimorbidity, are at risk of developing poor mental health. These seniors often remain in their homes with support from home care assistants (HCAs). Mental health promotion by HCAs needs to be studied further because they may be among the first to observe changes in clients’ mental health status. Aim To describe HCAs’ perspectives on detecting mental health problems and promoting mental health among homebound seniors with multimorbidity. Methods We applied a descriptive qualitative study design using semi-structured interviews. Content analyses were performed on five focus group interviews conducted in 2014 with 26 HCAs. Results Most HCAs stated that they were experienced in caring for clients with mental health problems such as anxiety, depression, sleep problems, and high alcohol consumption. The HCAs mentioned as causes, or risk factors, multiple chronic conditions, feelings of loneliness, and social isolation. The findings reveal that continuity of care and seniors’ own thoughts and perceptions were essential to detecting mental health problems. Observation, collaboration, and social support emerged as important means of detecting mental health problems and promoting mental health. Conclusion The HCAs had knowledge of risk factors, but they seemed insecure about which health professionals had the primary responsibility for mental health. They also seemed to have detected early signs of mental health problems, even though good personal knowledge of the client and continuity in home visits were crucial to do so. When it came to mental health promotion, the suggestions related to the aim of ending social isolation, decreasing feelings of loneliness, and increasing physical activity. The results indicate that the HCAs seemed dependent on supervision by district nurses and on care managers’ decisions to support the needed care, to schedule assignments related to the detection of mental health

  20. Stigma as a barrier to seeking health care among military personnel with mental health problems.

    Science.gov (United States)

    Sharp, Marie-Louise; Fear, Nicola T; Rona, Roberto J; Wessely, Simon; Greenberg, Neil; Jones, Norman; Goodwin, Laura

    2015-01-01

    Approximately 60% of military personnel who experience mental health problems do not seek help, yet many of them could benefit from professional treatment. Across military studies, one of the most frequently reported barriers to help-seeking for mental health problems is concerns about stigma. It is, however, less clear how stigma influences mental health service utilization. This review will synthesize existing research on stigma, focusing on those in the military with mental health problems. We conducted a systematic review and meta-analysis of studies between 2001 and 2014 to examine the prevalence of stigma for seeking help for a mental health problem and its association with help-seeking intentions/mental health service utilization. Twenty papers met the search criteria. Weighted prevalence estimates for the 2 most endorsed stigma concerns were 44.2% (95% confidence interval: 37.1, 51.4) for "My unit leadership might treat me differently" and 42.9% (95% confidence interval: 36.8, 49.0) for "I would be seen as weak." Nine studies found no association between anticipated stigma and help-seeking intentions/mental health service use and 4 studies found a positive association. One study found a negative association between self-stigma and intentions to seek help. Counterintuitively, those that endorsed high anticipated stigma still utilized mental health services or were interested in seeking help. We propose that these findings may be related to intention-behavior gaps or methodological issues in the measurement of stigma. Positive associations may be influenced by modified labeling theory. Additionally, other factors such as self-stigma and negative attitudes toward mental health care may be worth further attention in future investigation. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. 'Health should not have to be a problem': talking health and accountability in an internet forum on veganism.

    Science.gov (United States)

    Sneijder, Petra; te Molder, Hedwig F M

    2004-07-01

    This article draws upon insights from discursive psychology to examine how participants in an Internet forum on veganism orient to the relationship between food choice, health and accountability. First, we explore the ways in which participants ascribe responsibility for health problems like vitamin deficiency to individual recipients. By suggesting individual practices as a cause for problems, speakers undermine the notion that problems arise through veganism as a matter of principle. Second, we show how participants construct solutions to individual health problems as involving mundane and simple actions. Both discursive procedures enable speakers to resist negative assumptions about the potentially complicated nature of veganism in relation to health protection.

  2. Cybersecurity vulnerabilities in medical devices: a complex environment and multifaceted problem.

    Science.gov (United States)

    Williams, Patricia Ah; Woodward, Andrew J

    2015-01-01

    The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat.

  3. Cybersecurity vulnerabilities in medical devices: a complex environment and multifaceted problem

    Science.gov (United States)

    Williams, Patricia AH; Woodward, Andrew J

    2015-01-01

    The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat. PMID:26229513

  4. Tacit knowledge of public health nurses in identifying community health problems and need for new services: a case study.

    Science.gov (United States)

    Yoshioka-Maeda, Kyoko; Murashima, Sachiyo; Asahara, Kiyomi

    2006-09-01

    The purpose of this study was to explore the tacit knowledge of public health nurses in identifying community health problems and developing relevant new projects. Previous research only roughly showed those skills for creating new community health services, such as lobbying. Nine Japanese public health nurses who had created new projects in their municipalities were selected by theoretical sampling and interviewed in 2002-2003. Yin's Case Study Method, especially the multiple-case study design, was used. All 9 public health nurses used similar approaches in identifying community health problems and the need for creating new services, even though their experiences differed and the kinds of projects varied. They identified the difficulties of clients, recognized clients who had the same problems, elucidated the limitations of existing services, and forecasted outcomes from the neglect of the clients' problems. Then they succeeded in creating a new project by examining individual health problems in the context of their community's characteristics, societal factors, and using existing policies to support their clients. This is the first study to explore the skills of public health nurses and their intention to use such skills in creating new projects as well as the exact process. They could identify community health problems that will be the basis for developing new services to provide care for individual clients. This is different from the traditional community assessment approach that requires the collection of a huge amount of information to clarify community health problems. The tacit knowledge of public health nurses will help to create needs-oriented new services more smoothly.

  5. The promotion of mental health and the prevention of mental health problems in child and adolescent

    Directory of Open Access Journals (Sweden)

    sunmi cho

    2013-11-01

    Full Text Available Improving mental health and reducing the burden of mental illness are complementary strategies which, along with the treatment and rehabilitation of people with mental disorders, significantly improve population health and well-being. A Institute of Medicine report describes a range of interventions for mental disorders that included treatment and maintenance, reserving the term “prevention” for efforts that occur before onset of a diagnosable disorder. Mental health problems affect 10&#8211;20% of children and adolescents worldwide. Despite their relevance as a leading cause of health-related disability and their long lasting consequences, the mental health needs of children and adolescents are neglected. Early intervention can help reduce the significant impacts that children and adolescents with serious mental health problems may experience. Screening is the first step in early intervention, recognizing emotional and behavioral problems and providing help at an early stage. It is essential to implement early intervention in a sensitive and ethical manner to avoid any of the negative outcomes.

  6. Exposure to child abuse and risk for mental health problems in women.

    Science.gov (United States)

    Schneider, Renee; Baumrind, Nikki; Kimerling, Rachel

    2007-01-01

    Risk for adult mental health problems associated with child sexual, physical, or emotional abuse and multiple types of child abuse was examined. Logistic regression analyses were used to test study hypotheses in a population-based sample of women (N = 3,936). As expected, child sexual, physical, and emotional abuse were independently associated with increased risk for mental health problems. History of multiple types of child abuse was also associated with elevated risk for mental health problems. In particular, exposure to all three types of child abuse was linked to a 23-fold increase in risk for probable posttraumatic stress disorder (PTSD). Findings underscore relations between child emotional abuse and adult mental health problems and highlight the need for mental health services for survivors of multiple types of child abuse.

  7. Amodified probabilistic genetic algorithm for the solution of complex constrained optimization problems

    OpenAIRE

    Vorozheikin, A.; Gonchar, T.; Panfilov, I.; Sopov, E.; Sopov, S.

    2009-01-01

    A new algorithm for the solution of complex constrained optimization problems based on the probabilistic genetic algorithm with optimal solution prediction is proposed. The efficiency investigation results in comparison with standard genetic algorithm are presented.

  8. The stigma of mental health problems in the military.

    Science.gov (United States)

    Greene-Shortridge, Tiffany M; Britt, Thomas W; Castro, Carl Andrew

    2007-02-01

    The present review addresses the perceived stigma associated with admitting a mental health problem and seeking help for that problem in the military. Evidence regarding the public stigma associated with mental disorders is reviewed, indicating that the public generally holds negative stereotypes toward individuals with psychological problems, leading to potential discrimination toward these individuals. The internalization of these negative beliefs results in self-stigma, leading to reduced self-esteem and motivation to seek help. Even if soldiers form an intention to seek help for their psychological difficulty, barriers to mental health care may prevent the soldier from receiving the help they need. An overall model is proposed to illustrate how the stigma associated with psychological problems can prevent soldiers getting needed help for psychological difficulties and proposed interventions for reducing stigma in a civilian context are considered for military personnel.

  9. Inverse problems in complex material design: Applications to non-crystalline solids

    Science.gov (United States)

    Biswas, Parthapratim; Drabold, David; Elliott, Stephen

    The design of complex amorphous materials is one of the fundamental problems in disordered condensed-matter science. While impressive developments of ab-initio simulation methods during the past several decades have brought tremendous success in understanding materials property from micro- to mesoscopic length scales, a major drawback is that they fail to incorporate existing knowledge of the materials in simulation methodologies. Since an essential feature of materials design is the synergy between experiment and theory, a properly developed approach to design materials should be able to exploit all available knowledge of the materials from measured experimental data. In this talk, we will address the design of complex disordered materials as an inverse problem involving experimental data and available empirical information. We show that the problem can be posed as a multi-objective non-convex optimization program, which can be addressed using a number of recently-developed bio-inspired global optimization techniques. In particular, we will discuss how a population-based stochastic search procedure can be used to determine the structure of non-crystalline solids (e.g. a-SiH, a-SiO2, amorphous graphene, and Fe and Ni clusters). The work is partially supported by NSF under Grant Nos. DMR 1507166 and 1507670.

  10. A mismatch between population health literacy and the complexity of health information

    DEFF Research Database (Denmark)

    Rowlands, Gillian; Protheroe, Joanne; Winkley, John

    2015-01-01

    skills in relation to these. DESIGN AND SETTING: An English observational study comparing health materials with national working-age population skills. METHOD: Health materials were sampled using a health literacy framework. Competency thresholds to understand and use the materials were identified......BACKGROUND: Low health literacy is associated with poorer health and higher mortality. Complex health materials are a barrier to health. AIM: To assess the literacy and numeracy skills required to understand and use commonly used English health information materials, and to describe population...... of health materials and the skills of the English adult working-age population. Those most in need of health information have the least access to it. Efficacious strategies are building population skills, improving health professionals' communication, and improving written health information....

  11. Putting the puzzle together: the role of 'problem definition' in complex clinical judgement.

    Science.gov (United States)

    Cristancho, Sayra; Lingard, Lorelei; Forbes, Thomas; Ott, Michael; Novick, Richard

    2017-02-01

    We teach judgement in pieces; that is, we talk about each aspect separately (patient, plan, resources, technique, etc.). We also let trainees figure out how to put the pieces together. In complex situations, this might be problematic. Using data from a drawing-based study on surgeons' experiences with complex situations, we explore the notion of 'problem definition' in real-world clinical judgement using the theoretical lens of systems engineering. 'Emergence', the sensitising concept for analysis, is rooted in two key systems premises: that person and context are inseparable and that what emerges is an act of choice. Via a 'gallery walk' we used these premises to perform analysis on individual drawings as well as cross-comparisons of multiple drawings. Our focus was to understand similarities and differences among the vantage points used by multiple surgeons. In this paper we challenge two assumptions from current models of clinical judgement: that experts hold a fixed and static definition of the problem and that consequently the focus of the expert's work is on solving the problem. Each situation described by our participants revealed different but complementary perspectives of what a surgical problem might come to be: from concerns about ensuring standard of care, to balancing personal emotions versus care choices, to coordinating resources, and to maintaining control while in the midst of personality clashes. We suggest that it is only at the situation and system level, not at the individual level, that we are able to appreciate the nuances of defining the problem when experts make judgements during real-world complex situations. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  12. Antecedents and Consequences of Consumer's Response to Health Information Complexity

    DEFF Research Database (Denmark)

    Hansen, Torben; Uth Thomsen, Thyra; Beckmann, Suzanne C.

    2013-01-01

    This study develops and empirically tests a model for understanding food consumers' health information seeking behaviour. Data were collected from 504 food consumers using a nationally representative consumer panel. The obtained Lisrel results suggest that consumers' product-specific health...... information seeking is positively affected by general food involvement and by usability of product-specific health information. Moreover, product-specific health information seeking and product-specific health information complexity are both positively related to post-purchase health-related dissonance....... This link between information complexity and post-purchase dissonance has implications for marketers of food products since our results suggest that consumers might avoid purchasing the same food item again if post-purchase dissonance is experienced....

  13. SOCIAL MEASUREMENT OF YOUTH’S HEALTH: DESIGNING OF INDICATORS OF COMPLEX SOCIOLOGICAL RESEARCH

    Directory of Open Access Journals (Sweden)

    Vitalii Valeriyevich Kulish

    2017-06-01

    Full Text Available Purpose. The article is devoted to solving the problem of social measurement of modern youth’s health. The subject of the analysis is the content of the concept, characteristics and indicators of the social health of young people, which enable using sociological research’ methods to measure a given status of the younger generation in contemporary Russian society. The purpose of this work is to define the theoretical and methodological foundations of the sociological analysis of the young people social health and to substantiate its main indicators in the tools of complex sociological research. Methodology of the study. The basis of the research is formed by the system approach, the complex approach, the logical-conceptual method and general scientific methods of research: comparative analysis, system analysis, construction of social indicators, modeling. Results. The social health of young people is defined through the category “status” and is considered as an integrated indicator of the social quality of the younger generation. It is substantiated that the social health of youth is a status of socio-demographic community in which it is able not only to adapt to the changing conditions of the social environment but is also ready to transform actively the surrounding reality, having the potential to resist destructive social phenomena and processes. The main indicators that allow measuring the social health of young people by sociological methods are determined: adaptability in the social environment, social activity in all spheres of public life, social orientation and significance of activity, behavior regulativity by social norms and universal values, creativity of thinking and behavior, readiness for social integration and self-development. A system of social indicators and indicators for conducting a sociological study of social health in historical memory, value orientations and everyday practices of young people has been developed.

  14. A tool to guide the process of integrating health system responses to public health problems

    Directory of Open Access Journals (Sweden)

    Tilahun Nigatu Haregu

    2015-06-01

    Full Text Available An integrated model of health system responses to public health problems is considered to be the most preferable approach. Accordingly, there are several models that stipulate what an integrated architecture should look like. However, tools that can guide the overall process of integration are lacking. This tool is designed to guide the entire process of integration of health system responses to major public health problems. It is developed by taking into account the contexts of health systems of developing countries and the emergence of double-burden of chronic diseases in these settings. Chronic diseases – HIV/AIDS and NCDs – represented the evidence base for the development of the model. System level horizontal integration of health system responses were considered in the development of this tool.

  15. Utilization of health services in relation to mental health problems in adolescents: A population based survey

    Science.gov (United States)

    Zachrisson, Henrik D; Rödje, Kjetil; Mykletun, Arnstein

    2006-01-01

    Background Only a minority of adolescents reporting symptoms above case-levels on screenings for mental health seeks and receives help from specialist health services. The objective of this study was to a) examine help-seeking for symptoms of anxiety and depression in relation to symptom load dimensionally, b) identify the level of specialization in mental health among service-providers, and c) identify associations between mental health problems and contact with different types of health services. Methods This cross-sectional school-based study (response-rate 88%, n = 11154) is based on Norwegian health surveys among 15 and 16 year olds. Results We found a dose-response association between symptom-load and help seeking. Only 34% of individuals with mental symptom-load above 99th percentile reported help-seeking in the last 12 months. Forty percent of help seekers were in contact with specialists (psychiatrists or psychologists), the remaining were mainly in contact with GPs. Mental health problems increased help seeking to all twelve service providers examined. Conclusion It might not be reasonable to argue that all adolescents with case-level mental health problems are in need of treatment. However, concerning the 99th percentile, claiming treatment need is less controversial. Even in the Norwegian context where mental health services are relatively available and free of charge, help-seeking in individuals with the highest symptom-loads is still low. Most help seekers achieved contact with health care providers, half of them at a non specialized level. Our results suggest that adolescents' recognition of mental health problems or intention to seek help for these are the major "filters" restricting treatment. PMID:16480522

  16. Performance of community health workers : situating their intermediary position within complex adaptive health systems

    NARCIS (Netherlands)

    Kok, Maryse C; Broerse, Jacqueline E W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

    2017-01-01

    Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors.This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income

  17. Problem-solving intervention for caregivers of children with mental health problems.

    Science.gov (United States)

    Gerkensmeyer, Janis E; Johnson, Cynthia S; Scott, Eric L; Oruche, Ukamaka M; Lindsey, Laura M; Austin, Joan K; Perkins, Susan M

    2013-06-01

    Building Our Solutions and Connections (BOSC) focused on enhancing problem-solving skills (PSS) of primary caregivers of children with mental health problems. Aims were determining feasibility, acceptability, and effect size (ES) estimates for depression, burden, personal control, and PSS. Caregivers were randomized to BOSC (n=30) or wait-list control (WLC) groups (n=31). Data were collected at baseline, post-intervention, and 3 and 6 months post-intervention. Three-months post-intervention, ES for burden and personal control were .07 and .08, respectively. ES for depressed caregivers for burden and personal control were 0.14 and 0.19, respectively. Evidence indicates that the intervention had desired effects. Published by Elsevier Inc.

  18. Do On-Site Mental Health Professionals Change Pediatricians' Responses to Children's Mental Health Problems?

    Science.gov (United States)

    McCue Horwitz, Sarah; Storfer-Isser, Amy; Kerker, Bonnie D; Szilagyi, Moira; Garner, Andrew S; O'Connor, Karen G; Hoagwood, Kimberly E; Green, Cori M; Foy, Jane M; Stein, Ruth E K

    2016-01-01

    To assess the availability of on-site mental health professionals (MHPs) in primary care; to examine practice/pediatrician characteristics associated with on-site MHPs; and to determine whether the presence of on-site MHPs is related to pediatricians' comanaging or more frequently identifying, treating/managing, or referring mental health (MH) problems. Analyses included American Academy of Pediatrics (AAP) members who participated in an AAP Periodic Survey in 2013 and who practiced general pediatrics (n = 321). Measures included sociodemographics, practice characteristics, questions about on-site MHPs, comanagement of MH problems, and pediatricians' behaviors in response to 5 prevalent MH problems. Weighted univariate, bivariate, and multivariable analyses were performed. Thirty-five percent reported on-site MHPs. Practice characteristics (medical schools, universities, health maintenance organizations, managed, or referred 5 common child MH problems. Among the subset of pediatricians who reported comanaging, there was an association with comanagement when the on-site MHP was a child psychiatrist, substance abuse counselor, or social worker. On-site MHPs are more frequent in settings where low-income children are served and where pediatricians train. Pediatricians who comanage MH problems are more likely to do so when the on-site MHP is a child psychiatrist, substance abuse counselor, or social worker. Overall, on-site MHPs were not associated with comanagement or increased likelihood of pediatricians identifying, treating/managing, or referring children with 5 common child MH problems. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  19. Atopic conditions and mental health problems: a 3-year follow-up study.

    Science.gov (United States)

    Lien, Lars; Green, Kristian; Thoresen, Magne; Bjertness, Espen

    2010-09-01

    The aim of this study was to test the hypothesis that atopic conditions at 15/16 years of age affect both internalized and externalized mental health problems 3 years later. Combined school and postal survey was conducted in urban and rural settings. A total of 3,674 adolescents (70.1% response rate) were followed at two time points and interviewed with similar questionnaires at baseline and follow-up. Hopkins Symptoms Checklist (HSCL-10) was used to assess internalized problems, and two subscales (conduct problems and hyperactivity) from the Strength and Difficulties Questionnaire to measure externalized mental health problems. The atopic conditions investigated were asthma, hay fever and eczema by asking the adolescents whether these conditions were present or not. There was an increase in the prevalence of internalized mental health problems from about 17-25% and a decrease in externalized mental health problems and number of atopic conditions in the follow-up period. Of the atopic conditions, hay fever was most prevalent with about 34% at 15 years of age and 20% at 18. The asthma prevalence was at 10 and 5% and eczema at 25 and 10%, respectively. Internalized mental health problems among girls were significantly associated with atopic conditions 3 years earlier, also after controlling for confounding variables. To live with atopic conditions seem to affect the mood and level of anxiety among adolescent girls. This should be kept in mind by health professionals treating young girls with atopic conditions.

  20. Leadership and leadership development in healthcare settings - a simplistic solution to complex problems?

    Science.gov (United States)

    McDonald, Ruth

    2014-10-01

    There is a trend in health systems around the world to place great emphasis on and faith in improving 'leadership'. Leadership has been defined in many ways and the elitist implications of traditional notions of leadership sit uncomfortably with modern healthcare organisations. The concept of distributed leadership incorporates inclusivity, collectiveness and collaboration, with the result that, to some extent, all staff, not just those in senior management roles, are viewed as leaders. Leadership development programmes are intended to equip individuals to improve leadership skills, but we know little about their effectiveness. Furthermore, the content of these programmes varies widely and the fact that many lack a sense of how they fit with individual or organisational goals raises questions about how they are intended to achieve their aims. It is important to avoid simplistic assumptions about the ability of improved leadership to solve complex problems. It is also important to evaluate leadership development programmes in ways that go beyond descriptive accounts.

  1. Wounded Healers: A Multistate Study of Licensed Social Workers' Behavioral Health Problems.

    Science.gov (United States)

    Straussner, Shulamith Lala Ashenberg; Senreich, Evan; Steen, Jeffrey T

    2018-04-01

    Studies indicate that helping professionals are disproportionately affected by behavioral health problems. Among social workers, the nature and scope of these problems are understudied. This article reports the findings of a 2015 survey of 6,112 licensed social workers in 13 states regarding their problems with mental health; alcohol, tobacco, and other drugs; and gambling. To ascertain whether these problems preceded or developed during their social work careers, the periods of time when these issues were experienced were identified. Results indicate that 40.2 percent of respondents reported mental health problems before becoming social workers, increasing to 51.8 percent during their social work career, with 28 percent currently experiencing such problems. Nearly 10 percent of the sample experienced substance use problems before becoming social workers, decreasing to 7.7 percent during their career. Analyses by race or ethnicity, sex, and age identified between-group differences in the prevalence of these problems. The article concludes with a discussion of the implications for the social work profession.

  2. Mental health problems among individuals with persistent health challenges from adolescence to young adulthood: a population-based longitudinal study in Norway

    Directory of Open Access Journals (Sweden)

    Sølvi Helseth

    2016-09-01

    Full Text Available Abstract Background Persistent health challenges are increasing throughout the world. It has been shown that adolescents with persistent health challenges are at greater risk of having mental health problems than their healthy peers. However, these studies are mainly cross-sectional, and little is known about the transition to adulthood. Thus, the aim of this study was to examine how mental health problems in adolescents and young adults with persistent health challenges vary during adolescence and in the transition to young adulthood. Methods The study used longitudinal and time-series data from the “Young in Norway” study. A sample of adolescents was prospectively followed from adolescence to young adulthood with measures at four different time points (n = 3,087; T1–T4: 2921 adolescents (12–19 years participated at T1 and T2, while 2448 young adults participated at T3 and T4. Persistent health challenges, age, gender, mental health problems and parental socio-economic status were measured in the longitudinal survey. Regression models were applied to estimate associations between persistent health challenges (understood as having a chronic health condition or disability and mental health problems during adolescence and young adulthood. Different models were tested for chronic health conditions and disability. Results Adolescents with disability had higher scores for depressive and anxiety symptoms, loneliness and self-concept instability, and lower scores for self-worth, appearance satisfaction, scholastic competence and social acceptance compared with adolescents without disability. In young adulthood, there were also significant associations between disability and most mental health problems. The longitudinal associations between chronic health conditions and mental health problems during adolescence and young adulthood showed that significant associations between chronic health conditions and mental health problems were only

  3. Application of NASA management approach to solve complex problems on earth

    Science.gov (United States)

    Potate, J. S.

    1972-01-01

    The application of NASA management approach to solving complex problems on earth is discussed. The management of the Apollo program is presented as an example of effective management techniques. Four key elements of effective management are analyzed. Photographs of the Cape Kennedy launch sites and supporting equipment are included to support the discussions.

  4. Leaving school without qualifications and mental health problems to age 30.

    Science.gov (United States)

    Fergusson, David M; McLeod, Geraldine F H; Horwood, L John

    2015-03-01

    To examine the associations between leaving school without qualifications and subsequent mental health to age 30, using data gathered over the course of a 30-year longitudinal study. Data were gathered over the course of a 30-year study (Christchurch Health and Development Study) of a birth cohort of 1265 children, born in Christchurch in 1977. This cohort has been studied on 22 occasions from birth to age 30. As part of this study, information was gathered on: (a) school leaving qualifications, (b) mental health problems from 18 to 30; and (c) prospectively assessed childhood and adolescent factors including: child and family background; family violence and child abuse; and adolescent mental health problems. Leaving school without qualifications was associated with increased risks of subsequent: major depression (OR = 1.37 at 95 % CI 1.05-1.78, p = 0.019); anxiety disorder (OR = 1.99 at 95 % CI 1.55-2.57, p mental health problems) reduced these associations substantially and to the point of statistical non-significance. The findings of this study suggest that there was no direct causal association between leaving school without qualifications and subsequent mental health problems. Associations were explained by the linkages between leaving school without qualifications and: child and family social background; and mental health around the point of school leaving.

  5. Sexual Problems in Women: MedlinePlus Health Topic

    Science.gov (United States)

    ... Health and Human Development) Also in Spanish When Sex Is Painful (American College of Obstetricians and Gynecologists) - PDF Videos and Tutorials Sexual Problems (American Society for Reproductive ...

  6. Health problems of Nepalese migrants working in three Gulf countries

    Directory of Open Access Journals (Sweden)

    Prescott Gordon J

    2011-03-01

    Full Text Available Abstract Background Nepal is one of the largest suppliers of labour to countries where there is a demand for cheap and low skilled workers. In the recent years the Gulf countries have collectively become the main destinations for international migration. This paper aims to explore the health problems and accidents experienced by a sample of Nepalese migrant in three Gulf countries. Methods A cross-sectional survey was conducted among 408 Nepalese migrants who had at least one period of work experience of at least six months in any of three Gulf countries: Qatar, Saudi Arabia and United Arab Emirates (UAE. Face to face questionnaire interviews were conducted applying a convenience technique to select the study participants. Results Nepalese migrants in these Gulf countries were generally young men between 26-35 years of age. Unskilled construction jobs including labourer, scaffolder, plumber and carpenter were the most common jobs. Health problems were widespread and one quarter of study participants reported experiencing injuries or accidents at work within the last 12 months. The rates of health problems and accidents reported were very similar in the three countries. Only one third of the respondents were provided with insurance for health services by their employer. Lack of leave for illness, cost and fear of losing their job were the barriers to accessing health care services. The study found that construction and agricultural workers were more likely to experience accidents at their workplace and health problems than other workers. Conclusion The findings suggest important messages for the migration policy makers in Nepal. There is a lack of adequate information for the migrants making them aware of their health risks and rights in relation to health services in the destination countries and we suggest that the government of Nepal should be responsible for providing this information. Employers should provide orientation on possible health

  7. General health workers' description of mental health problems and treatment approaches used in Papua New Guinea.

    Science.gov (United States)

    Koka, Betty E; Deane, Frank P; Lyons, Geoffrey Cb; Lambert, Gordon

    2014-11-01

    Papua New Guinea is a developing country with limited resources for specialist mental health services. Little is known about the mental health and treatment services of Papua New Guinea. The aim of this study was to clarify the presenting mental health problems encountered by Papua New Guinean health workers and the common treatment approaches used. A total of 203 Papua New Guinean health workers completed a retrospective quantitative survey about their three most recent mental health patients. The survey asked about presenting symptomatology, diagnoses (including culture-bound diagnoses) and treatment approaches. The major presenting mental health problems for males included schizophrenia, substance use disorder, sorcery and spirit possession. Depression was the most common diagnoses for women, followed by sorcery and somatisation. Over 65% of patients were prescribed psychotropic medication, over 50% received some form of psychological intervention and 28% were receiving traditional treatments. Somatic symptoms are common among both male and female Papua New Guineans; however, males may be more likely to present with psychotic symptoms and females with mood-related problems. Schizophrenia and depression are commonly identified with substance use disorder more problematic among males. Culture-specific explanations and treatment are commonly used. © The Author(s) 2013.

  8. Problem-Posing in Education: Transformation of the Practice of the Health Professional.

    Science.gov (United States)

    Casagrande, L. D. R.; Caron-Ruffino, M.; Rodrigues, R. A. P.; Vendrusculo, D. M. S.; Takayanagui, A. M. M.; Zago, M. M. F.; Mendes, M. D.

    1998-01-01

    Studied the use of a problem-posing model in health education. The model based on the ideas of Paulo Freire is presented. Four innovative experiences of teaching-learning in environmental and occupational health and patient education are reported. Notes that the problem-posing model has the capability to transform health-education practice.…

  9. Problem Gambling Treatment within the British National Health Service

    Science.gov (United States)

    Rigbye, Jane; Griffiths, Mark D.

    2011-01-01

    According to the latest British Gambling Prevalence Survey, there are approximately 300,000 adult problem gamblers in Great Britain. In January 2007, the "British Medical Association" published a report recommending that those experiencing gambling problems should receive treatment via the National Health Service (NHS). This study…

  10. Physical health problems in adults with Prader-Willi syndrome

    NARCIS (Netherlands)

    Sinnema, M.; Maaskant, M.A.; Schrojenstein Lantman-de Valk, H.M.J. van; Nieuwpoort, I.C. van; Drent, M.L.; Curfs, L.M.G.; Schrander-Stumpel, C.T.R.M.

    2011-01-01

    Prader-Willi syndrome (PWS) is a genetic disorder which is characterized by severe hypotonia and feeding problems in early infancy. In later childhood and adolescence, this is followed by hyperphagia and extreme obesity if the diet is not strictly controlled. Data on physical health problems in

  11. Distress Tolerance Links Sleep Problems with Stress and Health in Homeless.

    Science.gov (United States)

    Reitzel, Lorraine R; Short, Nicole A; Schmidt, Norman B; Garey, Lorra; Zvolensky, Michael J; Moisiuc, Alexis; Reddick, Carrie; Kendzor, Darla E; Businelle, Michael S

    2017-11-01

    We examined associations between sleep problems, distress intolerance, and perceived stress and health in a convenience sample of homeless adults. Participants (N = 513, 36% women, Mage = 44.5 ±11.9) self-reported sleep adequacy, sleep duration, unintentional sleep during the daytime, distress tolerance, urban stress, and days of poor mental health and days of poor physical health over the last month. The indirect effects of sleep problems on stress and health through distress tolerance were examined using a non-parametric, bias-corrected bootstrapping procedure. Sleep problems were prevalent (eg, 13.0 ±11.4 days of inadequate sleep and 4.7 ±7.9 days of unintentionally falling asleep during the preceding month). Distress intolerance partially accounted for the associations of inadequate sleep and unintentionally falling asleep, but not sleep duration, with urban stress and more days of poor mental and physical health. Many homeless individuals endure sleep problems. Given the connections between sleep and morbidity and mortality, results further support the need for more attention directed toward facilitating improvements in sleep quality to improve the quality of life of homeless adults, potentially including attention to improving distress tolerance skills.

  12. Knowledge to action for solving complex problems: insights from a review of nine international cases.

    Science.gov (United States)

    Riley, B L; Robinson, K L; Gamble, J; Finegood, D T; Sheppard, D; Penney, T L; Best, A

    2015-05-01

    Solving complex problems such as preventing chronic diseases introduces unique challenges for the creation and application of knowledge, or knowledge to action (KTA). KTA approaches that apply principles of systems thinking are thought to hold promise, but practical strategies for their application are not well understood. In this paper we report the results of a scan of systems approaches to KTA with a goal to identify how to optimize their implementation and impact. A 5-person advisory group purposefully selected 9 initiatives to achieve diversity on issues addressed and organizational forms. Information on each case was gathered from documents and through telephone interviews with primary contacts within each organization. Following verification of case descriptions, an inductive analysis was conducted within and across cases. The cases revealed 5 guidelines for moving from conceiving KTA systems to implementing them: (1) establish and nurture relationships, (2) co-produce and curate knowledge, (3) create feedback loops, (4) frame as systems interventions rather than projects, and (5) consider variations across time and place. Results from the environmental scan are a modest start to translating systems concepts for KTA into practice. Use of the strategies revealed in the scan may improve KTA for solving complex public health problems. The strategies themselves will benefit from the development of a science that aims to understand adaptation and ongoing learning from policy and practice interventions, strengthens enduring relationships, and fills system gaps in addition to evidence gaps. Systems approaches to KTA will also benefit from robust evaluations.

  13. Home care assistants’ perspectives on detecting mental health problems and promoting mental health among community-dwelling seniors with multimorbidity

    Directory of Open Access Journals (Sweden)

    Grundberg Å

    2016-02-01

    Full Text Available Åke Grundberg,1,2 Anna Hansson,2 Dorota Religa,1 Pernilla Hillerås1,2 1Division of Neurogeriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Huddinge, 2Sophiahemmet University, Stockholm, Sweden Introduction: Elderly people with multiple chronic conditions, or multimorbidity, are at risk of developing poor mental health. These seniors often remain in their homes with support from home care assistants (HCAs. Mental health promotion by HCAs needs to be studied further because they may be among the first to observe changes in clients’ mental health status. Aim: To describe HCAs’ perspectives on detecting mental health problems and promoting mental health among homebound seniors with multimorbidity. Methods: We applied a descriptive qualitative study design using semi-structured interviews. Content analyses were performed on five focus group interviews conducted in 2014 with 26 HCAs. Results: Most HCAs stated that they were experienced in caring for clients with mental health problems such as anxiety, depression, sleep problems, and high alcohol consumption. The HCAs mentioned as causes, or risk factors, multiple chronic conditions, feelings of loneliness, and social isolation. The findings reveal that continuity of care and seniors’ own thoughts and perceptions were essential to detecting mental health problems. Observation, collaboration, and social support emerged as important means of detecting mental health problems and promoting mental health. Conclusion: The HCAs had knowledge of risk factors, but they seemed insecure about which health professionals had the primary responsibility for mental health. They also seemed to have detected early signs of mental health problems, even though good personal knowledge of the client and continuity in home visits were crucial to do so. When it came to mental health promotion, the suggestions related to the aim of ending social isolation, decreasing feelings of

  14. Health problems among detainees in Switzerland: a study using the ICPC-2 classification

    Directory of Open Access Journals (Sweden)

    Bertrand Dominique

    2011-04-01

    Full Text Available Abstract Background Little is known about the health status of prisoners in Switzerland. The aim of this study was to provide a detailed description of the health problems presented by detainees in Switzerland's largest remand prison. Methods In this retrospective cross-sectional study we reviewed the health records of all detainees leaving Switzerland's largest remand prison in 2007. The health problems were coded using the International Classification for Primary Care (ICPC-2. Analyses were descriptive, stratified by gender. Results A total of 2195 health records were reviewed. Mean age was 29.5 years (SD 9.5; 95% were male; 87.8% were migrants. Mean length of stay was 80 days (SD 160. Illicit drug use (40.2% and mental health problems (32.6% were frequent, but most of these detainees (57.6% had more generic primary care problems, such as skin (27.0%, infectious diseases (23.5%, musculoskeletal (19.2%, injury related (18.3%, digestive (15.0% or respiratory problems (14.0%. Furthermore, 7.9% reported exposure to violence during arrest by the police. Conclusion Morbidity is high in this young, predominantly male population of detainees, in particular in relation to substance abuse. Other health problems more commonly seen in general practice are also frequent. These findings support the further development of coordinated primary care and mental health services within detention centers.

  15. School nurses' perspectives on managing mental health problems in children and young people

    OpenAIRE

    Pryjmachuk, S.; Graham, T.; Haddad, M.; Tylee, A.

    2012-01-01

    Aims and objectives: To explore the views of school nurses regarding mental health problems in young people and their potential for engaging in mental health work with this client group.\\ud \\ud Background: Mental health problems in children and young people are an important public health issue. Universal children’s services play a key role in identifying and managing these problems and, while school nurses have an important function in this work, little is known about their views on this aspe...

  16. Social Problem Solving Ability Predicts Mental Health Among Undergraduate Students

    OpenAIRE

    Ranjbar, Mansour; Bayani, Ali Asghar; Bayani, Ali

    2013-01-01

    Background : The main objective of this study was predicting student′s mental health using social problem solving- ability . Methods : In this correlational- descriptive study, 369 (208 female and 161 male) from, Mazandaran University of Medical Science were selected through stratified random sampling method. In order to collect the data, the social problem solving inventory-revised and general health questionnaire were used. Data were analyzed through SPSS-19, Pearson′s correlation, t tes...

  17. Assessing correlations between geological hazards and health outcomes: Addressing complexity in medical geology.

    Science.gov (United States)

    Wardrop, Nicola Ann; Le Blond, Jennifer Susan

    2015-11-01

    The field of medical geology addresses the relationships between exposure to specific geological characteristics and the development of a range of health problems: for example, long-term exposure to arsenic in drinking water can result in the development of skin conditions and cancers. While these relationships are well characterised for some examples, in others there is a lack of understanding of the specific geological component(s) triggering disease onset, necessitating further research. This paper aims to highlight several important complexities in geological exposures and the development of related diseases that can create difficulties in the linkage of exposure and health outcome data. Several suggested approaches to deal with these complexities are also suggested. Long-term exposure and lengthy latent periods are common characteristics of many diseases related to geological hazards. In combination with long- or short-distance migrations over an individual's life, daily or weekly movement patterns and small-scale spatial heterogeneity in geological characteristics, it becomes problematic to appropriately assign exposure measurements to individuals. The inclusion of supplementary methods, such as questionnaires, movement diaries or Global Positioning System (GPS) trackers can support medical geology studies by providing evidence for the most appropriate exposure measurement locations. The complex and lengthy exposure-response pathways involved, small-distance spatial heterogeneity in environmental components and a range of other issues mean that interdisciplinary approaches to medical geology studies are necessary to provide robust evidence. Copyright © 2015. Published by Elsevier Ltd.

  18. Managing Madness: Mental Health and Complexity in Public Policy

    Directory of Open Access Journals (Sweden)

    Ian Hickie

    2013-09-01

    Full Text Available This paper explores the concept of collaborative care, particularly in relation to a range of new models of organisation and service that are emerging in response to one of the most problematic areas of public policy – mental health. These emerging models of coordinated mental health care are testing the limits of the evidence supporting coordinated care, and require critical evaluation. Myriad concepts of collaborative or coordinated care in health, including mental health, have created multiple definitions. Once definitional issues have been surmounted, however, the evidence for coordination of health care is reasonably strong. There is considerable research about which treatments and programs are best for people with a mental illness. There are few areas seemingly as complex as mental health, given that responsibility for policy and service lies across all three tiers of Australian government and across multiple jurisdictions. It also engages public, private and non-government sectors. Co-morbidities are commonplace, particularly drug and alcohol problems among younger people. Governments in Australia have traditionally taken responsibility for policy, programs and services, either as direct service providers or through contracting outputs from others. Yet the evidence indicates that for people with a mental illness, the best solutions are often not found in government but in the community and in organisations outside of government. New organisations and new structures are attempting more holistic management approaches, combining clinical care, community support, housing, employment and other services. This paper considers some of these new models in the light of existing evidence. The key challenge facing continued reform in mental health is not uncertainty regarding programs or services, but rather how to drive coordinated care for consumers across departments, governments and providers. This review will highlight the key changes that

  19. Common Occupational Health Problems In Disease Control In Nigeria

    African Journals Online (AJOL)

    This article reviews some common occupational health problems among health workers due to exposure to hazardous or pathogenic biological, chemical and physical agents in the line of duty. Highlighted biological agents are pathogenic viruses, bacteria etc; chemical agents are laboratory reagents, mercury and ...

  20. Mental health problems among young doctors: an updated review of prospective studies.

    Science.gov (United States)

    Tyssen, Reidar; Vaglum, Per

    2002-01-01

    Previous studies have shown the medical community to exhibit a relatively high level of certain mental health problems, particularly depression, which may lead to drug abuse and suicide. We reviewed prospective studies published over the past 20 years to investigate the prevalence and predictors of mental health problems in doctors during their first postgraduate years. We selected clinically relevant mental health problems as the outcome measure. We found nine cohort studies that met our selection criteria. Each of them had limitations, notably low response rate at follow-up, small sample size, and/or short observation period. Most studies showed that symptoms of mental health problems, particularly of depression, were highest during the first postgraduate year. They found that individual factors, such as family background, personality traits (neuroticism and self-criticism), and coping by wishful thinking, as well as contextual factors including perceived medical-school stress, perceived overwork, emotional pressure, working in an intensive-care setting, and stress outside of work, were often predictive of mental health problems. The studies revealed somewhat discrepant findings with respect to gender. The implications of these findings are discussed.

  1. A qualitative study: experiences of stigma by people with mental health problems.

    Science.gov (United States)

    Huggett, Charlotte; Birtel, Michèle D; Awenat, Yvonne F; Fleming, Paul; Wilkes, Sophie; Williams, Shirley; Haddock, Gillian

    2018-01-18

    Prior research has examined various components involved in the impact of public and internalized stigma on people with mental health problems. However, studies have not previously investigated the subjective experiences of mental health stigma by those affected in a non-statutory treatment-seeking population. An in-depth qualitative study was conducted using thematic analysis to investigate the experiences of stigma in people with mental health problems. Eligible participants were recruited through a local mental health charity in the North West of England. The topic of stigma was examined using two focus groups of thirteen people with experience of mental health problems and stigma. Two main themes and five subthemes were identified. Participants believed that (1) the 'hierarchy of labels' has a profound cyclical impact on several levels of society: people who experience mental health problems, their friends and family, and institutional stigma. Furthermore, participants suggested (2) ways in which they have developed psychological resilience towards mental health stigma. It is essential to utilize the views and experiences gained in this study to aid understanding and, therefore, develop ways to reduce the negative impact of public and internal stigma. People referred to their mental health diagnosis as a label and associated that label with stigmatizing views. Promote awareness and develop improved strategies (e.g., training) to tackle the cyclical impact of the 'hierarchy of labels' on people with mental health problems, their friends and family, and institutional stigma. Ensure the implementation of clinical guidelines in providing peer support to help people to combat feeling stigmatized. Talking about mental health in psychological therapy or health care professional training helped people to take control and develop psychological resilience. © 2018 The British Psychological Society.

  2. Food insecurity and mental health problems among a community sample of young adults.

    Science.gov (United States)

    Pryor, Laura; Lioret, Sandrine; van der Waerden, Judith; Fombonne, Éric; Falissard, Bruno; Melchior, Maria

    2016-08-01

    Food insecurity has been found to be related to anxiety and depression; however, the association with other psychiatric disorders, particularly among young adults, is not well known. We examined whether food insecurity is independently associated with four common mental health problems among a community sample of young adults in France. Data are from the TEMPO longitudinal cohort study. In 1991, participants' parents provided information on health and family socioeconomic characteristics. In 2011, participants' (18-35 years) reported food insecurity, mental health symptoms, and socioeconomic conditions (n = 1214). Mental health problems ascertained included major depressive episode, suicidal ideation, attention deficit and hyperactivity disorder, and substance abuse and/or dependence (nicotine, alcohol and cannabis). Cross-sectional associations between food insecurity and mental health problems were tested using modified Poisson regressions, weighted by inverse probability weights (IPW) of exposure. This makes food insecure and not food insecure participants comparable on all characteristics including socioeconomic factors and past mental health problems. 8.5 % of young adults were food insecure. In IPW-controlled analyses, food insecurity was associated with increased levels of depression (RR = 2.01, 95 % CI 1.01-4.02), suicidal ideation (RR = 3.23, 95 % CI 1.55-6.75) and substance use problems (RR = 1.68, 95 % CI 1.15-2.46). Food insecurity co-occurs with depression, suicidal ideation and substance use problems in young adulthood. Our findings suggest that reductions in food insecurity during this important life period may help prevent mental health problems. Policies aiming to alleviate food insecurity should also address individuals' psychiatric problems, to prevent a lifelong vicious circle of poor mental health and low socioeconomic attainment.

  3. Prisoners' assessments of mental health problems among their children.

    Science.gov (United States)

    Tasca, Melinda; Turanovic, Jillian J; White, Clair; Rodriguez, Nancy

    2014-02-01

    High rates of imprisonment among American men and women have motivated recent research on the well-being of children of incarcerated parents. Despite advances in the literature, little is known regarding the mental health status of children who experience maternal relative to paternal incarceration. Accordingly, we examine whether there are differences in mental health needs among children of incarcerated parents. Specifically, we assess whether incarcerated mothers are more likely than incarcerated fathers to report that their children suffer from mental health problems. Using cross-sectional data on children (N = 1,221) compiled from a sample of parents confined in the Arizona Department of Corrections, we find that children of incarcerated mothers are significantly more likely to be identified as suffering from mental health problems. This effect remained even after controlling for additional parent stressors and child risk factors such as exposure to violence, in utero exposure to drugs/alcohol, and parental mental illness. Policy implications and directions for future research are discussed.

  4. The mental health consequences of the recession: economic hardship and employment of people with mental health problems in 27 European countries.

    Science.gov (United States)

    Evans-Lacko, Sara; Knapp, Martin; McCrone, Paul; Thornicroft, Graham; Mojtabai, Ramin

    2013-01-01

    A period of economic recession may be particularly difficult for people with mental health problems as they may be at higher risk of losing their jobs, and more competitive labour markets can also make it more difficult to find a new job. This study assesses unemployment rates among individuals with mental health problems before and during the current economic recession. Using individual and aggregate level data collected from 27 EU countries in the Eurobarometer surveys of 2006 and 2010, we examined changes in unemployment rates over this period among individuals with and without mental health problems. Following the onset of the recession, the gap in unemployment rates between individuals with and without mental health problems significantly widened (odds ratio: 1.12, 95% confidence interval: 1.03, 1.34). This disparity became even greater for males, and individuals with low levels of education. Individuals with mental health problems living in countries with higher levels of stigmatizing attitudes regarding dangerousness of people with mental illness were more vulnerable to unemployment in 2010, but not 2006. Greater agreement that people with mental health problems have themselves to blame, was associated with lower likelihood of unemployment for individuals with and without mental health problems. These findings study suggest that times of economic hardship may intensify social exclusion of people with mental health problems, especially males and individuals with lower education. Interventions to combat economic exclusion and to promote social participation of individuals with mental health problems are even more important during times of economic crisis, and these efforts should target support to the most vulnerable groups.

  5. Problems in maintenance of herd health associated with acid forming emissions

    International Nuclear Information System (INIS)

    Kostuch, M.

    1992-01-01

    The effects of sour gas plant emissions on dairy herds are described. A veterinarian establishing a practice in Rocky Mountain House, Alberta, found that dairy herds in that area suffered from a disproportionately higher occurrence of health problems than Minnesota herds with similar types of management. These problems are postulated to result from acid-forming emissions from two large sour gas plants in the area (the Ram River and Gulf Strachan plants). Health problems found in dairy cattle in the Rocky Mountain House area were: unthriftiness, increased susceptibility to infectious diseases, reproductive problems, and 'downer' animals (cows unable to stand up unassisted). Problems related to the reproductive organs were the most apparent. Clinical observations of problems in dairy herds are described. Since the levels of emissions from the plants have decreased, incidence of problems in dairy herds has also decreased. 1 ref., 2 figs

  6. Hypertension: Believe it or not, a Complex Problem La hipertensión arterial: aunque no lo parezca, un problema complejo

    Directory of Open Access Journals (Sweden)

    Alfredo Darío Espinosa Brito

    2011-03-01

    Full Text Available High blood pressure (hypertension is recognized as a major health problem due both to its morbidity and the disability it causes and to its impact on mortality, especially cardiovascular mortality. However, effectively addressing its prevention and control, both in individuals and in the general population, does not seem to be an easy task, even these days. This paper aims to present different aspects of arterial hypertension (a concept through diagnosis, treatment and follow-up focusing on this entity as a complex system including multiple elements related to cardiovascular disease.La hipertensión arterial constituye un reconocido problema de salud, tanto por su morbilidad, por la discapacidad que provoca, como por su repercusión en la mortalidad, especialmente cardiovascular. Sin embargo, enfrentar eficazmente su prevención y control, tanto en los individuos como en la población en general, no parece una tarea fácil, aún en nuestros días. Este trabajo tiene como objetivo presentar diferentes aspectos de la hipertensión arterial (concepto pasando por el diagnóstico, tratamiento y seguimiento enfocando dicha entidad como un sistema complejo que abarca múltiples elementos relacionados con las enfermedades cardiovasculares.HYPERTENSION: BELIEVE IT OR NOT, A COMPLEX PROBLEMABSTRACTHigh blood pressure (hypertension is recognized as a major health problem due both to its morbidity and the disability it causes and to its impact on mortality, especially cardiovascular mortality. However, effectively addressing its prevention and control, both in individuals and in the general population, does not seem to be an easy task, even these days. This paper aims to present different aspects of arterial hypertension (a concept through diagnosis, treatment and follow-up focusing on this entity as a complex system including multiple elements related to cardiovascular disease.

  7. Solving complex fisheries management problems

    DEFF Research Database (Denmark)

    Petter Johnsen, Jahn; Eliasen, Søren Qvist

    2011-01-01

    A crucial issue for the new EU common fisheries policy is how to solve the discard problem. Through a study of the institutional set up and the arrangements for solving the discard problem in Denmark, the Faroe Islands, Iceland and Norway, the article identifies the discard problem as related...

  8. Health status transitions in community-living elderly with complex care needs: a latent class approach.

    Science.gov (United States)

    Lafortune, Louise; Béland, François; Bergman, Howard; Ankri, Joël

    2009-02-03

    For older persons with complex care needs, accounting for the variability and interdependency in how health dimensions manifest themselves is necessary to understand the dynamic of health status. Our objective is to test the hypothesis that a latent classification can capture this heterogeneity in a population of frail elderly persons living in the community. Based on a person-centered approach, the classification corresponds to substantively meaningful groups of individuals who present with a comparable constellation of health problems. Using data collected for the SIPA project, a system of integrated care for frail older people (n = 1164), we performed latent class analyses to identify homogenous categories of health status (i.e. health profiles) based on 17 indicators of prevalent health problems (chronic conditions; depression; cognition; functional and sensory limitations; instrumental, mobility and personal care disability) Then, we conducted latent transition analyses to study change in profile membership over 2 consecutive periods of 12 and 10 months, respectively. We modeled competing risks for mortality and lost to follow-up as absorbing states to avoid attrition biases. We identified four health profiles that distinguish the physical and cognitive dimensions of health and capture severity along the disability dimension. The profiles are stable over time and robust to mortality and lost to follow-up attrition. The differentiated and gender-specific patterns of transition probabilities demonstrate the profiles' sensitivity to change in health status and unmasked the differential relationship of physical and cognitive domains with progression in disability. Our approach may prove useful at organization and policy levels where many issues call for classification of individuals into pragmatically meaningful groups. In dealing with attrition biases, our analytical strategy could provide critical information for the planning of longitudinal studies of aging

  9. A Different Trolley Problem: The Limits of Environmental Justice and the Promise of Complex Moral Assessments for Transportation Infrastructure.

    Science.gov (United States)

    Epting, Shane

    2016-12-01

    Transportation infrastructure tremendously affects the quality of life for urban residents, influences public and mental health, and shapes social relations. Historically, the topic is rich with social and political controversy and the resultant transit systems in the United States cause problems for minority residents and issues for the public. Environmental justice frameworks provide a means to identify and address harms that affect marginalized groups, but environmental justice has limits that cannot account for the mainstream population. To account for this condition, I employ a complex moral assessment measure that provides a way to talk about harms that affect the public.

  10. Cross-national comparisons of complex problem-solving strategies in two microworlds.

    Science.gov (United States)

    Güss, C Dominik; Tuason, Ma Teresa; Gerhard, Christiane

    2010-04-01

    Research in the fields of complex problem solving (CPS) and dynamic decision making using microworlds has been mainly conducted in Western industrialized countries. This study analyzes the CPS process by investigating thinking-aloud protocols in five countries. Participants were 511 students from Brazil, Germany, India, the Philippines, and the United States who worked on two microworlds. On the basis of cultural-psychological theories, specific cross-national differences in CPS strategies were hypothesized. Following theories of situatedness of cognition, hypotheses about the specific frequency of problem-solving strategies in the two microworlds were developed. Results of the verbal protocols showed (a) modification of the theoretical CPS model, (b) task dependence of CPS strategies, and (c) cross-national differences in CPS strategies. Participants' CPS processes were particularly influenced by country-specific problem-solving strategies. Copyright © 2009 Cognitive Science Society, Inc.

  11. Problem drug use the public health imperative: what some of the literature says.

    Science.gov (United States)

    Bevan, Gez

    2009-12-16

    With more than 200,000 problem drug users is contact with structured treatment services in England the public health imperative behind drug treatment is great. Problem drug use for many is a chronic and relapsing condition, where "cure" is often neither a reasonable or appropriate expectation and it can further be argued that in these circumstances problem drug use is no different from any number of chronic and enduring health conditions that are managed in the health care system and therefore should be conceptualised as such. A public health approach to drug treatment emphasises the need for drug users in or accessing treatment, to reduce their harmful drug use, reduce drug use related risks such as sepsis and overdose and stay alive for longer. However a public health perspective in relation to problem drug use isn't always either apparent or readily understood and to that end there is still a significant need to continue the arguments and debate that treatment and interventions for problem and dependent drug users need to extend beyond an individualistic approach. For the purposes of discussion in this article public and population health will be used interchangeably. A recognition and acceptance that a public and population health approach to the management of problem drug users is sound public health policy also then requires a long term commitment in terms of staffing and resources where service delivery mirrors that of chronic condition management.

  12. The problem-based learning (PBL and health education.

    Directory of Open Access Journals (Sweden)

    Carine Moraes Vignochi

    2009-05-01

    Full Text Available The Problem-Based Learning (Problem-Based Learning - PBL has been recognized worldwide as an approach to promote the acquisition of knowledge by students at the same time that helps them develop skills and professional attitudes desirable. Unlike the conventional methods of teaching that use of application problems after the theory was presented, the PBL uses a problem to start, focus and motivate the learning of new concepts 13. In this approach, the student uses different mental processes, such as ability to raise hypotheses, compare, analyze, interpret, and evaluate and develop the ability to take responsibility for their education 11.12. The methodology of PBL has been a valuable tool in shaping the health care professional, with advantages over the traditional method of teaching. However, for its deployment there is a need for considerable institutional effort. Are necessary adjustments, including changes in the way of evaluation, for changes in mindset about the role of teachers in the process teaching / learning, investment in infrastructure, adaptations of the environment, improvement of libraries and other 19,20,21, 22. The process of change in education will bring many challenges, such as a break with traditional models of education and train health professionals with skills to recover the essential dimension of care: the relationship between humans.

  13. The social aspects in the identification of children’s mental health problems in two health services in Paris, France

    Directory of Open Access Journals (Sweden)

    Eunice Nakamura

    2017-06-01

    Full Text Available Children’s mental health problems were analyzed from a sociological approach addressing two questions: what are the main children’s behaviors identified and considered to be mental health problems, and what are the consequences of this classification for the debate on children’s problems in contemporary societies. This quantitative and qualitative study analyzed 275 patients’ records from two child mental health services (CMHS in the northeast area of Paris, France. The majority of children were boys from six to 11 years old; requests were presented mainly by schools and parents; the main problems were behavioural problems, cognitive difficulties and relational problems (boys, and affective or emotional problems (girls. There is an interdependence of a great number of actors who worry about children’s behavior and a system of expectations seems to be collectively woven by them as social classifications.

  14. Longitudinal associations between cyber-bullying perpetration and victimization and problem behavior and mental health problems in young Australians.

    Science.gov (United States)

    Hemphill, Sheryl A; Kotevski, Aneta; Heerde, Jessica A

    2015-02-01

    To investigate associations between Grade 9 and 10 cyber-bullying perpetration and victimization and Grade 11 problem behavior and mental health problems after controlling for risk factors for these outcomes in the analyses. The sample comprised 927 students from Victoria, Australia who completed a modified version of the self-report Communities That Care Youth Survey in Grades 9-11 to report on risk factors, traditional and cyber-bullying perpetration and victimization, problem behavior, and mental health. Complete data on over 650 participants were analyzed. Five per cent of Grade 9 and 10 students reported cyber-bullying perpetration only, 6-8% reported victimization only, and 8-9% both cyber-bullied others and were cyber-bullied. Results showed that cyber-bullying others in Grade 10 was associated with theft in Grade 11, cyber-victimization in Grade 10 was linked with Grade 11 depressive symptoms, and Grade 10 cyber-bullying perpetration and victimization combined predicted Grade 11 school suspension and binge drinking. Prevention approaches that target traditional and cyber-bullying, and established risk factors are necessary. Such multi-faceted programs may also reduce problem behavior and mental health problems.

  15. Identifying risks for mental health problems in HIV positive ...

    African Journals Online (AJOL)

    Background: Mental health problems of adolescents are underserved in low and middle-income countries where they account for a significant proportion of disease burden. Perinatally infected HIV-positive adolescents have a high prevalence of mental health disorders; however, little is known about those retained in care in ...

  16. Prevalence of work-related health problems among providers of car ...

    African Journals Online (AJOL)

    Prevalence of work-related health problems among providers of car battery ... the use of personal protective devices and safety measures should be promoted. Keywords: Prevalence, work-related, battery chargers, occupational health, Nigeria ...

  17. Two-Level Solutions to Exponentially Complex Problems in Glass Science

    DEFF Research Database (Denmark)

    Mauro, John C.; Smedskjær, Morten Mattrup

    Glass poses an especially challenging problem for physicists. The key to making progress in theoretical glass science is to extract the key physics governing properties of practical interest. In this spirit, we discuss several two-level solutions to exponentially complex problems in glass science....... Topological constraint theory, originally developed by J.C. Phillips, is based on a two-level description of rigid and floppy modes in a glass network and can be used to derive quantitatively accurate and analytically solvable models for a variety of macroscopic properties. The temperature dependence...... that captures both primary and secondary relaxation modes. Such a model also offers the ability to calculate the distinguishability of particles during glass transition and relaxation processes. Two-level models can also be used to capture the distribution of various network-forming species in mixed...

  18. [Health problems and illness of female workers in textile industries].

    Science.gov (United States)

    Soonthorndhada, K

    1989-07-01

    This paper examines 3 major health-related issues: 1) existing health problems and illnesses resulting from physical environmental conditions at workplaces; 2) female workers' perception on illness and health protection; and 3) the relationship between illness and risk factors. The study area is textile factories in Bangkok and its peripheries. Data are drawn from the 1987 Survey of Occupational Health and Textile Industrial Development in Thailand: Effect on Health and Socioeconomics of Female Migrant Workers. This study shows that about 20% of female workers have ill-health problems and illness after a period of working mainly due to high levels of dust and noise, and inadequate light. These conditions are hazardous to the respiratory system (resulting in cough and chest tightness), the hearing system (pains as well as impaired and hearing loss), eye systems (irritation, reduced visual capacity) and skin allergy. Such illnesses are intensified in the long- run. The analysis of variances reveals that education, section of work, perception (particularly mask and ear plug) significantly affect these illnesses. This study concludes that health education and occupational health should be provided in factories with emphasis on health prevention and promotion.

  19. Associations between overweight, peer problems, and mental health in 12-13-year-old Norwegian children.

    Science.gov (United States)

    Hestetun, Ingebjørg; Svendsen, Martin Veel; Oellingrath, Inger Margaret

    2015-03-01

    Overweight and mental health problems represent two major challenges related to child and adolescent health. More knowledge of a possible relationship between the two problems and the influence of peer problems on the mental health of overweight children is needed. It has previously been hypothesized that peer problems may be an underlying factor in the association between overweight and mental health problems. The purpose of the present study was to investigate the associations between overweight, peer problems, and indications of mental health problems in a sample of 12-13-year-old Norwegian schoolchildren. Children aged 12-13 years were recruited from the seventh grade of primary schools in Telemark County, Norway. Parents gave information about mental health and peer problems by completing the extended version of the Strength and Difficulties Questionnaire (SDQ). Height and weight were objectively measured. Complete data were obtained for 744 children. Fisher's exact probability test and multiple logistic regressions were used. Most children had normal good mental health. Multiple logistic regression analysis showed that overweight children were more likely to have indications of psychiatric disorders (adjusted OR: 1.8, CI: 1.0-3.2) and peer problems (adjusted OR: 2.6, CI: 1.6-4.2) than normal-weight children, when adjusted for relevant background variables. When adjusted for peer problems, the association between overweight and indications of any psychiatric disorder was no longer significant. The results support the hypothesis that peer problems may be an important underlying factor for mental health problems in overweight children.

  20. Globalisation, complex humanitarian emergencies and health.

    Science.gov (United States)

    O'Dempsey, T J D; Munslow, B

    2006-01-01

    A new political economy of conflict has emerged in the aftermath of colonialism and the Cold War. Complex political emergencies have been simmering in the post-colonial world for more than three decades. Intra-country armed conflict, often combined with natural disasters, at present contributes to the displacement of over 20 million people world-wide. The international community remains profoundly uncomfortable with the complex political emergencies of the new era, torn between the respect for national sovereignty upon which the international political system of the United Nations and other agencies is built, and the growth of concern with human rights and a burgeoning International Humanitarian Law. Globalisation may have brought many benefits to some but there are also many losers. The Word Bank and the International Monetary Fund imposed structural adjustment policies to ensure debt repayment and economic restructuring that have resulted in a net reduction in expenditure on health, education and development. A downward spiral has been created of debt, disease, malnutrition, missed education, economic entrapment, poverty, powerlessness, marginalization, migration and instability. Africa's complex political emergencies are particularly virulent and tenacious. Three examples that are among the most serious humanitarian emergencies to have faced the world in recent times--those in Angola, the Democratic Republic of Congo and Sudan--are reviewed here in detail. The political evolution of these emergencies and their impact on the health of the affected populations are also explored.

  1. Health-related Quality of Life after complex rectal surgery for primary advanced rectal cancer and locally recurrent rectal cancer

    DEFF Research Database (Denmark)

    Thaysen, Henriette Vind

    2013-01-01

    postoperative morbidity, Health-related Quality of Life (HRQoL) is an important issue. The overall aim of this thesis was therefore to evaluate HRQoL in patients with PARC and LRRC treated with COMP-RCS and curative intent. In study I a review of the literature was undertaken to provide an overview of HRQo......Advances in the treatment of rectal cancer, have made it possible to perform complex rectal cancer surgery (COMP-RCS) with curative intent in patients with primary advanced rectal caner (PARC) and local recurrent rectal cancer (LRRC). Due to the complexity of the treatment and its high...... in the study was 164 (86%) patients treated with standard rectal cancer surgery (STAN-RCS). The Danish version showed satisfactory psychometric properties for the scales concerning body image, sexual functioning, male sexual problems and defecations problems. Reduced psychometric properties were found...

  2. An analytical approach to managing complex process problems

    Energy Technology Data Exchange (ETDEWEB)

    Ramstad, Kari; Andersen, Espen; Rohde, Hans Christian; Tydal, Trine

    2006-03-15

    The oil companies are continuously investing time and money to ensure optimum regularity on their production facilities. High regularity increases profitability, reduces workload on the offshore organisation and most important; - reduces discharge to air and sea. There are a number of mechanisms and tools available in order to achieve high regularity. Most of these are related to maintenance, system integrity, well operations and process conditions. However, for all of these tools, they will only be effective if quick and proper analysis of fluids and deposits are carried out. In fact, analytical backup is a powerful tool used to maintain optimised oil production, and should as such be given high priority. The present Operator (Hydro Oil and Energy) and the Chemical Supplier (MI Production Chemicals) have developed a cooperation to ensure that analytical backup is provided efficiently to the offshore installations. The Operator's Research and Development (R and D) departments and the Chemical Supplier have complementary specialties in both personnel and equipment, and this is utilized to give the best possible service when required from production technologists or operations. In order for the Operator's Research departments, Health, Safety and Environment (HSE) departments and Operations to approve analytical work performed by the Chemical Supplier, a number of analytical tests are carried out following procedures agreed by both companies. In the present paper, three field case examples of analytical cooperation for managing process problems will be presented. 1) Deposition in a Complex Platform Processing System. 2) Contaminated Production Chemicals. 3) Improved Monitoring of Scale Inhibitor, Suspended Solids and Ions. In each case the Research Centre, Operations and the Chemical Supplier have worked closely together to achieve fast solutions and Best Practice. (author) (tk)

  3. How students process equations in solving quantitative synthesis problems? Role of mathematical complexity in students’ mathematical performance

    Directory of Open Access Journals (Sweden)

    Bashirah Ibrahim

    2017-10-01

    Full Text Available We examine students’ mathematical performance on quantitative “synthesis problems” with varying mathematical complexity. Synthesis problems are tasks comprising multiple concepts typically taught in different chapters. Mathematical performance refers to the formulation, combination, and simplification of equations. Generally speaking, formulation and combination of equations require conceptual reasoning; simplification of equations requires manipulation of equations as computational tools. Mathematical complexity is operationally defined by the number and the type of equations to be manipulated concurrently due to the number of unknowns in each equation. We use two types of synthesis problems, namely, sequential and simultaneous tasks. Sequential synthesis tasks require a chronological application of pertinent concepts, and simultaneous synthesis tasks require a concurrent application of the pertinent concepts. A total of 179 physics major students from a second year mechanics course participated in the study. Data were collected from written tasks and individual interviews. Results show that mathematical complexity negatively influences the students’ mathematical performance on both types of synthesis problems. However, for the sequential synthesis tasks, it interferes only with the students’ simplification of equations. For the simultaneous synthesis tasks, mathematical complexity additionally impedes the students’ formulation and combination of equations. Several reasons may explain this difference, including the students’ different approaches to the two types of synthesis problems, cognitive load, and the variation of mathematical complexity within each synthesis type.

  4. The mental health consequences of the recession: economic hardship and employment of people with mental health problems in 27 European countries.

    Directory of Open Access Journals (Sweden)

    Sara Evans-Lacko

    Full Text Available A period of economic recession may be particularly difficult for people with mental health problems as they may be at higher risk of losing their jobs, and more competitive labour markets can also make it more difficult to find a new job. This study assesses unemployment rates among individuals with mental health problems before and during the current economic recession.Using individual and aggregate level data collected from 27 EU countries in the Eurobarometer surveys of 2006 and 2010, we examined changes in unemployment rates over this period among individuals with and without mental health problems.Following the onset of the recession, the gap in unemployment rates between individuals with and without mental health problems significantly widened (odds ratio: 1.12, 95% confidence interval: 1.03, 1.34. This disparity became even greater for males, and individuals with low levels of education. Individuals with mental health problems living in countries with higher levels of stigmatizing attitudes regarding dangerousness of people with mental illness were more vulnerable to unemployment in 2010, but not 2006. Greater agreement that people with mental health problems have themselves to blame, was associated with lower likelihood of unemployment for individuals with and without mental health problems.These findings study suggest that times of economic hardship may intensify social exclusion of people with mental health problems, especially males and individuals with lower education. Interventions to combat economic exclusion and to promote social participation of individuals with mental health problems are even more important during times of economic crisis, and these efforts should target support to the most vulnerable groups.

  5. The Mental Health Consequences of the Recession: Economic Hardship and Employment of People with Mental Health Problems in 27 European Countries

    Science.gov (United States)

    Evans-Lacko, Sara; Knapp, Martin; McCrone, Paul

    2013-01-01

    Objectives A period of economic recession may be particularly difficult for people with mental health problems as they may be at higher risk of losing their jobs, and more competitive labour markets can also make it more difficult to find a new job. This study assesses unemployment rates among individuals with mental health problems before and during the current economic recession. Methods Using individual and aggregate level data collected from 27 EU countries in the Eurobarometer surveys of 2006 and 2010, we examined changes in unemployment rates over this period among individuals with and without mental health problems. Results Following the onset of the recession, the gap in unemployment rates between individuals with and without mental health problems significantly widened (odds ratio: 1.12, 95% confidence interval: 1.03, 1.34). This disparity became even greater for males, and individuals with low levels of education. Individuals with mental health problems living in countries with higher levels of stigmatizing attitudes regarding dangerousness of people with mental illness were more vulnerable to unemployment in 2010, but not 2006. Greater agreement that people with mental health problems have themselves to blame, was associated with lower likelihood of unemployment for individuals with and without mental health problems. Conclusion These findings study suggest that times of economic hardship may intensify social exclusion of people with mental health problems, especially males and individuals with lower education. Interventions to combat economic exclusion and to promote social participation of individuals with mental health problems are even more important during times of economic crisis, and these efforts should target support to the most vulnerable groups. PMID:23922801

  6. The Health Problems, Gastrointestinal and Blood Parasites ...

    African Journals Online (AJOL)

    The report on the disease conditions in donkeys in most West African countries is scanty in literature. This study was conducted to identify the health related problems including gastrointestinal and blood parasites of donkeys at the Bolgatanga livestock market in the Upper East region of Ghana from July to December, 2012.

  7. Commentary: getting real on addressing health care disparities and other systems problems.

    Science.gov (United States)

    Madara, James L

    2012-06-01

    Physician membership organizations vary in the extent of their engagement in activities to address health disparities. Increasing engagement of those organizations not already highly active in this critical area is, thus, an opportunity. Studies that provide definitional contours of key issues, like disparities, are necessary and must be iteratively refined. However, parallel activities of intervention with measured outcomes to assess the effects of these interventions are necessary to truly address major problems in the health care system. To date, work in the problem definition category exceeds work toward intervention in and mitigation of these problems with measured outcomes. Many problems in health care, including disparities, are now sufficiently understood that it is time to shift focus toward bold intervention with measured outcomes. Optimal approaches that yield superior outcomes generally require collaboration across the provider-payer spectrum and the private sectors, including physicians, hospitals, insurers, etc. Stakeholders are now free to act in such coordinated fashion; it only requires social capital that permits cooperation and compromise. Interventions for problems such as health care disparities can be developed in the private sector and mirrored by government payers if physicians and organizations can get real about collaborating to implement outcomes-based initiatives to improve the health of all patients.

  8. Sexual Problems in Men: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Retrograde ejaculation (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Sexual Problems in ... Premature ejaculation Reifenstein syndrome Retrograde ejaculation Related Health Topics Erectile Dysfunction Penis Disorders Prostate Diseases Testicular Disorders ...

  9. Medication management and practices in prison for people with mental health problems: a qualitative study

    OpenAIRE

    Bowen, Robert A; Rogers, Anne; Shaw, Jennifer

    2009-01-01

    Abstract Background Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore ...

  10. The problem of sustainability within the complexity of agricultural production systems

    International Nuclear Information System (INIS)

    Cotes Torres, Alejandro; Cotes Torres, Jose Miguel

    2005-01-01

    The problem of sustainability is a topic that since the end of the XX century has been worrying more the different sectors of society; becoming one of the topics of greatest interest for managers, consumers, academics and investigators that conform the different agricultural food chains of the world. This paper presents from the general systems theory point of view some elements of critical reflection, approaching the problem of sustainability from the complexity of agricultural production systems, beginning with the original philosophical conception of agricultural and ending by outlining some considerations that should be kept in mind for the development of scientific and technological advances concordant with the agricultural food chain needs of the XX century; which permit an orientation of not only work by profession is who lead the processes of animal and vegetable production, but also creates a sense of pertinence in all of the participants in the chain, highlighting the importance of studying by means of systemic thought, agronomy and animal science, as disciplines that approach to complexities of agriculture which is the angular stone of civilization, such as we know it at the moment

  11. Early Childhood Aetiology of Mental Health Problems: A Longitudinal Population-Based Study

    Science.gov (United States)

    Bayer, Jordana K.; Hiscock, Harriet; Ukoumunne, Obioha C.; Price, Anna; Wake, Melissa

    2008-01-01

    Background: Mental health problems comprise an international public health issue affecting up to 20% of children and show considerable stability. We aimed to identify child, parenting, and family predictors from infancy in the development of externalising and internalising behaviour problems by age 3 years. Methods: "Design"…

  12. A life course perspective on mental health problems, employment, and work outcomes

    NARCIS (Netherlands)

    Veldman, Karin; Reijneveld, Sijmen A; Verhulst, Frank C; Ortiz, Josue Almansa; Bültmann, Ute

    Objectives Little is known about how employment and work outcomes among young adults are influenced by their life-course history of mental health problems. Therefore, the aims of this study were to (i) identify trajectories of mental health problems from childhood to young adulthood and (ii)

  13. Taking power, politics, and policy problems seriously: the limits of knowledge translation for urban health research.

    Science.gov (United States)

    Murphy, Kelly; Fafard, Patrick

    2012-08-01

    Knowledge translation (KT) is a growing movement in clinical and health services research, aimed to help make research more relevant and to move research into practice and policy. This paper examines the conventional model of policy change presented in KT and assesses its applicability for increasing the impact of urban health research on urban health policy. In general, KT conceptualizes research utilization in terms of the technical implementation of scientific findings, on the part of individual decision-makers who can be "targeted" for a KT intervention, in a context that is absent of political interests. However, complex urban health problems and interventions infrequently resemble this single decision, single decision-maker model posited by KT. In order to clarify the conditions under which urban health research is more likely or not to have an influence on public policy development, we propose to supplement the conventional model with three concepts drawn from the social science: policy stages, policy networks, and a discourse analysis approach for theorizing power in policy-making.

  14. Substance Use Disorders and Related Health Problems in an Aging Offender Population.

    Science.gov (United States)

    Gates, Madison L; Staples-Horne, Michelle; Walker, Veronica; Turney, Asher

    2017-01-01

    Substance use disorders (SUD), including alcohol and tobacco, have been associated with chronic, infectious diseases, and mental health disorders. Few studies have examined associations between SUD and health issues for aging offenders (≥ 45 years old), who may have been long-term users. This study investigated associations between SUD and health problems in a prison population (men and women). We included 10,988 offenders, of whom 26.8% were aging. Aging offenders were more likely than younger peers to have health problems, such as cardiovascular diseases and hypertension, (80.8% compared with 63.6%). We found that aging African Americans with SUD had greater odds for being diagnosed with chronic conditions than White peers (p <.0001). Controlling for SUD, cardiovascular disease emerged as the most significant and frequently associated health problem for aging offenders. Results suggest a need to focus on the health of aging offenders with a history of SUD, particularly African Americans.

  15. Identifying problems and generating recommendations for enhancing complex systems: applying the abstraction hierarchy framework as an analytical tool.

    Science.gov (United States)

    Xu, Wei

    2007-12-01

    This study adopts J. Rasmussen's (1985) abstraction hierarchy (AH) framework as an analytical tool to identify problems and pinpoint opportunities to enhance complex systems. The process of identifying problems and generating recommendations for complex systems using conventional methods is usually conducted based on incompletely defined work requirements. As the complexity of systems rises, the sheer mass of data generated from these methods becomes unwieldy to manage in a coherent, systematic form for analysis. There is little known work on adopting a broader perspective to fill these gaps. AH was used to analyze an aircraft-automation system in order to further identify breakdowns in pilot-automation interactions. Four steps follow: developing an AH model for the system, mapping the data generated by various methods onto the AH, identifying problems based on the mapped data, and presenting recommendations. The breakdowns lay primarily with automation operations that were more goal directed. Identified root causes include incomplete knowledge content and ineffective knowledge structure in pilots' mental models, lack of effective higher-order functional domain information displayed in the interface, and lack of sufficient automation procedures for pilots to effectively cope with unfamiliar situations. The AH is a valuable analytical tool to systematically identify problems and suggest opportunities for enhancing complex systems. It helps further examine the automation awareness problems and identify improvement areas from a work domain perspective. Applications include the identification of problems and generation of recommendations for complex systems as well as specific recommendations regarding pilot training, flight deck interfaces, and automation procedures.

  16. Molecular computing towards a novel computing architecture for complex problem solving

    CERN Document Server

    Chang, Weng-Long

    2014-01-01

    This textbook introduces a concise approach to the design of molecular algorithms for students or researchers who are interested in dealing with complex problems. Through numerous examples and exercises, you will understand the main difference of molecular circuits and traditional digital circuits to manipulate the same problem and you will also learn how to design a molecular algorithm of solving any a problem from start to finish. The book starts with an introduction to computational aspects of digital computers and molecular computing, data representation of molecular computing, molecular operations of molecular computing and number representation of molecular computing, and provides many molecular algorithm to construct the parity generator and the parity checker of error-detection codes on digital communication, to encode integers of different formats, single precision and double precision of floating-point numbers, to implement addition and subtraction of unsigned integers, to construct logic operations...

  17. Mental Health Problems in Children and Young People with Learning Disabilities

    Science.gov (United States)

    Moradi Sheykhjan, Tohid

    2015-01-01

    We all have mental health. Mental health relates to how we think, feel, behave and interact with other people. At its simplest, good mental health is the absence of a mental disorder or mental health problem. Adults, children and young people with good mental health are likely to have high levels of mental wellbeing. The World Health Organisation…

  18. The Consensus String Problem and the Complexity of Comparing Hidden Markov Models

    DEFF Research Database (Denmark)

    Lyngsø, Rune Bang; Pedersen, Christian Nørgaard Storm

    2002-01-01

    The basic theory of hidden Markov models was developed and applied to problems in speech recognition in the late 1960s, and has since then been applied to numerous problems, e.g. biological sequence analysis. Most applications of hidden Markov models are based on efficient algorithms for computing...... the probability of generating a given string, or computing the most likely path generating a given string. In this paper we consider the problem of computing the most likely string, or consensus string, generated by a given model, and its implications on the complexity of comparing hidden Markov models. We show...... that computing the consensus string, and approximating its probability within any constant factor, is NP-hard, and that the same holds for the closely related labeling problem for class hidden Markov models. Furthermore, we establish the NP-hardness of comparing two hidden Markov models under the L∞- and L1...

  19. Addressing the critical health problem of adolescent substance use through health care, research, and public policy.

    Science.gov (United States)

    Feinstein, Emily C; Richter, Linda; Foster, Susan E

    2012-05-01

    The use of addictive substances-tobacco, alcohol, and other drugs-during adolescence interferes with brain development and increases the risk of serious health and mental health conditions, including addiction. Yet, adolescents live in a culture in which family, social, community, and media influences regularly bombard them with pro-substance use messages, creating an environment in which substance use is considered an expected behavior, rather than a considerable health risk. To prevent the significant harm that falls to teens and young adults because of substance use, The National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia) undertook a study to explore how adolescent brain development relates to the risk of substance use and addiction; the cultural influences that create an environment in which substance use is considered normative behavior; individual factors that make some teens more disposed to substance use and addiction; and evidence-based prevention and treatment strategies for addressing this problem. The recently published report Adolescent Substance Use: America's #1 Public Health Problem concludes that risky substance use is a major public health problem that can be ameliorated through evidence-based public health measures, including education about the disease and its risk factors, screenings, and clinical interventions, and that addiction can be treated and managed effectively within routine health care practice and specialty care. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. Sleep problems and mental health in primary school new entrants: cross-sectional community-based study.

    Science.gov (United States)

    Quach, Jon; Hiscock, Harriet; Wake, Melissa

    2012-12-01

    To determine at school entry (i) the prevalence and types of child sleep problems; (ii) sleep difficulties and hygiene practices associated with sleep problems; and (iii) their associations with child health-related quality of life, mental health and parent mental health. We conducted a cross-sectional community-based study at 22 primary schools in Melbourne, Australia. One thousand five hundred and twelve (70%) parents of children in the first 6 months of the child's first year of primary school took part. Parent report of child sleep problems (none, mild, and moderate/severe); sleep difficulties; pre-bedtime activities (television in bedroom, television or electronic games before bedtime, television or electronic games >2 h/day) and caffeine intake; child mental health (Strengths and Difficulties Questionnaire), health-related quality of life (Pediatric Quality of Life Inventory); and parent mental health (Depression Anxiety Stress Scale-21). 38.6% of children had a parent-reported sleep problem (27.9% mild, 10.8% moderate/severe). Sleep problems were characterised by problematic sleep difficulties but not poor sleep hygiene practices. Moderate/severe sleep problems were associated with poorer child mental health (mean difference -0.8; 95% confidence interval (CI) -1.1 to -0.5, P health-related quality of life (mean difference -9.9; 95% CI -11.9 to -7.9, P mental health (mean difference 9.8; 95% CI 7.7-11.9, P school entrants, sleep problems are common and associated with poorer child mental health, health-related quality of life and parent mental health. Future research needs to determine if systematically addressing sleep problems improves these outcomes. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  1. The effect of high and low assertiveness on locus of control and health problems.

    Science.gov (United States)

    Williams, J M; Stout, J K

    1985-03-01

    The effect of high and low assertiveness on locus of control and health problems was examined with 78 direct-service workers in mental health and mental retardation settings in northeastern Pennsylvania. The direct-service workers completed the Rathus (1973) Assertiveness Schedule, the Rotter (1966) Internal-External Locus of Control Scale, and a health-problems inventory. Highly assertive individuals were found to be more internally controlled and to experience fewer health problems than were individuals low in assertiveness.

  2. LIVED EXPERIENCES OF HEALTH PROBLEMS OF ELDERLY RESIDING IN URBAN AREAS, KATHMANDU: PILOT STUDY

    Directory of Open Access Journals (Sweden)

    Bista Archana, Joshi Sarala

    2015-10-01

    Full Text Available Introduction: Globally, number of old age population is increasing with advancement of biomedical technology. Old age is the time associated with biological, psychological and social changes which situate elderly to acquire different health related problems. Objectives: To find out lived experiences of elderly regarding their health problems residing in homes of Kathmandu city. Methods: Qualitative hermeneutic phenomenology approach was adopted. Researcher selected purposively four elderly residing in an urban area of Kathmandu Valley as the study participants. In-depth interview was conducted by using in-depth interview guideline, as well as medical records, field notes and observation clues were recorded. Interview was conducted in Nepali Language and was audio taped. The recording was transcribed by the researcher herself, and the data were analyzed thematically. Finally, different sources of data were triangulated. Results: The four main themes identified were physical health problems, impaired functional abilities, psychological and social problems. Experienced physical health problems were joint pain, hearing and vision deficit, chronic obstructive pulmonary disease, diabetes, gastritis and fall injury. Impaired Functional abilities in performing activities of daily living was commonly experienced problems. Loneliness and decreased recent memory power were the psychological problems. Being neglected by family members, financial constraints for treatment and improper care during illness were the discerned social problems. Conclusion: Elderly are suffering from different physical health problems, impaired functional abilities, as well as various psycho-social problems. Thus, health promotional activities need to be promoted for decreasing morbidity of elderly. Family members need to be focused in the care of elderly through national policy.

  3. Agency problems of global budget system in Taiwan's National Health Insurance.

    Science.gov (United States)

    Yan, Yu-Hua; Yang, Chen-Wei; Fang, Shih-Chieh

    2014-05-01

    The main purpose of this study was to investigate the agency problem presented by the global budget system followed by hospitals in Taiwan. In this study, we examine empirically the interaction between the principal: Bureau of National Health Insurance (BNHI) and agency: medical service providers (hospitals); we also describe actual medical service provider and hospital governance conditions from a agency theory perspective. This study identified a positive correlation between aversion to agency hazard (self-interest behavior, asymmetric information, and risk hedging) and agency problem risks (disregard of medical ethics, pursuit of extra-contract profit, disregard of professionalism, and cost orientation). Agency costs refer to BNHI auditing and monitoring expenditures used to prevent hospitals from deviating from NHI policy goals. This study also found agency costs negatively moderate the relationship between agency hazards and agency problems The main contribution of this study is its use of agency theory to clarify agency problems and several potential factors caused by the NHI system. This study also contributes to the field of health policy study by clarifying the nature and importance of agency problems in the health care sector. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. An interview study of persons who attribute health problems to dental filling materials--part two in a triangulation study on 65 and 75 years old Swedes.

    Science.gov (United States)

    Ståhlnacke, Katri; Söderfeldt, Björn

    2013-01-01

    Dental materials are perceived as a health problem by some people, although scientists do not agree about possible causes of such problems. The aim of this paper was to gain a deeper knowledge and understanding of experiences from living with health problems attributed to dental materials. Addressed topics were the type of problem, both as to general and oral health, perceived causes of the problems,their experienced effect on life, and reception by health professionals. Persons, who in a previous large questionnaire study had answered that they had experienced troubles from dental materials and also agreed to answer follow-up questions, were contacted with a request to take part in an interview study. Eleven individual interviews were held.The interviews were transcribed verbatim and the material was analysed according to the Qualitative Content Analysis method. Meaning units were extracted and condensed into a number of codes, which were combined into subcategories, categories, and themes. Four themes were identified: 1) Long-term oral, mental, and somatic difficulties of varying character, caused by dental amalgam. 2) Problems treated mainly by replacement of dental material in fillings. 3) Powerful effects on life, mostly negative. 4) The reception by health professionals was generally good, but with elements of encounters where they felt treated with nonchalance and lack of respect. In conclusion, people who attributed their health difficulties to dental materials had a complex range of problems and the perception was that amalgam/mercury was the cause of the troubles. The reception from health professionals was perceived as generally good, although with occasional negative experiences.

  5. System sight at a problem of efficiency of enterprises’s operaton of the Russian chemical complex

    Directory of Open Access Journals (Sweden)

    Svyatoslav Arkadyevich Nikitin

    2011-06-01

    Full Text Available Chemical industry plays an important role in the development of the domestic economy as one of the basic facilities of Russia's economy, laying the foundation for its long-term and stable development. As a major supplier of raw materials, intermediates, and products of various materials (plastics, chemical fibers, tires, paints and varnishes, dyes, fertilizers, feed additives, pharmaceuticals, medical equipment etc. in almost all sectors of industry, agriculture, health care, human services, commerce, science, culture and education, defense industry, chemical complex has direct impact on the efficiency of their operation and development in these new directions. Therefore, the condition and development of domestic chemistry determines the level of national competitiveness, economic growth and Russia's wealth. However, like most industries in Russia today, chemical industry is going through a difficult period. The presence of a set of common economic problems (identified by technological backwardness and high depreciation, low innovation activity of domestic enterprises of the chemical complex, a lack of effectiveness of the investment process, infrastructure and resource constraints etc., as well as internal management problems causes the rapid growth of interest of uncompetitive Russian chemical products on the world market. Under these conditions, not only a radical adjustment of the internal control systems and chemical plants, but also a significant organizational and economic change is required. Thus, unless we take measures to improve the domestic chemical industry in the coming years, almost all of it grow back and may get into the situation of struggle for survival.

  6. [Work days lost due to health problems in industry].

    Science.gov (United States)

    Yano, Sylvia Regina Trindade; Santana, Vilma Sousa

    2012-05-01

    This cross-sectional study estimated the prevalence of work days lost due to health problems and associated factors among industrial workers. The study population was a simple random cluster sample of 3,403 workers from 16 to 65 years of age in the city of Salvador, Bahia State, Brazil. Data were collected with individual home interviews. Among industrial workers, one-year prevalence of work days lost to health problems was 12.5%, of which 5.5% were directly work-related and 4.1% aggravated by work. There were no statistically significant differences when compared to other worker categories. Self-perceived workplace hazards, history of work-related injury, and poor self-rated health were associated with work days lost due to work-related injuries/diseases. The findings showed that work days lost are common among both industrial and non-industrial workers, thereby affecting productivity and requiring prevention programs.

  7. Digital Networked Information Society and Public Health: Problems and Promises of Networked Health Communication of Lay Publics.

    Science.gov (United States)

    Kim, Jeong-Nam

    2018-01-01

    This special issue of Health Communication compiles 10 articles to laud the promise and yet confront the problems in the digital networked information society related to public health. We present this anthology of symphony and cacophony of lay individuals' communicative actions in a digital networked information society. The collection of problems and promise of the new digital world may be a cornerstone joining two worlds-pre- and postdigital network society-and we hope this special issue will help better shape our future states of public health.

  8. Individual Differences in Students' Complex Problem Solving Skills: How They Evolve and What They Imply

    Science.gov (United States)

    Wüstenberg, Sascha; Greiff, Samuel; Vainikainen, Mari-Pauliina; Murphy, Kevin

    2016-01-01

    Changes in the demands posed by increasingly complex workplaces in the 21st century have raised the importance of nonroutine skills such as complex problem solving (CPS). However, little is known about the antecedents and outcomes of CPS, especially with regard to malleable external factors such as classroom climate. To investigate the relations…

  9. A review of the health problems of the internally displaced persons in Africa.

    Science.gov (United States)

    Owoaje, Eme T; Uchendu, Obioma C; Ajayi, Tumininu O; Cadmus, Eniola O

    2016-01-01

    Globally, over 40 million people were displaced as a result of wars and violence due to religious and ethnic conflicts in 2015 while 19.2 million were displaced by natural disasters such as famine and floods. In Africa, 12 million people were displaced by armed conflict and violence and there were hundreds of thousands of people displaced by natural disasters. Despite these large numbers of internally displaced persons (IDPs) in Sub-Saharan African countries and the potentially negative impact of displacement on the health of these populations, there is limited information on the health problems of IDPs in the region. The previous studies have mainly focused on the health problems of refugees and single disease entities among IDPs. However, a more comprehensive picture is required to inform the provision of adequate healthcare services for this vulnerable population. The objective of this review was to fill this knowledge gap. Bibliographic databases were searched and screened, and nine studies were selected and reviewed. The major physical health problems and symptoms were fever/malaria (85% in children and 48% in adults), malnutrition in children (stunting 52% and wasting 6%), malnutrition in adult males (24%), diarrhoea (62% in children and 22% in adults) and acute respiratory infections (45%). The prevalent mental health problems were post-traumatic stress disorder (range: 42%-54%) and depression (31%-67%). Most of the studies reviewed focused on mental health problems. Limited evidence suggests that IDPs experience various health problems but more research is required to inform the provision of adequate and comprehensive healthcare services for this group of individuals.

  10. Strategy to fight against malnutrition in chronic patients with complex health needs

    OpenAIRE

    Burgos, Rosa; Joaquin, Clara; Blay, Carles; Ledesma, Albert; Figueiras, Guadalupe; Pérez-Portabella, Cleofe; Granados, Antonio; Gómez, Mª Dolores; González, Asunción; Sarquella, Esther; Amil, Paloma; Vaqué, Cristina

    2016-01-01

    Disease-related malnutrition (DRM) is a prevalent condition amongst older people as well as patients in all healthcare settings around the world. Chronic patients with complex health needs (CPCHN defined as those with complex chronic conditions that involve multiple health requirements, complex social support needs, or both) are especially vulnerable to malnutrition. Malnutrition is associated with increased morbidity, a higher hospital admission and readmission rate, increased needs for soci...

  11. On the road to a stronger public health workforce: visual tools to address complex challenges.

    Science.gov (United States)

    Drehobl, Patricia; Stover, Beth H; Koo, Denise

    2014-11-01

    The public health workforce is vital to protecting the health and safety of the public, yet for years, state and local governmental public health agencies have reported substantial workforce losses and other challenges to the workforce that threaten the public's health. These challenges are complex, often involve multiple influencing or related causal factors, and demand comprehensive solutions. However, proposed solutions often focus on selected factors and might be fragmented rather than comprehensive. This paper describes approaches to characterizing the situation more comprehensively and includes two visual tools: (1) a fishbone, or Ishikawa, diagram that depicts multiple factors affecting the public health workforce; and (2) a roadmap that displays key elements-goals and strategies-to strengthen the public health workforce, thus moving from the problems depicted in the fishbone toward solutions. The visual tools aid thinking about ways to strengthen the public health workforce through collective solutions and to help leverage resources and build on each other's work. The strategic roadmap is intended to serve as a dynamic tool for partnership, prioritization, and gap assessment. These tools reflect and support CDC's commitment to working with partners on the highest priorities for strengthening the workforce to improve the public's health. Published by Elsevier Inc.

  12. Building University Capacity to Visualize Solutions to Complex Problems in the Arctic

    Science.gov (United States)

    Broderson, D.; Veazey, P.; Raymond, V. L.; Kowalski, K.; Prakash, A.; Signor, B.

    2016-12-01

    Rapidly changing environments are creating complex problems across the globe, which are particular magnified in the Arctic. These worldwide challenges can best be addressed through diverse and interdisciplinary research teams. It is incumbent on such teams to promote co-production of knowledge and data-driven decision-making by identifying effective methods to communicate their findings and to engage with the public. Decision Theater North (DTN) is a new semi-immersive visualization system that provides a space for teams to collaborate and develop solutions to complex problems, relying on diverse sets of skills and knowledge. It provides a venue to synthesize the talents of scientists, who gather information (data); modelers, who create models of complex systems; artists, who develop visualizations; communicators, who connect and bridge populations; and policymakers, who can use the visualizations to develop sustainable solutions to pressing problems. The mission of Decision Theater North is to provide a cutting-edge visual environment to facilitate dialogue and decision-making by stakeholders including government, industry, communities and academia. We achieve this mission by adopting a multi-faceted approach reflected in the theater's design, technology, networking capabilities, user support, community relationship building, and strategic partnerships. DTN is a joint project of Alaska's National Science Foundation Experimental Program to Stimulate Competitive Research (NSF EPSCoR) and the University of Alaska Fairbanks (UAF), who have brought the facility up to full operational status and are now expanding its development space to support larger team science efforts. Based in Fairbanks, Alaska, DTN is uniquely poised to address changes taking place in the Arctic and subarctic, and is connected with a larger network of decision theaters that include the Arizona State University Decision Theater Network and the McCain Institute in Washington, DC.

  13. Ethnographic methods for process evaluations of complex health behaviour interventions.

    Science.gov (United States)

    Morgan-Trimmer, Sarah; Wood, Fiona

    2016-05-04

    This article outlines the contribution that ethnography could make to process evaluations for trials of complex health-behaviour interventions. Process evaluations are increasingly used to examine how health-behaviour interventions operate to produce outcomes and often employ qualitative methods to do this. Ethnography shares commonalities with the qualitative methods currently used in health-behaviour evaluations but has a distinctive approach over and above these methods. It is an overlooked methodology in trials of complex health-behaviour interventions that has much to contribute to the understanding of how interventions work. These benefits are discussed here with respect to three strengths of ethnographic methodology: (1) producing valid data, (2) understanding data within social contexts, and (3) building theory productively. The limitations of ethnography within the context of process evaluations are also discussed.

  14. Management of common behaviour and mental health problems.

    Science.gov (United States)

    El-Radhi, A Sahib

    Behavioural problems are usually influenced by both biological and environmental factors. Disruptive behavioural problems such temper tantrums or attention deficit hyperactivity disorder are displayed during the first years of childhood. Breath-holding attacks are relatively common and are an important problem. Although the attacks are not serious and the prognosis is usually good, parents often fear that their child may die during an attack. Parents therefore require explanation and reassurance from health professionals. Conduct disorders (often referred to as antisocial behaviours), such as aggression to others or theft, are more serious as they tend to be repetitive and persistent behaviours where the basic rights of others are violated. Emotional problems, such as anxiety, depression and post-traumatic stress disorder tend to occur in later childhood, and are often unrecognised because young children often find it difficult to express their emotions, or it may go unnoticed by the child's parents. This article briefly discusses the most common behavioural problems, including autism, that affect children of all ages.

  15. Playing-Related Health Problems Among Instrumental Music Students at a University in Malaysia.

    Science.gov (United States)

    Lonsdale, Karen; Boon, Ong Kuan

    2016-09-01

    Musicians from a wide range of backgrounds experience playing-related health problems including musculoskeletal disorders, hearing loss, and performance anxiety. Few studies have focused specifically on the health concerns of musicians in Malaysia. This study aimed to investigate playing-related health problems among student musicians at a university in Malaysia as well as their knowledge and awareness of playing-related health problems. Instrumental music students enrolled in undergraduate and post-graduate university music courses (n=98) participated in a self-report online survey which addressed aspects such as educational background, playing experience, knowledge and awareness of musicians' health issues, history of physical problems, lifestyle factors, and prevention and management strategies. Of the total participants, 28.9% reported that they were currently experiencing playing-related pain in a body part, and 46.4% had experienced playing-related pain at some time. More than half (56.7%) felt that they have not received enough information or advice on playing-related health during their current studies. Musicians who experienced playing-related pain, tension, and discomfort reported the main problem sites to be the fingers and hands, arms, neck, and shoulders. The study results demonstrate that Malaysian university music students are affected by similar types of playing-related physical problems as their counterparts around the world. A greater awareness and knowledge of injury prevention and management strategies is needed so that these music students can sustain healthy playing careers.

  16. Prevalence of Children's Mental Health Problems and the Effectiveness of Population-Level Family Interventions.

    Science.gov (United States)

    Kato, Noriko; Yanagawa, Toshihiko; Fujiwara, Takeo; Morawska, Alina

    2015-01-01

    The prevalence of mental health problems among children and adolescents is of growing importance. Intervening in children's mental health early in life has been shown to be more effective than trying to resolve these problems when children are older. With respect to prevention activities in community settings, the prevalence of problems should be estimated, and the required level of services should be delivered. The prevalence of children's mental health disorders has been reported for many countries. Preventive intervention has emphasized optimizing the environment. Because parents are the primary influence on their children's development, considerable attention has been placed on the development of parent training to strengthen parenting skills. However, a public-health approach is necessary to confirm that the benefits of parent-training interventions lead to an impact at the societal level. This literature review clarifies that the prevalence of mental health problems is measured at the national level in many countries and that population-level parenting interventions can lower the prevalence of mental health problems among children in the community.

  17. Health physics problems encountered in the Saclay linear accelerator

    International Nuclear Information System (INIS)

    Delsaut, R.

    1979-01-01

    The safety and health physics problems specific to the Saclay linear accelerator are presented: activation (of gases, dust, water, structural materials, targets); individual dosimetry; the safety engineering [fr

  18. Peer support of complex health behaviors in prevention and disease management with special reference to diabetes: systematic reviews.

    Science.gov (United States)

    Fisher, Edwin B; Boothroyd, Renée I; Elstad, Emily A; Hays, Laura; Henes, Amy; Maslow, Gary R; Velicer, Clayton

    2017-01-01

    Examine Peer Support (PS) for complex, sustained health behaviors in prevention or disease management with emphasis on diabetes prevention and management. PS was defined as emotional, motivational and practical assistance provided by nonprofessionals for complex health behaviors. Initial review examined 65 studies drawn from 1442 abstracts identified through PubMed, published 1/1/2000-7/15/2011. From this search, 24 reviews were also identified. Extension of the search in diabetes identified 30 studies published 1/1/2000-12/31/2015. In initial review, 54 of all 65 studies (83.1%) reported significant impacts of PS, 40 (61.5%) reporting between-group differences and another 14 (21.5%) reporting significant within-group changes. Across 19 of 24 reviews providing quantifiable findings, a median of 64.5% of studies reviewed reported significant effects of PS. In extended review of diabetes, 26 of all 30 studies (86.7%) reported significant impacts of PS, 17 (56.7%) reporting between-group differences and another nine (30.0%) reporting significant within-group changes. Among 19 of these 30 reporting HbA1c data, average reduction was 0.76 points. Studies that did not find effects of PS included other sources of support, implementation or methodological problems, lack of acceptance of interventions, poor fit to recipient needs, and possible harm of unmoderated PS. Across diverse settings, including under-resourced countries and health care systems, PS is effective in improving complex health behaviors in disease prevention and management including in diabetes.

  19. Health problems of street children and women in Awassa, Southern ...

    African Journals Online (AJOL)

    Background: The number of street children and women in major towns of Ethiopia is rapidly increasing. Yet their problems have not been fully studied. Objective: To assess health and related problems in street children and women. Methods: A cross sectional survey was conducted in Awassa town, women southern ...

  20. Setting the stage for chronic health problems: cumulative childhood adversity among homeless adults with mental illness in Vancouver, British Columbia.

    Science.gov (United States)

    Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

    2014-04-12

    It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and substance use disorders, and physical health in a sample of homeless adults with mental illness. This study was conducted using baseline data from a randomized controlled trial in Vancouver, British Columbia for participants who completed the Adverse Childhood Experiences (ACE) scale at 18 months follow-up (n=364). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; and vocational functioning. In multivariable regression models, ACE total score independently predicted a range of mental health, physical health, and substance use problems, and marginally predicted duration of homelessness. Adverse childhood experiences are overrepresented among homeless adults with complex comorbidities and chronic homelessness. Our findings are consistent with a growing body of literature indicating that childhood traumas are potent risk factors for a number of adult health and psychiatric problems, particularly substance use problems. Results are discussed in the context of cumulative adversity and self-trauma theory. This trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374.

  1. Organisational simplification and secondary complexity in health services for adults with learning disabilities.

    Science.gov (United States)

    Heyman, Bob; Swain, John; Gillman, Maureen

    2004-01-01

    This paper explores the role of complexity and simplification in the delivery of health care for adults with learning disabilities, drawing upon qualitative data obtained in a study carried out in NE England. It is argued that the requirement to manage complex health needs with limited resources causes service providers to simplify, standardise and routinise care. Simplified service models may work well enough for the majority of clients, but can impede recognition of the needs of those whose characteristics are not congruent with an adopted model. The data were analysed in relation to the core category, identified through thematic analysis, of secondary complexity arising from organisational simplification. Organisational simplification generates secondary complexity when operational routines designed to make health complexity manageable cannot accommodate the needs of non-standard service users. Associated themes, namely the social context of services, power and control, communication skills, expertise and service inclusiveness and evaluation are explored in relation to the core category. The concept of secondary complexity resulting from organisational simplification may partly explain seemingly irrational health service provider behaviour.

  2. Examining the cost effectiveness of interventions to promote the physical health of people with mental health problems: a systematic review

    Science.gov (United States)

    2013-01-01

    Background Recently attention has begun to focus not only on assessing the effectiveness of interventions to tackle mental health problems, but also on measures to prevent physical co-morbidity. Individuals with mental health problems are at significantly increased risk of chronic physical health problems, such as cardiovascular disease or diabetes, as well as reduced life expectancy. The excess costs of co-morbid physical and mental health problems are substantial. Potentially, measures to reduce the risk of co-morbid physical health problems may represent excellent value for money. Methods To conduct a systematic review to determine what is known about economic evaluations of actions to promote better physical health in individuals identified as having a clinically diagnosed mental disorder, but no physical co-morbidity. Systematic searches of databases were supplemented by hand searches of relevant journals and websites. Results Of 1970 studies originally assessed, 11 met our inclusion criteria. In addition, five protocols for other studies were also identified. Studies looked at exercise programmes, nutritional advice, smoking, alcohol and drug cessation, and reducing the risk of blood borne infectious diseases such as HIV/AIDS and hepatitis. All of the lifestyle and smoking cessation studies focused on people with depression and anxiety disorders. Substance abuse and infectious disease prevention studies focused on people with psychoses and bipolar disorder. Conclusions There is a very small, albeit growing, literature on the cost effectiveness of interventions to promote the physical health of people with mental health problems. Most studies suggest that value for money actions in specific contexts and settings are available. Given that the success or failure of health promoting interventions can be very context specific, more studies are needed in more settings, focused on different population groups with different mental health problems and reporting

  3. Work organization and mental health problems in PhD students

    NARCIS (Netherlands)

    Levecque, K.; Anseel, F.; Beuckelaer, A. de; Van Der Heyden, J.; Gisle, L.

    2017-01-01

    Research policy observers are increasingly concerned about the potential impact of current academic working conditions on mental health, particularly in PhD students. The aim of the current study is threefold. First, we assess the prevalence of mental health problems in a representative sample of

  4. Mild cognitive impairment in early life and mental health problems in adulthood.

    Science.gov (United States)

    Chen, Chuan-Yu; Lawlor, John P; Duggan, Anne K; Hardy, Janet B; Eaton, William W

    2006-10-01

    We assessed the extent to which borderline mental retardation and mental retardation at preschool ages are related to emotional and behavioral problems in young adulthood. We also explored early risk factors for having mental health problems as a young adult that might be related to preschool differences in cognitive ability. We used data from a cohort of births studied in the Johns Hopkins Collaborative Perinatal Study and followed up in the Pathways to Adulthood Study. Preschool cognitive functioning was assessed at 4 years of age. Individual characteristics, psychosocial factors, and mental problems were prospectively evaluated from birth through young adulthood. Children with subaverage cognitive abilities were more likely to develop mental health problems than their counterparts with IQs above 80. Inadequate family interactions were shown to increase 2- to 4-fold the risk of emotional or behavioral problems among children with borderline mental retardation. Subaverage cognitive functioning in early life increases later risk of mental health problems. Future research may help to delineate possible impediments faced at different developmental stages and guide changes in supportive services to better address the needs of children with borderline mental retardation.

  5. [Ethical problems experienced by nurses in primary health care: integrative literature review].

    Science.gov (United States)

    Nora, Carlise Rigon Dalla; Zoboli, Elma Lourdes Campos Pavone; Vieira, Margarida

    2015-03-01

    The aim of this study is to identify ethical problems experienced by nurses in primary health care and resources for coping based on publications on the subject. An integrative literature review was performed between the months of October and November 2013, using the databases: BDTD, CINAHL, LILACS, MEDLINE, Biblioteca Cochrane, PubMed, RCAAP and SciELO. Articles, dissertations and theses published in Portuguese, English and Spanish were included, totalling 31 studies published from 1992 to 2013. This analysis resulted in four categories: ethical problems in the relationship between team members, ethical problems in the relationship with the user, ethical problems in health services management and resources for coping with ethical problems. Results showed that nurses need to be prepared to face ethical problems, emphasizing the importance of ethics education during the education process before and during professional practice to enhance the development of ethical sensitivity and competence for problem resolution.

  6. Diagnostic practice and its impacts on parental health and child behaviour problems in autism spectrum disorders.

    Science.gov (United States)

    Reed, Phil; Osborne, Lisa A

    2012-10-01

    Obtaining a diagnosis is a key point in developing a treatment plan for children with autism spectrum disorders (ASD), but little attention has been paid to the impacts of diagnostic practices on families, and the consequent impact on child outcomes. Parents' experiences during ASD diagnosis for their child can be stressful, and such stress can lead to parental ill health, child-behaviour problems, and poorer child outcomes following treatment. Thus, the conduct of diagnosis may be of particular importance for subsequent child outcomes and parental health. A lack of knowledge regarding best diagnostic practice may ultimately impair treatment efficacy and lead to increased health- and economic-burdens. Given this, the current article examines recent work concerning: parental experiences of ASD diagnoses; general health and psychological functioning of parents of newly-diagnosed children with ASD; aspects of the diagnostic process impacting on parental functioning; and the relationship of parental functioning to child outcomes. These are placed into the context of diagnostic best practice for ASD, and understanding the complex relationship between ASD and family variables.

  7. Self-complexity and health promotion: promising but premature.

    Science.gov (United States)

    Hershberger, P J

    1990-06-01

    Self-complexity, the number of nonredundant aspects by which the self is cognitively represented, was reported in 1987 by Linville to function as a buffer against the adverse consequences of stress under conditions of high stress. An attempt was made to increase the self-complexity of 110 undergraduates through the use of psychoeducational interventions, with the goal of decreasing physical symptoms. None of four interventions produced an increase in self-complexity or a decrease in physical symptoms. Using multiple regression, the previously reported buffering interaction was evident only among those experiencing the strongest intervention, and Linville's results were not replicated when the entire data set was analyzed. The hypothesis of a relationship between self-complexity and individuals' sense of meaning and purpose in life was not corroborated by correlational analysis. It is concluded that the relationship between self-complexity and health remains intriguing but inadequately tested.

  8. Child abuse, drug addiction and mental health problems of incarcerated women in Israel.

    Science.gov (United States)

    Chen, Gila; Gueta, Keren

    2015-01-01

    The mental health problems and pathways to drug addiction and crime among female inmates have long been of interest to researchers and practitioners. The purpose of the current study was to examine the possible association between multiple types of childhood abuse, mental health problems, and drug addiction and the incarceration of 50 Israeli women in prison. The findings indicated that female inmates come from risky families with a high prevalence of family mental health problems, parental drug addiction and crime, and sibling drug addiction and crime. Furthermore, they revealed that incarcerated women from risky families were victims of multiple types of childhood abuse and neglect by their parents, as well as their siblings. Overall, the results suggest that the adverse consequences of a family's mental health problems are much more dramatic than we assumed to date, and that women are more likely than men to be the victims of multiple types of childhood abuse and neglect, as well as suffering more severe psychiatric problems, depression, and drug addiction. The implications of these findings are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Mental Health Problems in Adults with Williams Syndrome

    Science.gov (United States)

    Stinton, Chris; Elison, Sarah; Howlin, Patricia

    2010-01-01

    Although many researchers have investigated emotional and behavioral difficulties in individuals with Williams syndrome, few have used standardized diagnostic assessments. We examined mental health problems in 92 adults with Williams syndrome using the Psychiatric Assessment Schedule for Adults with Developmental Disabilities--PAS-ADD (Moss,…

  10. Common mental health problems in immigrants and refugees: general approach in primary care

    Science.gov (United States)

    Kirmayer, Laurence J.; Narasiah, Lavanya; Munoz, Marie; Rashid, Meb; Ryder, Andrew G.; Guzder, Jaswant; Hassan, Ghayda; Rousseau, Cécile; Pottie, Kevin

    2011-01-01

    Background: Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. We aimed to identify risk factors and strategies in the approach to mental health assessment and to prevention and treatment of common mental health problems for immigrants in primary care. Methods: We searched and compiled literature on prevalence and risk factors for common mental health problems related to migration, the effect of cultural influences on health and illness, and clinical strategies to improve mental health care for immigrants and refugees. Publications were selected on the basis of relevance, use of recent data and quality in consultation with experts in immigrant and refugee mental health. Results: The migration trajectory can be divided into three components: premigration, migration and postmigration resettlement. Each phase is associated with specific risks and exposures. The prevalence of specific types of mental health problems is influenced by the nature of the migration experience, in terms of adversity experienced before, during and after resettlement. Specific challenges in migrant mental health include communication difficulties because of language and cultural differences; the effect of cultural shaping of symptoms and illness behaviour on diagnosis, coping and treatment; differences in family structure and process affecting adaptation, acculturation and intergenerational conflict; and aspects of acceptance by the receiving society that affect employment, social status and integration. These issues can be addressed through specific inquiry, the use of trained interpreters and culture brokers, meetings with families, and consultation with community organizations. Interpretation: Systematic inquiry into patients’ migration trajectory and subsequent follow-up on culturally

  11. Common mental health problems in immigrants and refugees: general approach in primary care.

    Science.gov (United States)

    Kirmayer, Laurence J; Narasiah, Lavanya; Munoz, Marie; Rashid, Meb; Ryder, Andrew G; Guzder, Jaswant; Hassan, Ghayda; Rousseau, Cécile; Pottie, Kevin

    2011-09-06

    Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. We aimed to identify risk factors and strategies in the approach to mental health assessment and to prevention and treatment of common mental health problems for immigrants in primary care. We searched and compiled literature on prevalence and risk factors for common mental health problems related to migration, the effect of cultural influences on health and illness, and clinical strategies to improve mental health care for immigrants and refugees. Publications were selected on the basis of relevance, use of recent data and quality in consultation with experts in immigrant and refugee mental health. The migration trajectory can be divided into three components: premigration, migration and postmigration resettlement. Each phase is associated with specific risks and exposures. The prevalence of specific types of mental health problems is influenced by the nature of the migration experience, in terms of adversity experienced before, during and after resettlement. Specific challenges in migrant mental health include communication difficulties because of language and cultural differences; the effect of cultural shaping of symptoms and illness behaviour on diagnosis, coping and treatment; differences in family structure and process affecting adaptation, acculturation and intergenerational conflict; and aspects of acceptance by the receiving society that affect employment, social status and integration. These issues can be addressed through specific inquiry, the use of trained interpreters and culture brokers, meetings with families, and consultation with community organizations. Systematic inquiry into patients' migration trajectory and subsequent follow-up on culturally appropriate indicators of social, vocational and

  12. Perceived health and work-environment related problems and associated subjective production loss in an academic population.

    Science.gov (United States)

    Lohela-Karlsson, Malin; Nybergh, Lotta; Jensen, Irene

    2018-02-14

    The aim was to investigate the prevalence of health problems and work environment problems and how these are associated with subjective production loss among women and men at an academic workplace. An additional aim was to investigate whether there were differences between women and men according to age group, years at current workplace, academic rank or managerial position. A questionnaire was sent in 2011 to all employees at a Swedish university (n = 5144). Only researchers and teachers were included in the study (n = 3207). Spearman correlations were performed to investigate differences in health and work environment problems. Employees who reported having experienced work environment or health problems in the previous seven days (n = 1475) were included in the analyses in order to investigate differences in subjective production loss. This was done using Student's t-test, One-way Anova and generalized linear models. The response rate was 63% (n = 2022). A total of 819 academic staff (40% of the population) reported experiencing either health problems, work environment problems or both during the previous seven days. The prevalence of health problems only or a combination of work environment and health problems was higher among women than men (p-value ˂0.05). This was especially the case for younger women, those in lower academic positions and those who had worked for fewer years at their current workplace. No difference was found for work environment problems. The majority of the employees who reported problems said that these problems affected their ability to perform at work (84-99%). The average production loss varied between 31 and 42% depending on the type of problem. Production loss due to health-related and work-environment related problems was highest among junior researchers and managers. No significant difference between men and women was found in the level of production loss. Subjective production loss in academia can be associated

  13. Setting up problems raised by construction of the EDF-Eurodif complex

    International Nuclear Information System (INIS)

    Fontaine, J.P.; Roux, J.P.

    1977-01-01

    After presentation of the Tricastin site and the nuclear complex to be built there, the main problems of social, economical or administrative order arising from the establishment of the site are analyzed and the solutions applied in order to overcome them are described. In conclusion they note that the largest site in Europe should be carried out up to completion in the best interests of local collectivities, of the Engineers and the populations concerned [fr

  14. Health status transitions in community-living elderly with complex care needs: a latent class approach

    Directory of Open Access Journals (Sweden)

    Béland François

    2009-02-01

    Full Text Available Abstract Background For older persons with complex care needs, accounting for the variability and interdependency in how health dimensions manifest themselves is necessary to understand the dynamic of health status. Our objective is to test the hypothesis that a latent classification can capture this heterogeneity in a population of frail elderly persons living in the community. Based on a person-centered approach, the classification corresponds to substantively meaningful groups of individuals who present with a comparable constellation of health problems. Methods Using data collected for the SIPA project, a system of integrated care for frail older people (n = 1164, we performed latent class analyses to identify homogenous categories of health status (i.e. health profiles based on 17 indicators of prevalent health problems (chronic conditions; depression; cognition; functional and sensory limitations; instrumental, mobility and personal care disability Then, we conducted latent transition analyses to study change in profile membership over 2 consecutive periods of 12 and 10 months, respectively. We modeled competing risks for mortality and lost to follow-up as absorbing states to avoid attrition biases. Results We identified four health profiles that distinguish the physical and cognitive dimensions of health and capture severity along the disability dimension. The profiles are stable over time and robust to mortality and lost to follow-up attrition. The differentiated and gender-specific patterns of transition probabilities demonstrate the profiles' sensitivity to change in health status and unmasked the differential relationship of physical and cognitive domains with progression in disability. Conclusion Our approach may prove useful at organization and policy levels where many issues call for classification of individuals into pragmatically meaningful groups. In dealing with attrition biases, our analytical strategy could provide critical

  15. Application of Artificial Neural Networks to Complex Groundwater Management Problems

    International Nuclear Information System (INIS)

    Coppola, Emery; Poulton, Mary; Charles, Emmanuel; Dustman, John; Szidarovszky, Ferenc

    2003-01-01

    As water quantity and quality problems become increasingly severe, accurate prediction and effective management of scarcer water resources will become critical. In this paper, the successful application of artificial neural network (ANN) technology is described for three types of groundwater prediction and management problems. In the first example, an ANN was trained with simulation data from a physically based numerical model to predict head (groundwater elevation) at locations of interest under variable pumping and climate conditions. The ANN achieved a high degree of predictive accuracy, and its derived state-transition equations were embedded into a multiobjective optimization formulation and solved to generate a trade-off curve depicting water supply in relation to contamination risk. In the second and third examples, ANNs were developed with real-world hydrologic and climate data for different hydrogeologic environments. For the second problem, an ANN was developed using data collected for a 5-year, 8-month period to predict heads in a multilayered surficial and limestone aquifer system under variable pumping, state, and climate conditions. Using weekly stress periods, the ANN substantially outperformed a well-calibrated numerical flow model for the 71-day validation period, and provided insights into the effects of climate and pumping on water levels. For the third problem, an ANN was developed with data collected automatically over a 6-week period to predict hourly heads in 11 high-capacity public supply wells tapping a semiconfined bedrock aquifer and subject to large well-interference effects. Using hourly stress periods, the ANN accurately predicted heads for 24-hour periods in all public supply wells. These test cases demonstrate that the ANN technology can solve a variety of complex groundwater management problems and overcome many of the problems and limitations associated with traditional physically based flow models

  16. Mental health problems and overweight in a nationally representative sample of adolescents: effects of race and ethnicity.

    Science.gov (United States)

    BeLue, Rhonda; Francis, Lori Ann; Colaco, Brendon

    2009-02-01

    In this study we examined the relation between mental health problems and weight in a population-based study of youth aged 12 to 17 years and whether the association between mental health problems and weight is moderated by race and ethnicity. We used 2003 National Survey on Children's Health data. Logistic regression was used to arrive at adjusted odds ratios showing the relation between BMI and mental health problems. Compared with their nonoverweight counterparts, both white and Hispanic youth who were overweight were significantly more likely to report depression or anxiety, feelings of worthlessness or inferiority, behavior problems, and bullying of others. Odds ratios relating mental health problems and BMI in black subjects were not statistically significant except for physician diagnosis of depression. Our results suggest that, when addressing youth overweight status, mental health problems also need to be addressed. Given that the relationship between mental health problems and youth overweight differs according to race/ethnic group, public health programs that target overweight youth should be cognizant of potential comorbid mental health problems and that race/ethnicity may play a role in the relationship between mental health and overweight status.

  17. Methodological innovations in public health education: transdisciplinary problem solving.

    Science.gov (United States)

    Lawlor, Edward F; Kreuter, Matthew W; Sebert-Kuhlmann, Anne K; McBride, Timothy D

    2015-03-01

    In 2008, the faculty of the Brown School at Washington University in St. Louis designed a Master of Public Health program centered on transdisciplinary problem solving in public health. We have described the rationale for our approach, guiding principles and pedagogy for the program, and specific transdisciplinary competencies students acquire. We have explained how transdisciplinary content has been organized and delivered, how the program is being evaluated, and how we have demonstrated the feasibility of this approach for a Master of Public Health degree.

  18. Why performance-based contracting failed in Uganda--an "open-box" evaluation of a complex health system intervention.

    Science.gov (United States)

    Ssengooba, Freddie; McPake, Barbara; Palmer, Natasha

    2012-07-01

    Performance-based contracting (PBC) is a tool that links rewards to attainment of measurable performance targets. Significant problems remain in the methods used to evaluate this tool. The primary focus of evaluations on the effects of PBC (black-box) and less attention to how these effects arise (open-box) generates suboptimal policy learning. A black-box impact evaluation of PBC pilot by the Development Research Group of the World Bank (DRG) and the Ministry of Health (MOH) concluded that PBC was ineffective. This paper reports a theory-based case study intended to clarify how and why PBC failed to achieve its objectives. To explain the observed PBC implementation and responses of participants, this case study employed two related theories i.e. complex adaptive system and expectancy theory respectively. A prospective study trailed the implementation of PBC (2003-2006) while collecting experiences of participants at district and hospital levels. Significant problems were encountered in the implementation of PBC that reflected its inadequate design. As problems were encountered, hasty adaptations resulted in a de facto intervention distinct from the one implied at the design stage. For example, inadequate time was allowed for the selection of service targets by the health centres yet they got 'locked-in' to these poor choices. The learning curve and workload among performance auditors weakened the validity of audit results. Above all, financial shortfalls led to delays, short-cuts and uncertainty about the size and payment of bonuses. The lesson for those intending to implement similar interventions is that PBC should not be attempted 'on the cheap'. It requires a plan to boost local institutional and technical capacities of implementers. It also requires careful consideration of the responses of multiple actors - both insiders and outsiders to the intended change process. Given the costs and complexity of PBC implementation, strengthening conventional approaches

  19. A mismatch between population health literacy and the complexity of health information: an observational study.

    Science.gov (United States)

    Rowlands, Gillian; Protheroe, Joanne; Winkley, John; Richardson, Marty; Seed, Paul T; Rudd, Rima

    2015-06-01

    Low health literacy is associated with poorer health and higher mortality. Complex health materials are a barrier to health. To assess the literacy and numeracy skills required to understand and use commonly used English health information materials, and to describe population skills in relation to these. An English observational study comparing health materials with national working-age population skills. Health materials were sampled using a health literacy framework. Competency thresholds to understand and use the materials were identified. The proportion of the population above and below these thresholds, and the sociodemographic variables associated with a greater risk of being below the thresholds, were described. Sixty-four health materials were sampled. Two competency thresholds were identified: text (literacy) only, and text + numeracy; 2515/5795 participants (43%) were below the text-only threshold, while 2905/4767 (61%) were below the text + numeracy threshold. Univariable analyses of social determinants of health showed that those groups more at risk of socioeconomic deprivation had higher odds of being below the health literacy competency threshold than those at lower risk of deprivation. Multivariable analysis resulted in some variables becoming non-significant or reduced in effect. Levels of low health literacy mirror those found in other industrialised countries, with a mismatch between the complexity of health materials and the skills of the English adult working-age population. Those most in need of health information have the least access to it. Efficacious strategies are building population skills, improving health professionals' communication, and improving written health information. © British Journal of General Practice 2015.

  20. The exocyst complex in health and disease

    Directory of Open Access Journals (Sweden)

    Magdanela eMartin-Urdiroz

    2016-04-01

    Full Text Available Exocytosis involves the fusion of intracellular secretory vesicles with the PM, thereby delivering integral membrane proteins to the cell surface and releasing material into the extracellular space. Importantly, exocytosis also provides a source of lipid moieties for membrane extension. The tethering of the secretory vesicle before docking and fusion with the PM is mediated by the exocyst complex, an evolutionary conserved octameric complex of proteins. Recent findings indicate that the exocyst complex also takes part in other intra-cellular processes besides secretion. These various functions seem to converge towards defining a direction of membrane growth in a range of systems from fungi to plants and from neurons to cilia. In this review we summarise the current knowledge of exocyst function in cell polarity, signalling and cell-cell communication and discuss implications for plant and animal health and disease.

  1. Risk of mental health problems in adolescents skipping meals: The Korean National Health and Nutrition Examination Survey 2010 to 2012.

    Science.gov (United States)

    Lee, Gyungjoo; Han, Kyungdo; Kim, Hyunju

    Adolescents frequently skip meals, doing so even more than once per day. This is associated with more mental health problems. This study identified mental health problems' associations with skipping meals and the frequency thereof among adolescents. This cross-sectional population-based study used a data set of 1,413 adolescents from the 2010 to 2012 Korean National Health and Nutrition Examination Survey. Hierarchical multivariable logistic regression was conducted to determine the risk of mental health problems, including stress, depressive mood, and suicidal ideation in relation to skipping meals and the frequency thereof per day. Breakfast skipping significantly increased the risks of stress and depressive mood. Stress, depressive mood, and suicidal ideation were significantly prevalent as the daily frequency of skipping meals increased. Specific strategies should be developed at government or school level to decrease the frequency of skipping meals per day, associated with serious mental health problems in adolescents. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Performance of community health workers: situating their intermediary position within complex adaptive health systems.

    Science.gov (United States)

    Kok, Maryse C; Broerse, Jacqueline E W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

    2017-09-02

    Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors.This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income countries. It examines their unique intermediary position between the communities they serve and actors in the health sector, and the complexity of the health systems in which they operate. The assessment combines evidence from the international literature on CHW programmes with research outcomes from the 5-year REACHOUT consortium, undertaking implementation research to improve CHW performance in six contexts (two in Asia and four in Africa). A conceptual framework on CHW performance, which explicitly conceptualizes the interface role of CHWs, is presented. Various categories of factors influencing CHW performance are distinguished in the framework: the context, the health system and intervention hardware and the health system and intervention software. Hardware elements of CHW interventions comprise the supervision systems, training, accountability and communication structures, incentives, supplies and logistics. Software elements relate to the ideas, interests, relationships, power, values and norms of the health system actors. They influence CHWs' feelings of connectedness, familiarity, self-fulfilment and serving the same goals and CHWs' perceptions of support received, respect, competence, honesty, fairness and recognition.The framework shines a spotlight on the need for programmes to pay more attention to ideas, interests, relationships, power, values and norms of CHWs, communities, health professionals and other actors in the health system, if CHW performance is to improve.

  3. From DTCA-PD to patient information to health information: the complex politics and semantics of EU health policy.

    Science.gov (United States)

    Brooks, Eleanor; Geyer, Robert

    2012-12-01

    Between 2001 and 2011 the pharmaceutical industry, supported by DG Enterprise, was engaged in an ongoing campaign to repeal/amend the European Union (EU) ban on direct-to-consumer advertising of prescription drugs (DTCA-PD). As it became increasingly clear that the ban would not be repealed, DTCA-PD supporters tried to shift the debate away from advertising and towards the provision of 'patient information' and the rights of patients to access such information. Meanwhile, a variety of national and European health organizations, supported by DG SANCO, sought to maintain the ban and oppose the industry-supported 'patient information' campaign. Instead, they promoted a concept of 'health information' that included all aspects of citizens' health, not just pharmaceuticals. This article aims to analyse the transition from DTCA-PD to patient information to health information and examine its implications for EU health policy as a complex policy space. The article examines the emergence and development of EU health policy and the evolution of the DTCA-PD debate through the lens of complexity theory. It analyses the nature of the semantic, political and policy transition and asks why it occurred, what it tells us about EU health policy and future EU health legislation and how it may be understood from a complexity perspective. The article concludes that the complexity framework is ideally suited for the field of public health and, in particular, the DTCA-PD debate. Having successfully shifted the policy-focus of the debate to patients' rights and health information, opponents of the legislation are likely to face their next battle in the realm of cyberspace, where regulatory issues change the nature of advertising. © 2012 Blackwell Publishing Ltd.

  4. Indoor and Outdoor Air Pollution- related Health Problem in Ethiopia ...

    African Journals Online (AJOL)

    Background: The health effects of air pollution are generally global problems, but they have, since recently become issues of particular concern for developing countries. This review assessed the situation of air pollution and related health effects in the context of Ethiopia. Methods: The materials reviewed in this publication ...

  5. Ethical problems experienced by nurses in primary health care: integrative literature review

    Directory of Open Access Journals (Sweden)

    Carlise Rigon Dalla Nora

    Full Text Available The aim of this study is to identify ethical problems experienced by nurses in primary health care and resources for coping based on publications on the subject. An integrative literature review was performed between the months of October and November 2013, using the databases: BDTD, CINAHL, LILACS, MEDLINE, Biblioteca Cochrane, PubMed, RCAAP and SciELO. Articles, dissertations and theses published in Portuguese, English and Spanish were included, totalling 31 studies published from 1992 to 2013. This analysis resulted in four categories: ethical problems in the relationship between team members, ethical problems in the relationship with the user, ethical problems in health services management and resources for coping with ethical problems. Results showed that nurses need to be prepared to face ethical problems, emphasizing the importance of ethics education during the education process before and during professional practice to enhance the development of ethical sensitivity and competence for problem resolution.

  6. A Life Course Model of Self-Reported Violence Exposure and Ill-health with A Public Health Problem Perspective.

    Science.gov (United States)

    Olofsson, Niclas

    2014-01-01

    Violence has probably always been part of the human experience. Its impact can be seen, in various forms, in all parts of the world. In 1996, WHO:s Forty-Ninth World Health Assembly adopted a resolution, declaring violence a major and growing public health problem around the world. Public health work centers around health promotion and disease prevention activities in the population and public health is an expression of the health status of the population taking into account both the level and the distribution of health. Exposure to violence can have many aspects, differing throughout the life course - deprivation of autonomy, financial exploitation, psychological and physical neglect or abuse - but all types share common characteristics: the use of destructive force to control others by depriving them of safety, freedom, health and, in too many instances, life; the epidemic proportions of the problem, particularly among vulnerable groups; a devastating impact on individuals, families, neighborhoods, communities, and society. There is considerable evidence that stressful early life events influence a variety of physical and/or psychological health problems later in life. Childhood adversity has been linked to elevated rates of morbidity and mortality from number of chronic diseases. A model outlining potential biobehavioural pathways is put forward that may be a potential explanation of how exposure to violence among both men and women work as an important risk factor for ill health and should receive greater attention in public health work.

  7. Problem gambling and substance use in patients attending community mental health services.

    Science.gov (United States)

    Manning, Victoria; Dowling, Nicki A; Lee, Stuart; Rodda, Simone; Garfield, Joshua Benjamin Bernard; Volberg, Rachel; Kulkarni, Jayashri; Lubman, Dan Ian

    2017-12-01

    Background and aims Relatively little is known about co-occurring gambling problems and their overlap with other addictive behaviors among individuals attending mental health services. We aimed to determine rates of gambling and substance use problems in patients accessing mental health services in Victoria, Australia. Methods A total of 837 adult patients were surveyed about their gambling and administered standardized screening tools for problem gambling and harmful tobacco, alcohol, and drug use. Prevalence of gambling problems was estimated and regression models used to determine predictors of problem gambling. Results The gambling participation rate was 41.6% [95% CI = 38.2-44.9]. The Problem Gambling Severity Index identified 19.7% [CI = 17.0-22.4] as "non-problem gamblers," 7.2% [CI = 5.4-8.9] as "low-risk" gamblers, 8.4% [CI = 6.5-10.2] as "moderate-risk" gamblers, and 6.3% [CI = 4.7-8.0] as "problem gamblers." One-fifth (21.9%) of the sample and 52.6% of all gamblers were identified as either low-risk, moderate-risk, or problem gamblers (PGs). Patients classified as problem and moderate-risk gamblers had significantly elevated rates of nicotine and illicit drug dependence (p gambling. Discussion and conclusions Patients were less likely to gamble, but eight times as likely to be classified as PG, relative to Victoria's adult general population. Elevated rates of harmful substance use among moderate-risk and PG suggest overlapping vulnerability to addictive behaviors. These findings suggest mental health services should embed routine screening into clinical practice, and train clinicians in the management of problem gambling.

  8. [Health problems of working-age population in the Russian Federation].

    Science.gov (United States)

    Izmerov, N F; Tikhonova, G I

    2010-01-01

    The paper deals with health problems of working-age population in the Russian Federation. According to foreign and domestic experts reduction of the able-bodied population and its fraction in the general population will be accompanied by ageing of labour force in the nearest two decades. Despite the growth of life expectancy in 2006-2007 demonstrated by disability, mortality and life expectancy indices for the age group of interest, its health status is considered to be critical. Mathematical simulation of mortality rates allowed for the assessment of potential years of life lost (PYLL) from leading causes of death among active working population. The data obtained provide a basis for the elaboration of medical and social programs aimed at increasing life expectancy. The most essential role in current negative tendencies in the health of active working population belongs to the deterioration of work conditions and safety at industrial enterprises coupled to low efficiency of occupational health prevention system accounting for the significantly reduced accessibility of health services. Restoration of occupational health system in Russia is of crucial importance. Experts of the Institute of Occupational Health have elaborated a draft National Action Plan designed to improve health protection of labour force in this country; its implementation would help to solve demographic problems and increase the amount and quality of labour force.

  9. The Development of Complex Problem Solving in Adolescence: A Latent Growth Curve Analysis

    Science.gov (United States)

    Frischkorn, Gidon T.; Greiff, Samuel; Wüstenberg, Sascha

    2014-01-01

    Complex problem solving (CPS) as a cross-curricular competence has recently attracted more attention in educational psychology as indicated by its implementation in international educational large-scale assessments such as the Programme for International Student Assessment. However, research on the development of CPS is scarce, and the few…

  10. Understanding the acceptability of e-mental health--attitudes and expectations towards computerised self-help treatments for mental health problems.

    Science.gov (United States)

    Musiat, Peter; Goldstone, Philip; Tarrier, Nicholas

    2014-04-11

    E-mental health and m-mental health include the use of technology in the prevention, treatment and aftercare of mental health problems. With the economical pressure on mental health services increasing, e-mental health and m-mental health could bridge treatment gaps, reduce waiting times for patients and deliver interventions at lower costs. However, despite the existence of numerous effective interventions, the transition of computerised interventions into care is slow. The aim of the present study was to investigate the acceptability of e-mental health and m-mental health in the general population. An advisory group of service users identified dimensions that potentially influence an individual's decision to engage with a particular treatment for mental health problems. A large sample (N = 490) recruited through email, flyers and social media was asked to rate the acceptability of different treatment options for mental health problems on these domains. Results were analysed using repeated measures MANOVA. Participants rated the perceived helpfulness of an intervention, the ability to motivate users, intervention credibility, and immediate access without waiting time as most important dimensions with regard to engaging with a treatment for mental health problems. Participants expected face-to-face therapy to meet their needs on most of these dimensions. Computerised treatments and smartphone applications for mental health were reported to not meet participants' expectations on most domains. However, these interventions scored higher than face-to-face treatments on domains associated with the convenience of access. Overall, participants reported a very low likelihood of using computerised treatments for mental health in the future. Individuals in this study expressed negative views about computerised self-help intervention and low likelihood of use in the future. To improve the implementation and uptake, policy makers need to improve the public perception of such

  11. Factors influencing the type of health problems presented by women in general practice: differences between women's health care and regular health care.

    NARCIS (Netherlands)

    Brink-Muinen, A. van den; Bensing, J.M.

    1996-01-01

    Objective: Differences between health problems presented by women (aged 20-45) to female "women's health care" doctors and both female and male regular health care doctors were investigated. This article explores the relationship of patients' roles (worker, partner, or parent) and the type of health

  12. The spectrosome of occupational health problems

    Science.gov (United States)

    de Gaudemaris, Régis; Bicout, Dominique J.

    2018-01-01

    Given the increased prevalence of cancer, respiratory diseases, and reproductive disorders, for which multifactorial origins are strongly suspected, the impact of the environment on the population represents a substantial public health challenge. Surveillance systems have become an essential public health decision-making tool. Networks have been constructed to facilitate the development of analyses of the multifactorial aspects of the relationships between occupational contexts and health. The aim of this study is to develop and present an approach for the optimal exploitation of observational databases to describe and improve the understanding of the (occupational) environment–health relationships, taking into account key multifactorial aspects. We have developed a spectral analysis (SA) approach that takes into account both the multi-exposure and dynamic natures of occupational health problems (OHPs) and related associations. The main results of this paper are to present the construction method of the “spectrum” and “spectrosome” of OHPs (range and structured list of occupational exposures) and describe the information contained therein with an illustrative example. The approach is illustrated using the case of non-Hodgkin lymphoma (NHL) from the French National Occupational Diseases Surveillance and Prevention Network database as a working example of an occupational disease. We found that the NHL spectrum includes 40 sets of occupational exposures characterized by important multi-exposures, especially solvent combinations or pesticide combinations, but also specific exposures such as polycyclic aromatic hydrocarbons, formaldehyde and ionizing radiation. These findings may be useful for surveillance and the assessment of occupational exposure related to health risks. PMID:29304043

  13. Mental Health Problems and Educational Attainment in Adolescence: 9-Year Follow-Up of the TRAILS Study

    Science.gov (United States)

    Veldman, Karin; Bültmann, Ute; Stewart, Roy E.; Ormel, Johan; Verhulst, Frank C.; Reijneveld, Sijmen A.

    2014-01-01

    Background This study examines if mental health problems at age 11 and changes in mental health problems between age 11 and 16 predict educational attainment of adolescents at age 19, overall and stratified by gender. Methods Data from 1711 adolescents (76.8% from initial cohort) of the Tracking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 9year follow-up, were used. Mental health problems (externalizing, internalizing and attention problems) were measured by the Youth Self Report and the Child Behavior Checklist at ages 11 and 16. Difference scores for mental health problems between age 11 and 16 were calculated. Educational attainment was assessed at age 19. Results Externalizing, internalizing and attention problems at age 11 were significantly associated with low educational attainment at age 19 (crude model). When adjusted for demographic variables and the other mental health problems, only the association for attention problems remained significant (odds ratio (OR), 95% confidence interval: 3.19, 2.11–4.83). Increasing externalizing problems between age 11 and 16 also predicted low educational attainment at age 19 (OR 3.12, 1.83–5.32). Among girls, increasing internalizing problems between age 11 and 16 predicted low educational attainment (OR 2.21, 1.25–3.94). For boys, no significant association was found for increasing internalizing problems and low educational attainment. For increasing attention problems between age 11 and 16 no significant association with low educational attainment was found. Conclusions Externalizing, internalizing and attention problems at age 11 and an increase of these problems during adolescence predicted low educational attainment at age 19. Early treatment of these mental health problems may improve educational attainment, and reduce socioeconomic health differences in adulthood. PMID:25047692

  14. A Problem Assisted Course Delivery for Occupational Health Students' Improved Learning: An Experience of Using Problems and Real Cases

    Directory of Open Access Journals (Sweden)

    Seyedeh Negar Assadi

    2016-05-01

    Full Text Available Background and Purpose: Problem based medical education had been useful in education of medical sciences students. The objective is the determination of effects of problem based medical education on occupational health students' learning.Methods: This study was a semi-experimental study. By using the curriculum of Ministry of Health, occupational toxicology course had been taught based on a problem based plan for group A, then students' grades or data had been analyzed by SPSS 16, mean, standard deviation, t-test with P<0.05.Results: The total grade of occupational toxicology in group A (with problem based medical education was 18.03±1.84 and in group B (regular education, it was 17.60±1.72 with t=0.852 and P=0.398 had not significant differences. The specific lessons such as cadmium and allergic disorders were promoted and its mean grades were more in group A than B.Conclusions: Problem based medical education was helpful in learning of some chapters of occupational toxicology.Keywords: PROBLEM BASED MEDICAL EDUCATION, OCCUPATIONAL TOXICOLOGY, MEDICAL SCIENCES EDUCATION, OCCUPATIONAL HEALT

  15. Risk factors in equine transport-related health problems: A survey of the Australian equine industry.

    Science.gov (United States)

    Padalino, B; Raidal, S L; Hall, E; Knight, P; Celi, P; Jeffcott, L; Muscatello, G

    2017-07-01

    Transportation can affect equine health and is a potential source of economic loss to the industry. To identify journey (duration, vehicle, commercial or noncommercial) and horse (sex, age, breed, use, amateur or professional status) characteristics associated with the development of transport-related health problems in horses. Cross-sectional online survey. An online survey was conducted targeting amateur and professional participants in the Australian equine industry; eligible respondents were required to organise horse movements at least monthly. Respondents provided details of the last case of a transport-related health problem that had affected their horse(s). Associations between type of health problem, journey and horse characteristics were examined with multivariable multinomial regression analysis. Based on 214 responses, health problems were classified as injuries, muscular problems, heat stroke, gastrointestinal and respiratory problems, and death or euthanasia. Respiratory problems were reported most frequently (33.7%), followed by gastrointestinal problems (23.8%) and traumatic injuries (16.3%). The type of health problem was associated with journey duration (Pproblems, and death or euthanasia) were more likely to occur on long journeys. Using Standardbreds as the reference group, Thoroughbreds, Arabians and Warmbloods were more likely to experience a severe illness than an injury. Self-selected participation in the study and the self-reported nature of transport-related problems. Horses undertaking journeys of longer than 24 h are at greater risk for the development of severe disease or death. Further studies on long-haul transportation effects are required to safeguard the welfare of horses moved over long distances. © 2016 EVJ Ltd.

  16. Living with Stigma: Depressed Elderly Persons’ Experiences of Physical Health Problems

    Directory of Open Access Journals (Sweden)

    Anne Lise Holm

    2014-01-01

    Full Text Available The aim of this paper is to deepen the understanding of depressed elderly persons’ lived experiences of physical health problems. Individual in-depth interviews were conducted with 15 depressed elderly persons who suffer from physical health problems. A hermeneutic analysis was performed, yielding one main theme, living with stigma, and three themes: longing to be taken seriously, being uncertain about whether the pain is physical or mental, and a sense of living in a war zone. The second theme comprised two subthemes, feeling like a stranger and feeling dizzy, while the third had one subtheme: afraid of being helpless and dependent on others. Stigma deprives individuals of their dignity and reinforces destructive patterns of isolation and hopelessness. Nurses should provide information in a sensitive way and try to avoid diagnostic overshadowing. Effective training programmes and procedures need to be developed with more focus on how to handle depressive ill health and physical problems in older people.

  17. Childhood constipation as an emerging public health problem

    NARCIS (Netherlands)

    Rajindrajith, Shaman; Devanarayana, Niranga Manjuri; Crispus Perera, Bonaventure Jayasiri; Benninga, Marc Alexander

    2016-01-01

    Functional constipation (FC) is a significant health problem in children and contrary to common belief, has serious ramifications on the lives of children and their families. It is defined by the Rome criteria which encourage the use of multiple clinical features for diagnosis. FC in children has a

  18. Abortion: A significant problem of public health and a determinant of biological reproduction

    OpenAIRE

    Todorović Miodrag; Radovanović Olica

    2006-01-01

    Artificial abortion is a very important social-medical, economic and demographic problem. It is not only a problem of public health (disease disability, sterility) and social economy (to lose income and compensation because of absenteeism, increase of expense in health care sector for the treatment of direct, early and late consequences and sterility). It is a very important demographic problem because of the increase in "unrealized fertilities" and lost of descendents. According to the regis...

  19. Associations between physical and mental health problems and sexual dysfunctions in sexually active Danes

    DEFF Research Database (Denmark)

    Christensen, Birgitte Schütt; Grønbaek, Morten; Osler, Merete

    2011-01-01

    Studies have shown a high prevalence of sexual dysfunctions among individuals with a variety of health problems.......Studies have shown a high prevalence of sexual dysfunctions among individuals with a variety of health problems....

  20. Nanotechnology for sustainability: what does nanotechnology offer to address complex sustainability problems?

    Energy Technology Data Exchange (ETDEWEB)

    Wiek, Arnim, E-mail: arnim.wiek@asu.edu; Foley, Rider W. [Arizona State University, School of Sustainability (United States); Guston, David H. [Arizona State University, Center for Nanotechnology in Society, Consortium for Science, Policy and Outcomes (United States)

    2012-09-15

    Nanotechnology is widely associated with the promise of positively contributing to sustainability. However, this view often focuses on end-of-pipe applications, for instance, for water purification or energy efficiency, and relies on a narrow concept of sustainability. Approaching sustainability problems and solution options from a comprehensive and systemic perspective instead may yield quite different conclusions about the contribution of nanotechnology to sustainability. This study conceptualizes sustainability problems as complex constellations with several potential intervention points and amenable to different solution options. The study presents results from interdisciplinary workshops and literature reviews that appraise the contribution of the selected nanotechnologies to mitigate such problems. The study focuses exemplarily on the urban context to make the appraisals tangible and relevant. The solution potential of nanotechnology is explored not only for well-known urban sustainability problems such as water contamination and energy use but also for less obvious ones such as childhood obesity. Results indicate not only potentials but also limitations of nanotechnology's contribution to sustainability and can inform anticipatory governance of nanotechnology in general, and in the urban context in particular.

  1. Nanotechnology for sustainability: what does nanotechnology offer to address complex sustainability problems?

    International Nuclear Information System (INIS)

    Wiek, Arnim; Foley, Rider W.; Guston, David H.

    2012-01-01

    Nanotechnology is widely associated with the promise of positively contributing to sustainability. However, this view often focuses on end-of-pipe applications, for instance, for water purification or energy efficiency, and relies on a narrow concept of sustainability. Approaching sustainability problems and solution options from a comprehensive and systemic perspective instead may yield quite different conclusions about the contribution of nanotechnology to sustainability. This study conceptualizes sustainability problems as complex constellations with several potential intervention points and amenable to different solution options. The study presents results from interdisciplinary workshops and literature reviews that appraise the contribution of the selected nanotechnologies to mitigate such problems. The study focuses exemplarily on the urban context to make the appraisals tangible and relevant. The solution potential of nanotechnology is explored not only for well-known urban sustainability problems such as water contamination and energy use but also for less obvious ones such as childhood obesity. Results indicate not only potentials but also limitations of nanotechnology’s contribution to sustainability and can inform anticipatory governance of nanotechnology in general, and in the urban context in particular.

  2. Educational Level, Underachievement, and General Mental Health Problems in 10,866 Adolescents.

    Science.gov (United States)

    Tempelaar, Wanda M; de Vos, Nelleke; Plevier, Carolien M; van Gastel, Willemijn A; Termorshuizen, Fabian; MacCabe, James H; Boks, Marco P M

    2017-08-01

    Previous research suggests that cognitive functioning is associated with the risk of several adult psychiatric disorders. In this study we investigated whether adolescents who perform worse than expected at secondary school are at a higher risk for general mental health problems. In a cross-sectional survey comprising 10,866 Dutch adolescents aged 13 to 16 years, underachievement at secondary school was defined as the discrepancy between predicted school grade and actual grade 1 or 3 years later. Mental health problems were assessed using the Strengths and Difficulties Questionnaire. We investigated the association of underachievement with mental health problems using logistic regression, adjusting for potential confounders. Underachievement was associated with general psychopathology in pupils aged 13 to 14 years (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.47-2.37) and in pupils aged 15 to 16 years (OR, 2.05; 95% CI, 1.67-2.52) in a multivariate analysis including sociodemographic factors. The association between underachievement and mental health problems was attenuated when school factors such as teacher advice and interaction between underachievement and teacher advice were added, but underachievement remained significantly associated with mental health problems in adolescents in the higher educational tracks (pupils aged 13-14 years: OR, 2.22; 95% CI, 1.07-4.60 and OR, 2.41; 95% CI, 1.10-5.30, age 15-16 years: OR, 2.63; 95% CI, 1.38-5.03). In the multivariate analysis including the interaction between underachievement and teacher advice, a significant interaction effect occurs between underachievement and teacher advice in the higher tracks. Values of OR and CI are given for each significant interaction term. In the younger age group (pupils aged 13-14 years) this results in 2 sets of OR and CI. This association was most pronounced for the hyperactivity subscale of the Strengths and Difficulties Questionnaire. Underachievement at secondary school

  3. Measuring production loss due to health and work environment problems: construct validity and implications.

    Science.gov (United States)

    Karlsson, Malin Lohela; Bergström, Gunnar; Björklund, Christina; Hagberg, Jan; Jensen, Irene

    2013-12-01

    The aim was to validate two measures of production loss, health-related and work environment-related production loss, concerning their associations with health status and work environment factors. Validity was assessed by evaluating the construct validity. Health problems related and work environment-related problems (or factors) were included in separate analyses and evaluated regarding the significant difference in proportion of explained variation (R) of production loss. health problems production loss was not found to fulfill the criteria for convergent validity in this study; however, the measure of work environment-related production loss did fulfill the criteria that were set up. The measure of work environment-related production loss can be used to screen for production loss due to work environment problems as well as an outcome measure when evaluating the effect of organizational interventions.

  4. Communication in production animal medicine: modelling a complex interaction with the example of dairy herd health medicine

    Directory of Open Access Journals (Sweden)

    Kleen Joachim L

    2011-07-01

    Full Text Available Abstract Background The importance of communication skills in veterinary medicine is increasingly recognised. Appropriate communication skills towards the client are of utmost importance in both companion animal practice and production animal field and consultancy work. The need for building a relationship with the client, alongside developing a structure for the consultation is widely recognised and applies to both types of veterinary practice. Results Veterinary advisory practice in production animal medicine is, however, characterised by a more complex communication on different levels. While the person-orientated communication is a permanent process between veterinarian and client with a rather personal perspective and defines the roles of interaction, the problem-orientated communication deals with emerging difficulties; the objective is to solve an acute health problem. The solution - orientated communication is a form of communication in which both veterinarian and client address longstanding situations or problems with the objective to improve herd health and subsequently productivity performance. All three forms of communication overlap. Conclusions Based on this model, it appears useful for a veterinary practice to offer both a curative and an advisory service, but to keep these two separated when deemed appropriate. In veterinary education, the strategies and techniques necessary for solution orientated communication should be included in the teaching of communication skills.

  5. Communication in production animal medicine: modelling a complex interaction with the example of dairy herd health medicine.

    Science.gov (United States)

    Kleen, Joachim L; Atkinson, Owen; Noordhuizen, Jos Ptm

    2011-07-20

    The importance of communication skills in veterinary medicine is increasingly recognised. Appropriate communication skills towards the client are of utmost importance in both companion animal practice and production animal field and consultancy work. The need for building a relationship with the client, alongside developing a structure for the consultation is widely recognised and applies to both types of veterinary practice. Veterinary advisory practice in production animal medicine is, however, characterised by a more complex communication on different levels. While the person-orientated communication is a permanent process between veterinarian and client with a rather personal perspective and defines the roles of interaction, the problem-orientated communication deals with emerging difficulties; the objective is to solve an acute health problem. The solution - orientated communication is a form of communication in which both veterinarian and client address longstanding situations or problems with the objective to improve herd health and subsequently productivity performance. All three forms of communication overlap. Based on this model, it appears useful for a veterinary practice to offer both a curative and an advisory service, but to keep these two separated when deemed appropriate. In veterinary education, the strategies and techniques necessary for solution orientated communication should be included in the teaching of communication skills.

  6. Mental Health Services Use Predicted by Number of Mental Health Problems and Gender in a Total Population Study

    Directory of Open Access Journals (Sweden)

    Maj-Britt Posserud

    2013-01-01

    Full Text Available We examined the relationship between service use and the number of problem areas as reported by parents and teachers on questionnaires among children aged 7–9 years old in the Bergen Child Study, a total population study including more than 9000 children. A problem area was counted as present if the child scored above the 95th percentile on parent and/or teacher questionnaire. A total number of 13 problem areas were included. Odd ratios (ORs for contact with child and adolescent mental health services (CAMH, school psychology services (SPS, health visiting nurse/physician, and school support were calculated with gender as covariate. The number of symptom areas was highly predictive of service use, showing a dose-response relationship for all services. Children scoring on ≥4 problem areas had a more than hundredfold risk of being in contact with CAMH services compared to children without problems. The mean number of problem areas for children in CAMH and SPS was 6.1 and 4.4 respectively, strongly supporting the ESSENCE model predicting multisymptomatology in children in specialized services. Even after controlling for number of problem areas, boys were twice as likely as girls to be in contact with CAMH, replicating previous findings of female gender being a strong barrier to mental health services.

  7. The Role of Supplemental Complex Dietary Carbohydrates and Gut Microbiota in Promoting Cardiometabolic and Immunological Health in Obesity: Lessons from Healthy Non-Obese Individuals

    Directory of Open Access Journals (Sweden)

    Petra C. Vinke

    2017-07-01

    Full Text Available Dietary supplementation with complex carbohydrates is known to alter the composition of gut microbiota, and optimal implementation of the use of these so called “prebiotics” could be of great potential in prevention and possibly treatment of obesity and associated cardiometabolic and inflammatory diseases via changes in the gut microbiota. An alternative to this “microbiocentric view” is the idea that health-promoting effects of certain complex carbohydrates reside in the host, and could secondarily affect the diversity and abundance of gut microbiota. To circumvent this potential interpretational problem, we aimed at providing an overview about whether and how dietary supplementation of different complex carbohydrates changes the gut microbiome in healthy non-obese individuals. We then reviewed whether the reported changes in gut bacterial members found to be established by complex carbohydrates would benefit or harm the cardiometabolic and immunological health of the host taking into account the alterations in the microbiome composition and abundance known to be associated with obesity and its associated disorders. By combining these research areas, we aimed to give a better insight into the potential of (foods containing complex carbohydrates in the treatment and prevention of above-mentioned diseases. We conclude that supplemental complex carbohydrates that increase Bifidobacteria and Lactobacilli, without increasing the deleterious Bacteroides, are most likely promoting cardiometabolic and immunological health in obese subjects. Because certain complex carbohydrates also affect the host’s immunity directly, it is likely that host–microbiome interactions in determination of health and disease characteristics are indeed bidirectional. Overall, this review article shows that whereas it is relatively clear in which direction supplemental fermentable carbohydrates can alter the gut microbiome, the relevance of these changes regarding

  8. Gestational age and chronic 'body-mind' health problems in childhood: dose-response association and risk factors.

    Science.gov (United States)

    Cronin, Frances M; Segurado, Ricardo; McAuliffe, Fionnuala M; Kelleher, Cecily C; Tremblay, Richard E

    2017-01-01

    Understanding the developmental course of all health issues associated with preterm birth is important from an individual, clinical and public health point-of-view. Both the number of preterm births and proportion of survivors have increased steadily in recent years. The UK Millennium Cohort Study (n = 18,818) was used to examine the association of gestational age with maternal ratings of general health and behavior problems at ages 5 and 11 years using binary and multinomial logistic regression analyses. The association between mothers' ratings of general health and behavior problems was relatively weak at each time point. Children rated as being in poor general health remained constant over time (4.0 % at age 5, 3.8 % at age 11), but children rated as having behavioral problems increased by almost 100 % (5.6 % at 5; 10.5 % at 11). A gradient of increasing risk with decreasing gestational age was observed for a composite health measure (general health problems and/or behavior problems) at age 5, amplified at age 11 and was strongest for those with chronic problems (poor health at both age 5 and age 11). This association was found to be compounded by child sex, maternal characteristics at birth (education, employment, marital status) and duration of breast feeding. Integrated support to at-risk families initiated during, or soon after pregnancy, may prevent chronic problems and might potentially reduce long term health costs for both the individual and health services.

  9. Perceived health problems in swimmers according to the chemical treatment of water in swimming pools.

    Science.gov (United States)

    Fernández-Luna, Álvaro; Burillo, Pablo; Felipe, José Luis; del Corral, Julio; García-Unanue, Jorge; Gallardo, Leonor

    2016-01-01

    The objective of this study was to determine which chemical treatment used for disinfecting water in indoor swimming pools had the least impact on users' perceptions of health problems, and which generated the greatest satisfaction with the quality of the water. A survey on satisfaction and perceived health problems was given to 1001 users at 20 indoor swimming pools which used different water treatment methods [chlorine, bromine, ozone, ultraviolet lamps (UV) and salt electrolysis]. The findings suggest that there is a greater probability of perceived health problems, such as eye and skin irritation, respiratory problems and skin dryness, in swimming pools treated with chlorine than in swimming pools using other chemical treatment methods. Pools treated with bromine have similar, although slightly better, results. Other factors, such as age, gender, time of day of use (morning and afternoon) and type of user (competitive and recreational), can also affect the probability of suffering health problems. For all of the above, using combined treatment methods as ozone and UV, or salt electrolysis produces a lower probability of perceived health problems and greater satisfaction.

  10. Complex analysis and dynamical systems new trends and open problems

    CERN Document Server

    Golberg, Anatoly; Jacobzon, Fiana; Shoikhet, David; Zalcman, Lawrence

    2018-01-01

    This book focuses on developments in complex dynamical systems and geometric function theory over the past decade, showing strong links with other areas of mathematics and the natural sciences. Traditional methods and approaches surface in physics and in the life and engineering sciences with increasing frequency – the Schramm‐Loewner evolution, Laplacian growth, and quadratic differentials are just a few typical examples. This book provides a representative overview of these processes and collects open problems in the various areas, while at the same time showing where and how each particular topic evolves. This volume is dedicated to the memory of Alexander Vasiliev.

  11. Psychological Health Problems Among Adolescent Workers and Associated Factors in Istanbul, Turkey

    Directory of Open Access Journals (Sweden)

    Ozlem Koseoglu Ornek

    2018-03-01

    Full Text Available Background: Work and work environment have a critical influence on adolescent workers' health. They are subjected to more risks than adults. The aim of this study is to examine psychological health outcomes in adolescent workers in the areas of depression, somatization, anxiety, hostility, and negative self-concept, and to investigate any related factors. Methods: This is a descriptive and cross-sectional study. Research samples were collected from adolescent workers between 15 and 18 years old attending a 1-day mandatory education course at vocational training centers, working 5 days per week in small enterprises. Data were collected using the following instruments: Brief Symptom Inventory, Multidimensional Scale of Perceived Social Support, and Descriptive Characteristics of Children's Assessment Form. Results: The investigation covers 837 young workers, of whom 675 were males and 162 were females. The majority of the families had low incomes (68.1%. Overall, 33.5% of the adolescents had been hospitalized because of health problems. Their average weekly working hours were 78.1 ± 10.7. Almost 50% of adolescent workers scored above the mean average in the Brief Symptom Inventory, indicating serious pschological health symptoms.Those who scored high for hostility, depression, negative self-concept, anxiety, and somatization were between 45.4% and 48.9% of the sample. Logistic regression analysis was conducted to determine the underlying factors: a perception of “feeling very bad” health conditions was 2.07-fold whereas the rate of “no annual leave” was 0.73-fold, and both were found to be effective on psychological problems. Conclusion: In this study, it seems likely that psychological health problems are the result of multiple adverse factors including working conditions, annual leave, and health considerations. Keywords: adolescent workers, child Workers, occupational health, psychological problems, social support

  12. Factors Influencing the Prevalence of Mental Health Problems among Malay Elderly Residing in a Rural Community: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    M Rizal Abdul Manaf

    Full Text Available Mental health problems are common in old age, but frequently remain undetected and untreated. Mental health problems in the elderly are the result of a complex interaction of social, psychological and biological factors. The aim of this study is to determine the prevalence of mental health problems (depression, anxiety, and emotional stress and their associated factors among the Malay elderly in a rural community of Perak, Malaysia.It was a cross-sectional study. The Malay elderly aged 60 years and above were selected through convenient sampling to give a total of 230 respondents. The Depression, Anxiety, and Stress Scale (DASS-21 was used to assess the symptoms of depression, anxiety, and stress. Bivariate analyses were performed using chi-square tests and multiple logistic regression analyses were conducted to determine the association between the factors and each of the mental health statuses assessed.The results showed that the prevalence of depression, anxiety, and stress among the elderly respondents was 27.8%, 22.6%, and 8.7%, respectively. The significant factors for depression were single elderly (Adjusted OR = 3.27, 95%CI 1.66, 6.44, living with family (Adjusted OR = 4.98, 95%CI 2.05, 12.10, and poor general health status (Adjusted OR = 2.28, 95%CI 1.20, 4.36. Living with family was the only significant factor for anxiety (Adjusted OR = 2.68, 95%CI 1.09, 6.57. There was no significant factor for stress.Depression and anxiety among the Malay elderly in the rural community were very worrying. More equity in health should be created or strengthened in order to intensify the opportunity to identify, diagnose, and treat those with mental health problems. Living arrangement in the rural community was an important factor that had influenced depression and anxiety. Therefore, further research is recommended for more comprehensive information, as a result of which appropriate intervention can be made.

  13. Factors Influencing the Prevalence of Mental Health Problems among Malay Elderly Residing in a Rural Community: A Cross-Sectional Study.

    Science.gov (United States)

    Abdul Manaf, M Rizal; Mustafa, Madihah; Abdul Rahman, Mohd Rizam; Yusof, Khairul Hazdi; Abd Aziz, Noor Azah

    2016-01-01

    Mental health problems are common in old age, but frequently remain undetected and untreated. Mental health problems in the elderly are the result of a complex interaction of social, psychological and biological factors. The aim of this study is to determine the prevalence of mental health problems (depression, anxiety, and emotional stress) and their associated factors among the Malay elderly in a rural community of Perak, Malaysia. It was a cross-sectional study. The Malay elderly aged 60 years and above were selected through convenient sampling to give a total of 230 respondents. The Depression, Anxiety, and Stress Scale (DASS-21) was used to assess the symptoms of depression, anxiety, and stress. Bivariate analyses were performed using chi-square tests and multiple logistic regression analyses were conducted to determine the association between the factors and each of the mental health statuses assessed. The results showed that the prevalence of depression, anxiety, and stress among the elderly respondents was 27.8%, 22.6%, and 8.7%, respectively. The significant factors for depression were single elderly (Adjusted OR = 3.27, 95%CI 1.66, 6.44), living with family (Adjusted OR = 4.98, 95%CI 2.05, 12.10), and poor general health status (Adjusted OR = 2.28, 95%CI 1.20, 4.36). Living with family was the only significant factor for anxiety (Adjusted OR = 2.68, 95%CI 1.09, 6.57). There was no significant factor for stress. Depression and anxiety among the Malay elderly in the rural community were very worrying. More equity in health should be created or strengthened in order to intensify the opportunity to identify, diagnose, and treat those with mental health problems. Living arrangement in the rural community was an important factor that had influenced depression and anxiety. Therefore, further research is recommended for more comprehensive information, as a result of which appropriate intervention can be made.

  14. Mental health problems among conflict-affected adults in Grozny, Chechnya: a qualitative study.

    Science.gov (United States)

    Nguyen, Amanda J; Feo, Concetta; Idrisov, Kyuri; Pintaldi, Giovanni; Lenglet, Annick; Tsatsaeva, Zalina; Bolton, Paul; Bass, Judith

    2016-01-01

    A decade of conflict in Chechnya destroyed infrastructure and resulted in widespread exposure to violence. Amidst substantial reconstruction, periodic violence has contributed to an ongoing atmosphere of insecurity. We conducted a qualitative study to understand the mental health and psychosocial problems affecting adult Chechens in this context to inform development of assessment tools for an evaluation study related to individual counseling. Data were collected in July 2014. A convenience sample of 59 Chechen adults was asked to Free List all problems affecting people in the area. Four problems were explored further in 19 Key Interviewee (KI) interviews, with respondents identified using snowball sampling. Data analysis was conducted in Russian by the Chechen interviewers. Multiple mental health and psychosocial problems emerged, including 'bad psychological health', 'depression', 'stress and nervous people', and 'problems in the family'. Aggression, 'emotional blowing', and 'not adequate' behavior were frequently reported indicators of these problems, with negative effects on the whole family. Chechens reported seeking help through informal social networks, psychiatric and psychological services, and Islamic Centers. Chechens reported mental health and psychosocial problems similar to those experienced in other post-conflict settings. The description of 'emotional blowing' mirrored prior findings in Chechen asylum seekers and fits within a cluster of cultural concepts of distress featuring anger that has been identified in other conflict-affected populations. Further exploration of the nature and prevalence of this construct, as well as evaluations of interventions aimed at reducing these symptoms, is warranted.

  15. "What constitutes a 'problem'?" Producing 'alcohol problems' through online counselling encounters.

    Science.gov (United States)

    Savic, Michael; Ferguson, Nyssa; Manning, Victoria; Bathish, Ramez; Lubman, Dan I

    2017-08-01

    Typically, health policy, practice and research views alcohol and other drug (AOD) 'problems' as objective things waiting to be detected, diagnosed and treated. However, this approach to policy development and treatment downplays the role of clinical practices, tools, discourses, and systems in shaping how AOD use is constituted as a 'problem'. For instance, people might present to AOD treatment with multiple psycho-social concerns, but usually only a singular AOD-associated 'problem' is considered serviceable. As the assumed nature of 'the serviceable problem' influences what treatment responses people receive, and how they may come to be enacted as 'addicted' or 'normal' subjects, it is important to subject clinical practices of problem formulation to critical analysis. Given that the reach of AOD treatment has expanded via the online medium, in this article we examine how 'problems' are produced in online alcohol counselling encounters involving people aged 55 and over. Drawing on poststructural approaches to problematisation, we not only trace how and what 'problems' are produced, but also what effects these give rise to. We discuss three approaches to problem formulation: (1) Addiction discourses at work; (2) Moving between concerns and alcohol 'problems'; (3) Making 'problems' complex and multiple. On the basis of this analysis, we argue that online AOD counselling does not just respond to pre-existing 'AOD problems'. Rather, through the social and clinical practices of formulation at work in clinical encounters, online counselling also produces them. Thus, given a different set of circumstances, practices and relations, 'problems' might be defined or emerge differently-perhaps not as 'problems' at all or perhaps as different kinds of concerns. We conclude by highlighting the need for a critical reflexivity in AOD treatment and policy in order to open up possibilities for different ways of engaging with, and responding to, people's needs in their complexity

  16. New public management in Iran's health complex: a management framework for primary health care system.

    Science.gov (United States)

    Tabrizi, Jafar Sadegh; HaghGoshayie, Elaheh; Doshmangir, Leila; Yousefi, Mahmood

    2018-05-01

    New public management (NPM) was developed as a management reform to improve the efficiency and effectiveness in public organizations, especially in health sector. Using the features of private sector management, the managers of health organizations may try to implement the elements of NPM with the hope to improve the performance of their systems.AimsOur aim in the present study was to identify the elements and infrastructures suitable for implementing NPM in the Iranian health complex. In this qualitative study with conventional content analysis approach, we tried to explore the NPM elements and infrastructures in Iranian public health sector. A series of semi-structured interviews (n=48) were conducted in 2016 with a managers in public and private health complex. Three focus group discussions with nine faculty members were also conducted. A data collection form was used to collect the demographic characteristics and perspectives of the participants.FindingsFrom the perspective of managers, managerialism, decentralization, using market mechanism, performance management, customer orientation and performance budgeting were the main elements of NPM in the Iranian context. The most important infrastructures for implementing this reform were as follows: education and training, information technology, the proper use of human resources, decision support systems, top management commitment, organizational culture, flexibility of rules, rehabilitating of the aging infrastructures, and expanding the coverage of services. The NPM was generally identified to be an effective replacement for the traditional administration method. These reforms may be helpful in strengthening the public health complex and the management capacity, as well. NPM also seems to be useful in interacting the public health sector with the private sector in terms of personnel and resources, performance, reward structure, and methods of doing business.

  17. Undocumented migrants have diverse health problems

    DEFF Research Database (Denmark)

    Ehmsen, Boje Kvorning; Biswas, Dan; Jensen, Natasja Koitszch

    2014-01-01

    on the International Classification of Primary Care, 2nd Edition (ICPC-2). RESULTS: A total of 830 patients (39.75% women and 60.25% men) visited the clinic, which led to a total of 2,088 visits and 1,384 ICPC-2 classifications. The patients seen had 94 different nationalities. The most common reasons for medical......INTRODUCTION: In 2008, 1.9-3.8 million undocumented migrants lived in Europe. We aimed to strengthen the evidence base on undocumented migrants' health problems by describing characteristics of undocumented migrant patients in a Danish non-governmental organisation (NGO) health clinic. MATERIAL...... contact correspond well with the pattern seen in general practice and several chronic and severe cases were observed in the NGO clinic. Furthermore, a larger share of pregnant women presented (11.6%) compared with a Danish general practice (5.1%), and these were seen first in a late gestational age...

  18. Associations of health behaviors, school performance and psychosocial problems in adolescents in The Netherlands.

    Science.gov (United States)

    Busch, Vincent; Laninga-Wijnen, Lydia; Schrijvers, Augustinus Jacobus Petrus; De Leeuw, Johannes Rob Josephus

    2017-04-01

    School-based health-promoting interventions show promising results in improving various health outcomes of adolescents. Unfortunately, much is still unknown about the relations between health behaviors and school performances, while improving these would give schools a stronger incentive to invest in health promotion. This paper presents the associations of several health behaviors with school performances and studies the mediating effects of psychosocial problems. Health behavior and socio-demographic data were gathered from 905 Dutch high school students via an online survey, completed in-class. These data were matched with school records of the students' overall grade average (GA) on the three core subjects in Dutch high schools (Dutch, English and Math). The associations between health behaviors and school performances, and the potentially mediating effects of psychosocial problems, were studied via mixed-effects regression models. Smoking, being bullied, compulsive and excessive internet use and low physical activity were directly associated with lower school grades. Additionally, being bullied, bullying, smoking, excessive and compulsive internet use were associated with students' grades via mediation of psychosocial problems. This means that lower school grades were (also) associated with those behaviors through the effects of psychosocial problems in those students. This study showed the strong links between health behaviors and academic achievements among adolescents. Schools and health promoters should be educated more on these relations, so that they are aware of this common interest to get more support for health-promoting interventions. Additionally, the role of psychosocial problems in the relations between behaviors and school performances should be studied further in future research. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Conceptualising population health: from mechanistic thinking to complexity science

    Directory of Open Access Journals (Sweden)

    Jayasinghe Saroj

    2011-01-01

    Full Text Available Abstract The mechanistic interpretation of reality can be traced to the influential work by René Descartes and Sir Isaac Newton. Their theories were able to accurately predict most physical phenomena relating to motion, optics and gravity. This paradigm had at least three principles and approaches: reductionism, linearity and hierarchy. These ideas appear to have influenced social scientists and the discourse on population health. In contrast, Complexity Science takes a more holistic view of systems. It views natural systems as being 'open', with fuzzy borders, constantly adapting to cope with pressures from the environment. These are called Complex Adaptive Systems (CAS. The sub-systems within it lack stable hierarchies, and the roles of agency keep changing. The interactions with the environment and among sub-systems are non-linear interactions and lead to self-organisation and emergent properties. Theoretical frameworks such as epi+demos+cracy and the ecosocial approach to health have implicitly used some of these concepts of interacting dynamic sub-systems. Using Complexity Science we can view population health outcomes as an emergent property of CAS, which has numerous dynamic non-linear interactions among its interconnected sub-systems or agents. In order to appreciate these sub-systems and determinants, one should acquire a basic knowledge of diverse disciplines and interact with experts from different disciplines. Strategies to improve health should be multi-pronged, and take into account the diversity of actors, determinants and contexts. The dynamic nature of the system requires that the interventions are constantly monitored to provide early feedback to a flexible system that takes quick corrections.

  20. Conceptualising population health: from mechanistic thinking to complexity science.

    Science.gov (United States)

    Jayasinghe, Saroj

    2011-01-20

    The mechanistic interpretation of reality can be traced to the influential work by René Descartes and Sir Isaac Newton. Their theories were able to accurately predict most physical phenomena relating to motion, optics and gravity. This paradigm had at least three principles and approaches: reductionism, linearity and hierarchy. These ideas appear to have influenced social scientists and the discourse on population health. In contrast, Complexity Science takes a more holistic view of systems. It views natural systems as being 'open', with fuzzy borders, constantly adapting to cope with pressures from the environment. These are called Complex Adaptive Systems (CAS). The sub-systems within it lack stable hierarchies, and the roles of agency keep changing. The interactions with the environment and among sub-systems are non-linear interactions and lead to self-organisation and emergent properties. Theoretical frameworks such as epi+demos+cracy and the ecosocial approach to health have implicitly used some of these concepts of interacting dynamic sub-systems. Using Complexity Science we can view population health outcomes as an emergent property of CAS, which has numerous dynamic non-linear interactions among its interconnected sub-systems or agents. In order to appreciate these sub-systems and determinants, one should acquire a basic knowledge of diverse disciplines and interact with experts from different disciplines. Strategies to improve health should be multi-pronged, and take into account the diversity of actors, determinants and contexts. The dynamic nature of the system requires that the interventions are constantly monitored to provide early feedback to a flexible system that takes quick corrections.

  1. Mental Health Problems in Parents of Children with Congenital Heart Disease

    NARCIS (Netherlands)

    Kolaitis, Gerasimos A.; Meentken, Maya G.; Utens, Elisabeth M. W. J.

    2017-01-01

    This review will provide a concise description of mental health problems in parents of children with a (non-syndromic) congenital heart disease (CHD) during different stressful periods. Predictors of these problems and also implications for clinical practice will be mentioned. Having a child with

  2. Job dissatisfaction as a contributor to stress-related mental health problems among Japanese civil servants.

    Science.gov (United States)

    Tatsuse, Takashi; Sekine, Michikazu

    2013-01-01

    Although studies on the association of job dissatisfaction with mental health have been conducted in the past, few studies have dealt with the complicated links connecting job stress, job dissatisfaction, and stress-related illness. This study seeks to determine how job dissatisfaction is linked to common mental health issues. This study surveyed 3,172 civil servants (2,233 men and 939 women) in 1998, taking poor mental functioning, fatigue, and sleep disturbance as stress-related mental health problems. We examine how psychosocial risk factors at work and job dissatisfaction are associated independently with poor mental functioning, fatigue, and sleep disturbance after adjustment for other known risk factors, and how job dissatisfaction contributes to change in the degree of association between psychosocial risk factors at work and mental health problems. In general, psychosocial risk factors were independently associated with mental health problems. When adjusted for job dissatisfaction, not only was job satisfaction independently associated with mental health problems but it was also found that the association of psychosocial risk factors with mental health problems declined. Our results suggest that, although longitudinal research is necessary, attitudes toward satisfaction at work can potentially decrease the negative effects of psychosocial risk factors at work on mental health.

  3. Primary health care progress and problems.

    Science.gov (United States)

    Favin, M; Parlato, P; Kessler, S

    1984-01-01

    been instrumental in changing government attitudes. Some common implementation problems raise important issues for all PHC projects: provision of support services, project financing, community participation, and appropriate and effective use of community health workers, and balancing the perceived needs of the community with those of health professionals. By identifying some of the obstacles to PHC implementation, this study sets the agenda which the next generation of projects must address.

  4. A life course perspective on mental health problems, employment, and work outcomes.

    Science.gov (United States)

    Veldman, Karin; Reijneveld, Sijmen A; Verhulst, Frank C; Ortiz, Josue Almansa; Bültmann, Ute

    2017-07-01

    Objectives Little is known about how employment and work outcomes among young adults are influenced by their life-course history of mental health problems. Therefore, the aims of this study were to (i) identify trajectories of mental health problems from childhood to young adulthood and (ii) investigate the association between these trajectories and employment and work outcomes among young adults. Methods Data were used from 360 participants of the Tracking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study, with 12-year follow-up. Trajectories of externalizing and internalizing problems were identified with latent class growth models. Employment conditions and work outcomes (ie, psychosocial work characteristics) were measured at age 22. We assessed the association between mental health trajectories and employment conditions and work outcomes. Results Four trajectories of mental health problems were identified: high-stable, decreasing, moderate-stable and low-stable. Young adults with high-stable trajectories of externalizing problems worked over six hours more [B=6.71, 95% confidence interval (95% CI) 2.82-10.6] and had a higher income [odds ratio (OR) 0.33, 95% CI 0.15-0.71], than young adults with low-stable trajectories. Young adults with high-stable trajectories of internalizing problems worked six hours less per week (B=-6.07, 95% CI -10.1- -2.05) and reported lower income (OR 3.44, 95% CI 1.53-7.74) and poorer psychosocial work characteristics, compared to young adults with low-stable trajectories. Conclusions Among young adults who had a paid job at the age of 22 (and were not a student or unemployed), those with a history of internalizing problems are less likely to transition successfully into the labor market, compared to other young adults.

  5. Sociodemographic and health correlates of sleep problems and ...

    African Journals Online (AJOL)

    Objective. To investigate sleeping problems, sleep duration and associated factors in a national probability sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE) in 2008. Methods. In 2008 I conducted a national population-based cross-sectional study with a sample of 3 840 ...

  6. Adolescent Substance Use: America's #1 Public Health Problem

    Science.gov (United States)

    National Center on Addiction and Substance Abuse at Columbia University, 2011

    2011-01-01

    This report finds that adolescent smoking, drinking, misusing prescription drugs and using illegal drugs is, by any measure, a public health problem of epidemic proportion, presenting clear and present danger to millions of America's teenagers and severe and expensive long-range consequences for the entire population. This report is a wake-up call…

  7. Physical inactivity as a policy problem: applying a concept from policy analysis to a public health issue.

    Science.gov (United States)

    Rütten, Alfred; Abu-Omar, Karim; Gelius, Peter; Schow, Diana

    2013-03-07

    Despite the recent rapid development of policies to counteract physical inactivity (PI), only a small number of systematic analyses on the evolution of these policies exists. In this article we analyze how PI, as a public health issue, "translates" into a policy-making issue. First, we discuss why PI has become an increasingly important public health issue during the last two decades. We then follow Guy Peters and conceptualize PI as a "policy problem" that has the potential to be linked to policy instruments and policy impact. Analysis indicates that PI is a policy problem that i) is chronic in nature; ii) involves a high degree of political complexity; iii) can be disaggregated into smaller scales; iv) is addressed through interventions that can be difficult to "sell" to the public when their benefits are not highly divisible; v) cannot be solved by government spending alone; vi) must be addressed through a broad scope of activities; and vii) involves interdependencies among both multiple sectors and levels of government.We conclude that the new perspective on PI proposed in this article might be useful and important for i) describing and mapping policies to counteract PI in different contexts; ii) evaluating whether or not existing policy instruments are appropriate to the policy problem of PI, and iii) explaining the factors and processes that underlie policy development and implementation. More research is warranted in all these areas. In particular, we propose to focus on comparative analyses of how the problem of PI is defined and tackled in different contexts, and on the identification of truly effective policy instruments that are designed to "solve" the PI policy problem.

  8. Using Educational Data Mining Methods to Assess Field-Dependent and Field-Independent Learners' Complex Problem Solving

    Science.gov (United States)

    Angeli, Charoula; Valanides, Nicos

    2013-01-01

    The present study investigated the problem-solving performance of 101 university students and their interactions with a computer modeling tool in order to solve a complex problem. Based on their performance on the hidden figures test, students were assigned to three groups of field-dependent (FD), field-mixed (FM), and field-independent (FI)…

  9. The language of mental health problems in social media

    OpenAIRE

    Gkotsis, George; Oellrich, Anika; Hubbard, Tim; Dobson, Richard JB; Liakata, Maria; Velupillai, Sumithra; Dutta, Rina

    2016-01-01

    Online social media, such as Reddit, has become an important resource to share personal experiences and communicate with others. Among other personal information, some social media users communicate about mental health problems they are experiencing, with the intention of getting advice, support or empathy from other users. Here, we investigate the language of Reddit posts specific to mental health, to define linguistic characteristics that could be helpful for further applications. The latte...

  10. School nurses’ experiences working with students with mental health problems : A qualitative study

    OpenAIRE

    Jönsson, Julia; Maltestam, Malin; Bengtsson-Tops, Anita; Garmy, Pernilla

    2017-01-01

    The aim was to describe school nurses’ experiences working with students with mental health problems. In this inductive qualitative study, interviews were conducted with 14 school nurses in Sweden. The content analysis revealed three themes:(1) sense of worriedness about working with students with mental health problems, (2) taking care of students with mental health issues was an opportunity for personal and professional development, and (3) the experience of making a difference for young pe...

  11. Laying the foundations of a culture of health as a pedagogical problem

    Directory of Open Access Journals (Sweden)

    A.P. Khalajtsan

    2014-08-01

    Full Text Available Purpose : to show the dominant influence of educational - educational process lay the groundwork for a culture of health students. Material : processed more than 40 references, conducted a survey, questionnaires and observation of the living conditions of students. Results : named main reasons for creating a culture of health of students should be considered as primary pedagogical problem. The preconditions and conditions of the foundations of the culture of youth health, namely: social, educational, health, environmental, economic, geographic, individual. Traced the sequence and phasing of the pedagogical process of building a culture of health of students in the course of many years of teaching in higher education. Conclusions : proven pedagogical influence priority basis forming a culture of health of students in the individual development and identity formation for learning in higher education. The sequence and structure of the solution of pedagogical problems of forming the foundations of a culture of health students.

  12. Problem-based learning in a health sciences librarianship course.

    Science.gov (United States)

    Dimitroff, A; Ancona, A M; Beman, S B; Dodge, A M; Hutchinson, K L; LaBonte, M J; Mays, T L; Simon, D T

    1998-01-01

    Problem-based learning (PBL) has been adopted by many medical schools in North America. Because problem solving, information seeking, and lifelong learning skills are central to the PBL curriculum, health sciences librarians have been actively involved in the PBL process at these medical schools. The introduction of PBL in a library and information science curriculum may be appropriate to consider at this time. PBL techniques have been incorporated into a health sciences librarianship course at the School of Library and Information Science (LIS) at the University of Wisconsin-Milwaukee to explore the use of this method in an advanced Library and Information Science course. After completion of the course, the use of PBL has been evaluated by the students and the instructor. The modified PBL course design is presented and the perceptions of the students and the instructor are discussed. PMID:9681169

  13. [Is abortion a serious public health problem in Chile in the field of maternal-perinatal health?

    Science.gov (United States)

    Valenzuela, María Teresa; San-Martín P, Pamela; Cavada, Gabriel

    2017-08-01

    The World Health Organization, by 2014, estimates that approximately 22 million unsafe abortions take place every year in the world, almost all of them in developing countries. The Millennium Goals, as part of the fifth compendium, focused on maternal health by proposing that member states should reduce maternal mortality to 75% by 2015. To determine, using maternal health indicators, if abortion in Chile is a priority health problem. Data about maternal mortality and its causes between 1982 and 2014, was obtained from the databases available at the Chilean Ministry of Health. Trend analyzes were carried out using linear autoregressive models. Between 1982 and 2012, maternal mortality rates decreased from 51.8 to 18.3 per 100,000 live births. Complications of pregnancy, childbirth and puerperium were the first three causes and the last one is abortion. The proportion of abortions due to unspecified causes, including induced abortion, decreased from 36.6% to 26.1% between 2001 and 2012. Abortion is not a public health problem in Chile. To continue reducing maternal mortality, programs for the early detection of risks such as diabetes, obesity and hypertension should be implemented.

  14. Conceptual and Developmental Analysis of Mental Models: An Example with Complex Change Problems.

    Science.gov (United States)

    Poirier, Louise

    Defining better implicit models of children's actions in a series of situations is of paramount importance to understanding how knowledge is constructed. The objective of this study was to analyze the implicit mental models used by children in complex change problems to understand the stability of the models and their evolution with the child's…

  15. Managing Mental Health Problems Among Immigrant Women Attending Primary Health Care Services.

    Science.gov (United States)

    Straiton, Melanie L; Powell, Kathryn; Reneflot, Anne; Diaz, Esperanza

    2016-01-01

    Researchers in Norway explore treatment options in primary care for immigrant women with mental health problems compared with nonimmigrant women. Three national registers were linked together for 2008. Immigrant women from Sweden, Poland, the Philippines, Thailand, Pakistan, and Russia were selected for analysis and compared with Norwegian women. Using logistic regression, we investigated whether treatment type varied by country of origin. Rates of sickness leave and psychiatric referrals were similar across all groups. Conversational therapy and use of antidepressants and anxiolytics were lower among Filipina, Thai, Pakistani, and Russian women than among Norwegians. Using the broad term "immigrants" masks important differences in treatment and health service use. By closely examining mental health treatment differences by country of origin, gaps in service provision and treatment uptake may be identified and addressed with more success.

  16. The making of a public health problem: multi-drug resistant tuberculosis in India.

    Science.gov (United States)

    Engel, Nora C

    2013-07-01

    This paper examines how actors construct the public problem of multi-drug resistant tuberculosis (MDR-TB) in India. MDR-TB has been framed by the World Health Organization as a pressing, global public health problem. The responses to MDR-TB are complicated as treatment takes longer and is more expensive than routine TB treatment. This is particularly problematic in countries, such as India, with high patient loads, a large and unregulated private sector, weak health systems and potentially high numbers of MDR-TB cases. This paper analyses how actors struggle for control over ownership, causal theories and political responsibility of the public problem of MDR-TB in India. It combines Gusfield's theory on the construction of public problems with insights from literature on the social construction of diseases and on medical social control. It highlights that there are flexible definitions of public problems, which are negotiated among actor groups and which shift over time. The Indian government has shifted its policy in recent years and acknowledged that MDR-TB needs to be dealt with within the TB programme. The study results reveal how the policy shift happened, why debates on the construction of MDR-TB as a public problem in India continue, and why actors with alternative theories than the government do not succeed in their lobbying efforts. Two main arguments are put forward. First, the construction of the public problem of MDR-TB in India is a social and political process. The need for representative data, international influence and politics define what is controllable. Second, the government seems to be anxious to control the definition of India's MDR-TB problem. This impedes an open, critical and transparent discussion on the definition of the public problem of MDR-TB, which is important in responding flexibly to emerging public health challenges.

  17. Using expanded individualized health care plans to assist teachers of students with complex health care needs.

    Science.gov (United States)

    Heller, Kathryn Wolff; Tumlin, Jennifer

    2004-06-01

    As special education teachers have increasing numbers of students requiring health care procedures in their classrooms, school nurses need to help these teachers maintain a safe, healthy environment for their students. Part of this consists of having teachers know the steps to take should certain problems arise. This article examines the receptivity of using an expanded version of an individualized health care plan (IHP) to provide critical information to address health care problems, as well as having individualized education program (IEP) objectives for instructional targets identified in the IHP. The findings of this study indicate that a high percentage of school nurses and special education teachers were in favor of an expanded version of the IHP. There was also support for teaching students to independently or partially participate in performing their own health care procedures and having this instruction formalized as IEP objectives.

  18. Resilience associated with mental health problems among methadone maintenance treatment patients in Guangzhou, China.

    Science.gov (United States)

    Jiao, Mingxu; Gu, Jing; Xu, Huifang; Hao, Chun; Lau, Joseph T F; Mo, Phoenix; Liu, Di; Zhao, Yuteng; Zhang, Xiao; Babbitt, Andrew; Hao, Yuantao

    2017-05-01

    A considerable proportion of methadone maintenance treatment (MMT) clients have experienced mental health problems (e.g., depression and anxiety), and poor mental health status is associated with HIV-related risk behaviors and treatment drop-out. Resilience is known to be a protective factor for mental health problems but is not studied among MMT clients in China. This study aimed to explore the relationship between resilience and mental health problems (depression, anxiety and stress) among clients of community-based MMT clinics in China. A total of 208 MMT clients completed the face-to-face interview conducted at 4 of 11 MMT clinics in Guangzhou. The Chinese short version of Depression Anxiety Stress Scale (DASS-21) was used to assess the presence of depressive, anxiety and stress symptoms, and the Connor-Davidson Resilience Scale (CD-RISC) was used to measure resilience. Logistic regression models were fit in data analyses. Of all participants, 12.8%, 19.5% and 8.3% had depression, anxiety and stress, respectively. The mean resilience score was 57.6 (SD = 15.9). In the univariate analyses, resilience was negatively associated with two studied mental health problems (depression and anxiety, OR u  = 0.96 and 0.96, p mental health problems of MMT users should consider resilience as an important part in the designing of such interventions.

  19. Violence towards women is a public health problem.

    Science.gov (United States)

    Tetikcok, Ramazan; Ozer, Erdal; Cakir, Lutfullah; Enginyurt, Ozgur; İscanli, M Dogan; Cankaya, Soner; Ozer, Filiz

    2016-11-01

    Violence within the family is a significant health problem which threatens the health of the community. The global rates of domestic violence directed at women have been reported as 10%-69% and in Turkey as 25%-30%. The data of our study were obtained from the database of the official internet website of the Turkish Statistics Institute as the data related to violence between 2007 and 2012. In the evaluation of the data, SPSS 11.0 statistics software was used. Although it was determined that women from all groups experienced sexual, physical and emotional violence, higher rates were observed in those living in rural areas compared to those in urban areas, in the eastern region compared to all other regions, in the 45-59 years age group, those with low level of income and with a low level of education. When physicians encounter women who have experienced violence, by evaluating the violence in the context of a legal case, violence is identified and not allowed to become a cycle passed from generation to generation, and in addition to the medical intervention, without forgetting that violence is a public health problem, it is necessary to find a way to provide psychosocial and legal support for the victim. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  20. The influence of chronic health problems and work-related factors on loss of paid employment among older workers.

    Science.gov (United States)

    Leijten, Fenna R M; de Wind, Astrid; van den Heuvel, Swenne G; Ybema, Jan Fekke; van der Beek, Allard J; Robroek, Suzan J W; Burdorf, Alex

    2015-11-01

    With an ageing society and increasing retirement ages, it is important to understand how employability can be promoted in older workers with health problems. The current study aimed to determine whether (1) different chronic health problems predict transitions from paid employment to disability benefits, unemployment and early retirement, and (2) how work-related factors modify these associations. Self-report questionnaire data was used from the Dutch longitudinal Study on Transitions in Employment, Ability and Motivation with 3 years of follow-up (2010-2013), among employees aged 45-64 years (N=8149). The influence of baseline chronic health problems and work-related factors on transitions from paid employment to disability benefits, unemployment and early retirement during follow-up was estimated in a competing risks proportional hazards model. Relative excess risk of transitions due to the interaction between chronic health problems and work-related factors was assessed. Severe headache, diabetes mellitus and musculoskeletal, respiratory, digestive and psychological health problems predicted an increased risk of disability benefits (HR range 1.78-2.79). Circulatory (HR=1.35) and psychological health problems (HR=2.58) predicted unemployment, and musculoskeletal (HR=1.23) and psychological health problems (HR=1.57) predicted early retirement. Work-related factors did not modify the influence of health problems on unemployment or early retirement. Psychosocial work-related factors, especially autonomy, modified the influence of health problems on disability benefits. Specifically, among workers with health problems, higher autonomy, higher support and lower psychological job demands reduced the risk of disability benefits by 82%, 49%, and 11%, respectively. All health problems affected disability benefits to a similar extent, but psychological health problems especially predicted unemployment and early retirement. For older workers with health problems

  1. Perceived School Safety is Strongly Associated with Adolescent Mental Health Problems

    NARCIS (Netherlands)

    Nijs, Miesje M.; Bun, Clothilde J. E.; Tempelaar, Wanda M.; de Wit, Niek J.; Burger, Huibert; Plevier, Carolien M.; Boks, Marco P. M.

    School environment is an important determinant of psychosocial function and may also be related to mental health. We therefore investigated whether perceived school safety, a simple measure of this environment, is related to mental health problems. In a population-based sample of 11,130 secondary

  2. Internet skill-related problems in accessing online health information and services

    NARCIS (Netherlands)

    van Deursen, Alexander Johannes Aloysius Maria

    2012-01-01

    Purpose Despite the amount of health information available online, there are several barriers that limit the Internet from being adopted as a source of health information. The purpose of this study was to identify individual skill-related problems that users experience when accessing the Internet

  3. Employees with mental health problems: Survey of U.K. employers' knowledge, attitudes and workplace practices.

    Science.gov (United States)

    Brohan, Elaine; Henderson, Claire; Little, Kirsty; Thornicroft, Graham

    2010-01-01

    To investigate whether employers who have experience of hiring people with mental health problems differ significantly from those without such experience in terms of knowledge, attitudes and behaviours regarding mental health in the workplace, and the concerns which they report about employing people with mental health problems. We also examine whether non-workplace social contact is associated with the above variables. A telephone survey was conducted with a randomly selected sample of British employers. The sample included a similar number of human resource managers and managers/executive employees in other roles. 502 employers took part. Having employed someone with a mental health problem was associated with closer non-workplace social contact. Those with experience of employing applicants with mental health problems had significant differences in knowledge (regarding the law), and behaviour (having a policy on hiring applicants with disabilities) but not in attitudes. Non-workplace social contact may be useful to consider in understanding hiring practices. The nature of social contact at work and possible lack of impact of this contact on employer attitudes and concerns warrants further study. Greater support is needed for employers to understand the law regarding mental health problems in the workplace.

  4. Family problems among recently returned military veterans referred for a mental health evaluation.

    Science.gov (United States)

    Sayers, Steven L; Farrow, Victoria A; Ross, Jennifer; Oslin, David W

    2009-02-01

    Existing evidence suggests that military veterans with mental health disorders have poorer family functioning, although little research has focused on this topic. To test whether psychiatric symptoms are associated with family reintegration problems in recently returned military veterans. Cross-sectional survey of a clinical population. Respondents who were referred to behavioral health evaluation from April 2006 through August 2007 were considered for the survey. Philadelphia Veterans Affairs Medical Center, Pa. 199 military veterans who served in Iraq or Afghanistan after 2001 and were referred for behavioral health evaluation from primary care (mean age = 32.7 years, SD = 9.1). Measures included the Mini-International Neuropsychiatric Interview for psychiatric diagnoses, the 9-item Patient Health Questionnaire for depression diagnosis and severity, and screening measures of alcohol abuse and illicit substance use. A measure of military family readjustment problems and a screening measure of domestic abuse were developed for this study. Three fourths of the married/cohabiting veterans reported some type of family problem in the past week, such as feeling like a guest in their household (40.7%), reporting their children acting afraid or not being warm toward them (25.0%), or being unsure about their family role (37.2%). Among veterans with current or recently separated partners, 53.7% reported conflicts involving "shouting, pushing, or shoving," and 27.6% reported that this partner was "afraid of them." Depression and posttraumatic stress disorder symptoms were both associated with higher rates of family reintegration problems. Mental health problems may complicate veterans' readjustment and reintegration into family life. The findings suggest an opportunity to improve the treatment of psychiatric disorders by addressing family problems. Copyright 2009 Physicians Postgraduate Press, Inc.

  5. The problem of motivating teaching staff in a complex amalgamation.

    Science.gov (United States)

    Kenrick, M A

    1993-09-01

    This paper addresses some of the problems brought about by the merger of a number of schools of nursing into a new complex amalgamation. A very real concern in the new colleges of nursing and midwifery in the United Kingdom is the effect of amalgamation on management systems and staff morale. The main focus of this paper is the motivation of staff during this time of change. There is currently a lack of security amongst staff and in many instances the personal job satisfaction of nurse teachers and managers of nurse education has been reduced, which has made the task of motivating staff difficult. Hence, two major theories of motivation and the implications of these theories for managers of nurse education are discussed. The criteria used for the selection of managers within the new colleges, leadership styles and organizational structures are reviewed. The amalgamations have brought about affiliation with higher-education institutions. Some problems associated with these mergers and the effects on the motivation of staff both within the higher-education institutions and the nursing colleges are outlined. Strategies for overcoming some of the problems are proposed including job enlargement, job enrichment, potential achievement rewards and the use of individual performance reviews which may be useful for assessing the ability of all staff, including managers, in the new amalgamations.

  6. Measuring the success of specific health problem consultations in cats and dogs: a systematic review.

    Science.gov (United States)

    Corah, Louise; Mossop, Liz; Cobb, Kate; Dean, Rachel

    2018-03-15

    Consultations are complex interactions, are central to achieving optimal outcomes for all stakeholders, yet what constitutes a successful consultation has not been defined. The aim of this systematic review was to describe the scope of the literature available on specific health problem consultations and appraise their identified success measures. Searches of CAB Abstracts and MEDLINE were performed in May 2016 using species and consultation terms. Systematic sorting of the results allowed identification of consultation 'success factors' cited in peer-reviewed veterinary literature which were appraised using an appropriate critical appraisal tool (AXIS). Searches returned 11 330 results with a total of 17 publications meeting the inclusion criteria, of which four measured consultation success. Journal of the American Veterinary Medical Association was the most common journal of publication (9 of 17) and the majority of included papers had been published since 2010 (12 of 17). Success factors measured were compliance, client satisfaction and veterinary surgeon satisfaction, and publications primarily used communication analysis tools to measure success. The review highlights the paucity of peer-reviewed literature examining small animal, health problem veterinary consultations. The available evidence is of variable quality and provides weak evidence as to which factors contribute to a successful consultation. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Dynamic Modeling as a Cognitive Regulation Scaffold for Developing Complex Problem-Solving Skills in an Educational Massively Multiplayer Online Game Environment

    Science.gov (United States)

    Eseryel, Deniz; Ge, Xun; Ifenthaler, Dirk; Law, Victor

    2011-01-01

    Following a design-based research framework, this article reports two empirical studies with an educational MMOG, called "McLarin's Adventures," on facilitating 9th-grade students' complex problem-solving skill acquisition in interdisciplinary STEM education. The article discusses the nature of complex and ill-structured problem solving…

  8. Health risk evaluation in a population exposed to chemical releases from a petrochemical complex in Thailand.

    Science.gov (United States)

    Kampeerawipakorn, Ormrat; Navasumrit, Panida; Settachan, Daam; Promvijit, Jeerawan; Hunsonti, Potchanee; Parnlob, Varabhorn; Nakngam, Netnapa; Choonvisase, Suppachai; Chotikapukana, Passaornrawan; Chanchaeamsai, Samroeng; Ruchirawat, Mathuros

    2017-01-01

    Emissions from petrochemical industries may contain toxic and carcinogenic compounds that can pose health risk to human populations. The scenario may be worse in developing countries where management of such exposure-health problems is typically not well-implemented and the public may not be well-informed about such health risk. In Thailand, increasing incidences of respiratory diseases and cancers have been reported for the population around a major petrochemical complex, the Map Ta Phut Industrial Estate (MTPIE). This study aimed to systematically investigate an exposure-health risk among these populations. One-hundred and twelve healthy residents living nearby MTPIE and 50 controls located approximately 40km from MTPIE were recruited. Both external and internal exposure doses to benzene and 1,3-butadiene, known to be associated with the types of cancer that are of concern, were measured because they represent exposure to industrial and/or traffic-related emissions. Health risk was assessed using the biomarkers of early biological effects for cancer and inflammatory responses, as well as biomarkers of exposure for benzene and 1,3-butadiene. The exposure levels of benzene and 1,3-butadiene were similar for both the exposed and control groups. This was confirmed by a non-significant difference in the levels of specific urinary metabolites for benzene (trans,trans-muconic acid, t,t-MA) and 1,3-butadiene (monohydroxy-butyl mercapturic acid, MHBMA). Levels of 8-hydroxydeoxyguanosine (8-OHdG) and DNA strand breaks between the two groups were not statistically significantly different. However, functional biomarkers, interleukin-8 (IL-8) expression was significantly higher (pindustrial complex could be causing these functional abnormalities. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Human health risk assessment of trichloroethylene from industrial complex a.

    Science.gov (United States)

    Sin, Saemi; Byeon, Sang-Hoon

    2012-09-01

    This study investigated the human health risks of trichloroethylene from Industrial Complex A. The excessive carcinogenic risks for central tendency exposure were 1.40 × 10(?5) for male and female residents in the vicinity of Industrial Complex A. The excessive cancers risk for reasonable maximum exposure were 2.88 × 10(?5) and 1.97 × 10(?5) for males and females, respectively. These values indicate that there are potential cancer risks for exposure to these concentrations. The hazard index for central tendency exposure to trichloroethylene was 1.71 for male and female residents. The hazard indexes for reasonable maximum exposure were 3.27 and 2.41 for males and females, respectively. These values were over one, which is equivalent to the threshold value. This result showed that adverse cancer and non-cancer health effects may occur and that some risk management of trichloroethylene from Industrial Complex A was needed.

  10. Student Learning of Complex Earth Systems: A Model to Guide Development of Student Expertise in Problem-Solving

    Science.gov (United States)

    Holder, Lauren N.; Scherer, Hannah H.; Herbert, Bruce E.

    2017-01-01

    Engaging students in problem-solving concerning environmental issues in near-surface complex Earth systems involves developing student conceptualization of the Earth as a system and applying that scientific knowledge to the problems using practices that model those used by professionals. In this article, we review geoscience education research…

  11. Modern social life and never-married women's health problems

    Directory of Open Access Journals (Sweden)

    Patrapan Tamdee

    2016-01-01

    Full Text Available This study explored the health problems of never-married women as they relate to modern social life. In-depth interviews were conducted with a purposive sample of 45 never-married women aged 30–50 working or living in Bangkok and having health problems. It was found that never-married women in this modern era have experienced a variety of illnesses, such as “office syndrome” symptoms, chronic illnesses, and psychological and psychosomatic symptoms. Their social life resulted from the response to the context of modernity and was made through careful thought and deliberation. Whichever choice of social life they make, the consequences may lead them to a state of illness, distress, anxiety, and paranoia. These choices involve work, living conditions/environments, and intimacy aspects of their modern social life. This is the result of procuring by “husky modernity” which seems to be merely a “husk” or superficial modernization and changes so rapidly, but there is no core and it is full of double standards of traditional and new norms that have mixed together and fight against each other. Supporting health-related knowledge and information exchange within the network coupled with experience sharing essential for living in the modern society will enable them to sensibly decide on a path to good health.

  12. The promotion of mental health and the prevention of mental health problems in child and adolescent

    OpenAIRE

    sunmi cho; yunmi shin

    2013-01-01

    Improving mental health and reducing the burden of mental illness are complementary strategies which, along with the treatment and rehabilitation of people with mental disorders, significantly improve population health and well-being. A Institute of Medicine report describes a range of interventions for mental disorders that included treatment and maintenance, reserving the term “prevention” for efforts that occur before onset of a diagnosable disorder. Mental health problems affect 10&am...

  13. Numerical nonlinear complex geometrical optics algorithm for the 3D Calderón problem

    DEFF Research Database (Denmark)

    Delbary, Fabrice; Knudsen, Kim

    2014-01-01

    to the generalized Laplace equation. The 3D problem was solved in theory in late 1980s using complex geometrical optics solutions and a scattering transform. Several approximations to the reconstruction method have been suggested and implemented numerically in the literature, but here, for the first time, a complete...... computer implementation of the full nonlinear algorithm is given. First a boundary integral equation is solved by a Nystrom method for the traces of the complex geometrical optics solutions, second the scattering transform is computed and inverted using fast Fourier transform, and finally a boundary value...

  14. Health problems of victims before and after disaster: a longitudinal study in general practice.

    NARCIS (Netherlands)

    Yzermans, C.J.; Donker, G.A.; Kerssens, J.J.; Dirkzwager, A.J.E.; Soeteman, R.J.H.; Veen, P.M.H. ten

    2005-01-01

    BACKGROUND: We aimed to quantify the health problems and to assess the possible risk factors for developing health problems in persons affected by the explosion of a firework depot at Enschede, The Netherlands, on May 13, 2000. The explosion considerably damaged buildings in the local neighbourhood

  15. Marginalization and health service coverage among indigenous, rural, and urban populations: a public health problem in Mexico.

    Science.gov (United States)

    Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo

    2017-12-01

      Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage.   The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses.   Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban.   Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.

  16. Do work factors modify the association between chronic health problems and sickness absence among older employees?

    Science.gov (United States)

    Leijten, Fenna R M; van den Heuvel, Swenne G; Ybema, Jan Fekke; Robroek, Suzan J W; Burdorf, Alex

    2013-09-01

    The aim of this study was to (i) assess how common chronic health problems and work-related factors predict sickness absence and (ii) explore whether work-related factors modify the effects of health problems on sickness absence. A one-year longitudinal study was conducted among employed persons aged 45-64 years from the Study on Transitions in Employment, Ability and Motivation (N = 8984). The presence of common chronic health problems and work-related factors was determined at baseline and self-reported sickness absence at one-year follow-up by questionnaire. Multinomial multivariate logistic regression analyses were conducted to assess associations between health, work factors, and sickness absence, and relative excess risk due to interaction (RERI) techniques were used to test effect modification. Common health problems were related to follow-up sickness absence, most strongly to high cumulative sickness absence (> 9 days per year). Baseline psychological health problems were strongly related to high sickness absence at follow-up [odds ratio (OR) 3.67, 95% confidence interval (95% CI) 2.80-4.82]. Higher job demands at baseline increased the likelihood of high sickness absence at follow-up among workers with severe headaches [RERI 1.35 (95% CI 0.45-2.25)] and psychological health problems [RERI 3.51 (95% CI 0.67-6.34)] at baseline. Lower autonomy at baseline increased the likelihood of high sickness absence at follow-up among those with musculoskeletal [RERI 0.57 (95% CI 0.05-1.08)], circulatory [RERI 0.82 (95% CI 0.00-1.63)], and psychological health problems [RERI 2.94 (95% CI 0.17-5.70)] at baseline. Lower autonomy and higher job demands increased the association of an array of common chronic health problems with sickness absence, and thus focus should be placed on altering these factors in order to reduce sickness absence and essentially promote sustainable employability.

  17. Violence in Mexico: A social or public health problem?

    Science.gov (United States)

    Casas Patiño, Donovan; Rodríguez Torres, Alejandra; Salazar Morales, Mario Rodolfo

    2016-03-08

    This article seeks to explain the importance of violence as a social phenomenon and public health, trying to envision this issue not only from a curative approach to health, but from the social determinants of health, such as economics, politics and the administration of justice. Here, the younger population lacks real opportunities with an “absent State” that fails to provide structure. These frameworks play a fundamental role in the manifestation of violence. Thus, the debate for addressing and resolving violence opens the way to new perspectives regarding social factors as part of a public health, which cannot be oblivious to the state of the collective. Thus, the analysis of this situation shows that we cannot keep overlooking the whole picture of the real problem in the social health of our world instead of focusing on its discordant parts.

  18. Gendered emotion work around physical health problems in mid- and later-life marriages.

    Science.gov (United States)

    Thomeer, Mieke Beth; Reczek, Corinne; Umberson, Debra

    2015-01-01

    The provision and receipt of emotion work-defined as intentional activities done to promote another's emotional well-being-are central dimensions of marriage. However, emotion work in response to physical health problems is a largely unexplored, yet likely important, aspect of the marital experience. We analyze dyadic in-depth interviews with husbands and wives in 21 mid- to later-life couples to examine the ways that health-impaired people and their spouses provide, interpret, and explain emotion work. Because physical health problems, emotion work, and marital dynamics are gendered, we consider how these processes differ for women and men. We find that wives provide emotion work regardless of their own health status. Husbands provide emotion work less consistently, typically only when the husbands see themselves as their wife's primary source of stability or when the husbands view their marriage as balanced. Notions of traditional masculinity preclude some husbands from providing emotion work even when their wife is health-impaired. This study articulates emotion work around physical health problems as one factor that sustains and exacerbates gender inequalities in marriage with implications for emotional and physical well-being. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Gendered emotion work around physical health problems in mid- and later-life marriages☆

    Science.gov (United States)

    Thomeer, Mieke Beth; Reczek, Corinne; Umberson, Debra

    2015-01-01

    The provision and receipt of emotion work—defined as intentional activities done to promote another’s emotional well-being—are central dimensions of marriage. However, emotion work in response to physical health problems is a largely unexplored, yet likely important, aspect of the marital experience. We analyze dyadic in-depth interviews with husbands and wives in 21 mid-to later-life couples to examine the ways that health-impaired people and their spouses provide, interpret, and explain emotion work. Because physical health problems, emotion work, and marital dynamics are gendered, we consider how these processes differ for women and men. We find that wives provide emotion work regardless of their own health status. Husbands provide emotion work less consistently, typically only when the husbands see themselves as their wife’s primary source of stability or when the husbands view their marriage as balanced. Notions of traditional masculinity preclude some husbands from providing emotion work even when their wife is health-impaired. This study articulates emotion work around physical health problems as one factor that sustains and exacerbates gender inequalities in marriage with implications for emotional and physical well-being. PMID:25661852

  20. HSTLBO: A hybrid algorithm based on Harmony Search and Teaching-Learning-Based Optimization for complex high-dimensional optimization problems.

    Directory of Open Access Journals (Sweden)

    Shouheng Tuo

    Full Text Available Harmony Search (HS and Teaching-Learning-Based Optimization (TLBO as new swarm intelligent optimization algorithms have received much attention in recent years. Both of them have shown outstanding performance for solving NP-Hard optimization problems. However, they also suffer dramatic performance degradation for some complex high-dimensional optimization problems. Through a lot of experiments, we find that the HS and TLBO have strong complementarity each other. The HS has strong global exploration power but low convergence speed. Reversely, the TLBO has much fast convergence speed but it is easily trapped into local search. In this work, we propose a hybrid search algorithm named HSTLBO that merges the two algorithms together for synergistically solving complex optimization problems using a self-adaptive selection strategy. In the HSTLBO, both HS and TLBO are modified with the aim of balancing the global exploration and exploitation abilities, where the HS aims mainly to explore the unknown regions and the TLBO aims to rapidly exploit high-precision solutions in the known regions. Our experimental results demonstrate better performance and faster speed than five state-of-the-art HS variants and show better exploration power than five good TLBO variants with similar run time, which illustrates that our method is promising in solving complex high-dimensional optimization problems. The experiment on portfolio optimization problems also demonstrate that the HSTLBO is effective in solving complex read-world application.

  1. Health worker posting and transfer at primary level in Tamil Nadu: Governance of a complex health system function

    Directory of Open Access Journals (Sweden)

    Surekha Garimella

    2016-01-01

    Full Text Available Background: Posting and transfer (PT of health personnel - placing the right health workers in the right place at the right time - is a core function of any large-scale health service. In the context of government health services, this may be seen as a simple process of bureaucratic governance and implementation of the rule of law. However the literature from India and comparable low and middle-income country health systems suggests that in reality PT is a contested domain, driven by varied expressions of private and public interest throughout the chain of implementation. Objective: To investigate policymaking for PT in the government health sector and implementation of policies as experienced by different health system actors and stakeholders at primary health care level. Methodology: We undertook an empirical case study of a PT reform policy at primary health care level in Tamil Nadu State, to understand how different groups of health systems actors experience PT. In-depth qualitative methods were undertaken to study processes of implementation of PT policies enacted through ′counselling′ of health workers (individualized consultations to determine postings and transfers. Results: PT emerges as a complex phenomenon, shaped partially by the laws of the state and partially as a parallel system of norms and incentives requiring consideration and coordination of the interests of different groups. Micro-practices of governance represent homegrown coping mechanisms of health administrators that reconcile public and private interests and sustain basic health system functions. Beyond a functional perspective of PT, it also reflects justice and fairness as it plays out in the health system. It signifies how well a system treats its employees, and by inference, is an index of the overall health of the system. Conclusions: For a complex governance function such as PT, the roles of private actors and private interests are not easily separable from the

  2. Prospective associations between adolescent mental health problems and positive mental wellbeing in early old age.

    Science.gov (United States)

    Nishida, Atsushi; Richards, Marcus; Stafford, Mai

    2016-01-01

    Mental health problems in adolescence are predictive of future mental distress and psychopathology; however, few studies investigated adolescent mental health problems in relation to future mental wellbeing and none with follow-up to older age. To test prospective associations between adolescent mental health problems and mental wellbeing and life satisfaction in early old age. A total of 1561 men and women were drawn from the Medical Research Council National Survey of Health and Development (the British 1946 birth cohort). Teachers had previously completed rating scales to assess emotional adjustment and behaviours, which allowed us to extract factors of mental health problems measuring self-organisation, behavioural problems, and emotional problems during adolescence. Between the ages of 60-64 years, mental wellbeing was assessed using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and life satisfaction was self-reported using the Satisfaction with Life Scale (SWLS). After controlling for gender, social class of origin, childhood cognitive ability, and educational attainment, adolescent emotional problems were independently inversely associated with mental wellbeing and with life satisfaction. Symptoms of anxiety/depression at 60-64 years explained the association with life satisfaction but not with mental wellbeing. Associations between adolescent self-organisation and conduct problems and mental wellbeing and life satisfaction were of negligible magnitude, but higher childhood cognitive ability significantly predicted poor life satisfaction in early old age. Adolescent self-organisation and conduct problems may not be predictive of future mental wellbeing and life satisfaction. Adolescent emotional problems may be inversely associated with future wellbeing, and may be associated with lower levels of future life satisfaction through symptoms of anxiety/depression in early old age. Initiatives to prevent and treat emotional problems in adolescence may

  3. Health should not have to be problem: Talking health and accountability in an Internet forum on veganism

    NARCIS (Netherlands)

    Sneijder, P.W.J.; Molder, te H.F.M.

    2004-01-01

    This article draws upon insights from discursive psychology to examine how participants in an Internet forum on veganism orient to the relationship between food choice, health and accountability. First, we explore the ways in which participants ascribe responsibility for health problems like vitamin

  4. Mental health, behavioural problems and treatment seeking among students commencing university in Northern Ireland

    Science.gov (United States)

    McLafferty, Margaret; Lapsley, Coral R.; Ennis, Edel; Armour, Cherie; Murphy, Sam; Bunting, Brendan P.; Bjourson, Anthony J.; O'Neill, Siobhan M.

    2017-01-01

    Mental health and behavioural problems are common among students commencing university. University life can be stressful and problems often exacerbate during their course of study, while others develop disorders for the first time. The WHO World Mental Health Surveys International College Student Project aims to conduct longitudinal research to examine and monitor student mental health and wellbeing. The Ulster University Student Wellbeing study, which commenced in September 2015 in Northern Ireland (NI), was conducted as part of this initiative (wave 1, n = 739), using the WMH-CIDI to examine psychopathology. Baseline prevalence rates of lifetime and 12-month mental health and substance disorders, ADHD and suicidality were high, with more than half of new undergraduate students reporting any lifetime disorder. Co-morbidity was common with 19.1% of students experiencing three or more disorders. Logistic regression models revealed that females, those over 21, non-heterosexual students, and those from a lower SES background were more likely to have a range of mental health and behavioural problems. Overall, 10% of new entry students received treatment for emotional problems in the previous year. However, 22.3% of students with problems said they would not seek help. The study provides important information for universities, policy makers and practice, on mental health and wellbeing in young people generally but particularly for students commencing university. The findings will assist in the development and implementation of protection and prevention strategies in the university setting and beyond. PMID:29236727

  5. Mental health, behavioural problems and treatment seeking among students commencing university in Northern Ireland.

    Directory of Open Access Journals (Sweden)

    Margaret McLafferty

    Full Text Available Mental health and behavioural problems are common among students commencing university. University life can be stressful and problems often exacerbate during their course of study, while others develop disorders for the first time. The WHO World Mental Health Surveys International College Student Project aims to conduct longitudinal research to examine and monitor student mental health and wellbeing. The Ulster University Student Wellbeing study, which commenced in September 2015 in Northern Ireland (NI, was conducted as part of this initiative (wave 1, n = 739, using the WMH-CIDI to examine psychopathology. Baseline prevalence rates of lifetime and 12-month mental health and substance disorders, ADHD and suicidality were high, with more than half of new undergraduate students reporting any lifetime disorder. Co-morbidity was common with 19.1% of students experiencing three or more disorders. Logistic regression models revealed that females, those over 21, non-heterosexual students, and those from a lower SES background were more likely to have a range of mental health and behavioural problems. Overall, 10% of new entry students received treatment for emotional problems in the previous year. However, 22.3% of students with problems said they would not seek help. The study provides important information for universities, policy makers and practice, on mental health and wellbeing in young people generally but particularly for students commencing university. The findings will assist in the development and implementation of protection and prevention strategies in the university setting and beyond.

  6. Mental health, behavioural problems and treatment seeking among students commencing university in Northern Ireland.

    Science.gov (United States)

    McLafferty, Margaret; Lapsley, Coral R; Ennis, Edel; Armour, Cherie; Murphy, Sam; Bunting, Brendan P; Bjourson, Anthony J; Murray, Elaine K; O'Neill, Siobhan M

    2017-01-01

    Mental health and behavioural problems are common among students commencing university. University life can be stressful and problems often exacerbate during their course of study, while others develop disorders for the first time. The WHO World Mental Health Surveys International College Student Project aims to conduct longitudinal research to examine and monitor student mental health and wellbeing. The Ulster University Student Wellbeing study, which commenced in September 2015 in Northern Ireland (NI), was conducted as part of this initiative (wave 1, n = 739), using the WMH-CIDI to examine psychopathology. Baseline prevalence rates of lifetime and 12-month mental health and substance disorders, ADHD and suicidality were high, with more than half of new undergraduate students reporting any lifetime disorder. Co-morbidity was common with 19.1% of students experiencing three or more disorders. Logistic regression models revealed that females, those over 21, non-heterosexual students, and those from a lower SES background were more likely to have a range of mental health and behavioural problems. Overall, 10% of new entry students received treatment for emotional problems in the previous year. However, 22.3% of students with problems said they would not seek help. The study provides important information for universities, policy makers and practice, on mental health and wellbeing in young people generally but particularly for students commencing university. The findings will assist in the development and implementation of protection and prevention strategies in the university setting and beyond.

  7. [Health system in Afghanistan: problems and institutional perspectives].

    Science.gov (United States)

    Lejars, M

    2008-10-01

    Afghanistan has been ravaged by years of conflict. To provide emergency services and restore access health services, the Public Health Ministry with the assistance of partners developed first a package of basic health services delivered by NGO contractors and second a package of essential hospital services. The Ministry's role consists of providing guidance. To reduce the many issues and problems affecting this role, reforms are now being undertaken and a new national health care strategy is being developed within the framework of the National Development Strategy. An institution-building project has been initiated with European Union funding to allow the Health Ministry to carry out its stewardship and management functions with greater effectiveness and transparency. This project is essential for the successful outcome of all future strategies and programs planned by the Health Ministry to enhance its institutional effectiveness. The objectives of this project are to strengthen planning and auditing activities, promote quality assurance, implement funding mechanisms for health-related activities, organize management of human resources, maintain ongoing efforts to reform the administration and fight against corruption, and lay the foundations for managing finances and procurement. The scope of this project underlines the importance of its outcome. However the institution-building process will be long and constantly threatened by political instability and insecurity.

  8. The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation.

    Science.gov (United States)

    Spoorenberg, Sophie L W; Reijneveld, Sijmen A; Middel, Berrie; Uittenbroek, Ronald J; Kremer, Hubertus P H; Wynia, Klaske

    2015-01-01

    The aim of the present study was to develop a valid Geriatric ICF Core Set reflecting relevant health-related problems of community-living older adults without dementia. A Delphi study was performed in order to reach consensus (≥70% agreement) on second-level categories from the International Classification of Functioning, Disability and Health (ICF). The Delphi panel comprised 41 older adults, medical and non-medical experts. Content validity of the set was tested in a cross-sectional study including 267 older adults identified as frail or having complex care needs. Consensus was reached for 30 ICF categories in the Delphi study (fourteen Body functions, ten Activities and Participation and six Environmental Factors categories). Content validity of the set was high: the prevalence of all the problems was >10%, except for d530 Toileting. The most frequently reported problems were b710 Mobility of joint functions (70%), b152 Emotional functions (65%) and b455 Exercise tolerance functions (62%). No categories had missing values. The final Geriatric ICF Core Set is a comprehensive and valid set of 29 ICF categories, reflecting the most relevant health-related problems among community-living older adults without dementia. This Core Set may contribute to optimal care provision and support of the older population. Implications for Rehabilitation The Geriatric ICF Core Set may provide a practical tool for gaining an understanding of the relevant health-related problems of community-living older adults without dementia. The Geriatric ICF Core Set may be used in primary care practice as an assessment tool in order to tailor care and support to the needs of older adults. The Geriatric ICF Core Set may be suitable for use in multidisciplinary teams in integrated care settings, since it is based on a broad range of problems in functioning. Professionals should pay special attention to health problems related to mobility and emotional functioning since these are the most

  9. Food, health, and complexity: towards a conceptual understanding to guide collaborative public health action

    Directory of Open Access Journals (Sweden)

    Shannon E. Majowicz

    2016-06-01

    Full Text Available Abstract Background What we eat simultaneously impacts our exposure to pathogens, allergens, and contaminants, our nutritional status and body composition, our risks for and the progression of chronic diseases, and other outcomes. Furthermore, what we eat is influenced by a complex web of drivers, including culture, politics, economics, and our built and natural environments. To date, public health initiatives aimed at improving food-related population health outcomes have primarily been developed within ‘practice silos’, and the potential for complex interactions among such initiatives is not well understood. Therefore, our objective was to develop a conceptual model depicting how infectious foodborne illness, food insecurity, dietary contaminants, obesity, and food allergy can be linked via shared drivers, to illustrate potential complex interactions and support future collaboration across public health practice silos. Methods We developed the conceptual model by first conducting a systematic literature search to identify review articles containing schematics that depicted relationships between drivers and the issues of interest. Next, we synthesized drivers into a common model using a modified thematic synthesis approach that combined an inductive thematic analysis and mapping to synthesize findings. Results The literature search yielded 83 relevant references containing 101 schematics. The conceptual model contained 49 shared drivers and 227 interconnections. Each of the five issues was connected to all others. Obesity and food insecurity shared the most drivers (n = 28. Obesity shared several drivers with food allergy (n = 11, infectious foodborne illness (n = 7, and dietary contamination (n = 6. Food insecurity shared several drivers with infectious foodborne illness (n = 9 and dietary contamination (n = 9. Infectious foodborne illness shared drivers with dietary contamination (n = 8. Fewer drivers were

  10. Health effects of environmental pollution in population living near industrial complex areas in Korea.

    Science.gov (United States)

    Eom, Sang-Yong; Choi, Jonghyuk; Bae, Sanghyuk; Lim, Ji-Ae; Kim, Guen-Bae; Yu, Seung-Do; Kim, Yangho; Lim, Hyun-Sul; Son, Bu-Soon; Paek, Domyung; Kim, Yong-Dae; Kim, Heon; Ha, Mina; Kwon, Ho-Jang

    2018-01-01

    Several epidemiological studies have reported an association between environmental pollution and various health conditions in individuals residing in industrial complexes. To evaluate the effects of pollution from industrial complex on human health, we performed a pooled analysis of environmental epidemiologic monitoring data for residents living near national industrial complexes in Korea. The respiratory and allergic symptoms and the prevalence of acute and chronic diseases, including cancer, were used as the outcome variables for health effects. Multiple logistic regression analysis was used to analyze the relationship between exposure to pollution from industrial complexes and health conditions. After adjusting for age, sex, smoking status, occupational exposure, level of education, and body mass index, the residents near the industrial complexes were found to have more respiratory symptoms, such as cough (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.06 to 1.31) and sputum production (OR, 1.13; 95% CI, 1.03 to 1.24), and symptoms of atopic dermatitis (OR, 1.10; 95% CI, 1.01 to 1.20). Among residents of the industrial complexes, the prevalence of acute eye disorders was approximately 40% higher (OR, 1.39; 95% CI, 1.04 to 1.84) and the prevalence of lung and uterine cancer was 3.45 times and 1.88 times higher, respectively, than those among residents of the control area. This study showed that residents living in the vicinity of industrial complexes have a high risk of acute and chronic diseases including respiratory and allergic conditions. These results can be used as basic objective data for developing health management measures for individuals residing near industrial complexes.

  11. Health effects of environmental pollution in population living near industrial complex areas in Korea

    Directory of Open Access Journals (Sweden)

    Sang-Yong Eom

    2018-01-01

    Full Text Available Several epidemiological studies have reported an association between environmental pollution and various health conditions in individuals residing in industrial complexes. To evaluate the effects of pollution from industrial complex on human health, we performed a pooled analysis of environmental epidemiologic monitoring data for residents living near national industrial complexes in Korea. The respiratory and allergic symptoms and the prevalence of acute and chronic diseases, including cancer, were used as the outcome variables for health effects. Multiple logistic regression analysis was used to analyze the relationship between exposure to pollution from industrial complexes and health conditions. After adjusting for age, sex, smoking status, occupational exposure, level of education, and body mass index, the residents near the industrial complexes were found to have more respiratory symptoms, such as cough (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.06 to 1.31 and sputum production (OR, 1.13; 95% CI, 1.03 to 1.24, and symptoms of atopic dermatitis (OR, 1.10; 95% CI, 1.01 to 1.20. Among residents of the industrial complexes, the prevalence of acute eye disorders was approximately 40% higher (OR, 1.39; 95% CI, 1.04 to 1.84 and the prevalence of lung and uterine cancer was 3.45 times and 1.88 times higher, respectively, than those among residents of the control area. This study showed that residents living in the vicinity of industrial complexes have a high risk of acute and chronic diseases including respiratory and allergic conditions. These results can be used as basic objective data for developing health management measures for individuals residing near industrial complexes.

  12. Consultations for women's health problems: factors influencing women's choice of sex of general practitioner.

    NARCIS (Netherlands)

    Brink-Muinen, A. van den; Bakker, D.H. de; Bensing, J.M.

    1994-01-01

    AIM. This study set out to examine the degree to which women choose to visit a woman doctor for women's health problems and the determinants of this choice. The differences between women and men doctors with regard to treating women's health problems were also studied. METHOD. Data from the Dutch

  13. Spouses of older adults with late-life drinking problems: health, family, and social functioning.

    Science.gov (United States)

    Moos, Rudolf H; Brennan, Penny L; Schutte, Kathleen K; Moos, Bernice S

    2010-07-01

    This study focuses on the health, family, and social functioning of spouses of late-life remitted and continuing problem drinkers, and on predictors of spouses' alcohol-related functioning and depressive symptoms. Three groups of spouses were compared at baseline and a 10-year follow-up: (a) spouses (n = 73) of older adults who had no drinking problems at baseline or follow-up, (b) spouses (n = 25) of older adults who had drinking problems at baseline but not follow-up, and (c) spouses (n = 69) of older adults who had drinking problems at both baseline and follow-up. At each contact point, spouses completed an inventory that assessed their alcohol-related, health, family, and social functioning. At baseline, compared with spouses of problem-free individuals, spouses of older adults whose drinking problems later remitted reported more alcohol consumption, poorer health, more depressive symptoms, and less involvement in domestic tasks and social and religious activities. At the 10-year follow-up, spouses of remitted problem drinkers were comparable to spouses of problem-free individuals, but spouses of continuing problem drinkers consumed more alcohol, incurred more alcohol-related consequences, and had friends who approved more of drinking. Overall, spouses whose friends approved more of drinking and whose partners consumed more alcohol and had drinking problems were likely to consume more alcohol and to have drinking problems themselves. Spouses of older adults whose late-life drinking problems remit can attain normal functioning; however, spouses of older adults with continuing late-life drinking problems experience some ongoing deficits.

  14. Spouses of Older Adults With Late-Life Drinking Problems: Health, Family, and Social Functioning*

    Science.gov (United States)

    Moos, Rudolf H.; Brennan, Penny L.; Schutte, Kathleen K.; Moos, Bernice S.

    2010-01-01

    Objective: This study focuses on the health, family, and social functioning of spouses of late-life remitted and continuing problem drinkers, and on predictors of spouses' alcohol-related functioning and depressive symptoms. Method: Three groups of spouses were compared at baseline and a 10-year follow-up: (a) spouses (n = 73) of older adults who had no drinking problems at baseline or follow-up, (b) spouses (n = 25) of older adults who had drinking problems at baseline but not follow-up, and (c) spouses (n = 69) of older adults who had drinking problems at both baseline and follow-up. At each contact point, spouses completed an inventory that assessed their alcohol-related, health, family, and social functioning. Results: At baseline, compared with spouses of problem-free individuals, spouses of older adults whose drinking problems later remitted reported more alcohol consumption, poorer health, more depressive symptoms, and less involvement in domestic tasks and social and religious activities. At the 10-year follow-up, spouses of remitted problem drinkers were comparable to spouses of problem-free individuals, but spouses of continuing problem drinkers consumed more alcohol, incurred more alcohol-related consequences, and had friends who approved more of drinking. Overall, spouses whose friends approved more of drinking and whose partners consumed more alcohol and had drinking problems were likely to consume more alcohol and to have drinking problems themselves. Conclusions: Spouses of older adults whose late-life drinking problems remit can attain normal functioning; however, spouses of older adults with continuing late-life drinking problems experience some ongoing deficits. PMID:20553658

  15. Nursing students' experiences with refugees with mental health problems in Jordan: A qualitative content analysis.

    Science.gov (United States)

    Dotevall, Camilla; Winberg, Elin; Rosengren, Kristina

    2018-02-01

    The aim of this study was to describe Jordanian nursing students' experience of caring for refugees with mental health problems. According to refugees' experiences of crisis, a well-educated staff is needed to provide high quality of care due to mental health problems. Therefore, health professionals play an important role in creating an environment that promotes human rights regardless of ethnic origin. The study comprised eight interviews and was analysed using content analysis, a qualitative method that involves an inductive approach, to increase our understanding of nursing students' perspective and thoughts regarding caring for refugees with mental health problems. The results formed one category: to be challenged by refugees' mental health issues and three subcategories: managing refugees' mental health needs, affected by refugees' mental health, and improve mental healthcare for refugees. Language problems could be managed by using interpreters to decrease cultural clashes to facilitate equal healthcare. In addition, well-educated (theoretical knowledge) and trained (practical knowledge) nursing students have potential to fulfil refugees' care needs regardless of ethnicity or background by using nursing interventions built on communication skills and cultural competences (theory, practice) to facilitate high quality of healthcare. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Mental Health Problems in a School Setting in Children and Adolescents.

    Science.gov (United States)

    Schulte-Körne, Gerd

    2016-03-18

    10-20% of children and adolescents have a mental health problem of some type. Manifestations such as attention deficits, cognitive disturbances, lack of motivation, and negative mood all adversely affect scholastic development. It is often unclear what factors associated with school affect children's mental development and what preventive measures and interventions at school might be effective. This review is based on systematic reviews, meta-analyses, and randomized and non-randomized controlled trials that were retrieved by a selective search in the PubMed, PsycInfo, and Google Scholar databases. The prevalence of hyperkinetic disorder is 1-6%. Its main manifestations are motor hyperactivity, an attention deficit, and impulsive behavior. Learning disorders such as dyscalculia and dyslexia affect 4-6% of children each, while 4-5% of children and adolescents suffer from depression, which is twice as prevalent in girls as in boys. Mental health problems increase the risk of repeating a grade, truancy, and dropping out of school. The risk of developing an internalizing or externalizing mental health problem can be lessened by changes in the school environment and by the implementation of evidencebased school programs. Physicians, in collaboration with school social workers and psychologists, should help teachers recognize and contend with mental health problems among the children and adolescents whom they teach, to enable the timely detection of stress factors at school and the initiation of the necessary measures and aids. In particular, the school-entrance examination and screening for risk factors at school can make a positive contribution. Evidence-based preventive programs should be implemented in schools, and beneficial changes of the school environment should be a further goal.

  17. Continuous admission to primary school and mental health problems

    NARCIS (Netherlands)

    S.A. Reijneveld (Sijmen); C.H. Wiefferink (Carin); E. Brugman (Emily); F.C. Verhulst (Frank); S.P. Verloove-Vanhorick; A.D.C. Paulussen (Aimée)

    2006-01-01

    textabstractBackground: Younger children in a school class have higher rates of mental health problems if admission to primary school occurs once a year. This study examines whether this relative age effect also occurs if children are admitted to school continuously throughout the year. Methods: We

  18. Continuous admission to primary school and mental health problems

    NARCIS (Netherlands)

    Reijneveld, S.A.; Wiefferink, C.H.; Brugman, E.; Verhulst, F.C.; Verloove-Vanhorick, S.P.; Paulussen, T.G.W.

    2006-01-01

    Background: Younger children in a school class have higher rates of mental health problems if admission to primary school occurs once a year. This study examines whether this relative age effect also occurs if children are admitted to school continuously throughout the year. Methods: We assessed

  19. Health problems and stress in Information Technology and Business Process Outsourcing employees.

    Science.gov (United States)

    Padma, V; Anand, N N; Gurukul, S M G Swaminatha; Javid, S M A Syed Mohammed; Prasad, Arun; Arun, S

    2015-04-01

    Stress is high in software profession because of their nature of work, target, achievements, night shift, over work load. 1. To study the demographic profile of the employees. 2. To access the level of job stress and quality of life of the respondents. 3. To study in detail the health problems of the employees. All employees working in IT and BPO industry for more than two years were included into the study. A detailed questionnaire of around 1000 IT and BPO employees including their personal details, stress score by Holmes and Rahe to assess the level of stress and master health checkup profile were taken and the results were analysed. Around 56% had musculoskeletal symptoms. 22% had newly diagnosed hypertension,10% had diabetes, 36% had dyslipidemia, 54% had depression, anxiety and insomnia, 40% had obesity. The stress score was higher in employees who developed diabetes, hypertension and depression. Early diagnosis of stress induced health problems can be made out by stress scores, intense lifestyle modification, diet advice along with psychological counselling would reduce the incidence of health problems in IT sector and improve the quality of work force.

  20. The Daily Operational Brief: Fostering Daily Readiness, Care Coordination, and Problem-Solving Accountability in a Large Pediatric Health Care System.

    Science.gov (United States)

    Donnelly, Lane F; Basta, Kathryne C; Dykes, Anne M; Zhang, Wei; Shook, Joan E

    2018-01-01

    At a pediatric health system, the Daily Operational Brief (DOB) was updated in 2015 after three years of operation. Quality and safety metrics, the patient volume and staffing assessment, and the readiness assessment are all presented. In addition, in the problem-solving accountability system, problematic issues are categorized as Quick Hits or Complex Issues. Walk-the-Wall, a biweekly meeting attended by hospital senior administrative leadership and quality and safety leaders, is conducted to chart current progress on Complex Issues. The DOB provides a daily standardized approach to evaluate readiness to provide care to current patients and improvement in the care to be provided for future patients. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  1. Long-Term Mental Health Problems After Delirium in the ICU.

    Science.gov (United States)

    Wolters, Annemiek E; Peelen, Linda M; Welling, Maartje C; Kok, Lotte; de Lange, Dylan W; Cremer, Olaf L; van Dijk, Diederik; Slooter, Arjen J C; Veldhuijzen, Dieuwke S

    2016-10-01

    To determine whether delirium during ICU stay is associated with long-term mental health problems defined as symptoms of anxiety, depression, and posttraumatic stress disorder. Prospective cohort study. Survey study, 1 year after discharge from a medical-surgical ICU in the Netherlands. One-year ICU survivors of an ICU admission lasting more than 48 hours, without a neurologic disorder or other condition that would impede delirium assessment during ICU stay. None. One year after discharge, ICU survivors received a survey containing the Hospital Anxiety and Depression Scale with a subscale for symptoms of depression and a subscale for symptoms of anxiety, and the Impact of Event Scale 15 item measuring symptoms of posttraumatic stress disorder. Participants were classified as having experienced no delirium (n = 270; 48%), a single day of delirium (n = 86; 15%), or multiple days of delirium (n = 211; 37%) during ICU stay. Log-binomial regression was used to assess the association between delirium and symptoms of anxiety, depression, and posttraumatic stress disorder. The study population consisted of 567 subjects; of whom 246 subjects (43%) reported symptoms of anxiety (Hospital Anxiety and Depression Scale with a subscale for anxiety, ≥ 8), and 254 (45%) symptoms of depression (Hospital Anxiety and Depression Scale with a subscale for depression, ≥ 8). In 220 patients (39%), the Impact of Event Scale 15 item was greater than or equal to 35, indicating a high probability of posttraumatic stress disorder. There was substantial overlap between these mental health problems-63% of the subjects who scored positive for the presence of any three of the mental health problems, scored positive for all three. No association was observed between either a single day or multiple days of delirium and symptoms of anxiety, depression, or posttraumatic stress disorder. Although symptoms of anxiety, depression, and posttraumatic stress disorder were found to be common 1 year after

  2. An Examination of Physical and Mental Health Problems of the Homeless.

    Science.gov (United States)

    Solarz, Andrea; Mowbray, Carol

    Homelessness is a significant social problem in the United States and it has been estimated that there may be as many as 2.5 million homeless people in this country today. For these people, poverty, substance abuse, and harsh living conditions may further contribute to the development of physical and mental health problems. A study was conducted…

  3. “Damp in bathroom. Damp in back room. It's very depressing!” exploring the relationship between perceived housing problems, energy affordability concerns, and health and well-being in UK social housing

    International Nuclear Information System (INIS)

    Boomsma, Christine; Pahl, Sabine; Jones, Rory V.; Fuertes, Alba

    2017-01-01

    Social housing residents often struggle with achieving adequate levels of warmth in their home on a limited household budget. Additionally, other housing problems such as damp are common. Previous research has found a link between housing problems and poor health and reduced well-being, but this relationship is complex and poorly understood. A survey among UK social housing residents (N=536) investigated the association between cold and damp housing, as well as the role of energy affordability concerns in the relationship between housing problems and health. The findings indicated that struggles with keeping warm related to a cluster of damp and mould issues rather than any one specific issue. In describing these problems householders expressed a sense of frustration and helplessness. Support was found for an indirect effect on health whereby households experiencing cold, damp or mould issues reported more difficulty with affording their energy bills, these affordability concerns in turn related to poor health and well-being. The effects were found to be more consistent and stronger for men compared to women. Policies aimed at reducing housing problems should consider the important role of affordability concerns and the need for households to regain control of their energy bills. - Highlights: • Housing problems common in social housing could have negative health impacts. • We examine these housing problems and what may underlie the association with health. • Problems with keeping warm relate to a range of condensation, damp and mould issues. • Households with housing problems report more energy affordability concerns. • These concerns in turn were found to relate to poor health and reduced well-being.

  4. Excel 2016 for health services management statistics a guide to solving problems

    CERN Document Server

    Quirk, Thomas J

    2016-01-01

    This book shows the capabilities of Microsoft Excel in teaching health services management statistics effectively. Similar to the previously published Excel 2013 for Health Services Management Statistics, this book is a step-by-step exercise-driven guide for students and practitioners who need to master Excel to solve practical health service management problems. If understanding statistics isn’t your strongest suit, you are not especially mathematically-inclined, or if you are wary of computers, this is the right book for you. Excel, a widely available computer program for students and managers, is also an effective teaching and learning tool for quantitative analyses in health service courses. Its powerful computational ability and graphical functions make learning statistics much easier than in years past. However, Excel 2016 for Health Services Management Statistics: A Guide to Solving Practical Problems is the first book to capitalize on these improvements by teaching students and managers how to apply...

  5. Factors associated with acceptance of peers with mental health problems in childhood and adolescence.

    Science.gov (United States)

    Swords, Lorraine; Heary, Caroline; Hennessy, Eilis

    2011-09-01

    Research suggests that children's reactions to peers with mental health problems are related to the maintenance and outcomes of these problems. However, children's perceptions of such peers, particularly those with internalising problems, are neither well researched nor understood. The present study aimed to test a series of models relating socio-demographic and attributional variables to the acceptance of hypothetical boys and girls with attention deficit hyperactivity disorder (ADHD) and depression. A sample of 595 participants, drawn from five different age-groups spanning early childhood to late adolescence, completed a booklet of questions in response to two vignettes describing the behaviour of hypothetical target peers with depression and ADHD. The sample was drawn from schools randomly selected in the east of Ireland. The models indicated that age and gender of the participant, and the perceived responsibility of the target character for his/her condition, were the three most important predictors of acceptance in all models. However, the relationship between these variables and acceptance varied depending on the gender of the target child and the condition (depression or ADHD) in the models tested. The findings of the study suggest that the relationships between socio-demographic and attributional variables and acceptance of peers with mental health problems depend on the type of mental health problem under consideration. The findings have implications for the development of information and education programmes to improve the integration of children with mental health problems. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.

  6. FUZZY CLUSTERING BASED BAYESIAN FRAMEWORK TO PREDICT MENTAL HEALTH PROBLEMS AMONG CHILDREN

    Directory of Open Access Journals (Sweden)

    M R Sumathi

    2017-04-01

    Full Text Available According to World Health Organization, 10-20% of children and adolescents all over the world are experiencing mental disorders. Correct diagnosis of mental disorders at an early stage improves the quality of life of children and avoids complicated problems. Various expert systems using artificial intelligence techniques have been developed for diagnosing mental disorders like Schizophrenia, Depression, Dementia, etc. This study focuses on predicting basic mental health problems of children, like Attention problem, Anxiety problem, Developmental delay, Attention Deficit Hyperactivity Disorder (ADHD, Pervasive Developmental Disorder(PDD, etc. using the machine learning techniques, Bayesian Networks and Fuzzy clustering. The focus of the article is on learning the Bayesian network structure using a novel Fuzzy Clustering Based Bayesian network structure learning framework. The performance of the proposed framework was compared with the other existing algorithms and the experimental results have shown that the proposed framework performs better than the earlier algorithms.

  7. Mental health problems in a regional population of Australian adolescents: association with socio-demographic characteristics

    OpenAIRE

    Dray, Julia; Bowman, Jenny; Freund, Megan; Campbell, Elizabeth; Hodder, Rebecca K.; Lecathelinais, Christophe; Wiggers, John

    2016-01-01

    Background Population level data regarding the general mental health status, and the socio-demographic factors associated with the mental health status of adolescents in Australia aged 12?16?years is limited. This study assessed prevalence of mental health problems in a regional population of Australian students in Grades 7?10, and investigated associations between mental health problems and socio-demographic factors. Methods A web-based survey was conducted in 21 secondary schools located in...

  8. Pilot randomised controlled trial of the ENGAGER collaborative care intervention for prisoners with common mental health problems, near to and after release.

    Science.gov (United States)

    Lennox, Charlotte; Kirkpatrick, Tim; Taylor, Rod S; Todd, Roxanne; Greenwood, Clare; Haddad, Mark; Stevenson, Caroline; Stewart, Amy; Shenton, Deborah; Carroll, Lauren; Brand, Sarah L; Quinn, Cath; Anderson, Rob; Maguire, Mike; Harris, Tirril; Shaw, Jennifer; Byng, Richard

    2018-01-01

    Rates of common mental health problems are much higher in prison populations, but access to primary care mental health support falls short of community equivalence. Discontinuity of care on release is the norm and is further complicated by substance use and a range of social problems, e.g. homelessness. To address these problems, we worked with criminal justice, third sector social inclusion services, health services and people with lived experiences (peer researchers), to develop a complex collaborative care intervention aimed at supporting men with common mental health problems near to and following release from prison. This paper describes an external pilot trial to test the feasibility of a full randomised controlled trial. Eligible individuals with 4 to 16 weeks left to serve were screened to assess for common mental health problems. Participants were then randomised at a ratio of 2:1 allocation to ENGAGER plus standard care (intervention) or standard care alone (treatment as usual). Participants were followed up at 1 and 3 months' post release. Success criteria for this pilot trial were to meet the recruitment target sample size of 60 participants, to follow up at least 50% of participants at 3 months' post release from prison, and to deliver the ENGAGER intervention. Estimates of recruitment and retention rates and 95% confidence intervals (CIs) are reported. Descriptive analyses included summaries (percentages or means) for participant demographics, and baseline characteristics are reported. Recruitment target was met with 60 participants randomised in 9 months. The average retention rates were 73% at 1 month [95% CI 61 to 83] and 47% at 3 months follow-up [95% CI 35 to 59]. Ninety percent of participants allocated to the intervention successfully engaged with a practitioner before release and 70% engaged following release. This pilot confirms the feasibility of conducting a randomised trial for prison leavers with common mental health problems. Based

  9. Health Brokers: How Can They Help Deal with the Wickedness of Public Health Problems?

    Directory of Open Access Journals (Sweden)

    Celeste E. van Rinsum

    2017-01-01

    Full Text Available Background. The role of health broker is a relatively new one in public health. Health brokers aim to create support for efforts to optimise health promotion in complex or even “wicked” public health contexts by facilitating intersectoral collaborations and by exchanging knowledge with different stakeholders. The current study aimed to explore the role of health brokers, by examining the motivational, contextual, and behaviour-related factors they have to deal with. Methods. Fifteen professionals from various backgrounds and from various policy and practice organisations were recruited for a semistructured interview. To structure the interviews, we developed the “Health Broker Wheel” (HBW, a framework we then specified with more details derived from the interviews. Results. We identified seven primary types of behaviour that health brokers need to engage in: recognizing opportunities, agenda setting, implementing, network formation, intersectoral collaboration, adaptive managing, and leadership. Determinants of health brokers’ behaviours were identified and categorised as capability, opportunities, motivation, and local or national contextual factors. Conclusion. The health brokers’ role can be seen as an operational approach and is visualised in the HBW. This framework can assist further research to monitor and evaluate this role, and health promotion practitioners can use it as a tool to implement the health brokers’ role and to facilitate intersectoral collaboration.

  10. Health Brokers: How Can They Help Deal with the Wickedness of Public Health Problems?

    Science.gov (United States)

    van Rinsum, Celeste E; Gerards, Sanne M P L; Rutten, Geert M; van de Goor, Ien A M; Kremers, Stef P J

    2017-01-01

    The role of health broker is a relatively new one in public health. Health brokers aim to create support for efforts to optimise health promotion in complex or even "wicked" public health contexts by facilitating intersectoral collaborations and by exchanging knowledge with different stakeholders. The current study aimed to explore the role of health brokers, by examining the motivational, contextual, and behaviour-related factors they have to deal with. Fifteen professionals from various backgrounds and from various policy and practice organisations were recruited for a semistructured interview. To structure the interviews, we developed the "Health Broker Wheel" (HBW), a framework we then specified with more details derived from the interviews. We identified seven primary types of behaviour that health brokers need to engage in: recognizing opportunities, agenda setting, implementing, network formation, intersectoral collaboration, adaptive managing, and leadership. Determinants of health brokers' behaviours were identified and categorised as capability, opportunities, motivation, and local or national contextual factors. The health brokers' role can be seen as an operational approach and is visualised in the HBW. This framework can assist further research to monitor and evaluate this role, and health promotion practitioners can use it as a tool to implement the health brokers' role and to facilitate intersectoral collaboration.

  11. Complication amoebic liver abscess still a significant health problem ...

    African Journals Online (AJOL)

    Amoebic liver abscess still poses a serious clinical problem in tropical countries. Here we describe three complicated cases to illustrate the magnitude this disease condition could assume in the tropics. Limited access to health facilities as well as poverty and ignorance result in patients presenting late, often with ...

  12. Agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases

    Directory of Open Access Journals (Sweden)

    Fathelrahman Ahmed I

    2009-09-01

    Full Text Available Abstract Background The main objective of the present study was to evaluate the agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases. Methods Cross-sectional sample of 100 poisoning cases consecutively admitted to the Hospital Pulau Pinang, Malaysia during the period from September 2003 to February 2004 were studied. Data on health and socioeconomic problems were collected both by self-administered questionnaire and from medical records. Agreement between the two sets of data was assessed by calculating the concordance rate, Kappa (k and PABAK. McNemar statistic was used to test differences between categories. Results Data collected by questionnaire and medical records showed excellent agreement on the "marital status"; good agreements on "chronic illness", "psychiatric illness", and "previous history of poisoning"; and fair agreements on "at least one health problem", and "boy-girl friends problem". PABAK values suggest better agreements' measures. Conclusion There were excellent to good agreements between questionnaire and medical records on the marital status and most of the health problems and fair to poor agreements on the majority of socioeconomic problems. The implications of those findings were discussed.

  13. Integrative Treatment in Persons with Intellectual Disability and Mental Health Problems

    Science.gov (United States)

    Dosen, A.

    2007-01-01

    Background: Clinical experience has proven thus far that a monodisciplinary treatment approach to behavioural and psychiatric problems in persons with intellectual disability (ID), such as psychotropic medication or behaviour modification programmes, has yielded limited success. It is clear that the complexity of behavioural and psychiatric…

  14. Vision problems are a leading source of modifiable health expenditures.

    Science.gov (United States)

    Rein, David B

    2013-12-13

    According to recent studies, visual problems represent one of the top contributors to economic health burden in the United States. This burden is divided nearly equally between direct expenditures for the care and treatment of visual problems, and the indirect costs of outcomes caused by low vision, including productivity losses, the cost of care, and incremental nursing home placements. A large amount of academic research is devoted to visual science, the biology of the visual system, and the medical treatment of visual disorders. Compared to the burden, a disproportionate share of this research is devoted to the study of retinal disorders and glaucoma. This is understandable, as research into the retina and optic nerve has the potential to unlock fundamental insights into the nature of sight and visual cognition. However, population visual health and the functionality that depends upon it also may benefit greatly from additional research into areas of prevention, rehabilitation, and adaptation. In addition, comparative research into the benefits of resource allocation across prevention, treatment, and rehabilitative resources could lead to improvements in population health.

  15. Barriers and Facilitators of Responding to Problem Gambling: Perspectives from Australian Mental Health Services.

    Science.gov (United States)

    Rodda, S N; Manning, V; Dowling, N A; Lee, S J; Lubman, D I

    2018-03-01

    Despite high rates of comorbidity between problem gambling and mental health disorders, few studies have examined barriers or facilitators to the implementation of screening for problem gambling in mental health services. This exploratory qualitative study identified key themes associated with screening in mental health services. Semi-structured interviews were undertaken with 30 clinicians and managers from 11 mental health services in Victoria, Australia. Major themes and subthemes were identified using qualitative content analysis. Six themes emerged including competing priorities, importance of routine screening, access to appropriate screening tools, resources, patient responsiveness and workforce development. Barriers to screening included a focus on immediate risk as well as gambling being often considered as a longer-term concern. Clinicians perceived problem gambling as a relatively rare condition, but did acknowledge the need for brief screening. Facilitators to screening were changes to system processes, such as identification of an appropriate brief screening instrument, mandating its use as part of routine screening, as well as funded workforce development activities in the identification and management of problem gambling.

  16. Prevalence of mental health and behavioral problems among adolescents in institutional care in Jordan.

    Science.gov (United States)

    Gearing, Robin E; MacKenzie, Michael J; Schwalbe, Craig S; Brewer, Kathryne B; Ibrahim, Rawan W

    2013-02-01

    This study aimed to establish the prevalence rates of mental health and behavioral problems of Arab youths residing in Jordanian care centers due to family disintegration, maltreatment, or abandonment and to examine how functioning varies by child characteristics and placement history. Child Behavior Checklist and case history data were collected for 70 youths across four Jordanian care centers. Approximately 53% of the adolescents were identified as experiencing mental health problems, and 43% and 46% had high internalizing and externalizing scores, respectively. Ordinary least-squares regression models examining mental health functioning showed that male gender, care entry because of maltreatment, time in care, and transfers were the most significant predictors of problems. Paralleling international research, this study found high levels of mental health needs among institutionalized youths. The impact of transfers on functioning is particularly worrisome, given the standard practice of transferring youths to another facility when they reach age 12. Improving the institutional care model by requiring fewer transfers and offering family-based community alternatives may ameliorate risks of developing mental and behavioral problems.

  17. Coping with post-war mental health problems among survivors of violence in Northern Uganda: Findings from the WAYS study.

    Science.gov (United States)

    Amone-P'Olak, Kennedy; Omech, Bernard

    2018-05-01

    Cognitive emotion regulation strategies and mental health problems were assessed in a sample of war-affected youth in Northern Uganda. Univariable and multivariable regression models were fitted to assess the influence of CERS on mental health problems. Maladaptive cognitive emotion regulation strategies (e.g., rumination) were significantly associated with more mental health problems while adaptive cognitive emotion regulation strategies (e.g., putting into perspective) were associated with reporting fewer symptoms of mental health problems. The youth with significant scores on mental health problems (scores ≥ 85th percentile) reported more frequent use of maladaptive than adaptive strategies. Interventions to reduce mental health problems should focus on enhancing the use of adaptive strategies.

  18. [Insomnia. A severe health care problem].

    Science.gov (United States)

    Sánchez-Cárdenas, Ana Gabriela; Navarro-Gerrard, Christian; Nellen-Hummel, Haiko; Halabe-Cherem, José

    2016-01-01

    The magnitude which sleep has on personal well-being is similar to the effects of diet and exercise. Sleep deprivation has severe negative effects on an individual's overall health, and this is usually overseen. From 30 to 40 % of the population has presented insomnia at a certain moment of life and from 9 to 15 % have evolved into a chronic and severe insomnia. Recent investigations have related sleep deprivation with obesity, metabolic disorders, heart disease, mental health problems and dementia. Recently, more investigations have focused on the multiple alterations suffered by the immune system in cases of sleep deprivation. In order to make an opportune diagnosis of insomnia, it is vital to obtain a detailed history of the patients' sleep habits. In the physical exam one must search for signs and symptoms which might suggest an organic cause that generates the patient's insomnia. One of the pillars in treatment of these patients consists in acquiring an adequate sleep hygiene based on the optimization of the environment and the behavior that are associated with sleep.

  19. Embedding research in health systems: lessons from complexity theory.

    Science.gov (United States)

    Caffrey, Louise; Wolfe, Charles; McKevitt, Christopher

    2016-07-22

    Internationally, there has been increasing focus on creating health research systems. This article aims to investigate the challenges of implementing apparently simple strategies to support the development of a health research system. We focus on a case study of an English National Health Service Hospital Trust that sought to implement the national recommendation that health organisations should introduce a statement about research on all patient admission letters. We apply core concepts from complexity theory to the case study and undertake a documentary analysis of the email dialogue between staff involved in implementing this initiative. The process of implementing a research statement in patient admission letters in one clinical service took 1 year and 21 days. The length of time needed was influenced firstly by adaptive self-organisation, underpinned by competing interests. Secondly, it was influenced by the relationship between systems, rather than simply being a product of issues within those systems. The relationship between the health system and the research system was weaker than might have been expected. Responsibilities were unclear, leading to confusion and delayed action. Conventional ways of thinking about organisations suggest that change happens when leaders and managers change the strategic vision, structure or procedures in an organisation and then persuade others to rationally implement the strategy. However, health research systems are complex adaptive systems characterised by high levels of unpredictability due to self-organisation and systemic interactions, which give rise to 'emergent' properties. We argue for the need to study how micro-processes of organisational dynamics may give rise to macro patterns of behaviour and strategic organisational direction and for the use of systems approaches to investigate the emergent properties of health research systems.

  20. Self-reported unemployment status and recession: An analysis on the Italian population with and without mental health problems.

    Directory of Open Access Journals (Sweden)

    Fabrizio Starace

    Full Text Available During economic recession people with mental health problems have higher risk of losing their job. This paper analyses the issue by considering the Italian rates of unemployment amongst individuals with and without mental health problems in 2005 and 2013, that is prior and during the economic crisis.We used data from the National surveys on "Health conditions and use of health services" carried out by the Italian National Institute of Statistics (ISTAT for the years 2005 and 2013. The surveys collected information on the health status and socioeconomic conditions of the Italian population. Self-reported unemployment status was analysed amongst individuals with and without reported mental health problems. In addition, descriptive statistics were performed in order to detect possible differences in the risk of unemployment within different regional contexts characterised by different socio-economic conditions.The recession determined increased disparities in unemployment rates between people with and without mental health problems. Regardless to the presence of mental health problems, young people were more likely to be unemployed. Among people who reported mental health problems, males were more likely to be unemployed than females. People with low education level were more likely to be unemployed, particularly during the recession and in presence of mental health problems. Changes in unemployment rates due to the crisis showed different patterns across different regions of the Country.These analyses confirm that in periods of economic crisis people with mental health problems are at risk of experiencing exclusion from labour market. In addition, the impact is even worse within the group with low education and younger age. These findings emphasise the importance of specific interventions aimed at promoting labour market participation and reintegration for people with mental health problems.

  1. Self-reported unemployment status and recession: An analysis on the Italian population with and without mental health problems

    Science.gov (United States)

    Starace, Fabrizio; Mungai, Francesco; Sarti, Elena; Addabbo, Tindara

    2017-01-01

    Purpose During economic recession people with mental health problems have higher risk of losing their job. This paper analyses the issue by considering the Italian rates of unemployment amongst individuals with and without mental health problems in 2005 and 2013, that is prior and during the economic crisis. Methods We used data from the National surveys on “Health conditions and use of health services” carried out by the Italian National Institute of Statistics (ISTAT) for the years 2005 and 2013. The surveys collected information on the health status and socioeconomic conditions of the Italian population. Self-reported unemployment status was analysed amongst individuals with and without reported mental health problems. In addition, descriptive statistics were performed in order to detect possible differences in the risk of unemployment within different regional contexts characterised by different socio-economic conditions. Results The recession determined increased disparities in unemployment rates between people with and without mental health problems. Regardless to the presence of mental health problems, young people were more likely to be unemployed. Among people who reported mental health problems, males were more likely to be unemployed than females. People with low education level were more likely to be unemployed, particularly during the recession and in presence of mental health problems. Changes in unemployment rates due to the crisis showed different patterns across different regions of the Country. Conclusions These analyses confirm that in periods of economic crisis people with mental health problems are at risk of experiencing exclusion from labour market. In addition, the impact is even worse within the group with low education and younger age. These findings emphasise the importance of specific interventions aimed at promoting labour market participation and reintegration for people with mental health problems. PMID:28376098

  2. Correlation between patients' reasons for encounters/health problems and population density in Japan: a systematic review of observational studies coded by the International Classification of Health Problems in Primary Care (ICHPPC) and the International Classification of Primary care (ICPC).

    Science.gov (United States)

    Kaneko, Makoto; Ohta, Ryuichi; Nago, Naoki; Fukushi, Motoharu; Matsushima, Masato

    2017-09-13

    The Japanese health care system has yet to establish structured training for primary care physicians; therefore, physicians who received an internal medicine based training program continue to play a principal role in the primary care setting. To promote the development of a more efficient primary health care system, the assessment of its current status in regard to the spectrum of patients' reasons for encounters (RFEs) and health problems is an important step. Recognizing the proportions of patients' RFEs and health problems, which are not generally covered by an internist, can provide valuable information to promote the development of a primary care physician-centered system. We conducted a systematic review in which we searched six databases (PubMed, the Cochrane Library, Google Scholar, Ichushi-Web, JDreamIII and CiNii) for observational studies in Japan coded by International Classification of Health Problems in Primary Care (ICHPPC) and International Classification of Primary Care (ICPC) up to March 2015. We employed population density as index of accessibility. We calculated Spearman's rank correlation coefficient to examine the correlation between the proportion of "non-internal medicine-related" RFEs and health problems in each study area in consideration of the population density. We found 17 studies with diverse designs and settings. Among these studies, "non-internal medicine-related" RFEs, which was not thought to be covered by internists, ranged from about 4% to 40%. In addition, "non-internal medicine-related" health problems ranged from about 10% to 40%. However, no significant correlation was found between population density and the proportion of "non-internal medicine-related" RFEs and health problems. This is the first systematic review on RFEs and health problems coded by ICHPPC and ICPC undertaken to reveal the diversity of health problems in Japanese primary care. These results suggest that primary care physicians in some rural areas of Japan

  3. Mental health problems of Dutch adolescents: the association with adolescents' and their parents' educational level.

    Science.gov (United States)

    Havas, Jano; Bosma, Hans; Spreeuwenberg, Cor; Feron, Frans J

    2010-06-01

    We studied the hypothesis of socioeconomic equalization regarding adolescents' mental health problems by examining whether a low educational level of adolescents and their parents shows independent (cumulative) or dependent (including interactive) associations with adolescents' mental health problems, or whether equalization occurred. Cross-sectional data were obtained from the preventive Youth Health Care Centre in a relatively deprived Dutch former mining area. Participants were 1861 adolescents aged 13 or 14 years (response rate 71.7%). The self-administered Dutch version of the Strengths and Difficulties Questionnaire (SDQ) was used to identify adolescents' mental health problems. Multiple logistic regression analyses were used to examine the associations, and linear regression models to check the robustness of the findings. A low educational level of adolescents was strongly related to their mental health problems (OR = 5.37; 95% CI: 3.31-8.70). The initially high odds ratios for adolescents with low-educated parents (OR = 1.72; 95% CI: 1.14-2.59) disappeared after controlling for the adolescents' own educational level (OR = 1.12; 95% CI: 0.73-1.74). In terms of interactions, no specifically increased odds were found, e.g. for low-educated adolescents with high-educated parents. There was no evidence for socioeconomic equalization regarding adolescents' mental health problems. Lower educated adolescents had substantially higher odds of having mental health problems, regardless of their parents' education. The odds may be affected by differences in intelligence and life events. Youth healthcare workers should collaborate closely with schools to intervene in time, particularly among low-educated adolescents. More interventions are probably needed to reduce these major inequities.

  4. Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity

    Directory of Open Access Journals (Sweden)

    Stéphanie Stasse

    2015-01-01

    Full Text Available Background: Comzmercialization of health care has contributed to widen inequities between the rich and the poor, especially in settings with suboptimal regulatory frameworks of the health sector. Poorly regulated fee-for-service payment systems generate inequity and initiate a vicious circle in which access to quality health care gradually deteriorates. Although the abolition of user fees is high on the international health policy agenda, the sudden removal of user fees may have disrupting effects on the health system and may not be affordable or sustainable in resource-constrained countries, such as the Democratic Republic of Congo. Methods and Results: Between 2008 and 2011, the Belgian development aid agency (BTC launched a set of reforms in the Kisantu district, in the province of Bas Congo, through an action-research process deemed appropriate for the implementation of change within open complex systems such as the Kisantu local health system. Moreover, the entire process contributed to strengthen the stewardship capacity of the Kisantu district management team. The reforms mainly comprised the rationalization of resources and the regulation of health services financing. Flat fees per episode of disease were introduced as an alternative to fee-for-service payments by patients. A financial subsidy from BTC allowed to reduce the height of the flat fees. The provision of the subsidy was made conditional upon a range of measures to rationalize the use of resources. Conclusions: The results in terms of enhancing people access to quality health care were immediate and substantial. The Kisantu experience demonstrates that a systems approach is essential in addressing complex problems. It provides useful lessons for other districts in the country.

  5. Intervention complexity--a conceptual framework to inform priority-setting in health.

    Science.gov (United States)

    Gericke, Christian A; Kurowski, Christoph; Ranson, M Kent; Mills, Anne

    2005-04-01

    Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals.

  6. Intervention complexity--a conceptual framework to inform priority-setting in health.

    Science.gov (United States)

    Gericke, Christian A.; Kurowski, Christoph; Ranson, M. Kent; Mills, Anne

    2005-01-01

    Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals. PMID:15868020

  7. PREMATURITY, NEONATAL HEALTH STATUS, AND LATER CHILD BEHAVIORAL/EMOTIONAL PROBLEMS: A SYSTEMATIC REVIEW.

    Science.gov (United States)

    Cassiano, Rafaela G M; Gaspardo, Claudia M; Linhares, Maria Beatriz M

    2016-05-01

    Preterm birth can impact on child development. As seen previously, children born preterm present more behavioral and/or emotional problems than do full-term counterparts. In addition to gestational age, neonatal clinical status should be examined to better understand the differential impact of premature birth on later developmental outcomes. The aim of the present study was to systematically review empirical studies on the relationship between prematurity, neonatal health status, and behavioral and/or emotional problems in children. A systematic search of the PubMed, PsycINFO, Web of Science, and LILACS databases for articles published from 2009 to 2014 was performed. The inclusion criteria were empirical studies that evaluated behavioral and/or emotional problems that are related to clinical neonatal variables in children born preterm. Twenty-seven studies were reviewed. Results showed that the degree of prematurity and birth weight were associated with emotional and/or behavioral problems in children at different ages. Prematurity that was associated with neonatal clinical conditions (e.g., sepsis, bronchopulmonary dysplasia, and hemorrhage) and such treatments as corticoids and steroids increased the risk for these problems. The volume and abnormalities of specific brain structures also were associated with these outcomes. In conclusion, the neonatal health problems associated with prematurity present a negative impact on later child emotional and adapted behavior. © 2016 Michigan Association for Infant Mental Health.

  8. University staff experiences of students with mental health problems and their perceptions of staff training needs.

    Science.gov (United States)

    Gulliver, Amelia; Farrer, Louise; Bennett, Kylie; Ali, Kathina; Hellsing, Annika; Katruss, Natasha; Griffiths, Kathleen M

    2018-06-01

    University students experience high levels of mental health problems; however, very few seek professional help. Teaching staff within the university are well placed to assist students to seek support. To investigate university teaching staff experiences of, and training needs around, assisting students with mental health problems. A total of 224 teaching staff at the Australian National University completed an anonymous online survey (16.4% response rate from n ∼ 1370). Data on mental health training needs, and experiences of assisting students with mental health problems were described using tabulation. Qualitative data were analysed using thematic analysis. Most teaching staff (70.1-82.2%) reported at least moderate confidence in their ability to provide emotional support for students. However, many staff (60.0%) felt under-equipped overall to deal with student mental health problems; almost half (49.6%) reported they did not have access to formal training. Specific actions described in assisting students included referrals, offering support, or consulting others for advice. Given the high rates of students who approach staff about mental health problems, there is a critical need to provide and promote both formal mental health response training and explicit guidelines for staff on when, how, and where to refer students for help.

  9. Does the Association with Psychosomatic Health Problems Differ between Cyberbullying and Traditional Bullying?

    Science.gov (United States)

    Beckman, Linda; Hagquist, Curt; Hellstrom, Lisa

    2012-01-01

    The association between mental health problems and traditional bullying is well known, whereas the strength of the association in cyberbullying is less known. This study aimed to compare the association between mutually exclusive groups of bullying involvement and psychosomatic problems as measured by the PsychoSomatic Problems scale. The sample…

  10. Factors Associated With Service Use for Young Adolescents With Mental Health Problems

    Directory of Open Access Journals (Sweden)

    Siobhan M. Ryan

    2014-11-01

    Full Text Available The objective of the study wasto identify factors associated with use of services for adolescent mental health problems in an Australian community-based sample. Logistic regression analysis was conducted on data collected from 636 parents and their adolescent child to identify individual and family variables predicting parent report of service use for mental health problems in the adolescent 12 months later. The services most reported by parents to have been accessed were school-based ones. Multivariate analysis found that the following were associated with service use 12 months later: the adolescent being female, parent report of peer problems and hyperactivity, single-parent household, the parent being Australian born, and prior service use by the adolescent. Parental overcontrol was associated with reduced likelihood of service use at follow-up. No association was found between service use at follow-up and parent gender, socioeconomic status, number of siblings, parent psychopathology, family social connectedness, and prior service use by the parent. No association was also found for family environment factors, parental attachment, or for the adolescent’s emotional competence or use of social support. The results indicate that families provide a potential target for interventions aimed at increasing use of professional services for adolescent mental health problems.

  11. Severity of eczema and mental health problems in Japanese schoolchildren: The ToMMo Child Health Study.

    Science.gov (United States)

    Kuniyoshi, Yasutaka; Kikuya, Masahiro; Miyashita, Masako; Yamanaka, Chizuru; Ishikuro, Mami; Obara, Taku; Metoki, Hirohito; Nakaya, Naoki; Nagami, Fuji; Tomita, Hiroaki; Hozawa, Atsushi; Tsuji, Ichiro; Kure, Shigeo; Yaegashi, Nobuo; Yamamoto, Masayuki; Kuriyama, Shinichi

    2018-04-13

    The association between eczema and mental health problems in schoolchildren has been underexplored. We aimed to investigate this association with the validated questionnaires. Of 46,648 invited children, we analyzed 9954 (21.3%) in the 2nd to the 8th grades from the ToMMo Child Health Study conducted in 2014 and 2015, a cross-sectional survey in Miyagi Prefecture, Japan. We defined eczema status as "normal," "mild/moderate," or "severe," based on the presence of persistent flexural eczema and sleep disturbance, according to the International Study of Asthma and Allergies in Childhood (ISAAC) Eczema Symptom Questionnaire. Clinical ranges of Strengths and Difficulties Questionnaire (SDQ) total difficulties scores and four SDQ subcategories of emotional symptoms, conduct problems, hyperactivity/inattention, and peer problems were defined as scores ≥16, ≥5, ≥5, ≥7, and ≥5, respectively. The mean SDQ total difficulties score significantly increased as eczema status worsened (all P ≤ 0.004 for trend). The OR of scores in the clinical range for SDQ total difficulties were 1.51 (95% CI, 1.31-1.74) for mild/moderate eczema and 2.63 (95% CI, 1.91-3.63) for severe eczema (P eczema as a reference. The association between severity of eczema and four SDQ subcategories showed a similar trend (all P ≤ 0.017 for trend). We found a significant association between severity of eczema and mental health problems. The presence of eczema was associated with four SDQ subcategories. Copyright © 2018 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  12. [Private foundations Global Health Philanthropy: the problem of conflicts of interest].

    Science.gov (United States)

    2011-01-01

    Private foundations Global Health Philanthropy: the problem of conflicts of interest. Private foundations are in a position where they are granted several privileges and are very powerful and able to influence global health. A recent article published on Plos Medicine, analyzing five of the largest health foundations highlights the network of interests and conflicts. Many private health foundations have associations with private food and pharmaceutical corporations. In some instances, these corporations directly benefit from foundations grants, and foundations in turn are invested in the corporations to which they award these grants.

  13. Divide et impera: subgoaling reduces the complexity of probabilistic inference and problem solving.

    Science.gov (United States)

    Maisto, Domenico; Donnarumma, Francesco; Pezzulo, Giovanni

    2015-03-06

    It has long been recognized that humans (and possibly other animals) usually break problems down into smaller and more manageable problems using subgoals. Despite a general consensus that subgoaling helps problem solving, it is still unclear what the mechanisms guiding online subgoal selection are during the solution of novel problems for which predefined solutions are not available. Under which conditions does subgoaling lead to optimal behaviour? When is subgoaling better than solving a problem from start to finish? Which is the best number and sequence of subgoals to solve a given problem? How are these subgoals selected during online inference? Here, we present a computational account of subgoaling in problem solving. Following Occam's razor, we propose that good subgoals are those that permit planning solutions and controlling behaviour using less information resources, thus yielding parsimony in inference and control. We implement this principle using approximate probabilistic inference: subgoals are selected using a sampling method that considers the descriptive complexity of the resulting sub-problems. We validate the proposed method using a standard reinforcement learning benchmark (four-rooms scenario) and show that the proposed method requires less inferential steps and permits selecting more compact control programs compared to an equivalent procedure without subgoaling. Furthermore, we show that the proposed method offers a mechanistic explanation of the neuronal dynamics found in the prefrontal cortex of monkeys that solve planning problems. Our computational framework provides a novel integrative perspective on subgoaling and its adaptive advantages for planning, control and learning, such as for example lowering cognitive effort and working memory load. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  14. Exploring the relationship between quality of life and mental health problems in children: implications for measurement and practice.

    Science.gov (United States)

    Sharpe, Helen; Patalay, Praveetha; Fink, Elian; Vostanis, Panos; Deighton, Jessica; Wolpert, Miranda

    2016-06-01

    Quality of life is typically reduced in children with mental health problems. Understanding the relationship between quality of life and mental health problems and the factors that moderate this association is a pressing priority. This was a cross-sectional study involving 45,398 children aged 8-13 years from 880 schools in England. Self-reported quality of life was assessed using nine items from the KIDSCREEN-10 and mental health was assessed using the Me and My School Questionnaire. Demographic information (gender, age, ethnicity, socio-economic status) was also recorded. Quality of life was highest in children with no problems and lowest in children with both internalising and externalising problems. There was indication that quality of life may be reduced in children with internalising problems compared with externalising problems. Approximately 12 % children with mental health problems reported high quality of life. The link between mental health and quality of life was moderated by gender and age but not by socio-economic status or ethnicity. This study supports previous work showing mental health and quality of life are related but not synonymous. The findings have implications for measuring quality of life in child mental health settings and the need for approaches to support children with mental health problems that are at particular risk of poor quality of life.

  15. The Relationship between Students' Performance on Conventional Standardized Mathematics Assessments and Complex Mathematical Modeling Problems

    Science.gov (United States)

    Kartal, Ozgul; Dunya, Beyza Aksu; Diefes-Dux, Heidi A.; Zawojewski, Judith S.

    2016-01-01

    Critical to many science, technology, engineering, and mathematics (STEM) career paths is mathematical modeling--specifically, the creation and adaptation of mathematical models to solve problems in complex settings. Conventional standardized measures of mathematics achievement are not structured to directly assess this type of mathematical…

  16. Mental health problems in children with intellectual disability: Use of the Strengths and Difficulties Questionnaire

    NARCIS (Netherlands)

    Kaptein, S.; Jansen, D.E.M.C.; Vogels, A.G.C.; Reijneveld, S.A.

    2008-01-01

    Background: The assessment of mental health problems in children with intellectual disability (ID) mostly occurs by filling out long questionnaires that are not always validated for children without ID. The aim of this study is to assess the differences in mental health problems between children

  17. Problem structuring in Health Technology Assessment. An argumentative approach to increase its usefulness.

    NARCIS (Netherlands)

    Moret-Hartman, M.

    2008-01-01

    This thesis addresses the problem of the limited impact of Health Technology Assessment (HTA) research on health policy and clinical practice. HTA is a type of policy research that aims to provide information concerning medical technologies in order to support health care decision making. Although,

  18. The effect of salutogenic treatment principles on coping with mental health problems A randomised controlled trial.

    Science.gov (United States)

    Langeland, Eva; Riise, Trond; Hanestad, Berit R; Nortvedt, Monica W; Kristoffersen, Kjell; Wahl, Astrid K

    2006-08-01

    Although the theory of salutogenesis provides generic understanding of how coping may be created, this theoretical perspective has not been explored sufficiently within research among people suffering from mental health problems. The aim of this study is to investigate the effect of talk-therapy groups based on salutogenic treatment principles on coping with mental health problems. In an experimental design, the participants (residents in the community) were randomly allocated to a coping-enhancing experimental group (n=59) and a control group (n=47) receiving standard care. Coping was measured using the sense of coherence (SOC) questionnaire. Coping improved significantly in the experiment group (+6 points) compared with the control group (-2 points). The manageability component contributed most to this improvement. Talk-therapy groups based on salutogenic treatment principles improve coping among people with mental health problems. Talk-therapy groups based on salutogenic treatment principles may be helpful in increasing coping in the recovery process among people with mental health problems and seem to be applicable to people with various mental health problems.

  19. School nurses' perspectives on managing mental health problems in children and young people.

    Science.gov (United States)

    Pryjmachuk, Steven; Graham, Tanya; Haddad, Mark; Tylee, Andre

    2012-03-01

    To explore the views of school nurses regarding mental health problems in young people and their potential for engaging in mental health work with this client group. Mental health problems in children and young people are an important public health issue. Universal children's services play a key role in identifying and managing these problems and, while school nurses have an important function in this work, little is known about their views on this aspect of their role. A qualitative research design employing focus group methodology. School nurses (n = 33) were purposively sampled from four school nursing teams in two English cities for a series of focus groups. The focus group data were audio-recorded, transcribed and subsequently analysed using 'framework'. Four principal themes emerged from the data. In these themes, school nurses were found to value their involvement with the mental health of young people, recognising this as an important area of practice. Several obstacles to their work in this area were identified: heavy workloads, professional rivalries, a lack of confidence and limited education and training opportunities. The importance of support from local specialist mental health teams was emphasised. School nurses can be engaged in mental health work though, as public health specialists, their role should focus on health promotion, assessment, signposting and early intervention activities. To facilitate mental health work, school nurses are able to draw on established interpersonal skills and supportive networks; however, workload and a lack of confidence need to be managed and it is important that they are supported by constructive relationships with local specialist mental health teams. This study has implications for nurses and healthcare practitioners interested in enhancing the mental health of children and young people in school settings. © 2011 Blackwell Publishing Ltd.

  20. Problems in evaluating health effects of occupational and environmental exposures

    International Nuclear Information System (INIS)

    Gilbert, E.S.

    1981-01-01

    The assessment of health effects from low-level exposure to radiation is a matter of considerable controversy. Existing standards for exposure are based primarily on estimates of health effects obtained by extrapolation from effects of high-level exposures such as those experienced at Hiroshima and Nagasaki. Occupational and environmental exposures provide one source of data for this task. A number of studies of populations exposed in this manner have attracted recent attention. Because of the size of most of the groups and the magnitude of the exposures received, the amount that can be learned from such populations is severely limited. A number of the problems involved in analyzing and interpreting such data are addressed. Many of these problems are illustrated by a current study of the effects on mortality of occupational exposure to radiation at the Hanford plant