WorldWideScience

Sample records for current health system

  1. Current trends in health insurance systems: OECD countries vs. Japan.

    Science.gov (United States)

    Sasaki, Toshiyuki; Izawa, Masahiro; Okada, Yoshikazu

    2015-01-01

    Over the past few decades, the longest extension in life expectancy in the world has been observed in Japan. However, the sophistication of medical care and the expansion of the aging society, leads to continuous increase in health-care costs. Medical expenses as a part of gross domestic product (GDP) in Japan are exceeding the current Organization for Economic Co-operation and Development (OECD) average, challenging the universally, equally provided low cost health care existing in the past. A universal health insurance system is becoming a common system currently in developed countries, currently a similar system is being introduced in the United States. Medical care in Japan is under a social insurance system, but the injection of public funds for medical costs becomes very expensive for the Japanese society. In spite of some urgently decided measures to cover the high cost of advanced medical treatment, declining birthrate and aging population and the tendency to reduce hospital and outpatients' visits numbers and shorten hospital stays, medical expenses of Japan continue to be increasing.

  2. Current Trends in Health Insurance Systems: OECD Countries vs. Japan

    Science.gov (United States)

    SASAKI, Toshiyuki; IZAWA, Masahiro; OKADA, Yoshikazu

    2015-01-01

    Over the past few decades, the longest extension in life expectancy in the world has been observed in Japan. However, the sophistication of medical care and the expansion of the aging society, leads to continuous increase in health-care costs. Medical expenses as a part of gross domestic product (GDP) in Japan are exceeding the current Organization for Economic Co-operation and Development (OECD) average, challenging the universally, equally provided low cost health care existing in the past. A universal health insurance system is becoming a common system currently in developed countries, currently a similar system is being introduced in the United States. Medical care in Japan is under a social insurance system, but the injection of public funds for medical costs becomes very expensive for the Japanese society. In spite of some urgently decided measures to cover the high cost of advanced medical treatment, declining birthrate and aging population and the tendency to reduce hospital and outpatients’ visits numbers and shorten hospital stays, medical expenses of Japan continue to be increasing. PMID:25797778

  3. Public health system - current status and world experience

    Directory of Open Access Journals (Sweden)

    Andreyeva І.А.

    2016-09-01

    Full Text Available In the review, the evolution of Public Health and global development tendencies of Public Health system have been discussed. Stages of formation of the updated concept, principles of Public Health organization and the role of various organizations have been shown in the connection with development of the global concept of "Health for All". A well-functioning public health system is primarily the result of multisectoral cooperation. The aim of modern Public Health is to provide conditions of access to appropriate and cost-effective health care for all population groups, including health promotion and disease prevention.

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

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

    2009-09-01

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

  5. Future financial impact of the current health financing system.

    Science.gov (United States)

    Badham, J

    1998-01-01

    Major political parties remain publicly committed to Medicare and community-rated voluntary health insurance. It is important to understand the future financial consequences of this policy in order to assist community debate about whether such a commitment is appropriate or some other policy should be developed. This paper describes development of, and results from, the APHA health financing model. It suggests that health expenditure would represent 12.9% of gross domestic product by 2021, compared to 8.5% in 1995. Increasing per capita expenditure is the major contributor to the growth, with demographic changes responsible for only 14.3%.

  6. Public health services and systems research: current state of finance research.

    Science.gov (United States)

    Ingram, Richard C; Bernet, Patrick M; Costich, Julia F

    2012-11-01

    There is a growing recognition that the US public health system should strive for efficiency-that it should determine the optimal ways to utilize limited resources to improve and protect public health. The field of public health finance research is a critical part of efforts to understand the most efficient ways to use resources. This article discusses the current state of public health finance research through a review of public health finance literature, chronicles important lessons learned from public health finance research to date, discusses the challenges faced by those seeking to conduct financial research on the public health system, and discusses the role of public health finance research in relation to the broader endeavor of Public Health Services and Systems Research.

  7. The health care system for female workers and its current status in Japan.

    Science.gov (United States)

    Nohara, M; Kagawa, J

    2000-11-01

    In this paper we describe female workers' health care, the women's and maternal protection system within the Japanese legal system, the current status of female workers in Japan, and problems regarding methods of advancing health care and the women's or maternal protection system. Motherhood is respected in the workplace in Japan, and in order to provide an environment in which women can work and still bear and rear children with a sense of security, laws concerning maternal protection of female workers, and revisions in terms of the system have been made, and a new system has been in effect since the fiscal year of 1998. Nevertheless, gender discrimination against women and the disparagement of women, rooted in gender role stereotypes concerning the division of labor, remain firmly planted in the social environment and in long-established custom.

  8. Improving regional health care in West Africa using current space systems and technology

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    Jemison, Mae C.; Thomas, J. S.

    1992-01-01

    This paper discusses the issues involved with establishing an integrated satellite health network in West Africa based on currently available technology. The system proposed makes use of a central national facility capable of transmitting and receiving voice/data and video signals from the entire country. Regional, field and local facilities provides timely epidemiologic information, sharing of medical expertise through telemedical consultations, enhances optimized resource distribution and builds a framework for telecommunications for the entire country.

  9. The emergence and current performance of a health research system: lessons from Guinea Bissau

    Directory of Open Access Journals (Sweden)

    Kok Maarten O

    2012-02-01

    Full Text Available Abstract Background Little is known about how health research systems (HRS in low-income countries emerge and evolve over time, and how this process relates to their performance. Understanding how HRSs emerge is important for the development of well functioning National Health Research Systems (NHRS. The aim of this study was to assess how the HRS in Guinea Bissau has emerged and evolved over time and how the present system functions. Methods We used a qualitative case-study methodology to explore the emergence and current performance of the HRS, using the NHRS framework. We reviewed documents and carried out 39 in-depth interviews, ranging from health research to policy and practice stakeholders. Using an iterative approach, we undertook a thematic analysis of the data. Results The research practices in Guinea Bissau led to the emergence of a HRS with both local and international links and strong dependencies on international partners and donors. The post-colonial, volatile and resource-dependent context, changes in donor policies, training of local researchers and nature of the research findings influenced how the HRS evolved. Research priorities have mostly been set by 'expatriate' researchers and focused on understanding and reducing child mortality. Research funding is almost exclusively provided by foreign donors and international agencies. The training of Guinean researchers started in the mid-nineties and has since reinforced the links with the health system, broadened the research agenda and enhanced local use of research. While some studies have made an important contribution to global health, the use of research within Guinea Bissau has been constrained by the weak and donor dependent health system, volatile government, top-down policies of international agencies, and the controversial nature of some of the research findings. Conclusions In Guinea Bissau a de facto 'system' of research has emerged through research practices and co

  10. Who Would Be the Ideal Minister to Run the Current Health System of Iran?

    Science.gov (United States)

    Sajadi, Haniye Sadat; Majdzadeh, Reza

    2017-01-01

    In the course of progress toward achieving universal health coverage in the new term of President Rouhani, the health system of Iran will face with several challenges that have to be appropriately addressed. Sustainable financing, good governance, and comprehensive and fair health service delivery are examples of such challenges. A key issue is, therefore, who as a minister of health is qualified for this position? In this editorial, we answer this question based on the challenges that our health-care system has to go through and the criteria that have to be considered to deal with these challenges.

  11. Who would be the ideal minister to run the current health system of Iran?

    Directory of Open Access Journals (Sweden)

    Haniye Sadat Sajadi

    2017-01-01

    Full Text Available In the course of progress toward achieving universal health coverage in the new term of President Rouhani, the health system of Iran will face with several challenges that have to be appropriately addressed. Sustainable financing, good governance, and comprehensive and fair health service delivery are examples of such challenges. A key issue is, therefore, who as a minister of health is qualified for this position? In this editorial, we answer this question based on the challenges that our health-care system has to go through and the criteria that have to be considered to deal with these challenges.

  12. CURRENT ECONOMIC AND MEDICAL REFORMS IN THE ROMANIAN HEALTH CARE SYSTEM

    Directory of Open Access Journals (Sweden)

    Dragoi Mihaela Cristina

    2011-12-01

    Full Text Available The issue of health has always been, both in social reality and in academia and research, a sensitive topic considering the relationship each individual has with his own health and the health care system as a public policy. At public opinion levels and not only, health care is the most important sector demanding the outmost attention, considering that individual health is the fundamental prerequisite for well-being, happiness and a satisfying life. The ever present research and practical question is on the optimal financing of the health care system. Any answer to this question is also a political decision, reflecting the social-economic value of health for a particular country. The size of the resource pool and the criteria and methods for resource allocation are the central economic problems for any health system. This paper takes into consideration the limited resources of the national health care system (the rationalization of health services, the common methods of health financing, the specificity of health services market (the health market being highly asymmetric, with health professionals knowing most if not all of the relevant information, such as diagnosis, treatment options and costs and consumers fully dependent on the information provided in each case and the performance of all hospitals in Romania, in order to assess the latest strategic decisions (introduction of co-payment and merging and reconversion of hospitals taken within the Romanian health care system and their social and economic implications. The main finding show that, even though the intention of reforming and transforming the Romanian health care system into a more efficient one is obvious, the lack of economic and demographic analysis may results into greater discrepancies nationwide. This paper is aimed to renew the necessity of joint collaboration between the economic and medical field, since the relationship between health and economic development runs both ways

  13. [Capital accumulation patterns: capital and services in the current transformations of the health system].

    Science.gov (United States)

    de Andreazzi, Maria de Fátima Siliansky; Kornis, George Edward Machado

    2008-01-01

    The purpose of this article is to introduce elements of the capitalist society economic reproduction to the discussion around the current dynamics of health accumulation. It identifies the direction and significance of capital accumulation in the health area as well as the characteristics of the economic environment where the competition currently takes place. The hypothetic hypertrophy of the financial sphere is seen as a means for structuring the capitalist economy since the late twentieth century. The former delimitations between industrial production and service delivery are blurred and weakened; the competition process shows new features and the contradictions - internally between the different elements of the health industry and externally with other sectors - are changing. This article aggregates elements for a contemporary analysis of the "medical-industrial complex" on the basis of a theoretical-historical-conceptual approach. We identify changes in the capital dynamics of this complex at international and national level and stress the increasing role of the health services as a forefront of capital accumulation. The new approach is based on the economic thinking of Marx in addition to the current discussions about the theory of financial capital accumulation and the new productive configurations of the large corporations.

  14. The health systems' priority setting criteria for selecting health technologies: A systematic review of the current evidence

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    Mobinizadeh, Mohammadreza; Raeissi, Pouran; Nasiripour, Amir Ashkan; Olyaeemanesh, Alireza; Tabibi, Seyed Jamaleddin

    2016-01-01

    Background: In the recent years, using health technologies to diagnose and treat diseases has had a considerable and accelerated growth. The proper use of these technologies may considerably help in the diagnosis and treatment of different diseases. On the other hand, unlimited and unrestricted entry of these technologies may result in induced demand by service providers. The aim of this study was to determine the appropriate criteria used in health technologies priority-setting models in the world. Methods: Using MESH and free text, we sought and retrieved the relevant articles from the most appropriate medical databases (the Cochrane Library, PubMed and Scopus) through three separate search strategies up to March 2015. The inclusion criteria were as follows: 1) Studies with specific criteria; 2) Articles written in English; 3) Those articles conducted in compliance with priority setting of health technologies. Data were analyzed qualitatively using a thematic synthesis technique. Results: After screening the retrieved papers via PRISMA framework, from the 7,012 papers, 40 studies were included in the final phase. Criteria for selecting health technologies (in pre assessment and in the assessment phase) were categorized into six main themes: 1) Health outcomes; 2) Disease and target population; 3) Technology alternatives; 4) Economic aspects; 5) Evidence; 6) and other factors. "Health effects/benefits" had the maximum frequency in health outcomes (8 studies); "disease severity" had the maximum frequency in disease and target population (12 studies); "the number of alternatives" had the maximum frequency in alternatives (2 studies); "cost-effectiveness" had the maximum frequency in economic aspects (15 studies); "quality of evidence" had the maximum frequency in evidence (4 studies); and "issues concerning the health system" had the maximum frequency in other factors (10 studies). Conclusion: The results revealed an increase in the number of studies on health

  15. Evaluating Current and Future Rangeland Health in the Great Basin Ecoregion Using NASA Earth Observing Systems

    Science.gov (United States)

    Essoudry, E.; Wilson, K.; Ely, J.; Patadia, N.; Zajic, B.; Torres-Perez, J. L.; Schmidt, C.

    2014-12-01

    The Great Basin ecoregion in the western United States represents one of the last large expanses of wild lands in the nation and is currently facing significant challenges due to human impacts, drought, invasive species encroachment such as cheatgrass, and climate change. Rangelands in the Great Basin are of important ecological and economic significance for the United States; however, 40% of public rangelands fail to meet required health standards set by the Bureau of Land Management (BLM). This project provided a set of assessment tools for researchers and land managers that integrate remotely-sensed and in situ datasets to quantify and mitigate threats to public lands in the Great Basin ecoregion. The study area, which accounts for 20% of the total Great Basin ecoregion, was analyzed using 30 m resolution data from Landsat 8. Present conditions were evaluated from vegetation indices, landscape features, hydrological processes, and atmospheric conditions derived from the remotely-sensed data and validated with available in situ ground survey data, provided by the BLM. Rangeland health metrics were developed and landscape change drivers were identified. Subsequently, projected climate conditions derived from the Coupled Model Intercomparison Project (CMIP5) were used to forecast the impact of changing climatic conditions within the study area according to the RCP4.5 and RCP8.5 projections. These forecasted conditions were used in the Maximum Entropy Model (MaxEnt) to predict areas at risk for rangeland degradation on 30 year intervals for 2040, 2070, and 2100. Finally, vegetation health risk maps were provided to the project partners to aid in future land management decisions in the Great Basin ecoregion. These tools provide a low cost solution to assess landscape conditions, provide partners with a metric to identify potential problematic areas, and mitigate serious threats to the ecosystems.

  16. Current health care system policy for vulnerability reduction in the United States of America: a personal perspective.

    Science.gov (United States)

    Eckenfels, Edward J

    2002-04-01

    To raise questions about how the United States of America, which spends 1.3 trillion dollars on health care, conducts cutting-edge biomedical research, has the most advanced medical technology, and trains a cadre of highly competent health professionals cares for the most vulnerable members of its population. Relevant statistical data were extrapolated from the most current statistical sources and research reports, and assessed in terms of existing practices and policies. The data clearly demonstrated that particular population cohorts -- the elderly, the poor, new immigrants, the homeless, the HIV-positive, and substance abusers -- were especially vulnerable to illness and its consequences. Since American medicine, despite all of its science, technology, and clinical competence, operates in a non-system, there is currently no efficacious approach to vulnerability reduction. To turn health care in the U.S. into a high quality, comprehensive, and cost-effective system, government officials, health care planners, and medical practitioners must address a series of fundamental social, economic, and political issues. What other countries, like those in South Eastern Europe, can learn from this is not to duplicate these mistakes.

  17. Current Issues in Maritime Health

    DEFF Research Database (Denmark)

    Wagtmann, Maria Anne

    2008-01-01

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

  18. Application of structural health monitoring technologies to bio-systems: current status and path forward

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    Bhalla, Suresh; Srivastava, Shashank; Suresh, Rupali; Moharana, Sumedha; Kaur, Naveet; Gupta, Ashok

    2015-03-01

    This paper presents a case for extension of structural health monitoring (SHM) technologies to offer solutions for biomedical problems. SHM research has made remarkable progress during the last two/ three decades. These technologies are now being extended for possible applications in the bio-medical field. Especially, smart materials, such as piezoelectric ceramic (PZT) patches and fibre-Bragg grating (FBG) sensors, offer a new set of possibilities to the bio-medical community to augment their conventional set of sensors, tools and equipment. The paper presents some of the recent extensions of SHM, such as condition monitoring of bones, monitoring of dental implant post surgery and foot pressure measurement. Latest developments, such as non-bonded configuration of PZT patches for monitoring bones and possible applications in osteoporosis detection, are also discussed. In essence, there is a whole new gamut of new possibilities for SHM technologies making their foray into the bi-medical sector.

  19. Current stress and poor oral health

    OpenAIRE

    Vasiliou, A.; Shankardass, K.; Nisenbaum, R; Quiñonez, C.

    2016-01-01

    Background Psychological stress appears to contribute to poor oral health systemically in combination with other chronic diseases. Few studies directly examine this relationship. Methods Data from a cross-sectional study of 2,412 participants between the ages of 25–64 years old living in the City of Toronto between 2009 and 2012 were used to examine the relationship between current stress and two self-rated oral health outcomes (general oral health and oral pain). Dental care utilization and ...

  20. Current situations and future directions for mental health system governance in Nepal: findings from a qualitative study.

    Science.gov (United States)

    Upadhaya, Nawaraj; Jordans, Mark J D; Pokhrel, Ruja; Gurung, Dristy; Adhikari, Ramesh P; Petersen, Inge; Komproe, Ivan H

    2017-01-01

    Assessing and understanding health systems governance is crucial to ensure accountability and transparency, and to improve the performance of mental health systems. There is a lack of systematic procedures to assess governance in mental health systems at a country level. The aim of this study was to appraise mental health systems governance in Nepal, with the view to making recommendations for improvements. In-depth individual interviews were conducted with national-level policymakers (n = 17) and district-level planners (n = 11). The interview checklist was developed using an existing health systems governance framework developed by Siddiqi and colleagues as a guide. Data analysis was done with NVivo 10, using the procedure of framework analysis. The mental health systems governance assessment reveals a few enabling factors and many barriers. Factors enabling good governance include availability of mental health policy, inclusion of mental health in other general health policies and plans, increasing presence of Non-Governmental Organizations (NGOs) and service user organizations in policy forums, and implementation of a few mental health projects through government-NGO collaborations. Legal and policy barriers include the failure to officially revise or fully implement the mental health policy of 1996, the existence of legislation and several laws that have discriminatory provisions for people with mental illness, and lack of a mental health act and associated regulations to protect against this. Other barriers include lack of a mental health unit within the Ministry of Health, absence of district-level mental health planning, inadequate mental health record-keeping systems, inequitable allocation of funding for mental health, very few health workers trained in mental health, and the lack of availability of psychotropic drugs at the primary health care level. In the last few years, some positive developments have emerged in terms of policy recognition for

  1. Health systems

    DEFF Research Database (Denmark)

    Büchner, Vera Antonia; Hinz, Vera; Schreyögg, Jonas

    2016-01-01

    This study investigates potential changes in hospital performance after health system entry, while differentiating between hospital technical and cost efficiency and hospital profitability. In the first stage we obtained (bootstrapped) data envelopment analysis (DEA) efficiency scores. Then......, genetic matching is used as a novel matching procedure in this context along with a difference-in-difference approach within a panel regression framework. With the genetic matching procedure, independent and health system hospitals are matched along a number of environmental and organizational...... characteristics. The results show that health system entry increases hospital technical and cost efficiency by between 0.6 and 3.4 % in four alternative post-entry periods, indicating that health system entry has not a transitory but rather a permanent effect on hospital efficiency. Regarding hospital...

  2. Reforming health care in Canada: current issues

    Directory of Open Access Journals (Sweden)

    Baris Enis

    1998-01-01

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

  3. The current child and adolescent health screening system: an assessment and proposal for an early and periodic check-up program

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    Baik-Lin Eun

    2010-03-01

    Full Text Available Purpose : Recent changes in the population structure of Korea, such as rapid decline in birth rate and exponential increase in old-aged people, prompted us to prepare a new health improvement program in children and adolescents. Methods : We reviewed current health screenings applied for children and adolescents in Korea and other developed countries. We collected and reviewed population-based data focused on mortality and morbidity, and other health-related statistical data. We generated problem lists in current systems and developed new principles. Results : Current health screening programs for children and adolescents were usually based on laboratory tests, such as blood tests, urinalysis, and radiologic tests. Almost all of these programs lacked evidence based on population data or controlled studies. In most developed countries, laboratory tests are used only very selectively, and they usually focus on primary prevention of diseases and health improvement using anticipatory guidance. In Korea, statistics on mortality and morbidity reveal that diseases related to lifestyle, such as obesity and metabolic syndrome, are increasing in all generations. Conclusion : We recommend a periodic health screening program with anticipatory guidance, which is focused on growth and developmental surveillance in infants and children. We no longer recommend old programs that are based on laboratory and radiologic examinations. School health screening programs should also be changed to meet current health issues, such as developing a healthier lifestyle to minimize risk behaviors—for example, good mental health, balanced nutrition, and more exercise.

  4. Current challenges and future perspectives of the role of governments in the psychiatric/mental health systems of Latin America.

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    Maass, Juan; Mella, Cesar; Risco, Luis

    2010-01-01

    The practices and systems of mental health in Latin America and the Caribbean are heterogeneous and are connected to dissociation between national macro systems and the complex quotidian that occurs in the daily attention of mental pathologies. The health care experiences in mental health are diverse and go back to the 1960s; these took a boost with the Caracas Declaration of 1990. The Health Care Reform has had several stages, lately focused in the strength that derives from a growing psychiatric epidemiology "base". In addition, it notes that the majority of countries have a National Plan of Mental Health, but they do not seem purposely deployed in local developmental plans or in other sectors. It is proposed the existence of a willing to discuss psychiatry, critical and bold; trans and intrasectoral face to the national and communal developments. Governments need to prioritize strategies in mental health as an integral part of another national project with regard for quality of life and productivity of citizens. The communication poses challenges for the next 15 years, with what is complete the first quarter of this century, proposing a series of measures even basic, but valid for this part of the continent.

  5. Perceptions of Medical School Seniors of the Current Changes in the U.S. Health Care System.

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    Hojat, Mohammadreza; Veloski, J. Jon; Louis, Daniel Z.; Xu, Gang; Ibarra, David; Gottlieb, Jonathan E.; Erdmann, James B.

    1999-01-01

    Surveyed 196 medical college seniors about changes in the health-care system. Of the respondents, 79% believed that cost reduction rather than quality of care is the primary consideration behind recent changes, and 78% thought that managed-care organizations hamper physician ability in rendering optimal care. Discusses implications for curricular…

  6. Uncertainty analysis of practical structural health monitoring systems currently employed for tall buildings consisting of small number of sensors

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    Hirai, Kenta; Mita, Akira

    2016-04-01

    Because of social background, such as repeated large earthquakes and cheating in design and construction, structural health monitoring (SHM) systems are getting strong attention. The SHM systems are in a practical phase. An SHM system consisting of small number of sensors has been introduced to 6 tall buildings in Shinjuku area. Including them, there are 2 major issues in the SHM systems consisting of small number of sensors. First, optimal system number of sensors and the location are not well-defined. In the practice, system placement is determined based on rough prediction and experience. Second, there are some uncertainties in estimation results by the SHM systems. Thus, the purpose of this research is to provide useful information for increasing reliability of SHM system and to improve estimation results based on uncertainty analysis of the SHM systems. The important damage index used here is the inter-story drift angle. The uncertainty considered here are number of sensors, earthquake motion characteristics, noise in data, error between numerical model and real building, nonlinearity of parameter. Then I have analyzed influence of each factor to estimation accuracy. The analysis conducted here will help to decide sensor system design considering valance of cost and accuracy. Because of constraint on the number of sensors, estimation results by the SHM system has tendency to provide smaller values. To overcome this problem, a compensation algorithm was discussed and presented. The usefulness of this compensation method was demonstrated for 40 story S and RC building models with nonlinear response.

  7. Health Care Information Systems.

    Science.gov (United States)

    Banks, Jane L.; And Others

    1987-01-01

    The first of eight articles discusses the current state of the sensitive but unclassified information controversy. A series of six articles then explores the use of integrated information systems in the area of health services. Current trends in document management are provided in the last article. (CLB)

  8. Current limiter circuit system

    Energy Technology Data Exchange (ETDEWEB)

    Witcher, Joseph Brandon; Bredemann, Michael V.

    2017-09-05

    An apparatus comprising a steady state sensing circuit, a switching circuit, and a detection circuit. The steady state sensing circuit is connected to a first, a second and a third node. The first node is connected to a first device, the second node is connected to a second device, and the steady state sensing circuit causes a scaled current to flow at the third node. The scaled current is proportional to a voltage difference between the first and second node. The switching circuit limits an amount of current that flows between the first and second device. The detection circuit is connected to the third node and the switching circuit. The detection circuit monitors the scaled current at the third node and controls the switching circuit to limit the amount of the current that flows between the first and second device when the scaled current is greater than a desired level.

  9. Israel: Health System Review.

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    Rosen, Bruce; Waitzberg, Ruth; Merkur, Sherry

    2015-01-01

    Israel is a small country, with just over 8 million citizens and a modern market-based economy with a comparable level of gross domestic product per capita to the average in the European Union. It has had universal health coverage since the introduction of a progressively financed statutory health insurance system in 1995. All citizens can choose from among four competing, non-profit-making health plans, which are charged with providing a broad package of benefits stipulated by the government. Overall, the Israeli health care system is quite efficient. Health status levels are comparable to those of other developed countries, even though Israel spends a relatively low proportion of its gross domestic product on health care (less than 8%) and nearly 40% of that is privately financed. Factors contributing to system efficiency include regulated competition among the health plans, tight regulatory controls on the supply of hospital beds, accessible and professional primary care and a well-developed system of electronic health records. Israeli health care has also demonstrated a remarkable capacity to innovate, improve, establish goals, be tenacious and prioritize. Israel is in the midst of numerous health reform efforts. The health insurance benefits package has been extended to include mental health care and dental care for children. A multipronged effort is underway to reduce health inequalities. National projects have been launched to measure and improve the quality of hospital care and reduce surgical waiting times, along with greater public dissemination of comparative performance data. Major steps are also being taken to address projected shortages of physicians and nurses. One of the major challenges currently facing Israeli health care is the growing reliance on private financing, with potentially deleterious effects for equity and efficiency. Efforts are currently underway to expand public financing, improve the efficiency of the public system and constrain

  10. Systems thinking in practice: the current status of the six WHO building blocks for health system strengthening in three BHOMA intervention districts of Zambia: a baseline qualitative study.

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    Mutale, Wilbroad; Bond, Virginia; Mwanamwenge, Margaret Tembo; Mlewa, Susan; Balabanova, Dina; Spicer, Neil; Ayles, Helen

    2013-08-01

    The primary bottleneck to achieving the MDGs in low-income countries is health systems that are too fragile to deliver the volume and quality of services to those in need. Strong and effective health systems are increasingly considered a prerequisite to reducing the disease burden and to achieving the health MDGs. Zambia is one of the countries that are lagging behind in achieving millennium development targets. Several barriers have been identified as hindering the progress towards health related millennium development goals. Designing an intervention that addresses these barriers was crucial and so the Better Health Outcomes through Mentorship (BHOMA) project was designed to address the challenges in the Zambia's MOH using a system wide approach. We applied systems thinking approach to describe the baseline status of the Six WHO building blocks for health system strengthening. A qualitative study was conducted looking at the status of the Six WHO building blocks for health systems strengthening in three BHOMA districts. We conducted Focus group discussions with community members and In-depth Interviews with key informants. Data was analyzed using Nvivo version 9. The study showed that building block specific weaknesses had cross cutting effect in other health system building blocks which is an essential element of systems thinking. Challenges noted in service delivery were linked to human resources, medical supplies, information flow, governance and finance building blocks either directly or indirectly. Several barriers were identified as hindering access to health services by the local communities. These included supply side barriers: Shortage of qualified health workers, bad staff attitude, poor relationships between community and health staff, long waiting time, confidentiality and the gender of health workers. Demand side barriers: Long distance to health facility, cost of transport and cultural practices. Participating communities seemed to lack the capacity

  11. The concept of "intercultural opening": the development of an assessment tool for the appraisal of its current implementation in the mental health care system.

    Science.gov (United States)

    Penka, S; Kluge, U; Vardar, A; Borde, T; Ingleby, D

    2012-06-01

    The German concept of "intercultural opening" is an approach to facilitating migrants' access to the health care system and improving the care they receive. No data exist concerning the current status of the implementation of this approach in Germany, and the concept has never been analysed in practice. To assess the status of "intercultural opening" in the German mental health care system and to further analyse the concept, we developed a tool by combining pre-existing instruments. In order to review the preliminary tool we combined experts' knowledge by carrying out a consensusoriented, expert-based Delphi process with actual practice by piloting the instrument in each type of institution to be assessed. The assessment tool thus developed(1) is the first one to evaluate the current status of "intercultural opening" in the community mental health care system in Germany from a broad perspective. This paper is intended to present the development process of our assessment tool for demonstrating the benefits of this approach and as a model for future studies, as well as to increase transparency in relation to the current German approach to health care structures in dealing with migrants. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  12. Global Health - Cancer Currents Blog

    Science.gov (United States)

    A catalog of posts from NCI’s Cancer Currents blog on research related to cancer’s impact around the world. Includes posts on factors that influence global cancer incidence and mortality and new research initiatives.

  13. The current status of the Korean student health examination

    Directory of Open Access Journals (Sweden)

    Hye-Jung Shin

    2013-08-01

    Full Text Available Recent trends place an emphasis on school health care, the ultimate goal of which is to protect,maintain, and promote students’ health. School health care is a program that integrates health careservices, health education, health counseling, and local social health services. The student healthexamination (SHE system is a part of school health care and schools and communities must beavailable to provide professional health services. Pediatricians also have important roles as experts inboth school health care and the SHE system. In this article, the history of school health care, its legalbasis, and the current status of the SHE system in Korea are reviewed. Furthermore, sample surveysfrom the past few years are reviewed. Through this holistic approach, future directions are proposed forthe improvement of SHE and school health care.

  14. M-Health: Emerging Mobile Health Systems

    Science.gov (United States)

    Istepanian, Robert; Laxminarayan, Swamy; Pattichis, Constantinos S.

    M-health can be defined as the "emerging mobile communications and network technologies for healthcare systems.' This book paves the path toward understanding the future of m-health technologies and services and also introducing the impact of mobility on existing e-health and commercial telemedical systems. M-Health: Emerging Mobile Health Systems presents a new and forward-looking source of information that explores the present and future trends in the applications of current and emerging wireless communication and network technologies for different healthcare scenaria.

  15. Amoeba-related health risk in drinking water systems: could monitoring of amoebae be a complementary approach to current quality control strategies?

    Science.gov (United States)

    Codony, Francesc; Pérez, Leonardo Martín; Adrados, Bárbara; Agustí, Gemma; Fittipaldi, Mariana; Morató, Jordi

    2012-01-01

    Culture-based methods for fecal indicator microorganisms are the standard protocol to assess potential health risk from drinking water systems. However, these traditional fecal indicators are inappropriate surrogates for disinfection-resistant fecal pathogens and the indigenous pathogens that grow in drinking water systems. There is now a range of molecular-based methods, such as quantitative PCR, which allow detection of a variety of pathogens and alternative indicators. Hence, in addition to targeting total Escherichia coli (i.e., dead and alive) for the detection of fecal pollution, various amoebae may be suitable to indicate the potential presence of pathogenic amoeba-resisting microorganisms, such as Legionellae. Therefore, monitoring amoeba levels by quantitative PCR could be a useful tool for directly and indirectly evaluating health risk and could also be a complementary approach to current microbial quality control strategies for drinking water systems.

  16. Greece: Health system review.

    Science.gov (United States)

    Economou, Charalambos

    2010-01-01

    financing and equity in access to health care services. Efficiency is in question due to the lack of incentives to improve performance in the public sector. Mechanisms for needs assessment and priority-setting are underdeveloped and, as a consequence, the regional distribution of health resources is unequal. Centralization of the system is coupled with a lack of planning and coordination, and limited managerial and administrative capacity. In addition, the oversupply of physicians, the absence of a referral system, and irrational pricing and reimbursement policies are factors encouraging under-the-table payments and the black economy. These shortcomings result in low satisfaction with the health care system expressed by citizens. The landmark in the development of the Greek health care system was the creation of the national health system (ESY) in 1983. This report describes the development of the ESY at the structural level and generally, the process of implementing reforms. The strategic targets of health reform initiatives have been to structure a unified health care sector along the lines of the original ESY proposal and to cope with current inefficiencies. However, the three reforms attempted in the 1990s were never fully implemented, while the ambitious reform project of the period 2000–2004, which provided for the regionalization of the system, new management structures, prospective reimbursement, new employment conditions for hospital doctors, modernization of public health services and reorganization of primary health care, was abolished after the elections of 2004 and a change in government. While the new strategy, launched in 2005 with the stated aims of securing the financial viability of the health care system in the short term and its sustainability in the long term, addressed specific weaknesses, it has been rather controversial: the introduction of a centralized administrative public procurement system, the development of public–private partnerships

  17. HLS bunch current measurement system

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Bunch current is an important parameter for studying the injection fill-pattern in the storage ring and the instability threshold of the bunch, and the bunch current monitor also is an indispensable tool for the top-up injection. A bunch current measurement (BCM) system has been developed to meet the needs of the upgrade project of Hefei Light Source (HLS). This paper presents the layout of the BCM system. The system based on a high-speed digital oscilloscope can be used to measure the bunch current and synchronous phase shift. To obtain the absolute value of bunch-by-bunch current, the calibration coefficient is measured and analyzed. Error analysis shows that the RMS of bunch current is less than 0.01 mA when bunch current is about 5 mA, which can meet project requirement.

  18. Hungary health system review.

    Science.gov (United States)

    Gaal, Peter; Szigeti, Szabolcs; Csere, Marton; Gaskins, Matthew; Panteli, Dimitra

    2011-01-01

    diversified over the past 15 years, but the current mix has yet to be tested for sustainability. The fit between existing capacities and the health care needs of the population remains less than ideal, but improvements have been made over the past 15 years. In general, the average length of stay and hospital admission rates have decreased since 1990, as have bed occupancy rates. However, capacity for long-term nursing care in both the inpatient and outpatient setting is still considered insufficient. Hungary is currently also facing a health workforce crisis, explained by the fact that it is a net donor country with regard to health care worker migration, and health care professionals on the whole are ageing. Although the overall technical efficiency of the system has increased considerably, mainly due to the introduction of output-based payment systems, allocative efficiency remains a problem. Considerable variations exist in service delivery both geographically and by specialization, and equity of access is far from being realized, a fact which is mirrored in differing health outcomes for different population groups. A key problem is the continuing lack of an overarching, evidence-based strategy for mobilizing resources for health, which leaves the health system vulnerable to broader economic policy objectives and makes good governance hard to achieve. On the other hand, Hungary is a target country for cross-border health care, mainly for dental care but also for rehabilitative services, such as medical spa treatment. The health industry can thus be a potential strategic area for economic development and growth.

  19. A Review and Framework for Categorizing Current Research and Development in Health Related Geographical Information Systems (GIS) Studies.

    Science.gov (United States)

    Lyseen, A K; Nøhr, C; Sørensen, E M; Gudes, O; Geraghty, E M; Shaw, N T; Bivona-Tellez, C

    2014-08-15

    The application of GIS in health science has increased over the last decade and new innovative application areas have emerged. This study reviews the literature and builds a framework to provide a conceptual overview of the domain, and to promote strategic planning for further research of GIS in health. The framework is based on literature from the library databases Scopus and Web of Science. The articles were identified based on keywords and initially selected for further study based on titles and abstracts. A grounded theory-inspired method was applied to categorize the selected articles in main focus areas. Subsequent frequency analysis was performed on the identified articles in areas of infectious and non-infectious diseases and continent of origin. A total of 865 articles were included. Four conceptual domains within GIS in health sciences comprise the framework: spatial analysis of disease, spatial analysis of health service planning, public health, health technologies and tools. Frequency analysis by disease status and location show that malaria and schistosomiasis are the most commonly analyzed infectious diseases where cancer and asthma are the most frequently analyzed non-infectious diseases. Across categories, articles from North America predominate, and in the category of spatial analysis of diseases an equal number of studies concern Asia. Spatial analysis of diseases and health service planning are well-established research areas. The development of future technologies and new application areas for GIS and data-gathering technologies such as GPS, smartphones, remote sensing etc. will be nudging the research in GIS and health.

  20. [Current state and prospects of military personnel health monitoring].

    Science.gov (United States)

    Rezvantsev, M V; Kuznetsov, S M; Ivanov, V V; Zakurdaev, V V

    2014-01-01

    The current article is dedicated to some features of the Russian Federation Armed Forces military personnel health monitoring such as legal and informational provision, methodological basis of functioning, historical aspect of formation and development of the social and hygienic monitoring in the Russian Federation Armed Forces. The term "military personnel health monitoring" is defined as an analytical system of constant and long-term observation, analysis, assessment, studying of factors determined the military personnel health, these factors correlations, health risk factors management in order to minimize them. The current state of the military personnel health monitoring allows coming to the conclusion that the military health system does have forces and resources for state policy of establishing the population health monitoring system implementation. The following directions of the militarily personnel health monitoring improvement are proposed: the Russian Federation Armed Forces medical service record and report system reorganization bringing it closer to the civilian one, implementation of the integrated approach to the medical service informatisation, namely, military personnel health status and medical service resources monitoring. The leading means in this direction are development and introduction of a military serviceman individual health status monitoring system on the basis of a serviceman electronic medical record card. Also it is proposed the current Russian Federation Armed Forces social and hygienic monitoring improvement at the expense of informational interaction between the two subsystems on the basis of unified military medical service space.

  1. Vaccinations in migrants and refugees: a challenge for European health systems. A systematic review of current scientific evidence.

    Science.gov (United States)

    Mipatrini, Daniele; Stefanelli, Paola; Severoni, Santino; Rezza, Giovanni

    2017-03-01

    The decline of immunization rates in countries of origin of migrants and refugees, along with risky conditions during the journey to Europe, may threaten migrants' health. We performed a systematic review of the scientific literature in order to assess the frequency of vaccine preventable diseases, and vaccination coverage among migrants and refugees in Europe. To this end, Medline and Cochrane databases were considered. After the screening and the selection process, 58 papers were included in the review. We focused on the following vaccine-preventable diseases: hepatitis B, measles, rubella, mumps, tetanus, poliomyelitis, pertussis, diphtheria, meningitis, and varicella. The results were presented as a qualitative synthesis. In summary, several studies highlighted that migrants and refugees have lower immunization rates compared to European-born individuals. Firstly, this is due to low vaccination coverage in the country of origin. Then, several problems may limit migrants' access to vaccination in Europe: (i) migrants are used to move around the continent, and many vaccines require multiple doses at regular times; (ii) information on the immunization status of migrants is often lacking; (iii) hosting countries face severe economic crises; (iv) migrants often refuse registration with medical authorities for fear of legal consequences and (v) the lack of coordination among public health authorities of neighboring countries may determine either duplications or lack of vaccine administration. Possible strategies to overcome these problems include tailoring immunization services on the specific needs of the target population, developing strong communication campaigns, developing vaccination registers, and promoting collaboration among public health authorities of European Countries.

  2. [Allergology in the public health service of the Community of Madrid: current situation and opportunities in the XXI century public health system].

    Science.gov (United States)

    Domínguez-Ortega, J; Ruiz Hornillos, J; Chivato, T; De la Hoz, B; Elices, A; Iglesias, A; Quirce, S; Vega, F; Rodríguez Mosquera, M

    2014-01-01

    The high prevalence of allergic diseases and the use of more complex diagnostic techniques and therapeutic options require allergists to be highly trained professionals and health-care organizations to be knowledgeable about available structural and human resources. Updated information is lacking in Spain, and current activity indicators do not reflect complexity. The present article analyzes the situation of allergology in Madrid and proposes improvements where necessary. The heads of the allergy departments of public hospitals in Madrid voluntarily completed a purpose-designed survey. Data on care activity (2010) and on teaching and research activity (2009-2010) were provided. A SWOT analysis was performed, and strategic lines and proposals for improvement were designed. One hundred and seventeen allergists (41% with a PhD) worked in 24 hospitals with an allergology department (4.6 physicians/center; ≤3 in 10 hospitals). All the institutions had an outpatient clinic (4,000 first consultations/hospital/year, 36% high-resolution rate; 6200 successive visits/hospital/year) performing complex diagnostic and therapeutic procedures, most of which were not taken into account by activity indicators. Two hospitals had their own hospitalization facilities and 10 were accredited teaching hospitals (2.78 medical residents/year). The survey revealed that, twice yearly, a typical allergology service participated in 4 research projects, 2 clinical trials, 16 publications and 17 communications at scientific meetings, with notable differences between hospitals. Allergists in Madrid are well prepared. The allergology care structure is adequate, although possibly insufficient. Quality and efficiency can be improved with new tools for recording activity and by increasing coordination and taking advantage of new technologies and geographical proximity.

  3. Health System Measurement Project

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Health System Measurement Project tracks government data on critical U.S. health system indicators. The website presents national trend data as well as detailed...

  4. Cognitive impairment and preferences for current health

    Directory of Open Access Journals (Sweden)

    Tsevat Joel

    2009-01-01

    Full Text Available Abstract Background We assessed preferences for current health using the visual analogue scale (VAS, standard gamble (SG, time trade-off (TTO, and willingness to pay (WTP in patients with cerebral aneurysms, a population vulnerable to cognitive deficits related to aneurysm bleeding or treatment. Methods We measured VAS, SG, TTO, and WTP values for current health in 165 outpatients with cerebral aneurysms. We assessed cognitive impairment with the Mini Mental State Examination (MMSE; scores Results Eleven patients (7% had MMSE scores Conclusion Cognitive impairment is associated with lower preferences for current health in patients with cerebral aneurysms. Cognitively impaired patients have poor inter-preference test correlations and different response distributions compared to unimpaired patients.

  5. Current health issues in Korean adolescents

    Directory of Open Access Journals (Sweden)

    Chang Ho Hong

    2011-10-01

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

  6. Current status of family health in Mexico

    Directory of Open Access Journals (Sweden)

    Apolinar Membrillo Luna

    2013-01-01

    Full Text Available Family Health (FH has three main elements: individual health, life material conditions and family functioning. Its main actors are the individual, the family and society. A common framework is the basis of FH, as each one of these elements is extremely important. Currently, in Mexico two aspects are considered: epidemiological studies and those inherent to the family medicine specialty. That latter has a residency and an integrated specialty curriculum, as well as certification from the corresponding board. All of this allows us to apply the HF approach to each and every family and individual that is cared for.

  7. [Current situation of health surveys in Spain].

    Science.gov (United States)

    Requena, María Luisa; Suárez, Mónica; Pérez, Óscar

    2013-01-01

    To describe the evolution of health interview surveys in Spain (as of 01/01/2012), whether national or regional, its main characteristics and methodology, and in the case of general health surveys (GHIS), its contents. An adapted version of Eurostat quality control template European Health Interview Survey Technical and Methodological Report was filled in by those responsible for GHIS in each region (autonomous communities) and at the national level. The first part (11 questions) gathers general information about health surveys, both GHIS and surveys targeted to specific populations or health problems (SHIS). The second part (109 questions) asks about methodological characteristics of most recent GHIS. 1) regional or supra-regional scope; 2) for the second part, GHIS currently active series. Quality control was performed using double data entry and validated by informants.100 HIS were identified. 16 were GHIS and 84 SHIS. 32 (38%) of the latter were national and 52 (62%) regional. Nutrition 21 (25%), drug use 10 (12%), opinion polls 7 (9%) and dental health 7 (9%) were the most frequent topics in SHIS. Highest GHIS density was reached after year 2000, with several surveys on field at a time (mode=3). 11 GHIS (2 national, 9 regional) met inclusion criteria for the second part. All complied with general quality benchmarks. Few differences were observed in content.GHIS show more similarities than differences in objectives, methods and content. Rationalization and harmonization are needed. Physical activity, alcohol consumption, quality of life and mental health instruments are not yet consensual. Valid and comparable data are required on health status and its determinants to inform health policy.

  8. Ukraine: Health system review.

    Science.gov (United States)

    Lekhan, Valery; Rudiy, Volodymyr; Richardson, Erica

    2010-01-01

    The HiT profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Ukrainian health system has preserved the fundamental features of the Soviet Semashko system against a background of other changes, which are developed on market economic principles. The transition from centralized financing to its extreme decentralization is the main difference in the health system in comparison with the classic Soviet model. Health facilities are now functionally subordinate to the Ministry of Health, but managerially and financially answerable to the regional and local self-government, which has constrained the implementation of health policy and fragmented health financing. Health care expenditure in Ukraine is low by regional standards and has not increased significantly as a proportion of gross domestic product (GDP) since the mid 1990s; expenditure cannot match the constitutional guarantees of access to unlimited care. Although prepaid schemes such as sickness funds are growing in importance, out-of-pocket payments account for 37.4% of total health expenditure. The core challenges for Ukrainian health care therefore remain the ineffective protection of the population from the risk of catastrophic health care costs and the structural inefficiency of the health system, which is caused by the inefficient system of health care financing. Health system weaknesses are highlighted by increasing rates of avoidable mortality. Recent political impasse has complicated health system reforms and policy-makers face significant challenges in overcoming popular distrust and

  9. The integration of the applied Thai traditional medicine into hospitals of the current health delivery system: the development of an administrative/management model.

    Science.gov (United States)

    Fakkham, Supalak; Sirithanawutichi, Teabpaluck; Jarupoonpol, Vithaya; Homjumpa, Pitsamai; Bunalesnirunltr, Montri

    2012-02-01

    Develop a model of administration/management of district/general hospitals in the Ministry of Public Health of Thailand to enable the medical services of Applied Thai Traditional Medicine to be integrated into the current Modern Medical (Health) System. A prospective study of the various services of Applied Thai Traditional Medicine in relation to the needs of other related services of the hospitals and the health needs of the population of Huay Ploo District Hospital of Nakhon Pathom Province. The collection of data of services covered 12 months to enable the comparisons of changes that occurred during the period. The study was both quantitative and quantitative measures. There is a statistical difference in all aspects compared of the opinions of personnel related to the services of Thai Traditional Medicine before and after the interventions in the areas of knowledge, attitude, beliefs, and the support of the services rendered by Thai Traditional Medicine. The present study showed that more system diseases was seen before than after the interventions whereas the most common incidence of diseases was in the musculo-skeletal system when compared to those found in other systems. After the interventions, the patients' preferences in the methods of treatment were mixed, with several methods of treatment preferred and with the tendency to resort to Thai Traditional Medicine more than before the interventions. This was believed to be the result of changes in the hospital i.e. personnel from all service units after answering the questionnaires and voiced opinions were found to require more relevant competencies and in need of support from their superiors. The personnel surveyed wished that the planning and policies'goals succeed with efficiency The Administrators outlined the plan and strategies to move forward. With cooperation to solve problems, should any occur and with mutual role and coordination of personnel and services, the way towards solving problems should be

  10. Denmark: Health system review

    DEFF Research Database (Denmark)

    Olejaz, Maria; Juul, Annegrete; Rudkjøbing, Andreas;

    The Health Systems in Transition (HiT) series provide detailed descriptions of health systems in the countries of the WHO European Region as well as some additional OECD countries. An individual health system review (HiT) examines the specific approach to the organization, financing and delivery...... of health services in a particular country and the role of the main actors in the health system. It describes the institutional framework, process, content, and implementation of health and health care policies. HiTs also look at reforms in progress or under development and make an assessment of the health...... system based on stated objectives and outcomes with respect to various dimensions (health status, equity, quality, efficiency, accountability)....

  11. Electronic health records: current and future use.

    Science.gov (United States)

    Peters, Steve G; Khan, Munawwar A

    2014-09-01

    This paper provides an overview of the current state of the electronic medical record, including benefits and shortcomings, and presents key factors likely to drive development in the next decade and beyond. The current electronic medical record to a large extent represents a digital version of the traditional paper legal record, owned and maintained by the practitioner. The future electronic health record is expected to be a shared tool, engaging patients in decision making, wellness and disease management and providing data for individual decision support, population management and analytics. Many drivers will determine this path, including payment model reform, proliferation of mobile platforms, telemedicine, genomics and individualized medicine and advances in 'big data' technologies.

  12. Lithuania: health system review.

    Science.gov (United States)

    Murauskiene, Liubove; Janoniene, Raimonda; Veniute, Marija; van Ginneken, Ewout; Karanikolos, Marina

    2013-01-01

    This analysis of the Lithuanian health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance since 2000.The Lithuanian health system is a mixed system, predominantly funded from the National Health Insurance Fund through a compulsory health insurance scheme, supplemented by substantial state contributions on behalf of the economically inactive population amounting to about half of its budget. Public financing of the health sector has gradually increased since 2004 to 5.2 per cent of GDP in 2010.Although the Lithuanian health system was tested by the recent economic crisis, Lithuanias counter-cyclical state health insurance contribution policies (ensuring coverage for the economically inactive population) helped the health system to weather the crisis, and Lithuania successfully used the crisis as a lever to reduce the prices of medicines.Yet the future impact of cuts in public health spending is a cause for concern. In addition, out-of-pocket payments remain high (in particular for pharmaceuticals) and could threaten health access for vulnerable groups.A number of challenges remain. The primary care system needs strengthening so that more patients are treated instead of being referred to a specialist, which will also require a change in attitude by patients. Transparency and accountability need to be increased in resource allocation, including financing of capital investment and in the payer provider relationship. Finally, population health,albeit improving, remains a concern, and major progress can be achieved by reducing the burden of amenable and preventable mortality. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  13. Global Health System

    Science.gov (United States)

    ... Issue Past Issues From the NIH Director: A Global Health System Past Issues / Spring 2008 Table of ... officials the issues of world health and NIH's global outreach. He spoke with MedlinePlus ' Christopher Klose on ...

  14. Population-based cost-offset estimation for the treatment of borderline personality disorder: projected costs in a currently running, ideal health system.

    Science.gov (United States)

    Wunsch, Eva-Maria; Kliem, Sören; Kröger, Christoph

    2014-09-01

    Borderline personality disorder (BPD) is considered one of the most expensive mental disorders in terms of direct and indirect costs. The aim of this study was to carry out a cost-offset estimation of disorder-specific psychotherapy for BPD at the population level. The study investigated whether the possible financial benefits of dialectical behavior therapy outweigh the therapy costs, assuming a currently running, ideal health system, and whether the estimated cost-benefit relationships change depending upon the number of patients willing to be treated. A formula was elaborated that allows the user to calculate cost-benefit relationships for various conservative or progressive scenarios, with different stages of individuals' willingness to be treated (10%-90%). The possible costs and benefits of BPD-related treatment were evaluated using a 12-month, prevalence-based approach. The annual costs for untreated BPD were 8.69 billion EUR annually. The cost-benefit relationship for the treatment remained constant at 1.52 for all scenarios, implying that for each EUR invested, 1.52 EUR can be gained within one year, independent of the willingness to be treated. Additional intangible benefits were calculated with the aid of Quality-Adjusted Life Years. Findings suggest that BPD-related treatment might well be efficient at the population level.

  15. Consumer Mobile Health Apps: Current State, Barriers, and Future Directions.

    Science.gov (United States)

    Kao, Cheng-Kai; Liebovitz, David M

    2017-05-01

    This paper discusses the current state, barriers, and future directions of consumer-facing applications (apps). There are currently more than 165,000 mobile health apps publicly available in major app stores, the vast majority of which are designed for patients. The top 2 categories are wellness management and disease management apps, whereas other categories include self-diagnosis, medication reminder, and electronic patient portal apps. Apps specific to physical medicine and rehabilitation also are reviewed. These apps have the potential to provide low-cost, around-the-clock access to high-quality, evidence-based health information to end users on a global scale. However, they have not yet lived up to their potential due to multiple barriers, including lack of regulatory oversight, limited evidence-based literature, and concerns of privacy and security. The future directions may consist of improving data integration into the health care system, an interoperable app platform allowing access to electronic health record data, cloud-based personal health record across health care networks, and increasing app prescription by health care providers. For consumer mobile health apps to fully contribute value to health care delivery and chronic disease management, all stakeholders within the ecosystem must collaborate to overcome the significant barriers. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  16. Tajikistan: health system review.

    Science.gov (United States)

    Khodjamurodov, Ghafur; Rechel, Bernd

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. Tajikistan is undergoing a complex transition from a health system inherited from the Soviet period to new forms of management, financing and health care provision. Following independence and the consequences of the civil war, health funding collapsed and informal out-of-pocket payments became the main source of revenue, with particularly severe consequences for the poor. With the aim of ensuring equitable access to health care and formalizing out-of-pocket payments, the Ministry of Health developed a programme that encompassed a basic benefit package (also known as the guaranteed benefit package) for people in need and formal co-payments for other groups of the population. One of the main challenges for the future will be to reorient the health system towards primary care and public health rather than hospital-based secondary and tertiary care. Pilots of primary care reform, introducing per capita financing, are under way in three of the country's oblasts. There are marked geographical imbalances in health care resources and financing, favouring the capital and regional centres over rural areas. There are also significant inequities in health care expenditures across regions. The quality of care is another major concern, owing to the lack of investment in health facilities and technologies, an insufficient supply of pharmaceuticals, poorly trained health care workers, and a lack of medical protocols and systems for quality improvement.

  17. Current efforts in medical education to incorporate national health priorities.

    Science.gov (United States)

    Nair, Manisha; Fellmeth, Gracia

    2017-08-03

    As a reflection on the Edinburgh Declaration, this conceptual synthesis presents six important challenges in relation to the role of medical education in meeting current national health priorities. This paper presents a conceptual synthesis of current efforts in medical education to incorporate national health priorities as a reflection on how the field has evolved since the Edinburgh Declaration. Considering that health needs vary from country to country, our paper focuses on three broad and cross-cutting themes: health equity, health systems strengthening, and changing patterns of disease. Considering the complexity of this topic, we conducted a targeted search to broadly sample and critically review the literature in two phases. Phase 1: within each theme, we assessed the current challenges in the field of medical education to meet the health priority. Phase 2: a search for various strategies in undergraduate and postgraduate education that have been tested in an effort to address the identified challenges. We conducted a qualitative synthesis of the literature followed by mapping of the identified challenges within each of the three themes with targeted efforts. We identified six important challenges: (i) mismatch between the need for generalist models of health care and medical education curricula's specialist focus; (ii) attitudes of health care providers contributing to disparities in health care; (iii) the lack of a universal approach in preparing medical students for 21st century health systems; (iv) the inability of medical education to keep up with the abundance of new health care technologies; (v) a mismatch between educational requirements for integrated care and poorly integrated, specialised health care systems; and (vi) development of a globally interdependent education system to meet global health challenges. Examples of efforts being made to address these challenges are offered. Although strategies for combatting these challenges exist, the

  18. Food and Health Some Current Issues and Future Trends

    OpenAIRE

    Gormley, T. R. (Thomas Ronan)

    1991-01-01

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

  19. Ukraine: health system review.

    Science.gov (United States)

    Lekhan, Valery; Rudiy, Volodymyr; Shevchenko, Maryna; Nitzan Kaluski, Dorit; Richardson, Erica

    2015-03-01

    This analysis of the Ukrainian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Since the country gained independence from the Soviet Union in 1991, successive governments have sought to overcome funding shortfalls and modernize the health care system to meet the needs of the population's health. However, no fundamental reform of the system has yet been implemented and consequently it has preserved the main features characteristic of the Semashko model; there is a particularly high proportion of total health expenditure paid out of pocket (42.3 % in 2012), and incentives within the system do not focus on quality or outcomes. The most recent health reform programme began in 2010 and sought to strengthen primary and emergency care, rationalize hospitals and change the model of health care financing from one based on inputs to one based on outputs. Fundamental issues that hampered reform efforts in the past re-emerged, but conflict and political instability have proved the greatest barriers to reform implementation and the programme was abandoned in 2014. More recently, the focus has been on more pressing humanitarian concerns arising from the conflict in the east of Ukraine. It is hoped that greater political, social and economic stability in the future will provide a better environment for the introduction of deep reforms to address shortcomings in the Ukrainian health system.

  20. Azerbaijan: health system review.

    Science.gov (United States)

    Ibrahimov, Fuad; Ibrahimova, Aybaniz; Kehler, Jenni; Richardson, Erica

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. Azerbaijan gained independence from the Soviet Union in 1991. Reform of the health care system in Azerbaijan has been incremental so that organizationally it still has many of the key hallmarks of the Soviet model of health care, the Semashko system. However, relatively low levels of government expenditure on health as a proportion of gross domestic product since independence has meant that out of pocket (OOP) payments accounted for almost 62% of total health expenditure in 2007. This has serious implications for access to care and financial risk protection for vulnerable households. The private provision of services is an increasingly important part of the health system, and services provided in parallel by other ministries and state enterprises continue to account for a certain amount of health expenditure. Revenues from the recent oil boom have been used to fund large capital investment projects such as the building of new hospitals with the latest technology and the import of modern equipment. However, future plans include the strengthening of primary care and the introduction of mandatory health insurance as part of major reforms to the health financing system.

  1. Current concepts on airborne particles and health

    Energy Technology Data Exchange (ETDEWEB)

    Mauderly, J.L.

    1994-11-01

    Epidemiological evidence of associations between environmental particulate concentrations and both acute and chronic health effects has grown with numerous recent studies conducted in the US and other countries. An association between short-term changes in particulate levels and acute mortality now seems certain. The association is consistent among studies and coherent among indicators of mortality and morbidity. Effects observed at surprisingly low pollution levels have raised concern for current exposures even in modestly polluted cities. Toxicology did not predict the acute mortality effect, and causal mechanisms are difficult to rationalize. Present data suggest that the fine fraction of particulate pollution is more toxic than larger particles, but the contribution of specific particulate species is poorly understood.

  2. Belgium: Health system review.

    Science.gov (United States)

    Gerkens, Sophie; Merkur, Sherry

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Belgian population continues to enjoy good health and long life expectancy. This is partly due to good access to health services of high quality. Financing is based mostly on proportional social security contributions and progressive direct taxation. The compulsory health insurance is combined with a mostly private system of health care delivery, based on independent medical practice, free choice of physician and predominantly fee-for-service payment. This Belgian HiT profile (2010) presents the evolution of the health system since 2007, including detailed information on new policies. While no drastic reforms were undertaken during this period, policy-makers have pursued the goals of improving access to good quality of care while making the system sustainable. Reforms to increase the accessibility of the health system include measures to reduce the out-of-pocket payments of more vulnerable populations (low-income families and individuals as well as the chronically ill). Quality of care related reforms have included incentives to better integrate different levels of care and the establishment of information systems, among others. Additionally, several measures on pharmaceutical products have aimed to reduce costs for both the National Institute for Health and Disability Insurance (NIHDI) and patients, while maintaining the quality of care.

  3. Portugal: Health System Review.

    Science.gov (United States)

    de Almeida Simoes, Jorge; Figueiredo Augusto, Goncalo; Fronteira, Ines; Hernandez-Quevedo, Cristina

    2017-03-01

    This analysis of the Portuguese health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Overall health indicators such as life expectancy at birth and at age 65 years have shown a notable improvement over the last decades. However, these improvements have not been followed at the same pace by other important dimensions of health: child poverty and its consequences, mental health and quality of life after 65. Health inequalities remain a general problem in the country. All residents in Portugal have access to health care provided by the National Health Service (NHS), financed mainly through taxation. Out-of-pocket payments have been increasing over time, not only co-payments, but particularly direct payments for private outpatient consultations, examinations and pharmaceuticals. The level of cost-sharing is highest for pharmaceutical products. Between one-fifth and one-quarter of the population has a second (or more) layer of health insurance coverage through health subsystems (for specific sectors or occupations) and voluntary health insurance (VHI). VHI coverage varies between schemes, with basic schemes covering a basic package of services, whereas more expensive schemes cover a broader set of services, including higher ceilings of health care expenses. Health care delivery is by both public and private providers. Public provision is predominant in primary care and hospital care, with a gate-keeping system in place for access to hospital care. Pharmaceutical products, diagnostic technologies and private practice by physicians constitute the bulk of private health care provision. In May 2011, the economic crisis led Portugal to sign a Memorandum of Understanding with the International Monetary Fund, the European Commission and the European Central Bank, in exchange for a loan of 78 billion euros. The agreed Economic and Financial Adjustment Programme included

  4. Slovakia health system review.

    Science.gov (United States)

    Szalay, Tomás; Pazitný, Peter; Szalayová, Angelika; Frisová, Simona; Morvay, Karol; Petrovic, Marek; van Ginneken, Ewout

    2011-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services, and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Slovak health system is a system in progress. Major health reform in the period 2002 to 2006 introduced a new approach based on managed competition. Although large improvements have been made since the 1990s (for example in life expectancy and infant mortality), health outcomes are generally still substantially worse than the average for the EU15 but close to the other Visegrad Four countries. Per capita health spending (in purchasing power parity [PPP]) was around half the EU15 average. A large share of these resources was absorbed by pharmaceutical spending (28% in 2008, compared to 16% in OECD countries). Some important utilization indicators signal plenty of resources in the system but may also indicate excess bed capacity and overutilization. The number of physicians and nurses per capita has been actively reduced since 2001 but remains above the average of the EU12 (i.e. the 12 countries that joined the EU in 2004 and 2007). An ageing workforce and professional migration may reinforce a shortage of health care workers. People have free choice of general practitioner (GP) and specialist. Their services are provided without cost-sharing from patients, with the notable exception of dental procedures. Inpatient care and specialized ambulatory care are provided in general hospitals and specialized hospitals. Pharmaceutical expenditure per capita accounts for one-third of public expenditure on health care. Long-term care is provided by health care

  5. Poland health system review.

    Science.gov (United States)

    Sagan, Anna; Panteli, Dimitra; Borkowski, W; Dmowski, M; Domanski, F; Czyzewski, M; Gorynski, Pawel; Karpacka, Dorota; Kiersztyn, E; Kowalska, Iwona; Ksiezak, Malgorzata; Kuszewski, K; Lesniewska, A; Lipska, I; Maciag, R; Madowicz, Jaroslaw; Madra, Anna; Marek, M; Mokrzycka, A; Poznanski, Darius; Sobczak, Alicja; Sowada, Christoph; Swiderek, Maria; Terka, A; Trzeciak, Patrycja; Wiktorzak, Katarzyna; Wlodarczyk, Cezary; Wojtyniak, B; Wrzesniewska-Wal, Iwona; Zelwianska, Dobrawa; Busse, Reinhard

    2011-01-01

    Since the successful transition to a freely elected parliament and a market economy after 1989, Poland is now a stable democracy and is well represented within political and economic organizations in Europe and worldwide. The strongly centralized health system based on the Semashko model was replaced with a decentralized system of mandatory health insurance, complemented with financing from state and territorial self-government budgets. There is a clear separation of health care financing and provision: the National Health Fund (NFZ) the sole payer in the system is in charge of health care financing and contracts with public and non-public health care providers. The Ministry of Health is the key policy-maker and regulator in the system and is supported by a number of advisory bodies, some of them recently established. Health insurance contributions, borne entirely by employees, are collected by intermediary institutions and are pooled by the NFZ and distributed between the 16 regional NFZ branches. In 2009, Poland spent 7.4% of its gross domestic product (GDP) on health. Around 70% of health expenditure came from public sources and over 83.5% of this expenditure can be attributed to the (near) universal health insurance. The relatively high share of private expenditure is mostly represented by out-of-pocket (OOP) payments, mainly in the form of co-payments and informal payments. Voluntary health insurance (VHI) does not play an important role and is largely limited to medical subscription packages offered by employers. Compulsory health insurance covers 98% of the population and guarantees access to a broad range of health services. However, the limited financial resources of the NFZ mean that broad entitlements guaranteed on paper are not always available. Health care financing is overall at most proportional: while financing from health care contributions is proportional and budgetary subsidies to system funding are progressive, high OOP expenditures

  6. Malta: Health system review.

    Science.gov (United States)

    Azzopardi Muscat, Natasha; Calleja, Neville; Calleja, Antoinette; Cylus, Jonathan

    2014-01-01

    This analysis of the Maltese health system reviews the developments in its organization and governance, health financing, health-care provision, health reforms and health system performance. The health system in Malta consists of a public sector, which is free at the point of service and provides a comprehensive basket of health services for all its citizens, and a private sector, which accounts for a third of total health expenditure and provides the majority of primary care. Maltese citizens enjoy one of the highest life expectancies in Europe. Nevertheless, non-communicable diseases pose a major concern with obesity being increasingly prevalent among both adults and children. The health system faces important challenges including a steadily ageing population, which impacts the sustainability of public finances. Other supply constraints stem from financial and infrastructural limitations. Nonetheless, there exists a strong political commitment to ensure the provision of a healthcare system that is accessible, of high quality, safe and also sustainable. This calls for strategic investments to underpin a revision of existing processes whilst shifting the focus of care away from hospital into the community.

  7. Circumpolar Inuit health systems

    Directory of Open Access Journals (Sweden)

    Leanna Ellsworth

    2013-08-01

    Full Text Available Background . The Inuit are an indigenous people totalling about 160,000 and living in 4 countries across the Arctic – Canada, Greenland, USA (Alaska and Russia (Chukotka. In essence, they are one people living in 4 countries. Although there have been significant improvements in Inuit health and survival over the past 50 years, stark differences persist between the key health indicators for Inuit and those of the national populations in the United States, Canada and Russia and between Greenland and Denmark. On average, life expectancy in all 4 countries is lower for Inuit. Infant mortality rates are also markedly different with up to 3 times more infant deaths than the broader national average. Underlying these statistical differences are a range of health, social, economic and environmental factors which have affected Inuit health outcomes. Although the health challenges confronting the Inuit are in many cases similar across the Arctic, the responses to these challenges vary in accordance with the types of health systems in place in each of the 4 countries. Each of the 4 countries has a different health care system with varying degrees of accessibility and affordability for Inuit living in urban, rural and remote areas. Objective . To describe funding and governance arrangements for health services to Inuit in Canada, Greenland, USA (Alaska and Russia (Chukotka and to determine if a particular national system leads to better outcomes than any of the other 3 systems. Study design . Literature review. Results . It was not possible to draw linkages between the different characteristics of the respective health systems, the corresponding financial investment and the systems’ effectiveness in adequately serving Inuit health needs for several reasons including the very limited and inadequate collection of Inuit-specific health data by Canada, Alaska and Russia; and second, the data that are available do not necessarily provide a feasible point of

  8. Switzerland: Health System Review.

    Science.gov (United States)

    De Pietro, Carlo; Camenzind, Paul; Sturny, Isabelle; Crivelli, Luca; Edwards-Garavoglia, Suzanne; Spranger, Anne; Wittenbecher, Friedrich; Quentin, Wilm

    2015-01-01

    This analysis of the Swiss health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Swiss health system is highly complex, combining aspects of managed competition and corporatism (the integration of interest groups in the policy process) in a decentralized regulatory framework shaped by the influences of direct democracy. The health system performs very well with regard to a broad range of indicators. Life expectancy in Switzerland (82.8 years) is the highest in Europe after Iceland, and healthy life expectancy is several years above the European Union (EU) average. Coverage is ensured through mandatory health insurance (MHI), with subsidies for people on low incomes. The system offers a high degree of choice and direct access to all levels of care with virtually no waiting times, though managed care type insurance plans that include gatekeeping restrictions are becoming increasingly important. Public satisfaction with the system is high and quality is generally viewed to be good or very good. Reforms since the year 2000 have improved the MHI system, changed the financing of hospitals, strengthened regulations in the area of pharmaceuticals and the control of epidemics, and harmonized regulation of human resources across the country. In addition, there has been a slow (and not always linear) process towards more centralization of national health policy-making. Nevertheless, a number of challenges remain. The costs of the health care system are well above the EU average, in particular in absolute terms but also as a percentage of gross domestic product (GDP) (11.5%). MHI premiums have increased more quickly than incomes since 2003. By European standards, the share of out-of-pocket payments is exceptionally high at 26% of total health expenditure (compared to the EU average of 16%). Low and middle-income households contribute a greater share of their income to

  9. The management system of health information CAFAM IPS : a look at the current status and propose new actions to improve its performance

    Directory of Open Access Journals (Sweden)

    Javier Andrés Urrego Varela

    2015-11-01

    Full Text Available The information management is a very important factor to organize the processes taking place in a company and for complex systems function in a most harmonious way possible. This work intends to present the diagnosis was performed to determine the extent of the problem environment management system of information on the health sub CAFAM , describing internal and external factors that might influence the construction of a future SGIS . We conclude that there is much to do in terms of organizing a CAFAM IPS SGI in Health , but are also given the objective and subjective conditions for progress in the development of this system to contribute to the development of the company.

  10. The Chinese Health Care System

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter; Yu, Yi

    In the present paper we describe the structure of the Chinese health care system and sketch its future development. We analyse issues of provider incentives and the actual burden sharing between government, enterprises and people. We further aim to identify a number of current problems and link...

  11. Bulgaria health system review.

    Science.gov (United States)

    Dimova, Antoniya; Rohova, Maria; Moutafova, Emanuela; Atanasova, Elka; Koeva, Stefka; Panteli, Dimitra; van Ginneken, Ewout

    2012-01-01

    In the last 20 years, demographic development in Bulgaria has been characterized by population decline, a low crude birth rate, a low fertility rate, a high mortality rate and an ageing population. A stabilizing political situation since the early 2000s and an economic upsurge since the mid-2000s were important factors in the slight increase of the birth and fertility rates and the slight decrease in standardized death rates. In general, Bulgaria lags behind European Union (EU) averages in most mortality and morbidity indicators. Life expectancy at birth reached 73.3 years in 2008 with the main three causes of death being diseases of the circulatory system, malignant neoplasms and diseases of the respiratory system. One of the most important risk factors overall is smoking, and the average standardized death rate for smoking-related causes in 2008 was twice as high as the EU15 average. The Bulgarian health system is characterized by limited statism. The Ministry of Health is responsible for national health policy and the overall organization and functioning of the health system and coordinates with all ministries with relevance to public health. The key players in the insurance system are the insured individuals, the health care providers and the third party payers, comprising the National Health Insurance Fund, the single payer in the social health insurance (SHI) system, and voluntary health insurance companies (VHICs). Health financing consists of a publicprivate mix. Health care is financed from compulsory health insurance contributions, taxes, outofpocket (OOP) payments, voluntary health insurance (VHI) premiums, corporate payments, donations, and external funding. Total health expenditure (THE) as a share of gross domestic product (GDP) increased from 5.3% in 1995 to 7.3% in 2008. At the latter date it consisted of 36.5% OOP payments, 34.8% SHI, 13.6% Ministry of Health expenditure, 9.4% municipality expenditure and 0.3% VHI. Informal payments in the health

  12. Belarus: health system review.

    Science.gov (United States)

    Richardson, Erica; Malakhova, Irina; Novik, Irina; Famenka, Andrei

    2013-01-01

    This analysis of the Belarusian health system reviews the developments in organization and governance, health financing, healthcare provision, health reforms and health system performance since 2008. Despite considerable change since independence, Belarus retains a commitment to the principle of universal access to health care, provided free at the point of use through predominantly state-owned facilities, organized hierarchically on a territorial basis. Incremental change, rather than radical reform, has also been the hallmark of health-care policy, although capitation funding has been introduced in some areas and there have been consistent efforts to strengthen the role of primary care. Issues of high costs in the hospital sector and of weaknesses in public health demonstrate the necessity of moving forward with the reform programme. The focus for future reform is on strengthening preventive services and improving the quality and efficiency of specialist services. The key challenges in achieving this involve reducing excess hospital capacity, strengthening health-care management, use of evidence-based treatment and diagnostic procedures, and the development of more efficient financing mechanisms. Involving all stakeholders in the development of further reform planning and achieving consensus among them will be key to its success. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  13. [Health insurance in Tunisia, current context and future perspectives].

    Science.gov (United States)

    Blel, S

    2001-05-01

    The Tunisian health system, notably in its health insurance component, has allowed to record a satisfactory evolution of health indicators. Nevertheless, socio-economic, demographic and epidemiological transitions impose a global reform of the system, notably of its financing. The present article, leaving from the presentation of the current system of coverage of the social security insured, analyses observed insufficiencies that have brought public authorities to commit the health insurance reform. The main observed insufficiencies refer to the multiplicity of regimes and their heterogeneity, generating iniquities between insured and a strong growth of care expenses financed directly by households. In addition, relationships of social security bodies with public and private providers of health care are little transparent, marked by a preferential processing of public structures, despite an important development of the private sector. In a second part, the author analyzes successively objectives of the health insurance reform of the social security regimes, its founder principles, characteristics of the proposed regime (a mandatory basic regime and an optional complementary regime) and sketches of providers payment methods.

  14. [Social and health resources in Catalonia. Current situation].

    Science.gov (United States)

    Bullich-Marín, Ingrid; Sánchez-Ferrín, Pau; Cabanes-Duran, Concepció; Salvà-Casanovas, Antoni

    2017-03-20

    The network of social and health care has advanced since its inception. Furthermore, news services have been created and some resources have been adapted within the framework of respective health plans. This article presents the current situation of the different social and health resources in Catalonia, as well as the main changes that have occurred in recent years, more specifically in the period of the Health Plan 2011-2015. This period is characterised by an adaptation of the social and health network within the context of chronic care, for which the development of intermediate care resources has become the most relevant aspect. There is also a need to create a single long-term care sector in which the health care quality is guaranteed. Moreover, in this period, integral and cross-care level is promoted in the health system through a greater coordination between all different levels of care. The social and health network, due to its trajectory and expertise, plays a key role in the quality of care for people with social and medical needs. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Current status and development trend of oral health surveillance system%口腔卫生监测体系现况及发展趋势

    Institute of Scientific and Technical Information of China (English)

    时影影; 赵琦; 赵根明

    2013-01-01

    The establishment and improvement of oral health surveillance system can facilitate the timely understanding of the distribution of oral disease and risk factors as well as the improvement of people's oral health and life quality.As the development of disease surveillance and people's higher requirement to oral health,it is necessary to establish a comprehensive oral health sueveilance system for the information integration and sharing.%建立和完善口腔卫生监测系统可及时掌握疾病动态分布及其危险因素,有效改善人群口腔卫生,提高人群生活质量.随着疾病监测方法、内容的发展和人们对口腔健康需求的提高,建立综合的口腔监测系统,实现信息整合与共享是口腔监测的发展趋势之一.

  16. Romania: Health System Review.

    Science.gov (United States)

    Vladescu, Cristian; Scintee, Silvia Gabriela; Olsavszky, Victor; Hernandez-Quevedo, Cristina; Sagan, Anna

    2016-08-01

    This analysis of the Romanian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Romanian health care system is a social health insurance system that has remained highly centralized despite recent efforts to decentralize some regulatory functions. It provides a comprehensive benefits package to the 85% of the population that is covered, with the remaining population having access to a minimum package of benefits. While every insured person has access to the same health care benefits regardless of their socioeconomic situation, there are inequities in access to health care across many dimensions, such as rural versus urban, and health outcomes also differ across these dimensions. The Romanian population has seen increasing life expectancy and declining mortality rates but both remain among the worst in the European Union. Some unfavourable trends have been observed, including increasing numbers of new HIV/AIDS diagnoses and falling immunization rates. Public sources account for over 80% of total health financing. However, that leaves considerable out-of-pocket payments covering almost a fifth of total expenditure. The share of informal payments also seems to be substantial, but precise figures are unknown. In 2014, Romania had the lowest health expenditure as a share of gross domestic product (GDP) among the EU Member States. In line with the government's objective of strengthening the role of primary care, the total number of hospital beds has been decreasing. However, health care provision remains characterized by underprovision of primary and community care and inappropriate use of inpatient and specialized outpatient care, including care in hospital emergency departments. The numbers of physicians and nurses are relatively low in Romania compared to EU averages. This has mainly been attributed to the high rates of workers emigrating abroad over the

  17. Stakeholders Perception of Current Health Education Situation ...

    African Journals Online (AJOL)

    komla

    Informants were health policy makers, managers, healthcare providers and the ... The paper concludes that despite its importance health education seemed to enjoy .... by genetic counseling), the concerns of health promotion would in practice ..... Botswana, Mauritius, Malaysia, Singapore and Indonesia, where the mass ...

  18. France: Health system review.

    Science.gov (United States)

    Chevreul, Karine; Durand-Zaleski, Isabelle; Bahrami, Stéphane Bahrami; Hernández-Quevedo, Cristina; Mladovsky, Philipa

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The French health care system is a mix of public and private providers and insurers. Public insurance, financed by both employees and employer contributions and earmarked taxes, is compulsory and covers almost the whole population, while private insurance is of a complementary type and voluntary. Providers of outpatient care are largely private. Hospital beds are predominantly public or private non-profit-making. The French population enjoys good health and a high level of choice of providers. It is relatively satisfied with the health care system. However, as in many other countries, the rising cost of health care is of concern with regards to the objectives of the health care system. Many measures were or are being implemented in order to contain costs and increase efficiency. These include, for example, developing pay-for-performance for both hospitals and self-employed providers and increasing quality of professional practice; refining patient pathways; raising additional revenue for statutory health insurance (SHI); and increasing the role of voluntary health insurance (VHI). Meanwhile, socioeconomic disparities and geographic inequality in the density of health care professionals remain considerable challenges to providing a good level of equity in access to health care. Organizational changes at the regional level are important in attempting to tackle both equity and efficiency-related challenges. While the organizational structure of the system

  19. Public health law research: exploring law in public health systems.

    Science.gov (United States)

    Ibrahim, Jennifer K; Burris, Scott; Hays, Scott

    2012-11-01

    The importance of law in the organization and operation of public health systems has long been a matter of interest to public health lawyers and practitioners, but empirical research on law as a factor in health system performance has been limited in quantity and sophistication. The emergence of Public Health Law Research and Public Health Systems and Services Research within a coordinated effort to strengthen public health research and practice has dramatically changed matters. This article introduces Public Health Law Research as an integral part of Public Health Systems and Services Research, discusses the challenges of integrating the 2 fields, and highlights 2 examples of current research that demonstrate the benefits of an integrated approach to improve the use of law in public health practice.

  20. Malta: Health System Review.

    Science.gov (United States)

    Azzopardi-Muscat, Natasha; Buttigieg, Stefan; Calleja, Neville; Merkur, Sherry

    2017-01-01

    Maltese life expectancy is high, and Maltese people spend on average close to 90% of their lifespan in good health, longer than in any other EU country. Malta has recently increased the proportion of GDP spent on health to above the EU average, though the private part of that remains higher than in many EU countries. The total number of doctors and GPs per capita is at the EU average, but the number of specialists remains relatively low; education and training are being further strengthened in order to retain more specialist skills in Malta. The health care system offers universal coverage to a comprehensive set of services that are free at the point of use for people entitled to statutory provision. The historical pattern of integrated financing and provision is shifting towards a more pluralist approach; people already often choose to visit private primary care providers, and in 2016 a new public-private partnership contract for three existing hospitals was agreed. Important priorities for the coming years include further strengthening of the primary and mental health sectors, as well as strengthening the health information system in order to support improved monitoring and evaluation. The priorities of Malta during its Presidency of the Council of the EU in 2017 include childhood obesity, and Structured Cooperation to enhance access to highly specialized and innovative services, medicines and technologies. Overall, the Maltese health system has made remarkable progress, with improvements in avoidable mortality and low levels of unmet need. The main outstanding challenges include: adapting the health system to an increasingly diverse population; increasing capacity to cope with a growing population; redistributing resources and activity from hospitals to primary care; ensuring access to expensive new medicines whilst still making efficiency improvements; and addressing medium-term financial sustainability challenges from demographic ageing. World Health

  1. Defining and resolving current systems in geospace

    Science.gov (United States)

    Ganushkina, N. Y.; Liemohn, M. W.; Dubyagin, S.; Daglis, I. A.; Dandouras, I.; De Zeeuw, D. L.; Ebihara, Y.; Ilie, R.; Katus, R.; Kubyshkina, M.; Milan, S. E.; Ohtani, S.; Ostgaard, N.; Reistad, J. P.; Tenfjord, P.; Toffoletto, F.; Zaharia, S.; Amariutei, O.

    2015-11-01

    Electric currents flowing through near-Earth space (R ≤ 12 RE) can support a highly distorted magnetic field topology, changing particle drift paths and therefore having a nonlinear feedback on the currents themselves. A number of current systems exist in the magnetosphere, most commonly defined as (1) the dayside magnetopause Chapman-Ferraro currents, (2) the Birkeland field-aligned currents with high-latitude "region 1" and lower-latitude "region 2" currents connected to the partial ring current, (3) the magnetotail currents, and (4) the symmetric ring current. In the near-Earth nightside region, however, several of these current systems flow in close proximity to each other. Moreover, the existence of other temporal current systems, such as the substorm current wedge or "banana" current, has been reported. It is very difficult to identify a local measurement as belonging to a specific system. Such identification is important, however, because how the current closes and how these loops change in space and time governs the magnetic topology of the magnetosphere and therefore controls the physical processes of geospace. Furthermore, many methods exist for identifying the regions of near-Earth space carrying each type of current. This study presents a robust collection of these definitions of current systems in geospace, particularly in the near-Earth nightside magnetosphere, as viewed from a variety of observational and computational analysis techniques. The influence of definitional choice on the resulting interpretation of physical processes governing geospace dynamics is presented and discussed.

  2. Sweden health system review.

    Science.gov (United States)

    Anell, Anders; Glenngård, Anna H; Merkur, Sherry

    2012-01-01

    Life expectancy in Sweden is high and the country performs well in comparisons related to disease-oriented indicators of health service outcomes and quality of care. The Swedish health system is committed to ensuring the health of all citizens and abides by the principles of human dignity, need and solidarity, and cost-effectiveness. The state is responsible for overall health policy, while the funding and provision of services lies largely with the county councils and regions. The municipalities are responsible for the care of older and disabled people. The majority of primary care centres and almost all hospitals are owned by the county councils. Health care expenditure is mainly tax funded (80%) and is equivalent to 9.9% of gross domestic product (GDP) (2009). Only about 4% of the population has voluntary health insurance (VHI). User charges fund about 17% of health expenditure and are levied on visits to professionals, hospitalization and medicines. The number of acute care hospital beds is below the European Union (EU) average and Sweden allocates more human resources to the health sector than most OECD countries. In the past, the Achilles heel of Swedish health care included long waiting times for diagnosis and treatment and, more recently, divergence in quality of care between regions and socioeconomic groups. Addressing long waiting times remains a key policy objective along with improving access to providers. Recent principal health reforms over the past decade relate to: concentrating hospital services; regionalizing health care services, including mergers; improving coordinated care; increasing choice, competition and privatization in primary care; privatization and competition in the pharmacy sector; changing co-payments; and increasing attention to public comparison of quality and efficiency indicators, the value of investments in health care and responsiveness to patients needs. Reforms are often introduced on the local level, thus the pattern of

  3. Spain: Health system review.

    Science.gov (United States)

    García-Armesto, Sandra; Begoña Abadía-Taira, María; Durán, Antonio; Hernández-Quevedo, Cristina; Bernal-Delgado, Enrique

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. This edition of the Spanish HiT focuses on the consequences of the totally devolved status, consolidated in 2002, and the implementation of the road map established by the 2003 SNS Cohesion and Quality Act. Many of the steps already taken underline the improvement path chosen: the SNS Inter-territorial Council (CISNS) comprising the national and regional health ministries was upgraded to the highest SNS authority, paving the way for a brand new consensus-based policy-making process grounded in knowledge management; its effects are progressively starting to be evident. It led the way to the SNS common benefits basket or the SNS human resources policy framework, laying the cornerstones for coordination and the enactment of the SNS Quality Plan. The Plan includes the work in progress to implement the national health information system, the development of a single electronic clinical record (eCR) containing relevant clinical information guaranteeing to patients continuity of care outside their Autonomous Community (AC) of residence or a single patient ID to be used across the country, thus creating the basis for the SNS functional single insurer. It has also become one of the main drivers for the design, implementation and monitoring of quality standards across the SNS, developing national health strategies to tackle both most prevalent chronic diseases (e.g. cancer, cardiovascular diseases, diabetes) and rare diseases, as well as the National Strategy on

  4. Health Insurance: what is the current situation?

    CERN Document Server

    Association du personnel

    2007-01-01

    One month ago, at our public meetings (see ECHO no. 38 - 24 September), we gave you certain information concerning our CERN Health Insurance Scheme (CHIS). Since then, several discussions have taken place and, as promised, we come back to the subject to bring you the latest important news. Just to remind you: health insurance is the last point to be dealt with in the framework of the last five-yearly review.

  5. Norway: health system review.

    Science.gov (United States)

    Ringard, Ånen; Sagan, Anna; Sperre Saunes, Ingrid; Lindahl, Anne Karin

    2013-01-01

    Norways five million inhabitants are spread over nearly four hundred thousand square kilometres, making it one of the most sparsely populated countries in Europe. It has enjoyed several decades of high growth, following the start of oil production in early 1970s, and is now one of the richest countries per head in the world. Overall, Norways population enjoys good health status; life expectancy of 81.53 years is above the EU average of 80.14, and the gap between overall life expectancy and healthy life years is around half the of EU average. The health care system is semi decentralized. The responsibility for specialist care lies with the state (administered by four Regional Health Authorities) and the municipalities are responsible for primary care. Although health care expenditure is only 9.4% of Norways GDP (placing it on the 16th place in the WHO European region), given Norways very high value of GDP per capita, its health expenditure per head is higher than in most countries. Public sources account for over 85% of total health expenditure; the majority of private health financing comes from households out-of-pocket payments.The number of practitioners in most health personnel groups, including physicians and nurses, has been increasing in the last few decades and the number of health care personnel per 100 000 inhabitants is high compared to other EU countries. However, long waiting times for elective care continue to be a problem and are cause of dissatisfaction among the patients. The focus of health care reforms has seen shifts over the past four decades. During the 1970s the focus was on equality and increasing geographical access to health care services; during the 1980s reforms aimed at achieving cost containment and decentralizing health care services; during the 1990s the focus was on efficiency. Since the beginning of the millennium the emphasis has been given to structural changes in the delivery and organization of health care and to policies

  6. The Chinese Health Care System

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter; Yu, Yi

    In the present paper we describe the structure of the Chinese health care system and sketch its future development. We analyse issues of provider incentives and the actual burden sharing between government, enterprises and people. We further aim to identify a number of current problems and link...... these to a discussion of future challenges in the form of an aging population, increased privatization and increased inequity...

  7. Electronical Health Record's Systems. Interoperability

    Directory of Open Access Journals (Sweden)

    Simona Angela Apostol

    2008-01-01

    Full Text Available #Understanding the importance that the electronic medical health records system has, with its various structural types and grades, has led to the elaboration of a series of standards and quality control methods, meant to control its functioning. In time, the electronic health records system has evolved along with the medical data’s change of structure. Romania has not yet managed to fully clarify this concept, various definitions still being encountered, such as “Patient’s electronic chart”, “Electronic health file”. A slow change from functional interoperability (OSI level 6 to semantic interoperability (level 7 is being aimed at the moment. This current article will try to present the main electronic files models, from a functional interoperability system’s possibility to be created perspective.

  8. Nephrogenic systemic fibrosis: Current concepts

    Directory of Open Access Journals (Sweden)

    Prasanta Basak

    2011-01-01

    Full Text Available Nephrogenic systemic fibrosis (NSF was first described in 2000 as a scleromyxedema-like illness in patients on chronic hemodialysis. The relationship between NSF and gadolinium contrast during magnetic resonance imaging was postulated in 2006, and subsequently, virtually all published cases of NSF have had documented prior exposure to gadolinium-containing contrast agents. NSF has been reported in patients from a variety of ethnic backgrounds from America, Europe, Asia and Australia. Skin lesions may evolve into poorly demarcated thickened plaques that range from erythematous to hyperpigmented. With time, the skin becomes markedly indurated and tethered to the underlying fascia. Extracutaneous manifestations also occur. The diagnosis of NSF is based on the presence of characteristic clinical features in the setting of chronic kidney disease, and substantiated by skin histology. Differential diagnosis is with scleroderma, scleredema, scleromyxedema, graft-versus-host disease, etc. NSF has a relentlessly progressive course. While there is no consistently successful treatment for NSF, improving renal function seems to slow or arrest the progression of this condition. Because essentially all cases of NSF have developed following exposure to a gadolinium-containing contrast agent, prevention of this devastating condition involves the careful avoidance of administering these agents to individuals at risk.

  9. Wearable Health Monitoring Systems

    Science.gov (United States)

    Bell, John

    2015-01-01

    The shrinking size and weight of electronic circuitry has given rise to a new generation of smart clothing that enables biological data to be measured and transmitted. As the variation in the number and type of deployable devices and sensors increases, technology must allow their seamless integration so they can be electrically powered, operated, and recharged over a digital pathway. Nyx Illuminated Clothing Company has developed a lightweight health monitoring system that integrates medical sensors, electrodes, electrical connections, circuits, and a power supply into a single wearable assembly. The system is comfortable, bendable in three dimensions, durable, waterproof, and washable. The innovation will allow astronaut health monitoring in a variety of real-time scenarios, with data stored in digital memory for later use in a medical database. Potential commercial uses are numerous, as the technology enables medical personnel to noninvasively monitor patient vital signs in a multitude of health care settings and applications.

  10. Measuring name system health

    NARCIS (Netherlands)

    Casalicchio, Emiliano; Caselli, M.; Coletta, Alessio; Di Blasi, Salvatore; Fovino, Igor Nai; Butts, Jonathan; Shenoi, Sujeet

    2012-01-01

    Modern critical infrastructure assets are exposed to security threats arising from their use of IP networks and the Domain Name System (DNS). This paper focuses on the health of DNS. Indeed, due to the increased reliance on the Internet, the degradation of DNS could have significant consequences for

  11. Measuring name system health

    NARCIS (Netherlands)

    Casalicchio, Emiliano; Caselli, Marco; Coletta, Alessio; Di Blasi, Salvatore; Fovino, Igor Nai; Butts, Jonathan; Shenoi, Sujeet

    2012-01-01

    Modern critical infrastructure assets are exposed to security threats arising from their use of IP networks and the Domain Name System (DNS). This paper focuses on the health of DNS. Indeed, due to the increased reliance on the Internet, the degradation of DNS could have significant consequences for

  12. Current and Future Flight Operating Systems

    Science.gov (United States)

    Cudmore, Alan

    2007-01-01

    This viewgraph presentation reviews the current real time operating system (RTOS) type in use with current flight systems. A new RTOS model is described, i.e. the process model. Included is a review of the challenges of migrating from the classic RTOS to the Process Model type.

  13. Analyzing on the Motivation and Factors for Building Long-term Care Insurance System-Based on Current Situation and Data Analysis of Chengdu%CHINA HEALTH INSURANCE

    Institute of Scientific and Technical Information of China (English)

    谢俊萍; 胡兆舜

    2016-01-01

    With the accelerating of population aging, besides basic medical insurance, the demands for long-term care are also increasing, especially the needs for reducing the fi nancial and caring burden of families having disabled older people are more urgent. Through analyzing current situation and the data of Chengdu, as well as considering the advanced experience of other countries in long-term care insurance system, we propose that long-term care insurance should be an independent insurance system, which is led and coordinated by government, initiated at low level while mainly protecting target population, and has system elements of fi ne rating and service industry for the elderly care. We hope these suggestions can provide reference for the system design.%随着人口老龄化进程的加快,老年人群在享受基本医疗保险制度的同时,对长期照护的需求进一步加大,特别是失能老人对减轻家庭照护经济和精力负担的诉求尤为迫切。本文通过对成都市现状和数据的分析,在借鉴其他国家经验的基础上,提出我国要建立的长期照护保险制度应是一个独立的险种、应由政府主导协调推进、建制初期应低水平起步并以保障重点人群为主、建立完善的等级评定体系、发展养老服务业等制度建设要素,为制度设计提供参考。

  14. A Survey of Current Rotorcraft Propulsion Health Monitoring Technologies

    Science.gov (United States)

    Delgado, Irebert R.; Dempsey, Paula J.; Simon, Donald L.

    2012-01-01

    A brief review is presented on the state-of-the-art in rotorcraft engine health monitoring technologies including summaries on current practices in the area of sensors, data acquisition, monitoring and analysis. Also, presented are guidelines for verification and validation of Health Usage Monitoring System (HUMS) and specifically for maintenance credits to extend part life. Finally, a number of new efforts in HUMS are summarized as well as lessons learned and future challenges. In particular, gaps are identified to supporting maintenance credits to extend rotorcraft engine part life. A number of data sources were consulted and include results from a survey from the HUMS community, Society of Automotive Engineers (SAE) documents, American Helicopter Society (AHS) papers, as well as references from Defence Science & Technology Organization (DSTO), Civil Aviation Authority (CAA), and Federal Aviation Administration (FAA).

  15. Croatia: health system review.

    Science.gov (United States)

    Džakula, Aleksandar; Sagan, Anna; Pavić, Nika; Lonćčarek, Karmen; Sekelj-Kauzlarić, Katarina

    2014-01-01

    Croatia is a small central European country on the Balkan peninsula, with a population of approximately 4.3 million and a gross domestic product (GDP) of 62% of the European Union (EU) average (expressed in purchasing power parity; PPP) in 2012. On 1 July 2013, Croatia became the 28th Member State of the EU. Life expectancy at birth has been increasing steadily in Croatia (with a small decline in the years following the 1991 to 1995 War of Independence) but is still lower than the EU average. Prevalence of overweight and obesity in the population has increased during recent years and trends in physical inactivity are alarming. The Croatian Health Insurance Fund (CHIF), established in 1993, is the sole insurer in the mandatory health insurance (MHI) system that provides universal health coverage to the whole population. The ownership of secondary health care facilities is distributed between the State and the counties. The financial position of public hospitals is weak and recent reforms were aimed at improving this. The introduction of concessions in 2009 (public private partnerships whereby county governments organize tenders for the provision of specific primary health care services) allowed the counties to play a more active role in the organization, coordination and management of primary health care; most primary care practices have been privatized. The proportion of GDP spent on health by the Croatian government remains relatively low compared to western Europe, as does the per capita health expenditure. Although the share of public expenditure as a proportion of total health expenditure (THE) has been decreasing, at around 82% it is still relatively high, even by European standards. The main source of the CHIFs revenue is compulsory health insurance contributions, accounting for 76% of the total revenues of the CHIF, although only about a third of the population (active workers) is liable to pay full health care contributions. Although the breadth and scope

  16. Response Current from Spin-Vortex-Induced Loop Current System to Feeding Current

    Science.gov (United States)

    Morisaki, Tsubasa; Wakaura, Hikaru; Abou Ghantous, Michel; Koizumi, Hiroyasu

    2017-07-01

    The spin-vortex-induced loop current (SVILC) is a loop current generated around a spin-vortex formed by itinerant electrons. It is generated by a U(1) instanton created by the single-valued requirement of wave functions with respect to the coordinate, and protected by the topological number, "winding number". In a system with SVILCs, a macroscopic persistent current is generated as a collection of SVILCs. In the present work, we consider the situation where external currents are fed in the SVILC system and response currents are measured as spontaneous currents that flow through leads attached to the SVILC system. The response currents from SVILC systems are markedly different from the feeding currents in their directions and magnitude, and depend on the original current pattern of the SVILC system; thus, they may be used in the readout process in the recently proposed SVILC quantum computer, a quantum computer that utilizes SVILCs as qubits. We also consider the use of the response current to detect SVILCs.

  17. Health Research Information Tracking System

    Data.gov (United States)

    US Agency for International Development — The Health Research Information Tracking System (HRIT) is an expansion of the Child Health Research database that collects and maintains categorization, description,...

  18. Health Information Systems.

    Science.gov (United States)

    Sirintrapun, S Joseph; Artz, David R

    2015-06-01

    This article provides surgical pathologists an overview of health information systems (HISs): what they are, what they do, and how such systems relate to the practice of surgical pathology. Much of this article is dedicated to the electronic medical record. Information, in how it is captured, transmitted, and conveyed, drives the effectiveness of such electronic medical record functionalities. So critical is information from pathology in integrated clinical care that surgical pathologists are becoming gatekeepers of not only tissue but also information. Better understanding of HISs can empower surgical pathologists to become stakeholders who have an impact on the future direction of quality integrated clinical care.

  19. Thermal currents in highly correlated systems

    OpenAIRE

    MORENO, J; Coleman, P.

    1996-01-01

    Conventional approaches to thermal conductivity in itinerant systems neglect the contribution to thermal current due to interactions. We derive this contribution to the thermal current and show how it produces important corrections to the thermal conductivity in anisotropic superconductors. We discuss the possible relevance of these corrections for the interpretation of the thermal conductivity of anisotropic superconductors.

  20. Multiple Currents in the Gulf Stream System

    OpenAIRE

    Fuglister, F. C.

    2011-01-01

    A new interpretation of the accumulated temperature and salinity data from the Gulf Stream Area indicates that the System is made up of a series of overlapping currents. These currents are separated by relatively weak countercurrents. Data from a recent survey are presented as supporting this hypothesis.DOI: 10.1111/j.2153-3490.1951.tb00804.x

  1. Current frontiers in systemic sclerosis pathogenesis

    NARCIS (Netherlands)

    Ciechomska, Marzena; van Laar, Jacob; O'Reilly, Steven

    2015-01-01

    Systemic sclerosis is an autoimmune disease characterised by vascular dysfunction, impaired angiogenesis, inflammation and fibrosis. There is no currently accepted disease-modifying treatment with only autologous stem cell transplant showing clinically meaningful benefit. The lack of treatment optio

  2. Superpersistent Currents in Dirac Fermion Systems

    Science.gov (United States)

    2017-03-06

    TITLE AND SUBTITLE Superpersistent Currents in Dirac Fermion Systems 5a.  CONTRACT NUMBER 5b.  GRANT NUMBER FA9550-15-1-0151 5c.   PROGRAM ELEMENT...currents in 2D Dirac material systems and pertinent phenomena in the emerging field of relativistic quantum nonlinear dynamics and chaos. Systematic...anomalous optical transitions, and spin control in topological insulator quantum dots, (4) the discovery of nonlinear dynamics induced anomalous Hall

  3. The German health care system and health care reform.

    Science.gov (United States)

    Kamke, K

    1998-02-01

    This article presents a structured survey of the German health care and health insurance system, and analyzes major developments of current German health policy. The German statutory health insurance system has been known as a system that provides all citizens with ready access to comprehensive high quality medical care at a cost the country considered socially acceptable. However, an increasing concern for rapidly rising health care expenditure led to a number of cost-containment measures since 1977. The aim was to bring the growth of health care expenditure in line with the growth of wages and salaries of the sickness fund members. The recent health care reforms of 1989 and 1993 yielded only short-term reductions of health care expenditure, with increases in the subsequent years. 'Stability of the contribution rate' is the uppermost political objective of current health care reform initiatives. Options under discussion include reductions in the benefit package and increases of patients' co-payments. The article concludes with the possible consequences of the 1997 health care reform of which the major part became effective 1 July 1997.

  4. Integrating child health information systems in public health agencies.

    Science.gov (United States)

    Bara, Debra; McPhillips-Tangum, Carol; Wild, Ellen L; Mann, Marie Y

    2009-01-01

    Public health agencies at state and local levels are integrating information systems to improve health outcomes for children. An assessment was conducted to describe the extent to which public health agencies are currently integrating child health information systems (CHIS). Using online technology information was collected, to assess completed and planned activities related to integration of CHIS, maturity of these systems, and factors that influence decisions by public health agencies to pursue integration activities. Of the 39 public health agencies that participated, 18 (46%) reported already integrating some or all of their CHIS, and 13 (33%) reported to be planning to integrate during the next 3 years. Information systems most commonly integrated include Early Hearing Detection and Intervention (EHDI), immunization, vital records, and Newborn Dried Bloodspot Screening (NDBS). Given the high priority that has been placed on using technology to improve health status in the United States, the emphasis on expanding the capability for the electronic exchange of health information, and federal support for electronic health records by 2014, public health agencies should be encouraged and supported in their efforts to develop, implement, and maintain integrated CHIS to facilitate the electronic exchange of health information with the clinical healthcare sector.

  5. Chinese health care system and clinical epidemiology

    Science.gov (United States)

    Sun, Yuelian; Gregersen, Hans; Yuan, Wei

    2017-01-01

    China has gone through a comprehensive health care insurance reform since 2003 and achieved universal health insurance coverage in 2011. The new health care insurance system provides China with a huge opportunity for the development of health care and medical research when its rich medical resources are fully unfolded. In this study, we review the Chinese health care system and its implication for medical research, especially within clinical epidemiology. First, we briefly review the population register system, the distribution of the urban and rural population in China, and the development of the Chinese health care system after 1949. In the following sections, we describe the current Chinese health care delivery system and the current health insurance system. We then focus on the construction of the Chinese health information system as well as several existing registers and research projects on health data. Finally, we discuss the opportunities and challenges of the health care system in regard to clinical epidemiology research. China now has three main insurance schemes. The Urban Employee Basic Medical Insurance (UEBMI) covers urban employees and retired employees. The Urban Residence Basic Medical Insurance (URBMI) covers urban residents, including children, students, elderly people without previous employment, and unemployed people. The New Rural Cooperative Medical Scheme (NRCMS) covers rural residents. The Chinese Government has made efforts to build up health information data, including electronic medical records. The establishment of universal health care insurance with linkage to medical records will provide potentially huge research opportunities in the future. However, constructing a complete register system at a nationwide level is challenging. In the future, China will demand increased capacity of researchers and data managers, in particular within clinical epidemiology, to explore the rich resources. PMID:28356772

  6. Discounting health effects in pharmacoeconomic evaluations : Current controversies

    NARCIS (Netherlands)

    Bos, JM; Postma, MJ; Annemans, L

    2005-01-01

    Currently, much debate still surrounds the discounting of health effects: Most general consensus statements have argued for the same discount rate for health and money; however, this practice has been questioned by several authors. The choice of discount rate can have varying effects on intervention

  7. Current perspectives: the impact of cyberbullying on adolescent health

    OpenAIRE

    Nixon CL

    2014-01-01

    Charisse L Nixon Pennsylvania State University, the Behrend College, Erie, PA, USA Abstract: Cyberbullying has become an international public health concern among adolescents, and as such, it deserves further study. This paper reviews the current literature related to the effects of cyberbullying on adolescent health across multiple studies worldwide and provides directions for future research. A review of the evidence suggests that cyberbullying poses a threat to adolescents' health...

  8. Medical Robots: Current Systems and Research Directions

    OpenAIRE

    Beasley, Ryan A.

    2012-01-01

    First used medically in 1985, robots now make an impact in laparoscopy, neurosurgery, orthopedic surgery, emergency response, and various other medical disciplines. This paper provides a review of medical robot history and surveys the capabilities of current medical robot systems, primarily focusing on commercially available systems while covering a few prominent research projects. By examining robotic systems across time and disciplines, trends are discernible that imply future capabilities ...

  9. Understanding health from a complex systems perspective.

    Science.gov (United States)

    Topolski, Stefan

    2009-08-01

    Doctors often use theory to inform medical practice. The current bio-psycho-social model of health may be advanced still further with theoretical rigour. Traditional fields of thermodynamics and newer fields of non-linear dynamics including chaos theory and complex systems science can inform our understanding of the complexity of human health, illness and disease. Commonly accepted aspects of human health may be projected as probabilities over time creating curves of human health potential. Maximum health may be represented by maximum functional complexity. Complexity's relationship to entropy and energy can produce a complex surface that better models the human experience of health and illness from birth to death. Such a potential health trajectory uniting complexity and entropy expands upon earlier theories of health while allowing for unusual predictions and the novel opportunity to test and validate this model of human health.

  10. The Chinese health system at a crossroads.

    Science.gov (United States)

    Yip, Winnie; Hsiao, William C

    2008-01-01

    The Chinese government has committed to increasing government funding for health care by directing 1-1.5 percent of its gross domestic product to universal basic health care. However, China is at a loss as to how to transform its new money into efficient and effective health care. This paper critically examines the various options currently under heated debate in China. We argue that unless China tackles the root cause of unaffordable health care--rapid cost inflation caused by an irrational and wasteful health care delivery system--much of the new money is likely to be captured by providers as higher income and profits.

  11. The Netherlands: health system review

    NARCIS (Netherlands)

    Schäfer, W.; Kroneman, M.; Boerma, W.; van den Berg, M.; Westert, G.; Devillé, W.; van Ginneken, E.

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of health systems and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of

  12. The Netherlands: health system review

    NARCIS (Netherlands)

    Schäfer, W.; Kroneman, M.; Boerma, W.; van den Berg, M.; Westert, G.; Devillé, W.; van Ginneken, E.

    2010-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of health systems and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of

  13. Automatic system for ionization chamber current measurements.

    Science.gov (United States)

    Brancaccio, Franco; Dias, Mauro S; Koskinas, Marina F

    2004-12-01

    The present work describes an automatic system developed for current integration measurements at the Laboratório de Metrologia Nuclear of Instituto de Pesquisas Energéticas e Nucleares. This system includes software (graphic user interface and control) and a module connected to a microcomputer, by means of a commercial data acquisition card. Measurements were performed in order to check the performance and for validating the proposed design.

  14. Direct current power delivery system and method

    Science.gov (United States)

    Zhang, Di; Garces, Luis Jose; Dai, Jian; Lai, Rixin

    2016-09-06

    A power transmission system includes a first unit for carrying out the steps of receiving high voltage direct current (HVDC) power from an HVDC power line, generating an alternating current (AC) component indicative of a status of the first unit, and adding the AC component to the HVDC power line. Further, the power transmission system includes a second unit for carrying out the steps of generating a direct current (DC) voltage to transfer the HVDC power on the HVDC power line, wherein the HVDC power line is coupled between the first unit and the second unit, detecting a presence or an absence of the added AC component in the HVDC power line, and determining the status of the first unit based on the added AC component.

  15. TRICARE, Military Health System

    Science.gov (United States)

    ... Claim Get Proof of TRICARE Coverage View My Military Health Record Less State of Emergency in North ... Disaster Information Download a Form Go Paperless My Military Health Records Multimedia Center Plan Information Kits Recoupment ...

  16. Current perspectives: the impact of cyberbullying on adolescent health.

    Science.gov (United States)

    Nixon, Charisse L

    2014-01-01

    Cyberbullying has become an international public health concern among adolescents, and as such, it deserves further study. This paper reviews the current literature related to the effects of cyberbullying on adolescent health across multiple studies worldwide and provides directions for future research. A review of the evidence suggests that cyberbullying poses a threat to adolescents' health and well-being. A plethora of correlational studies have demonstrated a cogent relationship between adolescents' involvement in cyberbullying and negative health indices. Adolescents who are targeted via cyberbullying report increased depressive affect, anxiety, loneliness, suicidal behavior, and somatic symptoms. Perpetrators of cyberbullying are more likely to report increased substance use, aggression, and delinquent behaviors. Mediating/moderating processes have been found to influence the relationship between cyberbullying and adolescent health. More longitudinal work is needed to increase our understanding of the effects of cyberbullying on adolescent health over time. Prevention and intervention efforts related to reducing cyberbullying and its associated harms are discussed.

  17. Current perspectives: the impact of cyberbullying on adolescent health

    Science.gov (United States)

    Nixon, Charisse L

    2014-01-01

    Cyberbullying has become an international public health concern among adolescents, and as such, it deserves further study. This paper reviews the current literature related to the effects of cyberbullying on adolescent health across multiple studies worldwide and provides directions for future research. A review of the evidence suggests that cyberbullying poses a threat to adolescents’ health and well-being. A plethora of correlational studies have demonstrated a cogent relationship between adolescents’ involvement in cyberbullying and negative health indices. Adolescents who are targeted via cyberbullying report increased depressive affect, anxiety, loneliness, suicidal behavior, and somatic symptoms. Perpetrators of cyberbullying are more likely to report increased substance use, aggression, and delinquent behaviors. Mediating/moderating processes have been found to influence the relationship between cyberbullying and adolescent health. More longitudinal work is needed to increase our understanding of the effects of cyberbullying on adolescent health over time. Prevention and intervention efforts related to reducing cyberbullying and its associated harms are discussed. PMID:25177157

  18. CURRENT TRENDS IN PULSATILE DRUG DELIVERY SYSTEMS

    Directory of Open Access Journals (Sweden)

    S. R. Tajane et al.

    2012-01-01

    Full Text Available The purpose for this review on pulsatile drug delivery systems (PDDS is to compile the recent literatures with special focus on the different types and approaches involved in the development of the formulation. Pulsatile drug delivery system is the most interesting time and site-specific system. This system is designed for chronopharmacotherapy. Thus, to mimic the function of living systems and in view of emerging chronotherapeutic approaches, pulsatile delivery, which is meant to release a drug following programmed lag phase, has increasing interest in the recent years. Diseases wherein PDDS are promising include asthma, peptic ulcer, cardiovascular diseases, arthritis, and attention deficit syndrome in children, cancer, diabetes, and hypercholesterolemia. Pulsatile drug delivery system divided into 2 types’ preplanned systems and stimulus induced system, preplanned systems based on osmosis, rupturable layers, and erodible barrier coatings. Stimuli induced system based on electrical, temperature and chemically induced systems. This review also summarizes some current PDDS already available in the market. These systems are useful to several problems encountered during the development of a pharmaceutical dosage form.

  19. Medical Robots: Current Systems and Research Directions

    Directory of Open Access Journals (Sweden)

    Ryan A. Beasley

    2012-01-01

    Full Text Available First used medically in 1985, robots now make an impact in laparoscopy, neurosurgery, orthopedic surgery, emergency response, and various other medical disciplines. This paper provides a review of medical robot history and surveys the capabilities of current medical robot systems, primarily focusing on commercially available systems while covering a few prominent research projects. By examining robotic systems across time and disciplines, trends are discernible that imply future capabilities of medical robots, for example, increased usage of intraoperative images, improved robot arm design, and haptic feedback to guide the surgeon.

  20. [The health system of Mexico].

    Science.gov (United States)

    Gómez Dantés, Octavio; Sesma, Sergio; Becerril, Victor M; Knaul, Felicia M; Arreola, Héctor; Frenk, Julio

    2011-01-01

    This paper describes the Mexican health system. In part one, the health conditions of the Mexican population are discussed, with emphasis in those emerging diseases that are now the main causes of death, both in men and women: diabetes, ischaemic heart disease, cerebrovascular diseases and cancer. Part two is devoted to the description of the basic structure of the system: its main institutions, the population coverage, the health benefits of those affiliated to the different heath institutions, its financial sources, the levels of financial protection in health, the availability of physical, material and human resources for health, and the stewardship functions displayed by the Ministry of Health and other actors. This part also discusses the role of citizens in the monitorization and evaluation of the health system, as well as the levels of satisfaction with the rendered health services. In part three the most recent innovations and its impact on the performance of the health system are discussed. Salient among them are the System of Social Protection in Health and the Popular Health Insurance. The paper concludes with a brief analysis of the short- and middle-term challenges faced by the Mexican health system.

  1. Current status of oral health research in Africa: an overview.

    Science.gov (United States)

    Kanoute, Aïda; Faye, Daouda; Bourgeois, Denis

    2012-12-01

    Research in oral health contributes effectively to decisions and strategies aimed at improving the oral health of populations. Further contributions to enhance current knowledge of oral health in Africa are required. The principal objective of this study was to produce an analysis of oral health research published from different subregions of Africa and to estimate bilateral and multilateral international cooperation in oral health research during the period 2005-2010. The PubMed database was searched for published articles on topics related to oral health in Africa. A total of 935 oral health-related articles were retrieved during April and May 2011. Publications emanating from Nigeria and South Africa accounted for a striking 68% of all oral health-related material published from Africa during the study period. Researchers from 30 different countries had participated in collaboration on at least one published article. A total of 262 journals had published at least one item examining oral health in Africa, but only 29 journals had published more than seven articles. These 29 journals accounted for 66% of all published material and induced non-African reviews (26%) and African reviews (40%). This study shows strong variation among countries in the production of articles on oral health whereby rich countries produce greater quantities of published research and poorer nations more frequently develop research partnerships with other countries. © 2012 FDI World Dental Federation.

  2. Health record systems that meet clinical needs

    Directory of Open Access Journals (Sweden)

    Gabriella Negrini

    2012-10-01

    Full Text Available Introduction Increased attention has recently been focused on health record systems as a result of accreditation programs, a growing emphasis on patient safety, and the increase in lawsuits involving allegations of malpractice. Health-care professionals frequently express dissatisfaction with the health record systems and complain that the data included are neither informative nor useful for clinical decision making. This article reviews the main objectives of a hospital health record system, with emphasis on its roles in communication and exchange among clinicians, patient safety, and continuity of care, and asks whether current systems have responded to the recent changes in the Italian health-care system.Discussion If health records are to meet the expectations of all health professionals, the overall information need must be carefully analyzed, a common data set must be created, and essential specialist contributions must be defined. Working with health-care professionals, the hospital management should define how clinical information is to be displayed and organized, identify a functionally optimal layout, define the characteristics of ongoing patient assessment in terms of who will be responsible for these activities and how often they will be performed. Internet technology can facilitate data retrieval and meet the general requirements of a paper-based health record system, but it must also ensure focus on clinical information, business continuity, integrity, security, and privacy.Conclusions The current health records system needs to be thoroughly revised to increase its accessibility, streamline the work of health-care professionals who consult it, and render it more useful for clinical decision making—a challenging task that will require the active involvement of the many professional classes involved.

  3. Current and future impact of osteoarthritis on health care

    DEFF Research Database (Denmark)

    Turkiewicz, A; Petersson, I F; Björk, J

    2014-01-01

    OBJECTIVE: To estimate the current and future (to year 2032) impact of osteoarthritis (OA) health care seeking. METHOD: Population-based study with prospectively ascertained data from the Skåne Healthcare Register (SHR), Sweden, encompassing more than 15 million person-years of primary and specia......OBJECTIVE: To estimate the current and future (to year 2032) impact of osteoarthritis (OA) health care seeking. METHOD: Population-based study with prospectively ascertained data from the Skåne Healthcare Register (SHR), Sweden, encompassing more than 15 million person-years of primary...

  4. United Kingdom: Health System Review.

    Science.gov (United States)

    Cylus, Jonathan; Richardson, Erica; Findley, Lisa; Longley, Marcus; O'Neill, Ciaran; Steel, David

    2015-01-01

    This analysis of the United Kingdom health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. It provides an overview of how the national health services operate in the four nations that make up the United Kingdom, as responsibility for organizing health financing and services was devolved from 1997. With devolution, the health systems in the United Kingdom have diverged in the details of how services are organized and paid for, but all have maintained national health services which provide universal access to a comprehensive package of services that are mostly free at the point of use. These health services are predominantly financed from general taxation and 83.5% of total health expenditure in the United Kingdom came from public sources in 2013. Life expectancy has increased steadily across the United Kingdom, but health inequalities have proved stubbornly resistant to improvement, and the gap between the most deprived and the most privileged continues to widen, rather than close. The United Kingdom faces challenges going forward, including how to cope with the needs of an ageing population, how to manage populations with poor health behaviours and associated chronic conditions, how to meet patient expectations of access to the latest available medicines and technologies, and how to adapt a system that has limited resources to expand its workforce and infrastructural capacity so it can rise to these challenges.

  5. Review of Current Nuclear Vacuum System Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Carroll, M.; McCracken, J.; Shope, T.

    2003-02-25

    Nearly all industrial operations generate unwanted dust, particulate matter, and/or liquid wastes. Waste dust and particulates can be readily tracked to other work locations, and airborne particulates can be spread through ventilation systems to all locations within a building, and even vented outside the building - a serious concern for processes involving hazardous, radioactive, or nuclear materials. Several varieties of vacuum systems have been proposed and/or are commercially available for clean up of both solid and liquid hazardous and nuclear materials. A review of current technologies highlights both the advantages and disadvantages of the various systems, and demonstrates the need for a system designed to address issues specific to hazardous and nuclear material cleanup. A review of previous and current hazardous/nuclear material cleanup technologies is presented. From simple conventional vacuums modified for use in industrial operations, to systems specifically engineered for such purposes, the advantages and disadvantages are examined in light of the following criteria: minimal worker exposure; minimal secondary waste generation;reduced equipment maintenance and consumable parts; simplicity of design, yet fully compatible with all waste types; and ease of use. The work effort reviews past, existing and proposed technologies in light of such considerations. Accomplishments of selected systems are presented, including identified areas where technological improvements could be suggested.

  6. The current state of evidence regarding the health effects of wifi communication systems Sistemas de comunicación wifi y efectos sobre la salud. El estado de las evidencias actuales Sistemas de comunicação wifi e efeitos na saúde: O estado atual da evidência

    National Research Council Canada - National Science Library

    Francisco Vargas Marcos

    2012-01-01

    ...) emitted by wifi telecommunication systems. These reports have generated demands for information, which the relevant environmental health authorities have to deal with in a transparent, clear and effective way, based on current scientific evidence...

  7. [The current importance of veterinary public health: the SAPUVET project].

    Science.gov (United States)

    Ortega, C; de Meneghi, D; de Balogh, K; de Rosa, M; Estol, L; Leguia, G; Fonseca, A; Torres, M; Caballero-Castillo, M

    2004-12-01

    The authors propose reviewing the current needs for implementing veterinary public health programmes, from both the teaching and professional standpoints. This is warranted by the fact that veterinary public health has become extremely important in various fields of work, beyond conventional food inspection. The article discusses the public health role which veterinarians must play and the interactions between their activities and those of other groups such as doctors, epidemiologists, ecologists, chemists, or even sociologists and anthropologists. The authors also study and assess the basic working tool in veterinary public health--epidemiological surveillance--and how it operates on the basis of diagnosis and risk analysis. The second part of the article discusses the need to unify criteria for veterinary public health training and the role which the SAPUVET network is playing in doing so (SAPUVET is a European Union-supported project within the ALFA programme that is designed to establish links between Latin American and European veterinary faculties).

  8. Republic of Moldova health system review.

    Science.gov (United States)

    Turcanu, Ghenadie; Domente, Silviu; Buga, Mircea; Richardson, Erica

    2012-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The reform of health financing in the Republic of Moldova began in earnest in 2004 with the introduction of a mandatory health insurance (MHI) system. Since then, MHI has become a sustainable financing mechanism that has improved the technical and allocative efficiency of the system as well as overall transparency. This has helped to further consolidate the prioritization of primary care in the system, which has been bas ed on a family medicine model since the 1990s. Hospital stock in the country has been reduced since independence as the country inherited a Semashko health system with excessive infrastructure, but there is still room for efficiency gains, particularly through the consolidation of specialist services in the capital city. The rationalization of duplicated specialized services, therefore, remains a key challenge facing the Moldovan health system. Other challenges include health workforce shortages (particularly in rural areas) and improving equity in financing and access to care by reducing out of pocket (OOP) payments. OOP spending on health is dominated by the cost of pharmaceuticals and this is currently a core focus of reform efforts.

  9. Current therapy of systemic sclerosis (scleroderma).

    Science.gov (United States)

    Müller-Ladner, U; Benning, K; Lang, B

    1993-04-01

    Treatment of systemic sclerosis (scleroderma) presents a challenge to both the patient and the physician. Established approaches include long-term physiotherapy, disease-modifying agents such as D-penicillamine, and treatment of organ involvement. These efforts are often unsatisfactory since the results are poor. However, recent advances include treatment of Raynaud's phenomenon (plasmapheresis, stanozolol, and prostacyclin analogues), scleroderma renal crisis (angiotensin-converting enzyme inhibitors), and gastric hypomotility (cisapride). This article covers the current approaches to the disease-modifying therapy including those related to the function of collagen-producing fibroblasts, vascular alterations, and the cellular and humoral immune system, as well as treatment of involved organs.

  10. Why focus on mental health systems?

    Directory of Open Access Journals (Sweden)

    Minas Harry

    2007-08-01

    Full Text Available Abstract The global situation for people with mental illness – in developing and developed countries – is dire. Legislative and human rights protections are frequently lacking. Mental health budgets are inadequate. There are insufficient numbers of skilled policy makers, managers and clinicians. Communities are poorly informed about mental health and illness and not well organised for purposes of advocacy. In most of the world, mental health services are inaccessible or of poor quality. Most people who would benefit from psychiatric treatment and rehabilitation do not have affordable access to such services. Leadership – at all levels – for mental health system development needs to be greatly strengthened. While mental health research attention and funds are devoted predominantly to neuroscience and clinical research, we believe that the highest global mental health research priority is mental health systems research. There is an urgent need to focus on the development of effective, appropriate, affordable mental health services. The evidence base for such development is currently weak. The International Journal of Mental Health Systems aims to stimulate greater attention to the central importance of building functioning mental health systems. Rapid publication and global reach through open access will make this journal a resource for all those who wish to contribute to such development.

  11. Community mental health care worldwide: current status and further developments.

    Science.gov (United States)

    Thornicroft, Graham; Deb, Tanya; Henderson, Claire

    2016-10-01

    This paper aims to give an overview of the key issues facing those who are in a position to influence the planning and provision of mental health systems, and who need to address questions of which staff, services and sectors to invest in, and for which patients. The paper considers in turn: a) definitions of community mental health care; b) a conceptual framework to use when evaluating the need for hospital and community mental health care; c) the potential for wider platforms, outside the health service, for mental health improvement, including schools and the workplace; d) data on how far community mental health services have been developed across different regions of the world; e) the need to develop in more detail models of community mental health services for low- and middle-income countries which are directly based upon evidence for those countries; f) how to incorporate mental health practice within integrated models to identify and treat people with comorbid long-term conditions; g) possible adverse effects of deinstitutionalization. We then present a series of ten recommendations for the future strengthening of health systems to support and treat people with mental illness.

  12. 齐齐哈尔市精神卫生防治体系现状调查与对策研究%Investigation on current situation and countermeasures of mental health prevention system in Qiqihar

    Institute of Scientific and Technical Information of China (English)

    张丽宏; 周秋雅; 王文翔; 李平; 周馨竹; 齐金玲; 于增艳; 曹运华

    2015-01-01

    Objective To investigate and study current situation of mental health prevention system in Qiqihar, and analyze the existing problems and study the countermeasures .Methods Literature review, expert interview and questionnaire were used .Results There were mainly 5 psychiatric hospitals ( department ) in Qiqihar, 1,310 preparation beds and 688 preparation staffing, including 553 health technical personnel , 20 other technical personnel , 29 managers and 86 workers.Professionals have low academic education and titles .Most mental hospitals are in the way of closed management and at the preliminary stage of development .Conclusions Mental health prevention system in Qiqihar takes shape , but lacks human resources , basic technical equipment is hard to meet the work needs and still lack control efforts .%目的:调查了解齐齐哈尔市精神卫生防治体系现状,分析存在的问题并进行对策探讨。方法采用文献法、访谈法和问卷调查法。结果齐齐哈尔市主要有5所精神病院(科),编制床位1310张,编制人员688人,其中卫生技术人员553人,其他技术人员20人,管理人员29人,工勤人员86人,专业人员学历、职称偏低;精神病院多以封闭式管理为主,基本处在初步发展阶段。结论齐齐哈尔市精神卫生防治体系初具规模,但人力资源不足,基础技术设备难以满足工作需要,防治力度还有所欠缺。

  13. Is health systems integration being advanced through Local Health District planning?

    Science.gov (United States)

    Saunders, Carla; Carter, David J

    2016-04-21

    Objective Delivering genuine integrated health care is one of three strategic directions in the New South Wales (NSW) Government State Health Plan: Towards 2021. This study investigated the current key health service plan of each NSW Local Health District (LHD) to evaluate the extent and nature of health systems integration strategies that are currently planned.Methods A scoping review was conducted to identify common key principles and practices for successful health systems integration to enable the development of an appraisal tool to content assess LHD strategic health service plans.Results The strategies that are planned for health systems integration across LHDs focus most often on improvements in coordination, health care access and care delivery for complex at-risk patients across the care continuum by both state- and commonwealth-funded systems, providers and agencies. The most common reasons given for integrated activities were to reduce avoidable hospitalisation, avoid inappropriate emergency department attendance and improve patient care.Conclusions Despite the importance of health systems integration and finding that all NSW LHDs have made some commitment towards integration in their current strategic health plans, this analysis suggests that health systems integration is in relatively early development across NSW.What is known about the topic? Effective approaches to managing complex chronic diseases have been found to involve health systems integration, which necessitates sound communication and connection between healthcare providers across community and hospital settings. Planning based on current health systems integration knowledge to ensure the efficient use of scarce resources is a responsibility of all health systems.What does this paper add? Appropriate planning and implementation of health systems integration is becoming an increasingly important expectation and requirement of effective health systems. The present study is the first of its

  14. [Mobile health and health systems: determining progress in global health].

    Science.gov (United States)

    Frenk, Julio

    2015-01-01

    Usually when we talk about information technologies we are speaking about the technology itself and its contents. In this article I want to focus on mobile technologies for health (mobile health), but not so much on the content of mobile health but in its context, represented by the health systems where these technologies are deployed. The central message is that in order to capitalize on the potential of the mobile communications revolution, it is not only necessary to innovate in the field of the same technologies but also in the institutions that enable these technologies to reach their potential beneficiaries.

  15. Gender relations and health research: a review of current practices

    Directory of Open Access Journals (Sweden)

    Bottorff Joan L

    2011-12-01

    Full Text Available Abstract Introduction The importance of gender in understanding health practices and illness experiences is increasingly recognized, and key to this work is a better understanding of the application of gender relations. The influence of masculinities and femininities, and the interplay within and between them manifests within relations and interactions among couples, family members and peers to influence health behaviours and outcomes. Methods To explore how conceptualizations of gender relations have been integrated in health research a scoping review of the existing literature was conducted. The key terms gender relations, gender interactions, relations gender, partner communication, femininities and masculinities were used to search online databases. Results Through analysis of this literature we identified two main ways gender relations were integrated in health research: a as emergent findings; and b as a basis for research design. In the latter, gender relations are included in conceptual frameworks, guide data collection and are used to direct data analysis. Conclusions Current uses of gender relations are typically positioned within intimate heterosexual couples whereby single narratives (i.e., either men or women are used to explore the influence and/or impact of intimate partner gender relations on health and illness issues. Recommendations for advancing gender relations and health research are discussed. This research has the potential to reduce gender inequities in health.

  16. Current perspectives: the impact of cyberbullying on adolescent health

    Directory of Open Access Journals (Sweden)

    Nixon CL

    2014-08-01

    Full Text Available Charisse L Nixon Pennsylvania State University, the Behrend College, Erie, PA, USA Abstract: Cyberbullying has become an international public health concern among adolescents, and as such, it deserves further study. This paper reviews the current literature related to the effects of cyberbullying on adolescent health across multiple studies worldwide and provides directions for future research. A review of the evidence suggests that cyberbullying poses a threat to adolescents' health and well-being. A plethora of correlational studies have demonstrated a cogent relationship between adolescents' involvement in cyberbullying and negative health indices. Adolescents who are targeted via cyberbullying report increased depressive affect, anxiety, loneliness, suicidal behavior, and somatic symptoms. Perpetrators of cyberbullying are more likely to report increased substance use, aggression, and delinquent behaviors. Mediating/moderating processes have been found to influence the relationship between cyberbullying and adolescent health. More longitudinal work is needed to increase our understanding of the effects of cyberbullying on adolescent health over time. Prevention and intervention efforts related to reducing cyberbullying and its associated harms are discussed. Keywords: cyberbullying, adolescent health, prevention, intervention

  17. Dimensions of health system reform.

    Science.gov (United States)

    Frenk, J

    1994-01-31

    During recent years there has been a growth of worldwide interest in health system reform. Countries at all levels of economic development are engaged in a creative search for better ways of organizing and financing health care, while promoting the goals of equity, effectiveness, and efficiency. Together with economic, political, and ideological reasons, this search has been fueled by the need to find answers to the complexities posed by the epidemiologic transition, whereby many nations are facing the simultaneous burdens of old, unresolved problems and new, emerging challenges. In order to better understand reform attempts, it is necessary to develop a clear conception of the object of reform: the health system. This paper presents the health system as a set of relationships among five major groups of actors: the health care providers, the population, the state as a collective mediator, the organizations that generate resources, and the other sectors that produce services with health effects. The relationships among providers, population, and the state form the basis for a typology of health care modalities. The type and number of modalities present in a country make it possible to characterize its health system. In the last part, the paper proposes that health system reform operates at four policy levels: systemic, which deals with the institutional arrangements for regulation, financing, and delivery of services; programmatic, which specifies the priorities of the system, by defining a universal package of health care interventions; organizational, which is concerned with the actual production of services by focusing on issues of quality assurance and technical efficiency; and instrumental, which generates the institutional intelligence for improving system performance through information, research, technological innovation, and human resource development. The dimensions of reform offer a repertoire of policy options, which need to be enriched by cross

  18. Electronic health in ghana: current status and future prospects.

    Science.gov (United States)

    Afarikumah, Ebenezer

    2014-01-01

    The health-care system in Ghana is similar to those in other developing countries and access to health services for remote communities is extremely limited. In July, 2010, the Government of Ghana launched the national e health strategy. A number of international organizations have initiated various pilot projects, including disseminating and collecting data, education initiatives and telemedicine. In addition, several institutions and organizations are dedicated to the promotion of e-health and a range of Web-based health consultancy services have begun. The main objective of this study is to provide an overview of eHealth activities in Ghana. It was a daunting task, not least because of the need to gather information on eHealth projects and initiatives in Ghana, as there is no existing repository of such information. Through literature search in Africa journals online, Hinari, Medline, Google.com, Journal of Telemedicine and e-Health, Journal of Telemedicine and Telecare, Journal of Medical Internet Research and Interaction with eHealth experts, followed up with some of the authors' for directions to other projects, and following the references in some articles. A total of twenty-two (22) pilot projects have been identified in Ghana. Mobile devices in use range from PDAs to simple phones and smart phones. The key findings of this research are that there are about 22 eHealth project at various stages of implementation in Ghana. Some of these projects have wind up and others are still being implemented. Mobile devices in use range from PDAs to simple mobile phones and smart phones. Most of the projects have been donor initiated. Data collection started in March 2010 to June 2013. Although eHealth seems to have a limited role in Ghana at present, there is growing interest in the opportunities it may offer in terms of improving the delivery and access to services, especially in remote locations. Recommendations for further research are provided.

  19. [Electronic health strategies in The Americas: current situation and perspectives].

    Science.gov (United States)

    D Agostino, Marcelo

    2015-01-01

    The main objective of the Strategy and Plan of Action on eHealth (2012-2017) is to contribute to sustainable development of health systems of member states. Its adoption aims to improve quality and access to health services through the use of information and communication technologies (ICT), the implementation of digital literacy programs and access to quality information to advance towards more informed, equitable, competitive and democratic societies. PAHO/WHO considers that in society, free and equal access to health information should be a fundamental right of individuals. Access to information, knowledge sharing and use of information and communication technology in the health sector continues to grow and is driving significant changes in the way people interact with health services and among themselves in social networks and through the use of mobile devices (mHealth). This hyper-connected society, or information society, brings new challenges and opportunities related to the use of massive data (Big Data) that forces us to rethink our relationship with reality and the traditional ways of managing health information.

  20. [Evolution of the health system in Mexico].

    Science.gov (United States)

    García-Junco Machado, David

    2012-01-01

    This text is a summary of how the health system evolves in Mexico since the first institutions to date. Primarily addresses the problems that led to the creation of the Social Protection in Health System or Seguro Popular in 2003, as well as its objectives, performance, challenges faced and strategies that have been implemented over the past eight years. Also shown are the main results that have been achieved in health since the creation of Seguro Popular: membership of vulnerable groups, universal coverage, medical coverage and impact on out of pocket expenses and catastrophic expenses. The text concludes with the current vision of the health system; by which means, the objectives set out in the long run to Mexico.

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

    Science.gov (United States)

    Samet, Jonathan M

    2014-01-01

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

  2. [Current and future competencies for public health professionals].

    Science.gov (United States)

    Rodríguez, Dolors; Berenguera, Anna; Pujol-Ribera, Enriqueta; Capella, Jordina; Peray, Josep Lluís de; Roma, Josep

    2013-01-01

    To identify current and future competencies (managers and technicians) for public health professionals in Catalonia (Spain). Qualitative research with a phenomenological approach. Between November 2009 and February 2010, 31 semistructured interviews were completed with public health professionals working in Catalonia. We purposely used a theoretical sample to include the maximum multiplicity of discourses. We conducted a thematic content analysis. We obtained a wide range of current professional competencies, as well as those required for the future, classified according to professional profile. The participants highlighted transversal competencies, such as the importance of sharing a general theoretical framework of the discipline and the institution. Among the most frequently reported competencies were knowledge management, communication skills, teamwork, multidisciplinary and intersectoral orientation, legal knowledge, computer skills and languages, particularly English. It was also important for individual professionals to have specific skills in their areas of activity. In terms of differences between managers and technicians, the study showed that technicians prioritize management skills concerning human and material resources, while managers emphasize organizational and professional public health expertise. There is a need for transversal and specific competencies in distinct areas. Public health is a multidisciplinary field, which collaborates with a wide range of professionals and organizations. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  3. Integrated Systems Health Management for Intelligent Systems

    Science.gov (United States)

    Figueroa, Fernando; Melcher, Kevin

    2011-01-01

    The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

  4. Mobile health systems and emergence

    NARCIS (Netherlands)

    Jones, Valerie M.; Graziosi, Barbara

    2015-01-01

    Changes in the age distribution of the population and increased prevalence of chronic illnesses, together with a shortage of health professionals and other resources, will increasingly challenge the ability of national healthcare systems to meet rising demand for services. Large-scale use of eHealth

  5. Diver Health Monitoring System

    Science.gov (United States)

    2011-09-15

    Software - Small Business Innovative Research (SBIR) Program clause contained in the above identified contract. No restrictions apply after the...safety and effectiveness—their body. The goal of this Small Business Technology Transfer (STTR) Phase II project is the development of a Diver Health...Between DHMS and Biopac -0.47 ± 0.86 -0.57 ± 1.39 -0.52 i 1.16 Across all tests, however, a standard deviation of 1.16 bpm is small and validates the

  6. Wearable Health Monitoring Systems Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The objective of this proposal is to demonstrate the feasibility of producing a wearable health monitoring system for the human body that is functional, comfortable,...

  7. Wearable Health Monitoring Systems Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The objective of this proposal is to demonstrate the feasibility of producing a wearable health monitoring system for the human body that is functional, comfortable,...

  8. [The health system of Venezuela].

    Science.gov (United States)

    Bonvecchio, Anabelle; Becerril-Montekio, Victor; Carriedo-Lutzenkirchen, Angela; Landaeta-Jiménez, Maritza

    2011-01-01

    This paper describes the Venezuelan health system, including its structure and coverage, financial sources, human and material resources and its stewardship functions. This system comprises a public and a private sector. The public sector includes the Ministry of Popular Power for Health (MS) and several social security institutions, salient among them the Venezuelan Institute for Social Security (IVSS). The MH is financed with federal, state and county contributions. The IVSS is financed with employer, employee and government contributions. These two agencies provide services in their own facilities. The private sector includes providers offering services on an out-of-pocket basis and private insurance companies. The Venezuelan health system is undergoing a process of reform since the adoption of the 1999 Constitution which calls for the establishment of a national public health system. The reform process is now headed by the Barrio Adentro program.

  9. Catalytic currents in dithiophosphate-iodide systems

    Energy Technology Data Exchange (ETDEWEB)

    Gabdullin, M.G.; Garifzyanov, A.R.; Toropova, V.F.

    1986-01-01

    Catalytic currents of oxidizing agents are used to determinerate constants of simultaneous chemical reactions. In the present paper, the authors investigated electrochemical oxidation of iodide ions in the presence of a series of dithiophosphates (RO)/sub 2/PSS/sup -/ at a glassy carbon electrode n that (R=CH/sub 3/, C/sub 2/H/sub 5/, n-C/sub 3/H/sub 7/, n-C/sub 4/H/sub 9/, iso-C/sub 4/H/sub 9/, and sec-C/sub 4/H/sub 9/). It is know n that dithiophosphates (DTP) are strong reducing agents and are oxidized by iodine. At the same time, as shown previously, electrochemical oxidation of DTP occurs at more positive potentials in comparision with the oxidation potential of iodide ions. This suggested that it is possible for a catalytic effect to be manifested in DTP-I/sup -/ systems. Current-voltage curves are shown for solutions of I/sup -/ in the absence and in the presence of DTP. All data indicate a catalytic nature of the electrode process. The obtained data show that the rates of reactions of DTP with iodine decrease with increasing volume and branching of the substituents at the phosphorus atom.

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

    Science.gov (United States)

    Robinson, S M

    2015-10-01

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

  11. The current status of environmental health research in Australia.

    Science.gov (United States)

    Gowland, Angela; Cook, Angus; Heyworth, Jane

    2012-01-01

    At present, the extent of environmental health research in Australia is unclear and there are no recent overarching reviews of national publications on the subject. This study investigates the current status of environmental health research in Australia using a bibliometric analysis. Three databases (Medline, Web of Science, and AUSTHealth) were used to access original, peer-reviewed journal articles with Australian data published between 1 January 2001 and 11 June 2010. A total of 337 articles from 174 different journal titles were used in the analysis and were classified according to 15 pre-determined environmental health areas. The highest number of articles related to water health and resources (66 articles), exposure to hazardous chemicals (57 articles), and air pollution including indoor air (58 articles). These areas made up 54% of the total publication output over the past 10 years. The amount of environmental health research published in Australia over the past 10 years, and the topics explored in these studies, is comparable to that of other countries of similar socio-economic status.

  12. [Corruption and health care system].

    Science.gov (United States)

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions.

  13. THE E-HEALTH SYSTEMS IN POLAND

    Directory of Open Access Journals (Sweden)

    Zdzisław PÓLKOWSKI

    2013-11-01

    Full Text Available Information Technologies are disruptive technologies that have caused major changes in health system in Poland. Current digital economy is driven by modern information and new IT tools, which offer hospitals, doctors and patient access to any type of information, regardless of its form of existence, storage type or geographical location. These tools encourage the development of new activities, health services. The purpose of this article is to analyze the the current state of development of e-services in Poland in the context of nowadays health system. In the first part of the paper, the authors present various programmes, which enable the access to the medical services and patients’ data online. The next part of the paper is devoted to examining the technical aspects of the said programmes and presenting their advantages as well as the areas which might be improved.The last part of the work will be focused on the websites of the selected health institutions. According to the authors, WWW services provide much information on how the process of computer systems are being implemented, what data the services include and the capacity of the equipment as well as the software, human resources and the knowledge in this sphere. Moreover this section highlights the latest trends in e-health with particular emphasis on aspects such as the use of private and public cloud computer and t heir integration with web sites of health institutions. This study brings its contribution to the understanding of the change of health system in Poland behavior by using a new perspective e-health systems and IT tools above by doctors, officers and patients.

  14. Health Systems Strengthening

    DEFF Research Database (Denmark)

    Hanlin, Rebecca; Andersen, Margrethe Holm

    The Global Network for the Economics of Learning, Innovation, and Competence Building Systems (Globelics) is an open and diverse community of scholars working on innovation and competence building in the context of economic development. The major purpose of the network is to contribute to buildin...

  15. Evaluation of computerized health management information system for primary health care in rural India

    OpenAIRE

    Singh Satyavir; Yadav Kapil; Nongkynrih Baridalyne; Krishnan Anand; Gupta Vivek

    2010-01-01

    Abstract Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS), New Delhi has a computerized Health Management Information System (HMIS) since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Met...

  16. Current depression as a potential barrier to health care utilization in adult cancer survivors.

    Science.gov (United States)

    Cheruvu, Vinay K; Oancea, S Cristina

    2016-10-01

    Depression in cancer survivors is a major concern and is associated with poor health related quality of life (HRQOL). Delaying or forgoing care due to depression may further augment poor HRQOL. Although several studies have documented depression as a barrier to health care utilization in non-cancer populations, the impact of current depression on health care utilization among adult cancer survivors (ACS) has not been fully elucidated. The objective of this study was to examine the association between current depression and health care utlization among ACS. Data from the 2010 Behavioral Risk Factor Surveillance System involving ACS were used in this study. The Patient Health Questionnaire 8 (PHQ-8) item scale was used to measure current depression. Two indicators of health care utilization were examined as outcomes of interest: cost as a barrier to medical care and not having a routine care. Logistic regression models were used to examine the association between current depression and health care utilization. Overall, 13.0% of ACS reported symptoms of current depression. Despite no differences in having access to care, current depression in ACS was a significant barrier to health care utilization: cost as a barrier to medical care (AOR: 5.3 [95% CI: 3.1-9.1]), and not having a routine care (AOR: 2.0 [95% CI: 1.2-3.3]). Our findings have implications for future studies to further understand the association between depression and health care utlization among ACS, its impact on their overall wellbeing, and efforts to detect and treat depression in ACS. Routine assessment of depression in ACS and effective treatment interventions may aid in seeking timely and appropriate medical care. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Embedding health literacy into health systems: a case study of a regional health service.

    Science.gov (United States)

    Vellar, Lucia; Mastroianni, Fiorina; Lambert, Kelly

    2016-10-28

    . Currently, only 40% of consumers in Australia have the health literacy skills needed to understand everyday health information to effectively access and use health services.What does this paper add? Addressing health literacy in a coordinated way has the potential to increase safety and quality of care. This paper outlines the practical and sustainable actions the Illawarra Shoalhaven Local Health District took to partner with consumers to address health literacy and to improve the health experience and health outcomes of consumers. Embedding health literacy into public health services requires a coordinated whole-of-organisation approach; it requires the integration of leadership and governance, revision of consumer health information and revision of consumer and staff processes to effect change and support the delivery of health-literate healthcare services.What are the implications for practitioners? Embedding health literacy into health systems promotes equitable, safe and quality healthcare. Practitioners in a health-literate environment adopt consumer-centred communication and care strategies, provide information in a way that is easy to understand and follow and involve consumers and their families in decisions regarding and management of the consumer's care.

  18. Clinical Education In psychiatric mental health nursing: Overcoming current challenges.

    Science.gov (United States)

    Choi, Heeseung; Hwang, Boyoung; Kim, Sungjae; Ko, Heesung; Kim, Sumi; Kim, Chanhee

    2016-04-01

    In response to current challenges in psychiatric mental health nursing education, nursing schools have implemented new strategies in teaching undergraduate nursing students. The objectives of the study were to evaluate learning outcomes of a mental health nursing clinical practicum and to explore students' perceptions of the clinical practicum. This was a mixed-method study. Sixty-three undergraduate nursing students, who were undertaking their first mental health clinical practicum, completed a set of structured questionnaires and answered open-ended questions about the clinical practicum. Answers to open-ended questions were analyzed qualitatively, and learning outcomes (i.e., empathy, mental illness prejudice, simulation-related efficacy, and satisfaction) were measured at three time points: pre-clinical, post-simulation, and post-clinical. Students reported improvement in empathy and simulation-related self-efficacy after the clinical practicum, but no change was found in mental illness prejudice. Students' expectations for and evaluation of the clinical practicum are summarized. The observed improvement in learning outcomes of the clinical practicum may be attributed to the unique contribution of each component of the clinical practicum and the synergic effect of these diverse components. To manage emerging challenges in clinical settings and nursing education, it is critical to develop systematic and comprehensive mental health nursing clinical practicums for undergraduate nursing students. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Dynamics of the southern California current system

    Science.gov (United States)

    di Lorenzo, Emanuele

    The dynamics of seasonal to long-term variability of the Southern California Current System (SCCS) is studied using a four dimensional space-time analysis of the 52 year (1949--2000) California Cooperative Oceanic Fisheries Investigations (CalCOFI) hydrography combined with a sensitivity analysis of an eddy permitting primitive equation ocean model under various forcing scenarios. The dynamics of the seasonal cycle in the SCCS can be summarized as follows. In spring upwelling favorable winds force an upward tilt of the isopycnals along the coast (equatorward flow). Quasi-linear Rossby waves are excited by the ocean adjustment to the isopycnal displacement. In summer as these waves propagate offshore poleward flow develops at the coast and the Southern California Eddy (SCE) reaches its seasonal maxima. Positive wind stress curl in the Southern California Bight is important in maintaining poleward flow and locally reinforcing the SCE with an additional upward displacement of isopycnals through Ekman pumping. At the end of summer and throughout the fall instability processes within the SCE are a generating mechanism for mesoscale eddies, which fully develop in the offshore waters during winter. On decadal timescales a warming trend in temperature (1 C) and a deepening trend in the depth of the mean thermocline (20 m) between 1950 and 1998 are found to be primarily forced by large-scale decadal fluctuations in surface heat fluxes combined with horizontal advection by the mean currents. After 1998 the surface heat fluxes suggest the beginning of a period of cooling, which is consistent with colder observed ocean temperatures. The temporal and spatial distribution of the warming is coherent over the entire northeast Pacific Ocean. Salinity changes are decoupled from temperature and uncorrelated with indices of large-scale oceanic variability. Temporal modulation of southward horizontal advection by the California Current is the primary mechanism controlling local

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

    Directory of Open Access Journals (Sweden)

    Emmanuel Kusi Achampong

    2014-02-01

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

  1. Current trends in health facility planning, design, and construction.

    Science.gov (United States)

    Beale, Craig; Kittredge, Frank D

    2014-01-01

    It is critical now more than ever for today's healthcare facilities to serve as more than just a backdrop to the care provided--they can, and should, be an integral part of that care. In addition to promoting efficacy, delighting the senses, and placing patients and families at ease, facilities need to be high-performing, sustainable, and healthy environments. Creating today's healthcare facilities requires breaking through barriers in unexpected ways, and it often requires looking outside the healthcare profession for guidance. In this article, we explore current trends in health facility planning, design, and construction. Our focus is on the buildings that serve as venues for the provision of healthcare services across the full continuum, from prevention to critical care. In particular, we discuss four current broad trends and conclude with thoughts on future developments.

  2. Introduction on health recommender systems.

    Science.gov (United States)

    Sanchez-Bocanegra, C L; Sanchez-Laguna, F; Sevillano, J L

    2015-01-01

    People are looking for appropriate health information which they are concerned about. The Internet is a great resource of this kind of information, but we have to be careful if we don't want to get harmful info. Health recommender systems are becoming a new wave for apt health information as systems suggest the best data according to the patients' needs.The main goals of health recommender systems are to retrieve trusted health information from the Internet, to analyse which is suitable for the user profile and select the best that can be recommended, to adapt their selection methods according to the knowledge domain and to learn from the best recommendations.A brief definition of recommender systems will be given and an explanation of how are they incorporated in the health sector. A description of the main elementary recommender methods as well as their most important problems will also be made. And, to finish, the state of the art will be described.

  3. Current-potential characteristics of electrochemical systems

    Energy Technology Data Exchange (ETDEWEB)

    Battaglia, V.S.

    1993-07-01

    This dissertation contains investigations in three distinct areas. Chapters 1 and 2 provide an analysis of the effects of electromagnetic phenomena during the initial stages of cell discharge. Chapter 1 includes the solution to Maxwell`s equations for the penetration of the axial component of an electric field into an infinitely long cylindrical conductor. Chapter 2 contains the analysis of the conductor included in a radial circuit. Chapter 3 provides a complete description of the equations that describe the growth of an oxide film. A finite difference program was written to solve the equations. The system investigated is the iron/iron oxide in a basic, aqueous solution. Chapters 4 and 5 include the experimental attempts for replacing formaldehyde with an innocuous reducing agent for electroless deposition. In chapter 4, current-versus-voltage curves are provided for a sodium thiosulfate bath in the presence of a copper disk electrode. Also provided are the cathodic polarization curves of a copper/EDTA bath in the presence of a copper electrode. Chapter 5 contains the experimental results of work done with sodium hypophosphite as a reducing agent. Mixed-potential-versus-time curves for solutions containing various combinations of copper sulfate, nickel chloride, and hypophosphite in the presence of a palladium disk electrode provide an indication of the reducing power of the solutions.

  4. [The health system of Chile].

    Science.gov (United States)

    Becerril-Montekio, Víctor; Reyes, Juan de Dios; Manuel, Annick

    2011-01-01

    This paper describes the Chilean health system, including its structure, financing, beneficiaries, and its physical, material and human resources. This system has two sectors, public and private. The public sector comprises all the organisms that constitute the National System of Health Services, which covers 70% of the population, including the rural and urban poor, the low middle-class, the retired, and the self-employed professionals and technicians.The private sector covers 17.5% of the population, mostly the upper middle-class and the high-income population. A small proportion of the population uses private health services and pays for them out-of-pocket. Around l0% of the population is covered by other public agencies, basically the Health Services for the Armed Forces. The system was recently reformed with the establishment of a Universal System of Explicit Entitlements, which operates through a Universal Plan of Explicit Entitlements (AUGE), which guarantees timely access to treatment for 56 health problems, including cancer in children, breast cancer, ischaemic heart disease, HIV/AIDS and diabetes.

  5. Factors Influencing Adult Physical Health after Controlling for Current Health Conditions: Evidence from a British Cohort

    Science.gov (United States)

    Cheng, Helen; Furnham, Adrian

    2013-01-01

    This study explored a longitudinal data set of 6875 British adults examining the effects of parental social status (measured at birth), cognitive ability (at age 11 yrs), personality traits, education and occupational attainment on physical health and functioning (all measured at age 50 yrs), after taking account of current health conditions (number of illness). Correlation analysis showed that parental social class, childhood cognitive ability, education and occupation, and two personality traits (Emotional Stability/Neuroticism, and Conscientiousness) were all significantly associated with adult physical health variables. Structural equation modelling showed that health conditions and personality traits were significantly, and inversely, associated with physical health (indicated by good daily physical functioning, relative absence of pain, perceived health, and low level of limitations at work due to physical health). Parental social status, childhood intelligence, educational and occupational attainment were all modestly, but significantly and directly, associated with adult physical health. The effect of childhood intelligence on adult physical health was, in part, mediated through Emotional Stability and Conscientiousness. After controlling for health conditions Emotional Stability was the strongest predictor of physical health. Implications and limitations are discussed. PMID:23826090

  6. Factors influencing adult physical health after controlling for current health conditions: evidence from a british cohort.

    Directory of Open Access Journals (Sweden)

    Helen Cheng

    Full Text Available This study explored a longitudinal data set of 6875 British adults examining the effects of parental social status (measured at birth, cognitive ability (at age 11 yrs, personality traits, education and occupational attainment on physical health and functioning (all measured at age 50 yrs, after taking account of current health conditions (number of illness. Correlation analysis showed that parental social class, childhood cognitive ability, education and occupation, and two personality traits (Emotional Stability/Neuroticism, and Conscientiousness were all significantly associated with adult physical health variables. Structural equation modelling showed that health conditions and personality traits were significantly, and inversely, associated with physical health (indicated by good daily physical functioning, relative absence of pain, perceived health, and low level of limitations at work due to physical health. Parental social status, childhood intelligence, educational and occupational attainment were all modestly, but significantly and directly, associated with adult physical health. The effect of childhood intelligence on adult physical health was, in part, mediated through Emotional Stability and Conscientiousness. After controlling for health conditions Emotional Stability was the strongest predictor of physical health. Implications and limitations are discussed.

  7. Coincident polio and Ebola crises expose similar fault lines in the current global health regime.

    Science.gov (United States)

    Calain, Philippe; Abu Sa'Da, Caroline

    2015-01-01

    In 2014, the World Health Organization (WHO) declared two "public health emergencies of international concern", in response to the worldwide polio situation and the Ebola epidemic in West Africa respectively. Both emergencies can be seen as testing moments, challenging the current model of epidemic governance, where two worldviews co-exist: global health security and humanitarian biomedicine. The resurgence of polio and the spread of Ebola in 2014 have not only exposed the weaknesses of national health systems, but also the shortcomings of the current global health regime in dealing with transnational epidemic threats. These shortcomings are of three sorts. Firstly, the global health regime is fragmented and dominated by the domestic security priorities of industrialised nations. Secondly, the WHO has been constrained by constitutional country allegiances, crippling reforms and the limited impact of the (2005) International Health Regulations (IHR) framework. Thirdly, the securitization of infectious diseases and the militarization of humanitarian aid undermine the establishment of credible public health surveillance networks and the capacity to control epidemic threats. The securitization of communicable diseases has so far led foreign aid policies to sideline health systems. It has also been the source of ongoing misperceptions over the aims of global health initiatives. With its strict allegiance to Member States, the WHO mandate is problematic, particularly when it comes to controlling epidemic diseases. In this context, humanitarian medical organizations are expected to palliate the absence of public health services in the most destitute areas, particularly in conflict zones. The militarization of humanitarian aid itself threatens this fragile and imperfect equilibrium. None of the reforms announced by the WHO in the wake of the 68(th) World Health Assembly address these fundamental issues.

  8. An overview of the mental health system in Gaza: an assessment using the World Health Organization’s Assessment Instrument for Mental Health Systems (WHO-AIMS)

    OpenAIRE

    Saymah, Dyaa; Tait, Lynda; Michail, Maria

    2015-01-01

    Background: Mental health system reform is urgently needed in Gaza to respond to increasing mental health consequences of conflict. Evidence from mental health systems research is needed to inform decision-making. We aimed to provide new knowledge on current mental health policy and legislation, and services and resource use, in Gaza to identify quality gaps and areas for urgent intervention. Methods: As part of a mixed methods study, we used the World Health Organization’s Assessment Inst...

  9. An integrated and sustainable EU health information system: national public health institutes' needs and possible benefits.

    Science.gov (United States)

    Bogaert, Petronille; Van Oyen, Herman

    2017-01-01

    Although sound data and health information are at the basis of evidence-based policy-making and research, still no single, integrated and sustainable EU-wide public health monitoring system or health information system exists. BRIDGE Health is working towards an EU health information and data generation network covering major EU health policy areas. A stakeholder consultation with national public health institutes was organised to identify the needs to strengthen the current EU health information system and to identify its possible benefits. Five key issues for improvement were identified: (1) coherence, coordination and sustainability; (2) data harmonization, collection, processing and reporting; (3) comparison and benchmarking; (4) knowledge sharing and capacity building; and (5) transferability of health information into evidence-based policy making. The vision of an improved EU health information system was formulated and the possible benefits in relation to six target groups. Through this consultation, BRIDGE Health has identified the continuous need to strengthen the EU health information system. A better system is about sustainability, better coordination, governance and collaboration among national health information systems and stakeholders to jointly improve, harmonise, standardise and analyse health information. More and better sharing of this comparable health data allows for more and better comparative health research, international benchmarking, national and EU-wide public health monitoring. This should be developed with the view to provide the tools to fight both common and individual challenges faced by the Members States and their politicians.

  10. X-33/RLV System Health Management/Vehicle Health Management

    Science.gov (United States)

    Mouyos, William; Wangu, Srimal

    1998-01-01

    To reduce operations costs, Reusable Launch Vehicles (RLVS) must include highly reliable robust subsystems which are designed for simple repair access with a simplified servicing infrastructure, and which incorporate expedited decision-making about faults and anomalies. A key component for the Single Stage To Orbit (SSTO) RLV system used to meet these objectives is System Health Management (SHM). SHM incorporates Vehicle Health Management (VHM), ground processing associated with the vehicle fleet (GVHM), and Ground Infrastructure Health Management (GIHM). The primary objective of SHM is to provide an automated and paperless health decision, maintenance, and logistics system. Sanders, a Lockheed Martin Company, is leading the design, development, and integration of the SHM system for RLV and for X-33 (a sub-scale, sub-orbit Advanced Technology Demonstrator). Many critical technologies are necessary to make SHM (and more specifically VHM) practical, reliable, and cost effective. This paper will present the X-33 SHM design which forms the baseline for the RLV SHM, and it will discuss applications of advanced technologies to future RLVs. In addition, this paper will describe a Virtual Design Environment (VDE) which is being developed for RLV. This VDE will allow for system design engineering, as well as program management teams, to accurately and efficiently evaluate system designs, analyze the behavior of current systems, and predict the feasibility of making smooth and cost-efficient transitions from older technologies to newer ones. The RLV SHM design methodology will reduce program costs, decrease total program life-cycle time, and ultimately increase mission success.

  11. [The health system of Brazil].

    Science.gov (United States)

    Montekio, Víctor Becerril; Medina, Guadalupe; Aquino, Rosana

    2011-01-01

    This paper describes the Brazilian health system, which includes a public sector covering almost 75% of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Único de Saúde (SUS) and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal). SUS provides health care through a decentralized network of clinics, hospitals and other establishments, as well as through contracts with private providers. SUS is also responsible for the coordination of the public sector. The private sector includes a system of insurance schemes known as Supplementary Health which is financed by employers and/or households: group medicine (companies and households), medical cooperatives, the so called Self-Administered Plans (companies) and individual insurance plans.The private sector also includes clinics, hospitals and laboratories offering services on out-of-pocket basis mostly used by the high-income population. This paper also describes the resources of the system, the stewardship activities developed by the Ministry of Health and other actors, and the most recent policy innovations implemented in Brazil, including the programs saúde da Familia and Mais Saúde.

  12. Regulatory system reform of occupational health and safety in China.

    Science.gov (United States)

    Wu, Fenghong; Chi, Yan

    2015-01-01

    With the explosive economic growth and social development, China's regulatory system of occupational health and safety now faces more and more challenges. This article reviews the history of regulatory system of occupational health and safety in China, as well as the current reform of this regulatory system in the country. Comprehensive, a range of laws, regulations and standards that promulgated by Chinese government, duties and responsibilities of the regulatory departments are described. Problems of current regulatory system, the ongoing adjustments and changes for modifying and improving regulatory system are discussed. The aim of reform and the incentives to drive forward more health and safety conditions in workplaces are also outlined.

  13. Superconducting Current Leads for Cryogenic Systems Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Space flight cryocoolers will be able to handle limited heat loads at their expected operating temperatures and the current leads may be the dominant contributor to...

  14. United Kingdom (Wales): Health system review.

    Science.gov (United States)

    Longley, Marcus; Riley, Neil; Davies, Paul; Hernandez-Quevedo, Cristina

    2012-01-01

    Wales is situated to the west of England, with a population of approximately 3 million (5% of the total for the United Kingdom), and a land mass of just over 20 000 km2. For several decades, Wales had a health system largely administered through the United Kingdom Governments Welsh Office, but responsibility for most aspects of health policy was devolved to Wales in a process beginning in 1999. Since then, differences between the policy approach and framework in England and Wales have widened. The internal market introduced in the United Kingdom National Health Service (NHS) has been abandoned in Wales, and seven local health boards (LHBs; supported by three specialist NHS trusts) now plan and provide all health services for their resident populations. Wales currently has more than 120 hospitals as part of an overall estate valued at 2.3 billion pounds. Total spending on health services increased in the first decade of the 21st century, but Wales now faces a period of financial retrenchment greater than in other parts of the United Kingdom as a result of the Welsh Governments decision not to afford the same degree of protection to health spending as that granted elsewhere. The health system in Wales continues to face some structural weaknesses that have proved resistant to reform for some time. However, there has been substantial improvement in service quality and outcomes since the end of the 1990s, in large part facilitated by substantial real growth in health spending. Life expectancy has continued to increase, but health inequalities have proved stubbornly resistant to improvement.

  15. Building health systems capacity in global health graduate programs: reflections from Australian educators.

    Science.gov (United States)

    Negin, Joel; Martiniuk, Alexandra; Morgan, Chris; Davies, Philip; Zwi, Anthony

    2012-08-24

    There has been increasing focus on the role of health systems in low and middle-income countries. Despite this, very little evidence exists on how best to build health systems program and research capacity in educational programs. The current experiences in building capacity in health systems in five of the most prominent global health programs at Australian universities are outlined. The strengths and weaknesses of various approaches and techniques are provided along with examples of global practice in order to provide a foundation for future discussion and thus improvements in global health systems education.

  16. Smart health monitoring systems: an overview of design and modeling.

    Science.gov (United States)

    Baig, Mirza Mansoor; Gholamhosseini, Hamid

    2013-04-01

    Health monitoring systems have rapidly evolved during the past two decades and have the potential to change the way health care is currently delivered. Although smart health monitoring systems automate patient monitoring tasks and, thereby improve the patient workflow management, their efficiency in clinical settings is still debatable. This paper presents a review of smart health monitoring systems and an overview of their design and modeling. Furthermore, a critical analysis of the efficiency, clinical acceptability, strategies and recommendations on improving current health monitoring systems will be presented. The main aim is to review current state of the art monitoring systems and to perform extensive and an in-depth analysis of the findings in the area of smart health monitoring systems. In order to achieve this, over fifty different monitoring systems have been selected, categorized, classified and compared. Finally, major advances in the system design level have been discussed, current issues facing health care providers, as well as the potential challenges to health monitoring field will be identified and compared to other similar systems.

  17. Marketing in Greek National Health System

    Directory of Open Access Journals (Sweden)

    Maria Tseroni

    2009-01-01

    Full Text Available Introduction: The international financial situation in combination with an aging population and the appropriation of health services imposes the management of hospital services as a necessity for the survival of hospitals.Aim: To examine the perceptions of 450 upper administrative hospital executives (Nursing, Medicine and Administrative services in the wider region of Attica, on marketing, communication, and public relations in health-care.Population study: Four hundred and fifty (450 higher health executives from the three basic fields of services in health institutions (medical, nursing, administration constituted the total sample of the research. These people are employed at 9 of the 36 hospitals in the 3 Health Regions of Attica (H.Re.Materials and method:The type of design that was chosen (to gather data for the study of attitudes and perceptions of the health personnel of the health institutions of G.S.H (Greek System of Health is a cross- sectional survey.Results: The participating subjects, even though expressed some reservations at first, formed a favorable attitude towards marketing and its application in the field of health-care. Statistically important correlations emerged between the perceptions of executives and their socio-demographic background including age, sex, education, and profession, work experience in health-care and specifically in their current position in the services as well as statistically important differences between doctors, nurses and administrators as to their perceptions of some issues in marketing.Conclusions: From the comments in the survey it appears there is a need to apply marketing correctly when providing quality care, respecting the patients’ rights and using human and not financial criteria as a guide. Based on the results of the research, important proposals are being submitted in the areas of health-care research, education and clinical practice.

  18. Infant Nutrition and Later Health: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Caroline Fall

    2012-07-01

    Full Text Available There is a growing recognition of the need for a lifecourse approach to understanding the aetiology of adult disease, and there is now significant evidence that links patterns of infant feeding to differences in health outcomes, both in the short and longer term. Breastfeeding is associated with lower rates of infection in infancy; in high-income populations, it is associated with reductions in blood pressure and total blood cholesterol, and lower risks of obesity and diabetes in adult life. Breastfeeding rates are suboptimal in many countries, and strategies to promote breastfeeding could therefore confer important benefits for health at a population level. However, there are particular challenges in defining nutritional exposures in infancy, including marked social gradients in initiation and duration of breastfeeding. In recent studies of low and middle-income populations of children and young adults, where the influences on infant feeding practice differ, beneficial effects of breastfeeding on blood pressure, BMI and risk of diabetes have not been confirmed, and further information is needed. Little is currently known about the long-term consequences of differences in the timing and nature of the weaning diet. Future progress will depend on new studies that provide detailed prospective data on duration and exclusivity of breastfeeding together with appropriate characterisation of the weaning diet.

  19. Health promotion and health systems: some unfinished business.

    Science.gov (United States)

    Ziglio, Erio; Simpson, Sarah; Tsouros, Agis

    2011-12-01

    One of the five action domains in the Ottawa Charter was Reorienting Health Services. In this paper, we reflect on why progress in this domain has been somewhat lethargic, particularly compared with some of the other action domains, and why now it is important to renew our commitment to this domain. Reorienting health services has been largely overlooked and opportunities missed, although good exceptions do exist. The occasion of the 25th anniversary of the Ottawa Charter represents an important opportunity for health promotion to: (i) renew its active voice in current policy debate and action and (ii) enhance achievements made to date by improving our efforts to advocate, enable and mediate for the reorientation of health services and systems. We outline six steps to reactivate and invest more in this action domain so as to be in a better position to promote health equitably and sustainably in today's fast changing world. Though our experience is mainly based in the European context, we hope that our reflections will be of some value to countries outside of this region.

  20. Promising future of probiotics for human health: Current scenario

    Directory of Open Access Journals (Sweden)

    Gaurav Tiwari

    2012-01-01

    Full Text Available Probiotics are nonpathogenic microorganisms mostly of human origin which, when administered in adequate amounts, confer a health benefit on the host and enable to prevent or improve some diseases. Probiotics may be a natural temporary constituent of the resident intestinal microflora, but their concentration is not sufficient for therapeutic purposes. The microbiota, the intestinal epithelium, and the mucosal immune system constitute the gastrointestinal ecosystem. All three components are essential for complete functional and developmental maturity of the system. Probiotics are defined as live microbial food ingredients that have a beneficial effect on human health. The use of antibiotics, immunosuppressive therapy, and irradiation, among other means of treatment, may cause alterations in the composition and have an effect on the gastrointestinal tract flora. Therefore, the introduction of beneficial bacterial species to GI tract may be a very attractive option to re-establish the microbial equilibrium and prevent disease. The efficacy of probiotics in acute enteric infections and post-antibiotic syndromes is now established and there is emerging evidence for a role in necrotizing enterocolitis, irritable bowel syndrome, periodontal diseases, and some forms of inflammatory bowel disease.

  1. Integrated primary health care in Greece, a missing issue in the current health policy agenda: a systematic review

    Directory of Open Access Journals (Sweden)

    Christos Lionis

    2009-07-01

    Full Text Available Background: Over the past years, Greece has undergone several endeavors aimed at modernizing and improving national health care services with a focus on PHC. However, the extent to which integrated primary health care has been achieved is still questioned. Purpose: This paper explores the extent to which integrated primary health care (PHC is an issue in the current agenda of policy makers in Greece, reporting constraints and opportunities and highlighting the need for a policy perspective in developing integrated PHC in this Southern European country. Methods: A systematic review in PubMed/Medline and SCOPUS, along with a hand search in selected Greek biomedical journals was undertaken to identify key papers, reports, editorials or opinion letters relevant to integrated health care. Results: Our systematic review identified 198 papers and 161 out of them were derived from electronic search. Fifty-three papers in total served the scope of this review and are shortly reported. A key finding is that the long-standing dominance of medical perspectives in Greek health policy has been paving the way towards vertical integration, pushing aside any discussions about horizontal or comprehensive integration of care. Conclusion: Establishment of integrated PHC in Greece is still at its infancy, requiring major restructuring of the current national health system, as well as organizational culture changes. Moving towards a new policy-based model would bring this missing issue on the discussion table, facilitating further development.

  2. Current Mode Data Converters for Sensor Systems

    DEFF Research Database (Denmark)

    Jørgensen, Ivan Herald Holger

    This thesis is mainly concerned with data conversion. Especially data conversion using current mode signal processing is treated.A tutorial chapter introducing D/A conversion is presented. In this chapter the effects that cause static and dynamic nonlinearities are discussed along with methods to...

  3. DAQ System of Current Based on MNSR

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The flux or power should be acquired using the detector in the operation of MNSR. As usual, the signal of detector is current, and it is very width range with 10-11-10-6 A. It is hard to satisfy the linearity to amplify this signal by using fix gain

  4. Review on the current trends in tongue diagnosis systems

    Directory of Open Access Journals (Sweden)

    Chang Jin Jung

    2012-12-01

    Full Text Available Tongue diagnosis is an essential process to noninvasively assess the condition of a patient's internal organs in traditional medicine. To obtain quantitative and objective diagnostic results, image acquisition and analysis devices called tongue diagnosis systems (TDSs are required. These systems consist of hardware including cameras, light sources, and a ColorChecker, and software for color correction, segmentation of tongue region, and tongue classification. To improve the performance of TDSs, various types TDSs have been developed. Hyperspectral imaging TDSs have been suggested to acquire more information than a two-dimensional (2D image with visible light waves, as it allows collection of data from multiple bands. Three-dimensional (3D imaging TDSs have been suggested to provide 3D geometry. In the near future, mobile devices like the smart phone will offer applications for assessment of health condition using tongue images. Various technologies for the TDS have respective unique advantages and specificities according to the application and diagnostic environment, but this variation may cause inconsistent diagnoses in practical clinical applications. In this manuscript, we reviewed the current trends in TDSs for the standardization of systems. In conclusion, the standardization of TDSs can supply the general public and oriental medical doctors with convenient, prompt, and accurate information with diagnostic results for assessing the health condition.

  5. Information Systems: Current Developments and Future Expansion.

    Science.gov (United States)

    1970

    On May 20, 1970, a one-day seminar was held for Congressional members and staff. The papers given at this seminar and included in the proceedings are: (1) "Understanding Information Systems" by J. D. Aron, (2) "Computer Applications in Political Science" by Kenneth Janda, (3) "Who's the Master of Your Information System?" by Marvin Kornbluh, (4)…

  6. Health systems in an interconnected world: a view from Nigeria.

    Science.gov (United States)

    Abimbola, Seye

    2011-07-01

    The benefits of an interconnected world for health care remain untapped. As a result of the politics of inequality between rich and poor countries, one or a few health systems are set up as models. Every country, irrespective of political or economic status, should be open to learning from others to build relevant and cost-effective systems. To combat the current global challenge of chronic non-communicable diseases, poor countries have the advantage of flexible health systems that are veritable laboratories of health systems research. Not only can research conducted in these health systems help harness the potential of mobile communication technologies and informal health providers, it can also help rich country health systems adapt to meet the chronic disease challenge.

  7. Paying for and receiving benefits from health services in South Africa: is the health system equitable?

    Science.gov (United States)

    Ataguba, John E; McIntyre, Di

    2012-03-01

    There is a global challenge for health systems to ensure equity in both the delivery and financing of health care. However, many African countries still do not have equitable health systems. Traditionally, equity in the delivery and the financing of health care are assessed separately, in what may be termed 'partial' analyses. The current debate on countries moving toward universal health systems, however, requires a holistic understanding of equity in both the delivery and the financing of health care. The number of studies combining these aspects to date is limited, especially in Africa. An assessment of overall health system equity involves assessing health care financing in relation to the principles of contributing to financing according to ability to pay and benefiting from health services according to need for care. Currently South Africa is considering major health systems restructuring toward a universal system. This paper examines together, for both the public and the private sectors, equity in the delivery and financing of health care in South Africa. Using nationally representative datasets and standard methodologies for assessing progressivity in health care financing and benefit incidence, this paper reports an overall progressive financing system but a pro-rich distribution of health care benefits. The progressive financing system is driven mainly by progressive private medical schemes that cover a small portion of the population, mainly the rich. The distribution of health care benefits is not only pro-rich, but also not in line with the need for health care; richer groups receive a far greater share of service benefits within both public and private sectors despite having a relatively lower share of the ill-health burden. The importance of the findings for the design of a universal health system is discussed.

  8. Strengthening public health surveillance and response using the health systems strengthening agenda in developing countries

    Directory of Open Access Journals (Sweden)

    Mukanga David

    2010-12-01

    Full Text Available Abstract There is increased interest in strengthening health systems for developing countries. However, at present, there is common uncertainty about how to accomplish this task. Specifically, several nations are faced with an immense challenge of revamping an entire system. To accomplish this, it is essential to first identify the components of the system that require modification. The World Health Organization (WHO has proposed health system building blocks, which are now widely recognized as essential components of health systems strengthening. With increased travel and urbanization, the threat of emerging diseases of pandemic potential is increasing alongside endemic diseases such as human immunodeficiency virus (HIV, tuberculosis (TB, malaria, and hepatitis virus infections. At the same time, the epidemiologic patterns are shifting, giving rise to a concurrent increase in disease burden due to non-communicable diseases. These diseases can be addressed by public health surveillance and response systems that are operated by competent public health workers in core public health positions at national and sub-national levels with a focus on disease prevention. We describe two ways that health ministries in developing countries could leverage President Obama’s Global Health Initiative (GHI to build public health surveillance and response systems using proven models for public health systems strengthening and to create the public health workforce to operate those systems. We also offer suggestions for how health ministries could strengthen public health systems within the broad health systems strengthening agenda. Existing programs (e.g., the Global Vaccine Alliance [GAVI] and the Global Fund Against Tuberculosis, AIDS, and Malaria [GFTAM] can also adapt their current health systems strengthening programs to build sustainable public health systems.

  9. A framework for current public mental health care practice in South Africa.

    Science.gov (United States)

    Janse Van Rensburg, A B

    2007-11-01

    One of the main aims of the new Mental Health Care Act, Act No. 17 of 2002 (MHCA) is to promote the human rights of people with mental disabilities in South Africa. However, the upholding of these rights seems to be subject to the availability of resources. Chapter 2 of the MHCA clarifies the responsibility of the State to provide infrastructure and systems. Chapters 5, 6 and 7 of the Act define and regulate the different categories of mental health care users, clarify the procedures around these categories and spell out mental health practitioners' roles and responsibilities in this regard. Also according to the National Health Act No. 61 of 2003, the State remains the key role player in mental health care provision, being responsible for adequate mental health infrastructure and resource allocation. Due to "limited resources" practitioners however often work in environments where staff ratios may be fractional of what should be expected and in units of which the physical structure and security is totally inadequate. The interface between professional responsibility of clinical workers versus the inadequacy of clinical interventions resulting from infrastructure and staffing constraints needs to be defined. This paper considered recent legislation currently relevant to mental health care practice in order to delineate the legal, ethical and labour framework in which public sector mental health practitioners operate as state employees. These included the Mental Health Care Act, No.17 of 2002; the National Health Act, No. 61 of 2003 and the proposed Traditional Health Practitioners Act, No. 35 of 2004. Formal legal review of and advice on this legislation as it pertains to public sector mental health practitioners as state employees, is necessary and should form the basis of the principles and standards for care endorsed by organized mental health care practitioner groups such as the South African Society of Psychiatrists (SASOP).

  10. [The health system of Argentina].

    Science.gov (United States)

    Belló, Mariana; Becerril-Montekio, Victor M

    2011-01-01

    This paper describes the health system of Argentina.This system has three sectors: public, social security and private.The public sector includes the national and provincial ministries as well as the network of public hospitals and primary health care units which provide care to the poor and uninsured population. This sector is financed with taxes and payments made by social security beneficiaries that use public health care facilities. The social security sector or Obras Sociales (OS) covers all workers of the formal economy and their families. Most OS operate through contracts with private providers and are financed with payroll contributions of employers and employees. Finally, the private sector includes all those private providers offering services to individuals, OS beneficiaries and all those with private health insurance.This sector also includes private insurance agencies called Prepaid Medicine Enterprises, financed mostly through premiums paid by families and/or employers.This paper also discusses some of the recent innovations implemented in Argentina, including the program Remediar.

  11. Managing complex systems: performance management in public health.

    Science.gov (United States)

    Landrum, Laura B; Baker, Stacy L

    2004-01-01

    The complexity of mobilizing and managing systems-wide public health responses has prompted Turning Point's Performance Management National Excellence Collaborative, funded by the Robert Wood Johnson Foundation, to develop a conceptual framework for performance management in public health. The framework has four integrated parts: (1) performance standards, (2) performance measures, (3) reporting of progress, and (4) a quality improvement process. The Collaborative based its framework on evidence gathered through a survey of current state performance management practices, a literature review, and its investigation of current practice models. This balanced and cohesive management model can be constructively used by public health programs, organizations, and community and state public health systems.

  12. Person-centred health care: a critical assessment of current and emerging research approaches.

    Science.gov (United States)

    Martin, Carmel M; Félix-Bortolotti, Margot

    2014-12-01

    Person-centred health care is prominent in international health care reforms. A shift to understanding and improving personal care at the point of delivery has generated debates about the nature of the person-centred research agenda. This paper purviews research paradigms that influence current person-centred research approaches and traditions that influence knowledge foundations in the field. It presents a synthesis of the emergent approaches and methodologies and highlights gaps between static academic research and the increasing accessibility of evaluation, informatics and big data from health information systems. Paradigms in health services research range from theoretical to atheoretical, including positivist, interpretive, postmodern and pragmatic. Interpretivist (subjective) and positivist (objectivist) paradigms have been historically polarized. Yet, integrative and pragmatic approaches have emerged. Nevertheless, there is a tendency to reductionism, and to reduce personal experiences to metrics in the positivist paradigm. Integrating personalized information into clinical systems is increasingly driven by the pervasive health information technology, which raises many issues about the asymmetry and uncertainty in the flow of information to support personal health journeys. The flux and uncertainty of knowledge between and within paradigmatic or pragmatic approaches highlights the uncertainty and the 'unorder and disorder' in what is known and what it means. Transdisciplinary, complex adaptive systems theory with multi-ontology sense making provides an overarching framework for making sense of the complex dynamics in research progress. A major challenge to current research paradigms is focus on the individualizing of care and enhancing experiences of persons in health settings. There is an urgent need for person-centred research to address this complex process. A transdisciplinary and complex systems approach provides a sense-making framework. © 2014 John

  13. Analysis of Sqp current systems by using corrected geomagneticcoordinates

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The Spq equivalent current system of the quiet day geomagnetic variation in the polar region is very complicated. It is composed of several currents, such as the ionospheric dynamo current and the auroral electrojet caused by the field-aligned current. Spq is unsymmetrical in both polar regions. In this paper, the Spq current systems are analyzed in the corrected geomagnetic coordinates (CGM) instead of the conventional geomagnetic coordinates (GM), and the symmetries of the Spq current indifferent systems are compared. Then the causes of Spq asymmetry in the GM coordinates are discussed; the effects of each component in Spq are determined.

  14. Energy Systems and Population Health

    Energy Technology Data Exchange (ETDEWEB)

    Ezzati, Majid; Bailis, Rob; Kammen, Daniel M.; Holloway, Tracey; Price, Lynn; Cifuentes, Luis A.; Barnes, Brendon; Chaurey, Akanksha; Dhanapala, Kiran N.

    2004-04-12

    It is well-documented that energy and energy systems have a central role in social and economic development and human welfare at all scales, from household and community to regional and national (41). Among its various welfare effects, energy is closely linked with people s health. Some of the effects of energy on health and welfare are direct. With abundant energy, more food or more frequent meals can be prepared; food can be refrigerated, increasing the types of food items that are consumed and reducing food contamination; water pumps can provide more water and eliminate the need for water storage leading to contamination or increased exposure to disease vectors such as mosquitoes or snails; water can be disinfected by boiling or using other technologies such as radiation. Other effects of energy on public health are mediated through more proximal determinants of health and disease. Abundant energy can lead to increased irrigation, agricultural productivity, and access to food and nutrition; access to energy can also increase small-scale income generation such as processing of agricultural commodities (e.g., producing refined oil from oil seeds, roasting coffee, drying and preserving fruits and meats) and production of crafts; ability to control lighting and heating allows education or economic activities to be shielded from daily or seasonal environmental constraints such as light, temperature, rainfall, or wind; time and other economic resources spent on collecting and/or transporting fuels can be used for other household needs if access to energy is facilitated; energy availability for transportation increases access to health and education facilities and allow increased economic activity by facilitating the transportation of goods and services to and from markets; energy for telecommunication technology (radio, television, telephone, or internet) provides increased access to information useful for health, education, or economic purposes; provision of energy

  15. [Health system reforms in South America: an opportunity for UNASUR].

    Science.gov (United States)

    Gomes-Temporão, José; Faria, Mariana

    2014-01-01

    Health systems in South America still support segmentation, privatization and fragmentation. Health reforms of the structural adjustment programs in the 1980s and 1990s in South America followed different purposes and strategies ranging from privatization, commodification and state intervention for the implementation of a national public health service with universal access as a right of the citizens. Since the 2000s, many countries have expanded social policies, reduced poverty and social inequalities, and improved access to healthcare. This article proposes to discuss the health systems in South America from historical and political backgrounds, and the progress from the reforms in the last three decades. It also presents the three paradigmatic models of reform and their evolution, as well as the contrasts between universal coverage and universal systems. Finally, it presents current strengths and weaknesses of the twelve South American health systems as well as current opportunities and challenges in health for UNASUR.

  16. Current dental adhesives systems. A narrative review.

    Science.gov (United States)

    Milia, Egle; Cumbo, Enzo; Cardoso, Rielson Jose A; Gallina, Giuseppe

    2012-01-01

    Adhesive dentistry is based on the development of materials which establish an effective bond with the tooth tissues. In this context, adhesive systems have attracted considerable research interest in recent years. Successful adhesive bonding depends on the chemistry of the adhesive, on appropriate clinical handling of the material as well as on the knowledge of the morphological changes caused on dental tissue by different bonding procedures. This paper outlines the status of contemporary adhesive systems, with particular emphasis on chemical characteristics and mode of interaction of the adhesives with enamel and dentinal tissues. Dental adhesives are used for several clinical applications and they can be classified based on the clinical regimen in "etch-and-rinse adhesives" and "self-etch adhesives". Other important considerations concern the different anatomical characteristics of enamel and dentine which are involved in the bonding procedures that have also implications for the technique used as well as for the quality of the bond. Etch-and-rinse adhesive systems generally perform better on enamel than self-etching systems which may be more suitable for bonding to dentine. In order to avoid a possible loss of the restoration, secondary caries or pulp damage due to bacteria penetration or due to cytotoxicity effects of eluted adhesive components, careful consideration of several factors is essential in selecting the suitable bonding procedure and adhesive system for the individual patient situation.

  17. Current trends on knowledge-based systems

    CERN Document Server

    Valencia-García, Rafael

    2017-01-01

    This book presents innovative and high-quality research on the implementation of conceptual frameworks, strategies, techniques, methodologies, informatics platforms and models for developing advanced knowledge-based systems and their application in different fields, including Agriculture, Education, Automotive, Electrical Industry, Business Services, Food Manufacturing, Energy Services, Medicine and others. Knowledge-based technologies employ artificial intelligence methods to heuristically address problems that cannot be solved by means of formal techniques. These technologies draw on standard and novel approaches from various disciplines within Computer Science, including Knowledge Engineering, Natural Language Processing, Decision Support Systems, Artificial Intelligence, Databases, Software Engineering, etc. As a combination of different fields of Artificial Intelligence, the area of Knowledge-Based Systems applies knowledge representation, case-based reasoning, neural networks, Semantic Web and TICs used...

  18. Current and future impact of osteoarthritis on health care

    DEFF Research Database (Denmark)

    Turkiewicz, A; Petersson, I F; Björk, J

    2014-01-01

    .6% (95% confidence interval (CI): 26.5-26.8) (men 22.4%, women 30.5%). The most common locations were knee (13.8%), hip (5.8%) and hand (3.1%). Of the prevalent cases 26.8% had OA in multiple joints. By the year 2032, the proportion of the population aged ≥45 with doctor-diagnosed OA is estimated......OBJECTIVE: To estimate the current and future (to year 2032) impact of osteoarthritis (OA) health care seeking. METHOD: Population-based study with prospectively ascertained data from the Skåne Healthcare Register (SHR), Sweden, encompassing more than 15 million person-years of primary...... and specialist outpatient care and hospitalizations. We studied all Skåne region residents aged ≥45 by the end of 2012 (n = 531, 254) and determined the prevalence of doctor-diagnosed OA defined as the proportion of the prevalent population that had received a diagnosis of OA of the knee, hip, hand, or other...

  19. Current initiatives in One Health: consolidating the One Health Global Network.

    Science.gov (United States)

    Vandersmissen, A; Welburn, S C

    2014-08-01

    The Global Response to Avian Influenza has led to a longer-term One Health movement, which addresses risks, including zoonoses, at the human-animal- environment interface, and requires the development of innovative partnerships at the political, institutional and technical levels. One Health is a sustainable and rational option when the cumulative effects of health hazards on food and economic security are considered, but demands long-term financial investment. Projections of growth in the demand for livestock production and consumption in Asia and Africa also call for effective One Health responses. However, an effective response also requires validated evidence of the socio-economic value that the One Health approach can provide. Implementing the One Health approach depends on forging strong links between human and animal health services, the environment and public policy. The authors present a list of some of the national and transnational partnerships established since 2006. Political support, good governance and effective policies and networks are crucial building blocks for One Health sustainability. The Global Response to Avian Influenza was initially established under the joint leadership of the European Union, the United States and the United Nations System Influenza Coordination Office. Since then it has supported numerous initiatives, including the World Health Organization (WHO)/Food and Agriculture Organization of the United Nations (FAO)/World Organisation for Animal Health (OIE) Global Early Warning System (GLEWS). Indeed, the Global Response to Avian Influenza paved the way for an unprecedented WHO/FAO/OIE tripartite partnership, which promoted the integration of foodborne, neglected zoonotic and tropical diseases within the One Health movement and led to the tripartite High-Level Technical Meeting of 2011 in Mexico. The One Health Global Network, which began as a proposition at an Expert Consultation in Winnipeg, Canada, in 2009, is now a reality

  20. Current status of the TSensor systems roadmap

    NARCIS (Netherlands)

    Walsh, Steven Thomas; Bryzek, Janusz; Pisano, Albert P.

    2014-01-01

    We apply our work from the contemporary pharmaceutical industry to generate a third generation-style technology roadmap for TSensor Systems. First we identify drivers and consortia. We then identify relevant technology components, namely multiple root technologies, multiple unit cells, multiple crit

  1. Current status of the TSensor systems roadmap

    NARCIS (Netherlands)

    Walsh, Steven; Bryzek, Janusz; Pisano, Albert P.

    2014-01-01

    We apply our work from the contemporary pharmaceutical industry to generate a third generation-style technology roadmap for TSensor Systems. First we identify drivers and consortia. We then identify relevant technology components, namely multiple root technologies, multiple unit cells, multiple crit

  2. Current status of the TSensor systems roadmap

    NARCIS (Netherlands)

    Walsh, Steven Thomas; Bryzek, Janusz; Pisano, Albert P.

    2014-01-01

    We apply our work from the contemporary pharmaceutical industry to generate a third generation-style technology roadmap for TSensor Systems. First we identify drivers and consortia. We then identify relevant technology components, namely multiple root technologies, multiple unit cells, multiple

  3. Health Care Information System (HCIS) Data File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data was derived from the Health Care Information System (HCIS), which contains Medicare Part A (Inpatient, Skilled Nursing Facility, Home Health Agency (Part A...

  4. The Regulation of Health Requirements for Police and Current Problems

    National Research Council Canada - National Science Library

    Ramazan Akçan; Mahmut Şerif Yıldırım; Aykut Lale; Abdurrahman İsak; Mehmet Cavlak; Aysun Balseven Odabaşı; Ali Rıza Tümer

    2017-01-01

    Introduction: Forensic medicine specialists might prepare reports about health conditions of candidates for Police Organization or assessment of organization's staff based on The Regulation of Health Requirements for Police...

  5. Current status of dentin adhesive systems.

    Science.gov (United States)

    Leinfelder, K F

    1998-12-01

    Undoubtedly, dentin bonding agents have undergone a major evolution during the last several years. The shear bond strength of composite resin to the surface of dentin is actually greater than the inherent strength of the dentin itself under well-controlled conditions. No longer must the clinician depend only upon the bonding to enamel as the sole bonding mechanism. Bonding to both types of dental structure permits even better reinforcement of the tooth itself. Perhaps even more important than the high level of bonding exhibited by the current dentin adhesives is their ability to seal the dentin. So effective is this sealing capability that it is now possible to protect the pulpal tissue from microbial invasion through the dentinal tubules. Further, by enclosing the odontoblastic processes and preventing fluid flow, the potential for postoperative sensitivity is diminished considerably. In fact, so evolutionary is the concept of bonding that the procedures associated with the restoration of teeth has changed dramatically. Undoubtedly, far greater improvements can be anticipated in the future.

  6. Development of BSCCO persistent current system

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Jin Ho; Nah, Wan Soo; Kang, Hyung Koo; Yoo, Jung Hoon [Sungkyunkwan University, Seoul (Korea)

    1998-05-01

    We have developed temperature-variable critical current measurement device for high Tc superconducting wires. For this end, vacuum shroud was designed and fabricated, and that both signal lines and power lines into the vacuum shroud were installed on it. Secondly, the design procedures for the PCS were established for the high Tc superconducting wires based on the electrical circuit analyses during energizations. We have also evaluated mechanical properties such as hardness, strength and elongation of sheath alloys made by addition of Cu, Mg, Ti, Zr and Ni to Ag matrix using induction melting furnace. It was observed that hardness and strength were improved by increasing additive contents from 0.05 to 0.2 at.%. Specifically, the increment of strength was relatively higher for alloys made by addition of Mg, Cu and Zr elements than that made by Ni and Ti addition. On the other hand, elongation was measured to be significantly reduced for former sheath alloy materials. (author). 12 refs., 13 figs., 4 tabs.

  7. NADIR: A Flexible Archiving System Current Development

    Science.gov (United States)

    Knapic, C.; De Marco, M.; Smareglia, R.; Molinaro, M.

    2014-05-01

    The New Archiving Distributed InfrastructuRe (NADIR) is under development at the Italian center for Astronomical Archives (IA2) to increase the performances of the current archival software tools at the data center. Traditional softwares usually offer simple and robust solutions to perform data archive and distribution but are awkward to adapt and reuse in projects that have different purposes. Data evolution in terms of data model, format, publication policy, version, and meta-data content are the main threats to re-usage. NADIR, using stable and mature framework features, answers those very challenging issues. Its main characteristics are a configuration database, a multi threading and multi language environment (C++, Java, Python), special features to guarantee high scalability, modularity, robustness, error tracking, and tools to monitor with confidence the status of each project at each archiving site. In this contribution, the development of the core components is presented, commenting also on some performance and innovative features (multi-cast and publisher-subscriber paradigms). NADIR is planned to be developed as simply as possible with default configurations for every project, first of all for LBT and other IA2 projects.

  8. CURRENT VIEWS OF THE GLEASON GRADING SYSTEM

    Directory of Open Access Journals (Sweden)

    N. A. Gorban

    2014-07-01

    Full Text Available The authors provide the proceedings of the 2005 First International Society of Urological Pathology Consensus Conference and the basic provisions that differ the modified Gleason grading system from its original interpretation. In particular, we should do away with Gleason grade 1 (or 1 + 1 = 2 while assessing the needle biopsy specimens. Contrary to the recommendations by Gleason himself, the conference decided to apply stringent criteria for using Gleason grades 3 and 4. This is due to the fact that these grades are of special prognostic value so it is important to have clear criteria in defining each Gleason grade. Notions, such as secondary and tertiary Gleason patterns, are considered; detailed recommendations are given on the lesion extent sufficient to diagnose these components.

  9. 42 CFR 457.80 - Current State child health insurance coverage and coordination.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Current State child health insurance coverage and... HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies...

  10. Prioritization in Somali health system strengthening: a qualitative study.

    Science.gov (United States)

    Warsame, Abdihamid; Handuleh, Jibril; Patel, Preeti

    2016-05-01

    After years of decline and disintegration, the Somalia Federal Government alongside international and domestic partners is beginning the process of rebuilding its national health system. In this study, we aim to shed light on the current approaches to health system strengthening, as viewed by stakeholders closely involved in its development. Key informant interviews were undertaken with health and development professionals working within all three administrative regions of Somalia, as well as with Somali ministry of health officials, global health and policy specialists with interests in health system reconstruction in fragile states. A review of published and grey literature on Somalia, health systems, fragile and conflict-affected countries using PubMed and Reliefweb was also conducted. Technical documents designed for Somali health system building by external development partners were also reviewed. Key priorities identified by participants were, strengthening of local governance and management capacity, scaling-up efforts to structure a robust health financing mechanism, engagement with the burgeoning and dynamic private sector, as well as investing in the appropriate human resources for health. The study found that there was widespread agreement among participants that health system strengthening through a coordinated system would improve long-term capacity in Somalia's health sector. Future research should focus on the evaluation of the modalities by which health system strengthening interventions are implemented, on neglected topics such as mental health within the Somali health system, as well as on population-level barriers to accessing health systems. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. A superconducting transformer system for high current cable testing.

    Science.gov (United States)

    Godeke, A; Dietderich, D R; Joseph, J M; Lizarazo, J; Prestemon, S O; Miller, G; Weijers, H W

    2010-03-01

    This article describes the development of a direct-current (dc) superconducting transformer system for the high current test of superconducting cables. The transformer consists of a core-free 10,464 turn primary solenoid which is enclosed by a 6.5 turn secondary. The transformer is designed to deliver a 50 kA dc secondary current at a dc primary current of about 50 A. The secondary current is measured inductively using two toroidal-wound Rogowski coils. The Rogowski coil signal is digitally integrated, resulting in a voltage signal that is proportional to the secondary current. This voltage signal is used to control the secondary current using a feedback loop which automatically compensates for resistive losses in the splices to the superconducting cable samples that are connected to the secondary. The system has been commissioned up to 28 kA secondary current. The reproducibility in the secondary current measurement is better than 0.05% for the relevant current range up to 25 kA. The drift in the secondary current, which results from drift in the digital integrator, is estimated to be below 0.5 A/min. The system's performance is further demonstrated through a voltage-current measurement on a superconducting cable sample at 11 T background magnetic field. The superconducting transformer system enables fast, high resolution, economic, and safe tests of the critical current of superconducting cable samples.

  12. Comparative radiopacity of six current adhesive systems.

    Science.gov (United States)

    de Moraes Porto, Isabel Cristina Celerino; Honório, Naira Cândido; Amorim, Dayse Annie Nicácio; de Melo Franco, Aurea Valéria; Penteado, Luiz Alexandre Moura; Parolia, Abhishek

    2014-01-01

    The radiopacity of contemporary adhesive systems has been mentioned as the indication for replacement of restorations due to misinterpretation of radiographic images. This study aimed to evaluate the radiopacity of contemporary bonding agents and to compare their radiodensities with those of enamel and dentin. To measure the radiopacity, eight specimens were fabricated from Clearfil SE Bond (CF), Xeno V (XE), Adper SE Bond (ASE), Magic Bond (MB), Single Bond 2 (SB), Scotchbond Multipurpose (SM), and gutta-percha (positive control). The optical densities of enamel, dentin, the bonding agents, gutta-percha, and an aluminium (Al) step wedge were obtained from radiographic images using image analysis software. The radiographic density data were analyzed statistically by analysis of variance and Tukey's test (α =0.05). Significant differences were found between ASE and all other groups tested and between XE and CF. No statistical difference was observed between the radiodensity of 1 mm of Al and 1 mm of dentin, between 2 mm of Al and enamel, and between 5 mm of Al and gutta-percha. Five of the six adhesive resins had radiopacity values that fell below the value for dentin, whereas the radiopacity of ASE adhesive was greater than that of dentin but below that of enamel. This investigation demonstrates that only ASE presented a radiopacity within the values of dentin and enamel. CF, XE, MB, SB, and SM adhesives are all radiolucent and require alterations to their composition to facilitate their detection by means of radiographic images.

  13. Virtual smile design systems: a current review.

    Science.gov (United States)

    Zimmermann, Moritz; Mehl, Albert

    2015-01-01

    In the age of digital dentistry, virtual treatment planning is becoming an increasingly important element of dental practice. Thanks to new technological advances in the computer- assisted design and computer-assisted manufacturing (CAD/CAM) of dental restorations, predictable interdisciplinary treatment using the backward planning approach appears useful and feasible. Today, a virtual smile design can be used as the basis for creating an esthetic virtual setup of the desired final result. The virtual setup, in turn, is used to plan further treatment steps in an interdisciplinary team approach, and communicate the results to the patient. The smile design concept and the esthetic analyses required for it are described in this article. We include not only a step-by-step description of the virtual smile design workflow, but also describe and compare the several available smile design options and systems. Subsequently, a brief discussion of the advantages and limitations of virtual smile design is followed by a section on different ways to integrate a two-dimensional (2D) smile design into the digital three-dimensional (3D) workflow. New technological developments are also described, such as the integration of smile designs in digital face scans, and 3D diagnostic follow-up using intraoral scanners.

  14. [Considerations on the Brazilian national health system (SUS) performance index].

    Science.gov (United States)

    Oliveira, Lilian; Passador, Claudia

    2014-01-01

    The Brazilian National Health System (SUS), a universal model currently established in Brazil, has a leading position among social policies. In a context of increased resources and growth of demand, the SUS constantly undergoes changes designed to improve the quality, access and effectiveness of the service provided. One of the major assessments conducted within the SUS consists of performance appraisals and health economic evaluations. One of the new tools used by the SUS is the IDSUS (Brazilian National Health System Performance Index) designed to measure the performance of each municipality and region in relation to access to and effectiveness of the health care system. This index is composed of twenty-four indicators, fourteen that measure access to health care and ten that measure the effectiveness of the system. Briefly, indicators such as the IDSUS can help to improve levels of health in Brazil. The primary objective of this study was to identify the currently National Health System assessment models and verify the potential of evaluation models, especially IDSUS, for enhancement and improvement of public health management in Brazil. This study was based on a review of the literature for structuring and development of the theoretical approach. Application of the various available health care system evaluation models remains fragmented and does not result in an action plan for public health administrators.

  15. Music therapy in cardiac health care: current issues in research.

    Science.gov (United States)

    Hanser, Suzanne B

    2014-01-01

    Music therapy is a service that has become more prevalent as an adjunct to medical practice-as its evidence base expands and music therapists begin to join the cardiology team in every phase of care, from the most serious cases to those maintaining good heart health. Although applications of music medicine, primarily listening to short segments of music, are capable of stabilizing vital signs and managing symptoms in the short-term, music therapy interventions by a qualified practitioner are showing promise in establishing deeper and more lasting impact. On the basis of mind-body approaches, stress/coping models, the neuromatrix theory of pain, and entrainment, music therapy capitalizes on the ability of music to affect the autonomic nervous system. Although only a limited number of randomized controlled trials pinpoint the efficacy of specific music therapy interventions, qualitative research reveals some profound outcomes in certain individuals. A depth of understanding related to the experience of living with a cardiovascular disease can be gained through music therapy approaches such as nonverbal music psychotherapy and guided imagery and music. The multifaceted nature of musical responsiveness contributes to strong individual variability and must be taken into account in the development of research protocols for future music therapy and music medicine interventions. The extant research provides a foundation for exploring the many potential psychosocial, physiological, and spiritual outcomes of a music therapy service for cardiology patients.

  16. Beam Current Measurement and Adjustment System on AMS

    Institute of Scientific and Technical Information of China (English)

    WUShao-yong; HEMING; SUSheng-yong; WANGZhen-jun; JIANGShan

    2003-01-01

    The beam current measurement and adjustment system of HI-13 tandem accelerator mass spectrometry detector system is consisted of the faraday cup, fluorescent target and a series of adjustable vertical slits(Fig. 1). The system's operation is very complicated and the transmission is low for the old system. A new system is instalated for improvement. We put the adjustable vertical slit, Faraday cup.

  17. Patient and citizen participation in German health care--current state and future perspectives.

    Science.gov (United States)

    Loh, Andreas; Simon, Daniela; Bieber, Christiane; Eich, Wolfgang; Härter, Martin

    2007-01-01

    Patient participation within the German healthcare system is described at three different levels: the macro level as active patient influence on the regulation of medical care, the meso level in terms of institutions enhancing patient information and counselling, and the micro level focusing on the actual treatment decision-making process in the medical encounter. The main focus of the present publication is on the health care system-specific influences on patient participation in medical decision-making and on the current state of research and implementation of shared decision-making in Germany. We describe institutions promoting patient involvement, their aims and initiatives as well as recent changes in German legislation. Against the background of German health politics' endorsement of patient participation the German Ministry of Health funded a research consortium with shared decision-making intervention projects in various disease areas. The present state of the intervention projects' results is outlined as well as subsequently funded transfer projects and future perspectives of research grants. Supported by health politics and the utilisation of scientific evidence shared decision-making's transfer into practice is considered to be relevant to the German health care system.

  18. Systemic antioxidants and skin health.

    Science.gov (United States)

    Nguyen, Gloria; Torres, Abel

    2012-09-01

    Most dermatologists agree that antioxidants help fight free radical damage and can help maintain healthy skin. They do so by affecting intracellular signaling pathways involved in skin damage and protecting against photodamage, as well as preventing wrinkles and inflammation. In today's modern world of the rising nutraceutical industry, many people, in addition to applying topical skin care products, turn to supplementation of the nutrients missing in their diets by taking multivitamins or isolated, man-made nutraceuticals, in what is known as the Inside-Out approach to skin care. However, ingestion of large quantities of isolated, fragmented nutrients can be harmful and is a poor representation of the kind of nutrition that can be obtained from whole food sources. In this comprehensive review, it was found that few studies on oral antioxidants benefiting the skin have been done using whole foods, and that the vast majority of current research is focused on the study of compounds in isolation. However, the public stands to benefit greatly if more research were to be devoted toward the impact that physiologic doses of antioxidants (obtained from fruits, vegetables, and whole grains) can have on skin health, and on health in general.

  19. Environmental health in Mexico: current situation and future prospects

    National Research Council Canada - National Science Library

    Riojas-Rodríguez, Horacio; Schilmann, Astrid; López-Carrillo, Lizbeth; Finkelman, Jacobo

    2013-01-01

    Environmental health has been established in Mexico as a discipline since the early nineties resuming the sanitarian tradition developed over the past century and incorporating new knowledge generated...

  20. Health content in local television news: a current appraisal.

    Science.gov (United States)

    Wang, Zheng; Gantz, Walter

    2010-04-01

    While local television news remains an important channel for the dissemination of health information, there has been little systematic examination of health content on those newscasts. This study, designed to update and expand upon earlier efforts, examined 1,382.5 hours of newscasts that aired on seven channels in four markets between December 2004 and June 2005. The four markets were a major-, a large-, a medium-, and a small-size market in the Midwestern United States. In total, 40,112 news stories were coded. About 8.1% of the news stories were devoted to health content. Health stories covered a large array of topics. Physical illnesses/diseases and healthy living issues received the most frequent coverage, while mental health and aging-related content were covered least frequently. Most health stories were neutral in tone and rather brief, with an average duration of less than 1 minute. One in eight (12.4%) health stories provided follow-up options. This is primarily due to an increase in the number of health news stories presented with a website URL compared to previous findings. Market differences emerged, although, interestingly, stations in the larger markets were not the leaders in health coverage.

  1. Design of BEPC Ⅱ bunch current monitor system

    Institute of Scientific and Technical Information of China (English)

    ZHANG Lei; MA Hui-Zhou; YUE Jun-Hui; LEI Ge; CAO Jian-She; MA Li

    2008-01-01

    BEPC Ⅱ is an electron-positron collider designed to run under multi-bunches and high beam current condition. The accelerator consists of an electron ring, a positron ring and a linear injector. In order to achieve the target luminosity and implement the equal bunch charge injection, the Bunch Current Monitor (BCM)system is built on BEPC Ⅱ. The BCM system consists of three parts: the front-end circuit, the bunch current acquisition system and the bucket selection system. The control software of BCM is based on VxWorks and EPICS. With the help of BCM system, the bunch current in each bucket can be monitored in the Central Control Room. The BEPC Ⅱ timing system can also use the bunch current database to decide which bucket needs to refill to implement "top-off" injection.

  2. Evolutionary Autonomous Health Monitoring System (EAHMS) Project

    Data.gov (United States)

    National Aeronautics and Space Administration — For supporting NASA's Robotics, Tele-Robotics and Autonomous Systems Roadmap, we are proposing the "Evolutionary Autonomous Health Monitoring System" (EAHMS) for...

  3. Electronic health records and online medical records: an asset or a liability under current conditions?

    Science.gov (United States)

    Allen-Graham, Judith; Mitchell, Lauren; Heriot, Natalie; Armani, Roksana; Langton, David; Levinson, Michele; Young, Alan; Smith, Julian A; Kotsimbos, Tom; Wilson, John W

    2017-01-20

    Objective The aim of the present study was to audit the current use of medical records to determine completeness and concordance with other sources of medical information.Methods Medical records for 40 patients from each of five Melbourne major metropolitan hospitals were randomly selected (n=200). A quantitative audit was performed for detailed patient information and medical record keeping, as well as data collection, storage and utilisation. Using each hospital's current online clinical database, scanned files and paperwork available for each patient audited, the reviewers sourced as much relevant information as possible within a 30-min time allocation from both the record and the discharge summary.Results Of all medical records audited, 82% contained medical and surgical history, allergy information and patient demographics. All audited discharge summaries lacked at least one of the following: demographics, medication allergies, medical and surgical history, medications and adverse drug event information. Only 49% of records audited showed evidence the discharge summary was sent outside the institution.Conclusions The quality of medical data captured and information management is variable across hospitals. It is recommended that medical history documentation guidelines and standardised discharge summaries be implemented in Australian healthcare services.What is known about this topic? Australia has a complex health system, the government has approved funding to develop a universal online electronic medical record system and is currently trialling this in an opt-out style in the Napean Blue Mountains (NSW) and in Northern Queensland. The system was originally named the personally controlled electronic health record but has since been changed to MyHealth Record (2016). In Victoria, there exists a wide range of electronic health records used to varying degrees, with some hospitals still relying on paper-based records and many using scanned medical records. This

  4. Men's Health Promotion in Canada: Current Context and Future Direction

    Science.gov (United States)

    Robertson, Steve; Galdas, Paul M.; McCreary, Donald R.; Oliffe, John L.; Tremblay, Gilles

    2009-01-01

    The issue of "men's health", and how best to promote it, has been gaining increasing attention in both academic and media arenas across the globe. Whilst commentaries on the state of health promotion for men have been provided in countries including Australia and the United Kingdom, no corresponding Canadian-specific insights have yet…

  5. Absinthe - is its history relevant for current public health?

    NARCIS (Netherlands)

    Huisman, Martijn; Brug, Johannes; Mackenbach, Johan

    This paper briefly addresses the history of the social experience with absinthe in France during the 19th century and the beginning of the 20th. We draw on some important parallels of this history with that of smoking to demonstrate that public health threats in the form of (ill-)health related

  6. Challenges to the current provision of mental health services and ...

    African Journals Online (AJOL)

    banzi

    The history of the development of mental health services in Africa falls into four phases, ... ical process described above still prevails in almost all the rural areas in Africa ... most countries in the region have had a decentralisation policy for mental health ... Constant departure or brain drain of well-trained and spe- cialised ...

  7. Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System.

    Science.gov (United States)

    East, Marlene Lynette; Havard, Byron C

    2015-01-01

    The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can promote cognitive learning, personal growth, and mental health enhancement. As key influencers in the mental health social system, counselor educators and professional associations may either help or hinder diffusion of beneficial mHealth technologies. As mental health mobile apps move towards ubiquity, research will continue to be conducted. The studies published thus far, combined with the potential of mental health mobile apps for learning and personal growth, offer enough evidence to compel mental health professionals to infuse these technologies into education and practice. Counselor educators and professional associations must use their influential leadership roles to train students and practitioners in how to research, evaluate, and integrate mental health mobile apps into practice. The objectives of this article are to (1) increase awareness of mHealth and mental health mobile apps, (2) demonstrate the potential for continued growth in mental health mobile apps based on technology use and acceptance theory, mHealth organizational initiatives, and evidence about how humans learn, (3) discuss evidence-based benefits of mental health mobile apps, (4) examine the current state of mHealth diffusion in the mental health profession, and (5) offer solutions for impelling innovation diffusion by infusing mental health mobile apps into education, training, and clinical settings. This discussion has implications for counselor educators, mental health practitioners, associations

  8. Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System

    Science.gov (United States)

    2015-01-01

    The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can promote cognitive learning, personal growth, and mental health enhancement. As key influencers in the mental health social system, counselor educators and professional associations may either help or hinder diffusion of beneficial mHealth technologies. As mental health mobile apps move towards ubiquity, research will continue to be conducted. The studies published thus far, combined with the potential of mental health mobile apps for learning and personal growth, offer enough evidence to compel mental health professionals to infuse these technologies into education and practice. Counselor educators and professional associations must use their influential leadership roles to train students and practitioners in how to research, evaluate, and integrate mental health mobile apps into practice. The objectives of this article are to (1) increase awareness of mHealth and mental health mobile apps, (2) demonstrate the potential for continued growth in mental health mobile apps based on technology use and acceptance theory, mHealth organizational initiatives, and evidence about how humans learn, (3) discuss evidence-based benefits of mental health mobile apps, (4) examine the current state of mHealth diffusion in the mental health profession, and (5) offer solutions for impelling innovation diffusion by infusing mental health mobile apps into education, training, and clinical settings. This discussion has implications for counselor educators, mental health practitioners, associations

  9. Qualitative ergonomics/human factors research in health care: Current state and future directions.

    Science.gov (United States)

    Valdez, Rupa Sheth; McGuire, Kerry Margaret; Rivera, A Joy

    2017-07-01

    The objective of this systematic review was to understand the current state of Ergonomics/Human Factors (E/HF) qualitative research in health care and to draw implications for future efforts. This systematic review identified 98 qualitative research papers published between January 2005 and August 2015 in the seven journals endorsed by the International Ergonomics Association with an impact factor over 1.0. The majority of the studies were conducted in hospitals and outpatient clinics, were focused on the work of formal health care professionals, and were classified as cognitive or organizational ergonomics. Interviews, focus groups, and observations were the most prevalent forms of data collection. Triangulation and data archiving were the dominant approaches to ensuring rigor. Few studies employed a formal approach to qualitative inquiry. Significant opportunities remain to enhance the use of qualitative research to advance systems thinking within health care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. [The research and expectation on wearable health monitoring system].

    Science.gov (United States)

    Chang, Feiba; Yin, Jun; Zhang, Hehua; Yan, Lexian; Li, Shuying; Zhou, Deqiang

    2015-01-01

    Wearable health monitoring systems that use wearable biosensors capturing human motion and physiological parameters, to achieve the wearer's movement and health management needs. Wearable health monitoring system is a noninvasive continuous detection of human physiological information, data wireless transmission and real-time processing capabilities of integrated system, can satisfy physiological condition monitoring under the condition of low physiological and psychological load. This paper first describes the wearable health monitoring system structure and the relevant technology applied to wearable health monitoring system, and focuses on the current research work what we have done associated with wearable monitoring that wearable respiration and ECG acquisition and construction of electric multi-parameter body area network. Finally, the wearable monitoring system for the future development direction is put forward a simple expectation.

  11. Strengthening of oral health systems

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2014-01-01

    Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care...... is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral...... diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work...

  12. Active pharmaceutical management strategies of health insurance systems to improve cost-effective use of medicines in low- and middle-income countries: a systematic review of current evidence.

    Science.gov (United States)

    Faden, Laura; Vialle-Valentin, Catherine; Ross-Degnan, Dennis; Wagner, Anita

    2011-05-01

    Health insurance systems have great potential to improve the cost-effective use of medicines by leveraging better provider prescribing, more cost-effective use by consumers, and lower prices from industry. Despite ample evidence from high-income countries, little is known about insurance system strategies targeting medicines in low- and middle-income countries (LMIC). This paper provides a critical review of the literature on these strategies and their impacts in LMIC. We conducted a systematic review of published peer-reviewed and grey literature and organized the insurance system strategies into four categories: medicines selection, purchasing, contracting and utilization management. In n=63 reviewed publications we found reasonable evidence supporting the use of insurance as an overall strategy to improve access to pharmaceuticals and outcomes in LMIC. Beyond this, most of the literature focused on provider contracting strategies to influence prescribing. There was very little evidence on medicines selection, purchasing, or utilization management strategies. There is a paucity of published evidence on the impact of insurance system strategies on improving the use of medicines in LMIC. The existing evidence is questionable since the majority of the published studies utilize weak study designs. This review highlights the need for well-designed studies to build an evidence base on the impact of medicines management strategies deployed by LMIC insurance programs. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  13. Existing public health surveillance systems for mental health in China.

    Science.gov (United States)

    Zhou, Wei; Xiao, Shuiyuan

    2015-01-01

    Mental health is a challenging public health issue worldwide and surveillance is crucial for it. However, mental health surveillance has not been developed until recently in certain developed countries; many other countries, especially developing countries, have poor or even no health information systems. This paper presents surveillance related to mental health in China, a developing country with a large population of patients with mental disorders. Detailed information of seven relevant surveillance systems is introduced respectively. From the perspective of utilization, problems including accessibility, comprehensiveness and data quality are discussed. Suggestions for future development are proposed.

  14. Prognostics and Health Management of Wind Turbines: Current Status and Future Opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Sheng, Shuangwen

    2015-12-14

    Prognostics and health management is not a new concept. It has been used in relatively mature industries, such as aviation and electronics, to help improve operation and maintenance (O&M) practices. In the wind industry, prognostics and health management is relatively new. The level for both wind industry applications and research and development (R&D) has increased in recent years because of its potential for reducing O&M cost of wind power, especially for turbines installed offshore. The majority of wind industry application efforts has been focused on diagnosis based on various sensing and feature extraction techniques. For R&D, activities are being conducted in almost all areas of a typical prognostics and health management framework (i.e., sensing, data collection, feature extraction, diagnosis, prognosis, and maintenance scheduling). This presentation provides an overview of the current status of wind turbine prognostics and health management that focuses on drivetrain condition monitoring through vibration, oil debris, and oil condition analysis techniques. It also discusses turbine component health diagnosis through data mining and modeling based on supervisory control and data acquisition system data. Finally, it provides a brief survey of R&D activities for wind turbine prognostics and health management, along with future opportunities.

  15. Climate change and respiratory health: current evidence and knowledge gaps.

    Science.gov (United States)

    Takaro, Tim K; Knowlton, Kim; Balmes, John R

    2013-08-01

    Climate change is a key driver of the accelerating environmental change affecting populations around the world. Many of these changes and our response to them can affect respiratory health. This is an expert opinion review of recent peer-reviewed literature, focused on more recent medical journals and climate-health relevant modeling results from non-biomedical journals pertaining to climate interactions with air pollution. Global health impacts in low resource countries and migration precipitated by environmental change are addressed. The major findings are of respiratory health effects related to heat, air pollution, shifts in infectious diseases and allergens, flooding, water, food security and migration. The review concludes with knowledge gaps and research need that will support the evidence-base required to address the challenges ahead.

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

    Science.gov (United States)

    Hunter, C

    1991-07-01

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

  17. Symposium: Organizational Health Intervention Research: Current Empirical Developments

    DEFF Research Database (Denmark)

    Ipsen, Christine; Jenny, Gregor

    2014-01-01

    This symposium is one of three symposia submitted by the "International organizational health intervention research partnership". The aim of this symposium is to present new empirical developments based on participatory intervention models. All five studies have developed and applied intervention...

  18. Understanding the impact of global trade liberalization on health systems pursuing universal health coverage.

    Science.gov (United States)

    Missoni, Eduardo

    2013-01-01

    In the context of reemerging universalistic approaches to health care, the objective of this article was to contribute to the discussion by highlighting the potential influence of global trade liberalization on the balance between health demand and the capacity of health systems pursuing universal health coverage (UHC) to supply adequate health care. Being identified as a defining feature of globalization affecting health, trade liberalization is analyzed as a complex and multidimensional influence on the implementation of UHC. The analysis adopts a systems-thinking approach and refers to the six building blocks of World Health Organization's current "framework for action," emphasizing their interconnectedness. While offering new opportunities to increase access to health information and care, in the absence of global governance mechanisms ensuring adequate health protection and promotion, global trade tends to have negative effects on health systems' capacity to ensure UHC, both by causing higher demand and by interfering with the interconnected functioning of health systems' building blocks. The prevention of such an impact and the effective implementation of UHC would highly benefit from a more consistent commitment and stronger leadership by the World Health Organization in protecting health in global policymaking fora in all sectors. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. [A Maternal Health Care System Based on Mobile Health Care].

    Science.gov (United States)

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals.

  20. A microcomputer based system for current-meter data acquisition

    Science.gov (United States)

    Cheng, R.T.; Gartner, J.W.

    1979-01-01

    The U.S. Geological Survey is conducting current measurements as part of an interdisciplinary study of the San Francisco Bay estuarine system. The current meters used in the study record current speed, direction, temperature, and conductivity in digital codes on magnetic tape cartridges. Upon recovery of the current meters, the data tapes are translated by a tape reader into computer codes for further analyses. Quite often the importance of the data processing phase of a current-measurement program is underestimated and downplayed. In this paper a data-processing system which performs the complete data processing and analyses is described. The system, which is configured around an LSI-11 microcomputer, has been assembled to provide the capabilities of data translation, reduction, and tabulation and graphical display immediately following recovery of current meters. The flexibility inherent in a microcomputer has made it available to perform many other research functions which would normally be done on an institutional computer.

  1. Health care services, information systems & sustainability.

    Science.gov (United States)

    Hovenga, Evelyn J S

    2010-01-01

    This chapter gives an educational overview of: * many competing characteristics within national health systems * national primary information and knowledge flows between health care entities * the role of information technologies in assisting health organizations become sustainable enterprises * the business of maintaining healthy populations for any nation * desirable e-health strategy objectives.

  2. Prognostics and Health Management of Wind Turbines: Current Status and Future Opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Sheng, Shuangwen

    2016-10-04

    This presentation was given at the 2016 Annual Conference of the Prognostics and Health Management Society. It covers the current status and challenges and opportunities of prognostics and health management of wind turbines.

  3. Current Research Activities in Drive System Technology in Support of the NASA Rotorcraft Program

    Science.gov (United States)

    Handschuh, Robert F.; Zakrajsek, James J.

    2006-01-01

    Drive system technology is a key area for improving rotorcraft performance, noise/vibration reduction, and reducing operational and manufacturing costs. An overview of current research areas that support the NASA Rotorcraft Program will be provided. Work in drive system technology is mainly focused within three research areas: advanced components, thermal behavior/emergency lubrication system operation, and diagnostics/prognostics (also known as Health and Usage Monitoring Systems (HUMS)). Current research activities in each of these activities will be presented. Also, an overview of the conceptual drive system requirements and possible arrangements for the Heavy Lift Rotorcraft program will be reviewed.

  4. Shift Work and Health: Current Problems and Preventive Actions

    Directory of Open Access Journals (Sweden)

    Giovanni Costa

    2010-12-01

    Full Text Available The paper gives an overview of the problems to be tackled nowadays by occupational health with regards to shift work as well as the main guidelines at organizational and medical levels on how to protect workers’ health and well-being. Working time organization is becoming a key factor on account of new technologies, market globalization, economic competition, and extension of social services to general populations, all of which involve more and more people in continuous assistance and control of work processes over the 24 hours in a day. The large increase of epidemiological and clinical studies on this issue document the severity of this risk factor on human health and well being, at both social and psychophysical levels, starting from a disruption of biological circadian rhythms and sleep/wake cycle and ending in several psychosomatic troubles and disorders, likely also including cancer, and extending to impairment of performance efficiency as well as family and social life. Appropriate interventions on the organization of shift schedules according to ergonomic criteria and careful health surveillance and social support for shift workers are important preventive and corrective measures that allow people to keep working without significant health impairment.

  5. Health-related quality of life in current smokers with COPD: factors associated with current smoking and new insights into sex differences

    Directory of Open Access Journals (Sweden)

    Cheruvu VK

    2016-09-01

    Full Text Available Vinay K Cheruvu,1 Lorriane A Odhiambo,1 Dana S Mowls,2 Melissa D Zullo,1 Abdi T Gudina1 1Department of Biostatistics, Environmental Health Sciences, and Epidemiology, College of Public Health, Kent State University, Kent, OH, 2Department of Biostatistics & Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA Abstract: Findings from studies that examined the association between health-related ­quality of life (HRQOL and smoking status among COPD patients have been mixed. Moreover, factors associated with current smoking in COPD patients and differences by sex have not been fully elucidated. Data from the 2011 and 2012 Behavioral Risk Factor Surveillance System was used in this study. Four HRQOL indicators were examined in this study: general health, physical health, mental health, and activity limitations. General health was dichotomized into two groups: “excellent/very good/good” and “fair/poor”, and the other three HRQOL indicators were dichotomized into <14 (infrequent and ≥14 (frequent unhealthy days in the past 30 days. To examine HRQOL indicators in association with current versus former smoking and identify factors associated with current smoking, logistic regression models were used. Sex differences were explored. In COPD patients, current smokers compared to former smokers had significantly poor HRQOL on all subdomains: “fair/poor” general health (adjusted odds ratio [AOR]: 1.2 [95% confidence interval {CI}: 1.1–1.5]; poor physical health (AOR: 1.3 [CI: 1.1–1.5]; poor mental health (AOR: 1.8 [CI: 1.4–2.2]; and poor activity limitations (AOR: 1.5 [CI: 1.3–1.9]. HRQOL subdomains affected by current smoking differed by sex except activity limitations. General health (AOR: 1.5 [CI: 1.1–2.0] and activity limitations (AOR: 1.6 [95% CI: 1.2–2.2] in males and physical health (AOR: 1.3 [CI: 1.0–1.6], mental health (AOR: 2.1 [CI: 1.7–2.6], and activity

  6. [Active teaching-learning methodologies in health education: current debates].

    Science.gov (United States)

    Mitre, Sandra Minardi; Siqueira-Batista, Rodrigo; Girardi-de-Mendonça, José Márcio; de Morais-Pinto, Neila Maria; Meirelles, Cynthia de Almeida Brandão; Pinto-Porto, Cláudia; Moreira, Tânia; Hoffmann, Leandro Marcial Amaral

    2008-12-01

    The vertiginous transformations of the contemporary societies have been raising questions concerning aspects of professional education. Such questions have been raised in a more and more incisive way. This debate gains a new shape when applied to health work, where theory and practice cannot be dissociated, and where the development of an integral vision of the human being and the amplification of the concept care are essential for a proper performance. Based on these considerations, this article aims to discuss the main methodological transformations in the education process of health professionals, with emphasis to active teaching-learning methodologies.

  7. Asbestos case and its current implications for global health

    Directory of Open Access Journals (Sweden)

    Daniela Marsili

    2013-09-01

    Full Text Available Notwithstanding a major body of evidence on the carcinogenicity of all asbestos fibres and a general consensus of the scientific community on the health impact of this agent, asbestos is still produced and used in a large number of countries, thus determining further harm for future generations. Prevention of asbestos-related disease requires international cooperation, transfer of know-how and dissemination of successful procedures in order to contrast asbestos exposure in the frame of a global environmental health approach.

  8. Current development of UAV sense and avoid system

    Science.gov (United States)

    Zhahir, A.; Razali, A.; Mohd Ajir, M. R.

    2016-10-01

    As unmanned aerial vehicles (UAVs) are now gaining high interests from civil and commercialised market, the automatic sense and avoid (SAA) system is currently one of the essential features in research spotlight of UAV. Several sensor types employed in current SAA research and technology of sensor fusion that offers a great opportunity in improving detection and tracking system are presented here. The purpose of this paper is to provide an overview of SAA system development in general, as well as the current challenges facing UAV researchers and designers.

  9. Health and health systems in the Commonwealth of Independent States.

    Science.gov (United States)

    Rechel, Bernd; Roberts, Bayard; Richardson, Erica; Shishkin, Sergey; Shkolnikov, Vladimir M; Leon, David A; Bobak, Martin; Karanikolos, Marina; McKee, Martin

    2013-03-30

    The countries of the Commonwealth of Independent States differ substantially in their post-Soviet economic development but face many of the same challenges to health and health systems. Life expectancies dropped steeply in the 1990s, and several countries have yet to recover the levels noted before the dissolution of the Soviet Union. Cardiovascular disease is a much bigger killer in the Commonwealth of Independent States than in western Europe because of hazardous alcohol consumption and high smoking rates in men, the breakdown of social safety nets, rising social inequality, and inadequate health services. These former Soviet countries have embarked on reforms to their health systems, often aiming to strengthen primary care, scale back hospital capacities, reform mechanisms for paying providers and pooling funds, and address the overall shortage of public funding for health. However, major challenges remain, such as frequent private out-of-pocket payments for health care and underdeveloped systems for improvement of quality of care.

  10. The Consumer Health Information System Adoption Model.

    Science.gov (United States)

    Monkman, Helen; Kushniruk, Andre W

    2015-01-01

    Derived from overlapping concepts in consumer health, a consumer health information system refers to any of the broad range of applications, tools, and educational resources developed to empower consumers with knowledge, techniques, and strategies, to manage their own health. As consumer health information systems become increasingly popular, it is important to explore the factors that impact their adoption and success. Accumulating evidence indicates a relationship between usability and consumers' eHealth Literacy skills and the demands consumer HISs place on their skills. Here, we present a new model called the Consumer Health Information System Adoption Model, which depicts both consumer eHealth literacy skills and system demands on eHealth literacy as moderators with the potential to affect the strength of relationship between usefulness and usability (predictors of usage) and adoption, value, and successful use (actual usage outcomes). Strategies for aligning these two moderating factors are described.

  11. [Equity and health systems reform in Latin America].

    Science.gov (United States)

    Vargas, Ingrid; Vazquez, Maria Luisa; Jane, Elisabet

    2002-01-01

    The aim of any health care system is to help improve the people's health, and to do so as efficiently as possible. In order to improve the efficiency and equity of health services provision, many countries around the world have implemented reforms, including several Latin American nations. However similar the objectives may appear, the various ways societies implement such reforms reflect different values and concepts. This article analyzes the egalitarian and neoliberal values underlying different concepts of equity in health care. The authors develop criteria to interpret selected health services funding and provision strategies in Latin American health system reforms. These criteria are then applied to health care financing and delivery policies under the reforms currently being implemented in Colombia and Costa Rica.

  12. Do current sports nutrition guidelines conflict with good oral health?

    Science.gov (United States)

    Broad, Elizabeth M; Rye, Leslie A

    2015-01-01

    For optimal athletic performance, an athlete requires good oral health to reduce the risk of oral pain, inflammation, and infection and thereby minimize the use of analgesics and antimicrobial agents. Increased intake, frequency, and dental contact time of carbohydrate-rich foods, sports nutrition products, and acidic carbohydrate-containing sports and energy drinks may contribute to risks of dental erosion, caries, and inflammatory periodontal conditions in the athlete, especially when he or she also exhibits dehydration and poor oral hygiene habits. Examining the athlete before he or she begins participating in a sport allows the dental care provider to determine the patient's existing oral health, hygiene, and susceptibility to risk factors for erosion, caries, and inflammatory periodontal disease. This oral profile, in conjunction with the individual athlete's dietary needs, can be used to establish a treatment and preventive program, including oral health education. Good oral hygiene practices and application of topical fluoride, especially via fluoridated toothpastes and topical fluoride varnishes, must be available to the athlete. Rinsing with water or a neutral beverage after exposure to carbohydrates or acidic sports nutrition products may reduce carbohydrate contact time and bring oral pH levels back to neutral more quickly, reducing the risk of caries and erosion. Finally, the dentist should encourage the athlete to consult with an experienced sports dietitian to ensure that principles of sports nutrition are being appropriately applied for the type, frequency, and duration of exercise in consideration of the individual's oral health needs.

  13. Religion, spirituality, and mental health: current controversies and future directions.

    Science.gov (United States)

    Dein, Simon; Cook, Christopher C H; Koenig, Harold

    2012-10-01

    Although studies examining religion, spirituality, and mental health generally indicate positive associations, there is a need for more sophisticated methodology, greater discrimination between different cultures and traditions, more focus on situated experiences of individuals belonging to particular traditions, and, in particular, greater integration of theological contributions to this area. We suggest priorities for future research based on these considerations.

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

    Science.gov (United States)

    Bower, Wilma; And Others

    1986-01-01

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

  15. Mental Health Services for People with Intellectual Disability: Current Developments.

    Science.gov (United States)

    Molony, Helen

    1993-01-01

    This report gives an update on the status of planning and delivery of mental health services for people with intellectual disability who have psychiatric disorders in Australia and New Zealand. A number of innovative approaches in policy and planning, legislative support, education, consultation, and coordination among services are discussed.…

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

    Science.gov (United States)

    Bower, Wilma; And Others

    1986-01-01

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

  17. Keeping Current. Library Media Specialists: Addressing the Student Health Epidemic

    Science.gov (United States)

    Buddy, Juanita

    2005-01-01

    Health and educational leaders are sounding the alarm about the unhealthy condition of many students in America's K-12 schools. Each day, new scientific studies confirm that "The majority of American youth are sedentary and do not eat well. Sixteen percent of school-aged children and adolescents--or nine million--are overweight, a figure that has…

  18. Occupational Health Record-keeping System (OHRS)

    Data.gov (United States)

    Department of Veterans Affairs — Occupational Health Record-keeping System (OHRS) is part of the Clinical Information Support System (CISS) portal framework and the initial CISS partner system. OHRS...

  19. Health governance: principal-agent linkages and health system strengthening.

    Science.gov (United States)

    Brinkerhoff, Derick W; Bossert, Thomas J

    2014-09-01

    Governance is increasingly recognized as an important factor in health system performance, yet conceptually and practically it remains poorly understood and subject to often vague and competing notions of both what its role is and how to address its weaknesses. This overview article for the symposium on health governance presents a model of health governance that focuses on the multiplicity of societal actors in health systems, the distribution of roles and responsibilities among them and their ability and willingness to fulfil these roles and responsibilities. This focus highlights the principal-agent linkages among actors and the resulting incentives for good governance and health system performance. The discussion identifies three disconnects that constitute challenges for health system strengthening interventions that target improving governance: (1) the gap between the good governance agenda and existing capacities, (2) the discrepancy between formal and informal governance and (3) the inattention to sociopolitical power dynamics. The article summarizes the three country cases in the symposium and highlights their governance findings: health sector reform in China, financial management of health resources in Brazilian municipalities and budget reform in hospitals in Lesotho. The concluding sections clarify how the three cases apply the model's principal-agent linkages and highlight the importance of filling the gaps remaining between problem diagnosis and the development of practical guidance that supports 'best fit' solutions and accommodates political realities in health systems strengthening.

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

    Directory of Open Access Journals (Sweden)

    Safaei J

    2015-12-01

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

  1. E-health: effect on health system efficiency of Pakistan.

    Science.gov (United States)

    Naseem, Afshan; Rashid, Audil; Kureshi, Nadeem Ishaq

    2014-01-01

    The health system in Pakistan is spraining because of increasing cost and demand gravities. The shortage of skilled health care workers is one of the main factors of health issues. There is a need to move away from the dependency of tools such as pen, paper, and human memory to a milieu where patients and health care providers can reliably access and share health information in real time across geographic and health sector boundaries. The purpose of this research is to observe the effect of e-health on the physician-patient relationship and to analyze the capacity of health professionals by noting information and communication technologies usage as indicators. Structured questionnaire was used to gather data from physicians to judge the success and effect of existing e-health policy. Both categorical and Likert scale variables were used. The analysis of data was per.formed using chi-square test and binary logistic regression. Specialist doctors comprised the major proportion of health care professionals in both male and female categories with good knowledge about Internet usage. E-health-based communication does not seem to be gender specific. Logistic regression revealed that busy doctors whose patients are more than 100 per week believe that e-health would significantly strengthen their communication with patients (OR=3.06; 95% CI=1.05- 8.87). Among other significant impacts of e-health include reduced consultation period and time of diagnosis. E-health technology can play a crucial role in controlling many epidemic diseases through effective surveillance. E-health implementation will result in improving the efficiency, better access of general public to the health care system, and eradication of diseases in Pakistan.

  2. Integration of current identity-based district-varied health insurance schemes in China: implications and challenges.

    Science.gov (United States)

    Wang, Hai-Qiang; Liu, Zhi-Heng; Zhang, Yong-Zhao; Luo, Zhuo-Jing

    2012-03-01

    With China's great efforts to improve public health insurance, clear progress has been achieved toward the ambitious full health insurance coverage strategy for all. The current health insurance schemes in China fall into three categories: urban employee basic health insurance scheme, urban resident scheme, and new rural cooperative medical system. Despite their phasic success, these substantially identity-based, district-varied health insurance schemes have separate operation mechanisms, various administrative institutions, and consequently poor connections. On the other hand, the establishment and implementation of various health insurance schemes provide the preconditioning of more sophisticated social health insurance schemes, the increase in the income of urban and rural people, and the great importance attached by the government. Moreover, the reform of the "Hukou" (household register) system provides economical, official, and institutional bases. Therefore, the establishment of an urban-rural integrated, citizen-based, and nationwide-universal health insurance scheme by the government is critically important to attain equality and national connection. Accordingly, the differences between urban and rural areas should be minimized. In addition, the current schemes, administrative institutions, and networks should be integrated and interconnected. Moreover, more expenditure on health insurance might be essential for the integration despite the settings of global financial crisis. Regardless of the possible challenges in implementation, the proposed new scheme is promising and may be applied in the near future for the benefit of the Chinese people and global health.

  3. Diffusion current in a system of coupled Josephson junctions

    Science.gov (United States)

    Shukrinov, Yu. M.; Rahmonov, I. R.

    2012-08-01

    The role of a diffusion current in the phase dynamics of a system of coupled Josephson junctions (JJs) has been analyzed. It is shown that, by studying the temporal dependences of the superconducting, quasi-particle, diffusion, and displacement currents and the dependences of average values of these currents on the total current, it is possible to explain the main features of the current-voltage characteristic (CVC) of the system. The effect of a diffusion current on the character of CVC branching in the vicinity of a critical current and in the region of hysteresis, as well as on the part of CVC branch corresponding to a parametric resonance in the system is demonstrated. A clear interpretation of the differences in the character of CVC branching in a model of capacitively coupled JJs (CCJJ model) and a model of capacitive coupling with diffusion current (CCJJ+DC model) is proposed. It is shown that a decrease in the diffusion current in a JJ leads to the switching of this junction to an oscillating state. The results of model calculations are qualitatively consistent with the experimental data.

  4. Diffusion current in a system of coupled Josephson junctions

    Energy Technology Data Exchange (ETDEWEB)

    Shukrinov, Yu. M., E-mail: shukrinv@theor.jinr.ru; Rahmonov, I. R. [Joint Institute for Nuclear Research (Russian Federation)

    2012-08-15

    The role of a diffusion current in the phase dynamics of a system of coupled Josephson junctions (JJs) has been analyzed. It is shown that, by studying the temporal dependences of the superconducting, quasi-particle, diffusion, and displacement currents and the dependences of average values of these currents on the total current, it is possible to explain the main features of the current-voltage characteristic (CVC) of the system. The effect of a diffusion current on the character of CVC branching in the vicinity of a critical current and in the region of hysteresis, as well as on the part of CVC branch corresponding to a parametric resonance in the system is demonstrated. A clear interpretation of the differences in the character of CVC branching in a model of capacitively coupled JJs (CCJJ model) and a model of capacitive coupling with diffusion current (CCJJ+DC model) is proposed. It is shown that a decrease in the diffusion current in a JJ leads to the switching of this junction to an oscillating state. The results of model calculations are qualitatively consistent with the experimental data.

  5. Spin currents and magnetization dynamics in multilayer systems

    NARCIS (Netherlands)

    van der Bijl, E.

    2014-01-01

    In this Thesis the interplay between spin currents and magnetization dynamics is investigated theoretically. With the help of a simple model the relevant physical phenomena are introduced. From this model it can be deduced that in systems with small spin-orbit coupling, current-induced torques on

  6. West Coast Observing System (WCOS) ADCP Currents Data

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The West Coast Observing System (WCOS) project provides access to temperature and currents data collected at four of the five National Marine Sanctuary sites,...

  7. Population vulnerability of marine birds within the California Current System

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Six metrics were used to determine Population Vulnerability: global population size, annual occurrence in the California Current System (CCS), percent of the...

  8. Population vulnerability of marine birds within the California Current System

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Six metrics were used to determine Population Vulnerability: global population size, annual occurrence in the California Current System (CCS), percent of the...

  9. Health, Health Care, and Systems Science: Emerging Paradigm

    Science.gov (United States)

    2017-01-01

    Health is a continuum of an optimized state of a biologic system, an outcome of positive relationships with the self and others. A healthy system follows the principles of systems science derived from observations of nature, highlighting the character of relationships as the key determinant. Relationships evolve from our decisions, which are consequential to the function of our own biologic system on all levels, including the genome, where epigenetics impact our morphology. In healthy systems, decisions emanate from the reciprocal collaboration of hippocampal memory and the executive prefrontal cortex. We can decide to change relationships through choices. What is selected, however, only represents the cognitive interpretation of our limited sensory perception; it strongly reflects inherent biases toward either optimizing state, making a biologic system healthy, or not. Health or its absence is then the outcome; there is no inconsequential choice. Public health effort should not focus on punitive steps (e.g. taxation of unhealthy products or behaviors) in order to achieve a higher level of public’s health. It should teach people the process of making healthy decisions; otherwise, people will just migrate/shift from one unhealthy product/behavior to another, and well-intended punitive steps will not make much difference. Physical activity, accompanied by nutrition and stress management, have the greatest impact on fashioning health and simultaneously are the most cost-effective measures. Moderate-to-vigorous exercise not only improves aerobic fitness but also positively influences cognition, including memory and senses. Collective, rational societal decisions can then be anticipated. Health care is a business system principally governed by self-maximizing decisions of its components; uneven and contradictory outcomes are the consequences within such a non-optimized system. Health is not health care. We are biologic systems subject to the laws of biology in spite

  10. Zika virus: Global health challenge, threat and current situation.

    Science.gov (United States)

    Aziz, Hafsa; Zia, Aadarash; Anwer, Amania; Aziz, Muneeba; Fatima, Shazia; Faheem, Muhammad

    2017-06-01

    ZIKV has emerged as grave global health issue in the past few years. ZIKV was firstly isolated in 1947 from a rhesus sentinel monkey in the Zika forest in Uganda. It is usually transmitted by the bite of infected mosquitoes and infects skin fibroblasts, skin keratinocytes, etc. ZIKV until now was under reported because of its clinical similarity with the dengue and chikungunya. It is usually spread through the course of the sylvatic cycle. In this cycle, the virus or pathogen lifespan is spent between the wild animal and vectors. The intrinsic incubation period is not yet fully known but it is observed that the very first symptoms of ZIKV infection can appear or develop within 3-12 days of time period and usually subside within 7 days of time. There is a strong relationship between prenatal Zika virus infection and microcephaly; other serious brain anomalies to the infant or newborn are Guillain-Barré syndrome. To date no vaccines are available for ZIKV prevention hence only symptomatic treatment is recommended in infected patients. Usually ZIKV is detected by serologic (IgM ELISA), plaque reduction neutralization test (PRNT) along with in-house" molecular techniques (RT-PCR). ZIKV infection being imminent global health issue warrants strong protective measures to prevent it from becoming an epidemic. Early detection and prevention is the key to tackle this grave potential health hazard. J. Med. Virol. 89:943-951, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  11. [The current perspectives regarding the burden on mental health caregivers].

    Science.gov (United States)

    Cardoso, Lucilene; Vieira, Mariana Verderoce; Ricci, Maira Aparecida Malagutti; Mazza, Rafael Severio

    2012-04-01

    A systematic literature review was performed regarding the burden on mental health caregivers. The studies were selected from the Virtual Health Library - Biblioteca Virtual de Saúde (BVS), using the keyword caregiver burden. The main criteria for this study were: full-text articles published between 2000 and 2010, in Portuguese, English or Spanish; indexed on the BVS databases; which investigated the burden of mental health caregivers, and had caregivers as the main subject. The analysis was performed considering the following: title, year of publication, objectives, methodological approach, instruments and main results. The analysis of 114 full-text articles showed the predominant objectives were the burden on informal caregivers and the validation of psychometric scales, particularly the Zarit Scale. Some studies showed an association between high levels of burden, feelings of guilt and depressive symptoms. On the other hand, psycho-educational interventions were indicated as having a positive impact. This theme has a growing scientific interest and there is a need for deeper studies addressing formal caregivers.

  12. The Chilean Health System: 20 Years of Reforms

    Directory of Open Access Journals (Sweden)

    Manuel Annick

    2002-01-01

    Full Text Available The Chilean health care system has been intensively reformed in the past 20 years. Reforms under the Pinochet government (1973-1990 aimed mainly at the decentralization of the system and the development of a private sector. Decentralization involved both a deconcentration process and the devolution of primary health care to municipalities. The democratic governments after 1990 chose to preserve the core organization but introduced reforms intended to correct the system's failures and to increase both efficiency and equity. The present article briefly explains the current organization of the Chilean health care system. It also reviews the different reforms introduced in the past 20 years, from the Pinochet regime to the democratic governments. Finally, a brief discussion describes the strengths and weaknesses of the system, as well as the challenges it currently faces.

  13. The State Public Health Laboratory System

    OpenAIRE

    Inhorn, Stanley L.; Astles, J. Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M.; Wilcke, Burton W.; White, Vanessa A.

    2010-01-01

    This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the go...

  14. Applying information and communications technologies to collect health data from remote settings: a systematic assessment of current technologies.

    Science.gov (United States)

    Ashar, Raj; Lewis, Sheri; Blazes, David L; Chretien, J P

    2010-04-01

    Modern information and communications technologies (ICTs) are now so feature-rich and widely available that they can be used to "capture," or collect and transmit, health data from remote settings. Electronic data capture can reduce the time necessary to notify public health authorities, and provide important baseline information. A number of electronic health data capture systems based on specific ICTs have been developed for remote areas. We expand on that body of work by defining and applying an assessment process to characterize ICTs for remote-area health data capture. The process is based on technical criteria, and assesses the feasibility and effectiveness of specific technologies according to the resources and constraints of a given setting. Our characterization of current ICTs compares different system architectures for remote-area health data capture systems. Ultimately, we believe that our criteria-based assessment process will remain useful for characterizing future ICTs.

  15. Building health research systems to achieve better health

    Directory of Open Access Journals (Sweden)

    González Block Miguel

    2006-11-01

    Full Text Available Abstract Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics

  16. Building health research systems to achieve better health.

    Science.gov (United States)

    Hanney, Stephen R; González Block, Miguel A

    2006-01-01

    Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS) provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics related to the above

  17. Educating Medical Laboratory Technologists: Revisiting Our Assumptions in the Current Economic and Health-Care Environment

    Directory of Open Access Journals (Sweden)

    Regina Linder

    2012-08-01

    Full Text Available Health care occupies a distinct niche in an economy struggling to recover from recession. Professions related to the care of patients are thought to be relatively resistant to downturns, and thus become attractive to students typically drawn to more lucrative pursuits. Currently, a higher profile for clinical laboratory technology among college students and those considering career change results in larger and better prepared applicant pools. However, after decades of contraction marked by closing of programs, prospective students encounter an educational system without the capacity or vigor to meet their needs. Here discussed are some principles and proposals to allow universities, partnering with health-care providers, government agencies, and other stakeholders to develop new programs, or reenergize existing ones to serve our students and patients. Principles include academic rigor in biomedical and clinical science, multiple points of entry for students, flexibility in format, cost effectiveness, career ladders and robust partnerships.

  18. [Mental health nursing work: contradictions and current potentialities].

    Science.gov (United States)

    de Oliveira, Alice G Bottaro; Alessi, Neiry Primo

    2003-01-01

    This study aimed to identify contradictions and challenges that are present nowadays in mental health nursing work, in the context of the Psychiatric Reform, on the basis of the historical-social construction of this working process. The Psychiatric Reform presupposes a new design of work purpose and instruments, which still have little visibility in nursing practice, and the possibility for the person in mental suffering to achieve the subject-citizen condition - way of being and work purpose - which is directly related with the subject-citizen awareness of the nursing worker.

  19. Priority-setting in health systems

    DEFF Research Database (Denmark)

    Byskov, Jens

    2013-01-01

    tried herbal remedies for both of them for a week but without effect. The family permits her to travel with her child quite some distance to a fairly run down health centre ---- (Cont. with her meeting services, but going home unserved) WHAT ARE HEALTH SYSTEMS AND HEALTH SYSTEMS RESEARCH? Health systems...... and constraints. This effectively leaves policy-makers.without scientifically sound ideas of what they can and should actually strengthen within ever limited resources. Within such unmapped and misunderstood systems, interventions – even the very simplest – often fail to achieve their goals and no recommeded...

  20. The Global Health System: Strengthening National Health Systems as the Next Step for Global Progress

    OpenAIRE

    2010-01-01

    In the second in a series of articles on the changing nature of global health institutions, Julio Frenk offers a framework to better understand national health systems and their role in global health.

  1. Reverse innovation: an opportunity for strengthening health systems.

    Science.gov (United States)

    Snowdon, Anne W; Bassi, Harpreet; Scarffe, Andrew D; Smith, Alexander D

    2015-02-07

    Canada, when compared to other OECD countries, ranks poorly with respect to innovation and innovation adoption while struggling with increasing health system costs. As a result of its failure to innovate, the Canadian health system will struggle to meet the needs and demands of both current and future populations. The purpose of this initiative was to explore if a competition-based reverse innovation challenge could mobilize and stimulate current and future leaders to identify and lead potential reverse innovation projects that address health system challenges in Canada. An open call for applications took place over a 4-month period. Applicants were enticed to submit to the competition with a $50,000 prize for the top submission to finance their project. Leaders from a wide cross-section of sectors collectively developed evaluation criteria and graded the submissions. The criteria evaluated: proof of concept, potential value, financial impact, feasibility, and scalability as well as the use of prize money and innovation team. The competition received 12 submissions from across Canada that identified potential reverse innovations from 18 unique geographical locations that were considered developing and/or emerging markets. The various submissions addressed health system challenges relating to education, mobile health, aboriginal health, immigrant health, seniors health and women's health and wellness. Of the original 12 submissions, 5 finalists were chosen and publically profiled, and 1 was chosen to receive the top prize. The results of this initiative demonstrate that a competition that is targeted to reverse innovation does have the potential to mobilize and stimulate leaders to identify reverse innovations that have the potential for system level impact. The competition also provided important insights into the capacity of Canadian students, health care providers, entrepreneurs, and innovators to propose and implement reverse innovation in the context of the

  2. Defects and Improvements in the Current Accounting System of Medical and Health Organizations%现行医疗卫生机构会计制度中存在的缺陷与改进意见

    Institute of Scientific and Technical Information of China (English)

    刘洋

    2015-01-01

    The hospital financial accounting system plays an essential role in hospital management. Since the new century, the state has deepened the reform of medical system, so strengthening the hospital financial accounting management to im-prove the overall benefit of the hospital become the inevitable requirement for hospital to achieve sustainable development. The existing hospital financial accounting system is an important content of reform of hospital accounting work, which can makes the hospital is more adapt to the development of market economy, and improve hospital financial management and supervision level, to give a standard to the hospital financial behavior. In the process of hospital management, it is also the important way to realize the integration of hospital accounting and international practice and realize the modernization.. The main defects in the current hospital finance and accounting system in the presence of analysis, combined with the actual situation, put forward effective suggestions and realize the modernization and informationization of hospital accounting work, promote the further development of the hospital management.%医院财务会计制度工作在医院管理中始终扮演着必不可少的角色。新世纪以来,国家不断深化医疗体制改革,因此加强医院财务会计管理提高医院的总体效益成为医院实现可持续发展的必然要求。现行医院财务会计制度是医院会计工作的重要改革内容,其可以促使医院更加适应市场经济的发展,并且提高医院财务管理与监督水平,对医院财务行为予以规范。在医院经营过程中,其也是实现医院会计和国际惯例接轨、实现现代化的重要途径。该研究主要对现行医院财务会计制度中存在的缺陷进行分析,结合实际情况,提出有效的改进意见,实现医院会计工作的现代化、信息化,促进医院经营的进一步发展。

  3. [Information systems in health and health indicators: an integrating perspective].

    Science.gov (United States)

    Canela-Soler, Jaume; Elvira-Martínez, David; Labordena-Barceló, María Jesús; Loyola-Elizondo, Enrique

    2010-02-01

    Health Information Systems (HIS) are the core support to decision-making in health organizations. Within HIS, health indicators (HI) reflect, numerically, events measured in the health-illness continuum. The integrated health information system is intended to standardize, integrate and organize all the information available in health information systems through an accessible and secure repository, and to conveniently distribute information for decision-making. To standardize information it is necessary to define standards and semantic information to enable us to identify concepts and relate them uniquely to each other. The definition of a catalog of entities (DEA) with concepts, attributes and domains will enable the configuration of the information system, so there will be a catalog of entities (concepts of information and domains). Based on operational systems, analytical systems enabling management and strategy in the management of organizations will be built. The maximum level of analysis is the Balanced Score Card (BSC), which is established as the strategic tool for managers. It is necessary for the organization an integrated information system to plan, manage, evaluate and therefore provide managers with a decision tool for strategic and tactical decision-making in short and medium term. 2010 Elsevier España S.L. All rights reserved.

  4. Primary health care and public health: foundations of universal health systems.

    Science.gov (United States)

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable.

  5. Reforms of health care system in Romania

    NARCIS (Netherlands)

    Bara, AC; van den Heuvel, WJA; Maarse, JAM; Bara, Ana Claudia; Maarse, Johannes A.M.

    Aim. To describe health care reforms and analyze the transition of the health care system in Romania in the 1989-2001 period. Method. We analyzed policy documents, political intentions and objectives of health care reform, described new legislation, and presented changes in financial resources of

  6. Reforms of health care system in Romania

    NARCIS (Netherlands)

    Bara, AC; van den Heuvel, WJA; Maarse, JAM; Bara, Ana Claudia; Maarse, Johannes A.M.

    2002-01-01

    Aim. To describe health care reforms and analyze the transition of the health care system in Romania in the 1989-2001 period. Method. We analyzed policy documents, political intentions and objectives of health care reform, described new legislation, and presented changes in financial resources of th

  7. Participation in a trauma-focused epidemiological investigation may result in sensitization for current health problems

    NARCIS (Netherlands)

    Verschuur, M.J.; Spinhoven, Ph.; van Emmerik, A.A.P.; Rosendaal, F.R.

    2008-01-01

    Objectives - Participation in health survey research may result in a worsening of self-assessed health status and enhanced service-use by increasing self-awareness of current health status. The present study investigated whether participation in a traumafocused epidemiological study sensitized parti

  8. Opening up mental health service delivery to cultural diversity: current situation, development and examples from three northern European countries.

    Science.gov (United States)

    Bäärnhielm, Sofie; Jávo, Cecilie; Mösko, Mike-Oliver

    2013-01-01

    There are inequalities in health among migrants and local populations in Europe. Due to migration, Germany, Norway and Sweden have become ethnic culturally diverse nations. There are barriers to mental health care access for refugees, migrants and minorities, and problems with quality of culturally sensitive care in the three countries. This is despite tax-funded health care systems based on equity in service provision. There is a need to develop culturally sensitive mental health services that respond to the increasing diversity of the populations. In this chapter, we will take a closer look at cultural diversity in the countries in question, discuss challenges and give examples of current work to open up mental health services to cultural diversity. The German example will focus on the movement of Interkulturelle Öffnung (cross-cultural opening of the health care system) and work on creating national guidelines and quality standards. From Norway, the work of the National Centre for Mental Health for the indigenous Sámi population will be presented. The Swedish example will focus on the work carried out by the Transcultural Centre. The latter is a competence centre supporting development of culturally sensitive care as an integrated part of the regional health and mental health care system in Stockholm. Finally, the relevance of mental health care for a culturally diverse population, as a part of the larger social project of building tolerant multicultural societies, will be discussed.

  9. Genetic Analyses in Health Laboratories: Current Status and Expectations

    Science.gov (United States)

    Finotti, Alessia; Breveglieri, Giulia; Borgatti, Monica; Gambari, Roberto

    Genetic analyses performed in health laboratories involve adult patients, newborns, embryos/fetuses, pre-implanted pre-embryos, pre-fertilized oocytes and should meet the major medical needs of hospitals and pharmaceutical companies. Recent data support the concept that, in addition to diagnosis and prognosis, genetic analyses might lead to development of personalized therapy. Novel frontiers in genetic testing involve the development of single cell analyses and non-invasive assays, including those able to predict outcome of cancer pathologies by looking at circulating tumor cells, DNA, mRNA and microRNAs. In this respect, PCR-free diagnostics appears to be one of the most interesting and appealing approaches.

  10. Tidal current turbine based on hydraulic transmission system

    Institute of Scientific and Technical Information of China (English)

    Hong-wei LIU; Wei LI; Yong-gang LIN; Shun MA

    2011-01-01

    Tidal current turbines (TCTs) are newly developed electricity generating devices.Aiming at the stabilization of the power output of TCTs,this paper introduces the hydraulic transmission technologies into TCTs.The hydrodynamics of the turbine was analyzed at first and its power output characteristics were predicted.A hydraulic power transmission system and a hydraulic pitch-controlled system were designed.Then related simulations were conducted.Finally,a TCT prototype was manufactured and tested in the workshop.The test results have confirmed the correctness of the current design and availability of installation of the hydraulic system in TCTs.

  11. Modeling and strain gauging of eddy current repulsion deicing systems

    Science.gov (United States)

    Smith, Samuel O.

    1993-01-01

    Work described in this paper confirms and extends work done by Zumwalt, et al., on a variety of in-flight deicing systems that use eddy current repulsion for repelling ice. Two such systems are known as electro-impulse deicing (EIDI) and the eddy current repulsion deicing strip (EDS). Mathematical models for these systems are discussed for their capabilities and limitations. The author duplicates a particular model of the EDS. Theoretical voltage, current, and force results are compared directly to experimental results. Dynamic strain measurements results are presented for the EDS system. Dynamic strain measurements near EDS or EIDI coils are complicated by the high magnetic fields in the vicinity of the coils. High magnetic fields induce false voltage signals out of the gages.

  12. The VA Maryland Health Care System's telemental health program.

    Science.gov (United States)

    Koch, Edward F

    2012-05-01

    The VA Maryland Health Care System introduced videoconferencing technology to provide psychiatry, evidenced-based psychotherapy, case management, and patient education at rural clinics where it was difficult to recruit providers. Telemental health services enable rural clinics to offer additional services, such as case management and patient education. Services have been expanded to urban outpatient clinics where a limited number of mental health clinic hours are available. This technology expands the availability of mental health providers and services, allowing patients to receive services from providers located at distant medical centers.

  13. Structural health monitoring using genetic fuzzy systems

    CERN Document Server

    Pawar, Prashant M

    2014-01-01

    The high profile of structural health monitoring (SHM) will add urgency to this detailed treatment of intelligent SHM development and implementation via the evolutionary system, which uses a genetic algorithm to automate the development of the fuzzy system.

  14. Systems Biology and Health Systems Complexity in;

    NARCIS (Netherlands)

    Donald Combs, C.; Barham, S.R.; Sloot, P.M.A.

    2016-01-01

    Systems biology addresses interactions in biological systems at different scales of biological organization, from the molecular to the cellular, organ, organism, societal, and ecosystem levels. This chapter expands on the concept of systems biology, explores its implications for individual patients

  15. [Health care systems and impossibility theorems].

    Science.gov (United States)

    Penchas, Shmuel

    2004-02-01

    Health care systems, amongst the most complicated systems that serve mankind, have been in turmoil for many years. They are characterized by widespread dissatisfaction, repeated reforms and a general perception of failure. Is it possible that this abominable situation derives from underlying causes, which are inherent to the most basic elements of these systems? Those elements compromise the use of words and definitions in the formulation of their principles and their way of action, in their logical structure as well as in the social order in which they exist. An in-depth investigation of these elements raises findings that may negate the basic feasibility of the success of such complex systems, as currently known in the western world. One of the main elements of the democratic regime is its system of decision/choice making, i.e. the majority vote. But, already in the nineteenth century, it was discovered that a majority was an intransitive ordering and did not produce a consistent definition of a preference. The Marquis of Condorcet in his famous 1785 "Essai sur l'application de l'analyse a la probabilite des decisions rendues a la plurite des voix", clearly demonstrated that majority decisions might lead to intransitivity and an indeterminancy in social choices. On the basis of his discoveries, it was later shown that legislative rules may lead to the choice of a proposal that is actually opposed by the majority, or to a deadlock and therefore, to socially undesirable implications. Subsequent to these theories of Condorcet, which became known as "The Paradox of Condorcet", many papers were published in the 19th and 20th centuries regarding the issue of problems dealing with individual preferences leading to social order--a complex procedure of, amongst others, aggregation in a defined axiomatic framework. During the twentieth century it became astoundingly manifest that certain issues, although correctly attacked logically, could not be resolved. Two such famous

  16. [Health for All-Italia: an indicator system on health].

    Science.gov (United States)

    Burgio, Alessandra; Crialesi, Roberta; Loghi, Marzia

    2003-01-01

    The Health for All - Italia information system collects health data from several sources. It is intended to be a cornerstone for the achievement of an overview about health in Italy. Health is analyzed at different levels, ranging from health services, health needs, lifestyles, demographic, social, economic and environmental contexts. The database associated software allows to pin down statistical data into graphs and tables, and to carry out simple statistical analysis. It is therefore possible to view the indicators' time series, make simple projections and compare the various indicators over the years for each territorial unit. This is possible by means of tables, graphs (histograms, line graphs, frequencies, linear regression with calculation of correlation coefficients, etc) and maps. These charts can be exported to other programs (i.e. Word, Excel, Power Point), or they can be directly printed in color or black and white.

  17. Reforming the health care system: implications for health care marketers.

    Science.gov (United States)

    Petrochuk, M A; Javalgi, R G

    1996-01-01

    Health care reform has become the dominant domestic policy issue in the United States. President Clinton, and the Democratic leaders in the House and Senate have all proposed legislation to reform the system. Regardless of the plan which is ultimately enacted, health care delivery will be radically changed. Health care marketers, given their perspective, have a unique opportunity to ensure their own institutions' success. Organizational, managerial, and marketing strategies can be employed to deal with the changes which will occur. Marketers can utilize personal strategies to remain proactive and successful during an era of health care reform. As outlined in this article, responding to the health care reform changes requires strategic urgency and action. However, the strategies proposed are practical regardless of the version of health care reform legislation which is ultimately enacted.

  18. Dairy products on metabolic health: current research and clinical implications.

    Science.gov (United States)

    Da Silva, Marine S; Rudkowska, Iwona

    2014-03-01

    Dairy products have been thought to have a beneficial role in the metabolic syndrome (MetS). MetS constitutes a cluster of risk factors for an increased mortality, including obesity, impaired glucose homeostasis, hypertension and atherogenic dyslipidemia. Individuals with MetS are also often in a chronic, low-grade inflammatory state. The objective of this review is to examine recent meta-analyses and clinical studies on the association between dairy products consumption and these MetS risk factors. Findings from studies demonstrate that weight loss related to dairy product intake is due to the combination of an energy-restricted diet with consumption of dairy products. Further, a limited number of studies have shown beneficial effects of dairy consumption on plasma lipids, blood pressure, glucose homeostasis or inflammatory and oxidative stress profiles. Overall, this review article suggests that adults should consume at least 2-3 servings of dairy products per day within a well-balanced diet and a healthy lifestyle for metabolic health. Yet, higher dairy product consumption may have additional beneficial effects, but more well-designed intervention studies are needed to ascertain these effects.

  19. Current status of yoga in mental health services.

    Science.gov (United States)

    Varambally, Shivarama; Gangadhar, B N

    2016-06-01

    Yoga (derived from 'yuj' which means to yoke together or unite) has been used for millennia as a tool for self-improvement, with the ultimate goal of uniting the individual consciousness with the universal. The physical elements of yoga, although seen as necessary in the path to achieve the goal, they were not considered as the endpoint for a practitioner. Sage Patanjali, who codified the practices into an eight-limbed model (Ashtanga yoga) in the Patanjali Yoga Sutras, makes it clear that the target of yoga is primarily the mind. However, in the modern world, yoga practices have become immensely popular as aids to improve health. Yoga-based practices are being extensively used as therapeutic ingredients, alone or as adjuncts to other therapies in a variety of disorders, both physical and mental. There is now strong evidence to suggest that yoga-based interventions are beneficial in several lifestyle disorders. Recent research has also shown significant benefits in mental disorders such as depression, anxiety, and psychosis. This paper discusses the place of yoga as one of the therapeutic strategies in the holistic approach to mental disorders, and the challenges inherent to research in this area.

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

    Science.gov (United States)

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

    2016-05-01

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

  1. Scaling Health Information Systems in Developing Countries

    DEFF Research Database (Denmark)

    Mengiste, Shegaw Anagaw; Neilsen, Petter

    2006-01-01

    This article addresses the issues of scaling health information system in the context of developing countries by taking a case study from Ethiopia. Concepts of information infrastructure have been used as an analytical lens to better understand scaling of Health Information systems. More...

  2. Mapping and Mitigating the International Rip Current Health Hazard

    Science.gov (United States)

    Trimble, S. M.; Houser, C.

    2016-12-01

    Rip currents are concentrated seaward flows of water originating in the surf zones of beaches. Rips cause hundreds of international drownings each year. Calculating exact numbers is barred by logistical difficulties in obtaining accurate incident reports, but annual rip current fatalities are estimated at 100, 53 and 21 in the United States (US), Costa Rica, and Australia respectively. Notably, Australia's lifeguards rescue 17,600 swimmers from rips each year. This project addresses the geophysical, social, and systematic causes of fatalities in hopes of decreasing the global number of rip-related deaths. We demonstrate a novel method for mapping bathymetry in the surf zone (20m deep or less), specifically within rip channels (topographic low spots in the nearshore that result from feedback amongst waves, substrate, and antecedent bathymetry). We calculate bathymetry using 8-band multispectral imagery from the Digital Globe WorldView2 (WV2) satellite and field measurements of depth, generating maps of the changing nearshore at two embayed, rip-prone beaches: Playa Cocles, Costa Rica, and Bondi Beach, Australia. WV2 has a 1.1 day pass-over rate with 1.84m ground pixel resolution of 8 bands, including `yellow' (585-625 nm) and `coastal blue' (400-450 nm). Methods are tested for consistency amongst dates and locations. Previous research shows drownings result from a combination of the physical environment with personal and group behaviors; for this reason we build on rip-detection by evaluating tourists' and locals' knowledge and understanding of their beach's rip behavior. By combining the geomorphologic maps developed from WV2 with interview data, we evaluate how the physical environment dictates the exposure of certain swimmers. Controls include rip channel location, beach access points, and environmental factors favored by swimmers. The project serves as an evaluation of the landscape's creation of a physical feature that becomes a hazard when vulnerable humans

  3. On residents’ satisfaction with community health services after health care system reform in Shanghai, China, 2011

    Directory of Open Access Journals (Sweden)

    Li Zhijian

    2012-06-01

    Full Text Available Abstract Background Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents’ satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Methods Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents’ satisfaction. Results Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1 the health insurance system; 2 essential drugs; 3 basic clinical services; and 4 public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied and the public health/preventive services (average score=3.62; but less satisfied with the provision of essential drugs (average score=3.20 and health insurance schemes (average score=3.23. The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes had overall poorer satisfaction levels on these four aspects of health care (P Conclusion The respondents showed more satisfaction with the clinical services (average score=3.79 and public health services/interventions (average score=3.79; and less satisfaction with the health insurance system (average score=3.23 and the essential drug system

  4. Anesthesia information management systems marketplace and current vendors.

    Science.gov (United States)

    Stonemetz, Jerry

    2011-09-01

    This article addresses the brief history of anesthesia information management systems (AIMS) and discusses the vendors that currently market AIMS. The current market penetration based on the information provided by these vendors is presented and the rationale for the purchase of AIMS is discussed. The considerations to be evaluated when making a vendor selection are also discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. ARRAY PULSED EDDY CURRENT IMAGING SYSTEM USED TO DETECT CORROSION

    Institute of Scientific and Technical Information of China (English)

    Yang Binfeng; Luo Feilu; Cao Xiongheng; Xu Xiaojie

    2005-01-01

    A theory model is established to describe the voltage-current response function. The peak amplitude and the zero-crossing time of the transient signal is extracted as the imaging features, array pulsed eddy current (PEC) imaging is proposed to detect corrosion. The test results show that this system has the advantage of fast scanning speed, different imaging mode and quantitative detection, it has a broad application in the aviation nondestructive testing.

  6. Nonequilibrium Microscopic Distribution of Thermal Current in Particle Systems

    KAUST Repository

    Yukawa, Satoshi

    2009-02-15

    A nonequilibrium distribution function of microscopic thermal current is studied by a direct numerical simulation in a thermal conducting steady state of particle systems. Two characteristic temperatures of the thermal current are investigated on the basis of the distribution. It is confirmed that the temperature depends on the current direction; Parallel temperature to the heat-flux is higher than antiparallel one. The difference between the parallel temperature and the antiparallel one is proportional to a macroscopic temperature gradient. ©2009 The Physical Society of Japan.

  7. Mental Health Care in Nepal : Current Situation and Challenges for Development of a District Mental Health Care Plan

    NARCIS (Netherlands)

    Luitel, N.P., Jordans, M.J.D., Adhikari, Al, Upadhaya, N.P., Hanlon, C., Lund, C. & Komproe, I.H.

    2015-01-01

    Background Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of

  8. Mental health care in Nepal : current situation and challenges for development of a district mental health care plan

    NARCIS (Netherlands)

    Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H|info:eu-repo/dai/nl/142349321

    2015-01-01

    BACKGROUND: Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus

  9. Output Current Ripple Reduction Algorithms for Home Energy Storage Systems

    Directory of Open Access Journals (Sweden)

    Jin-Hyuk Park

    2013-10-01

    Full Text Available This paper proposes an output current ripple reduction algorithm using a proportional-integral (PI controller for an energy storage system (ESS. In single-phase systems, the DC/AC inverter has a second-order harmonic at twice the grid frequency of a DC-link voltage caused by pulsation of the DC-link voltage. The output current of a DC/DC converter has a ripple component because of the ripple of the DC-link voltage. The second-order harmonic adversely affects the battery lifetime. The proposed algorithm has an advantage of reducing the second-order harmonic of the output current in the variable frequency system. The proposed algorithm is verified from the PSIM simulation and experiment with the 3 kW ESS model.

  10. Can we solve current problems with nursing information systems?

    NARCIS (Netherlands)

    Goossen, WTF; Epping, PJMM; Dassen, TWN; Hasman, A; vandenHeuvel, WJA

    1997-01-01

    Dutch nurses are confronted with health care information systems quite often. However, they do not take full advantage of electronic support for their care activities and professional development. The nursing process is often considered the core of nursing care delivery and guides the documentation

  11. Current situation of health care in India and corporation in emerging economies--what is the way forward?

    Science.gov (United States)

    Surendra, Kumar; Amit, Sengupta; Kumar, Agarwal Vishnu

    2012-01-01

    In this study, we examine the management and operational problems faced by different categories of health care delivery platforms such as corporate hospitals, medium level private hospitals and public hospitals in Mumbai. Some suggestions are made and we believe many of the short falls or limitations that exist in the current set up can be removed and a way forward can be made in alleviating the suffering of vast majority of humankind living in our mega cities. Three major issues emerged as far as a public health system is concerned--that is shifting of trained health manpower from the public system to private or corporate hospitals, severe strain on the public health system's infrastructure and support services compounded by lack of accountability as far as management and governance are concerned.

  12. Evaluation of Current Controllers for Distributed Power Generation Systems

    DEFF Research Database (Denmark)

    Timbus, Adrian; Liserre, Marco; Teodorescu, Remus

    2009-01-01

    This paper discusses the evaluation of different current controllers employed for grid-connected distributed power generation systems having variable input power, such as wind turbines and photovoltaic systems. The focus is mainly set on linear controllers such as proportional....... First, in steady-state conditions, the contribution of controllers to the total harmonic distortion of the grid current is pursued. Further on, the behavior of controllers in the case of transient conditions like input power variations and grid voltage faults is also examined. Experimental results...

  13. Modelling system level health information exchange: an ontological approach.

    Science.gov (United States)

    McMurray, J; Zhu, L; McKillop, I; Chen, H

    2015-01-01

    Investment of resources to purposively improve the movement of information between health system providers is currently made with imperfect information. No inventories of system-level digital information flows currently exist, nor do measures of inter-organizational electronic information. exchange (HIE). Using Protégé 4, an open-source OWL Web ontology language editor and knowledge-based framework we formalized a model that decomposes inter-organizational electronic health information flow into derivative concepts such as diversity, breadth, volume, structure, standardization and connectivity. Self-reported data from a regional health system is used to measure HIE; the ontology identifies providers with low and high HIE, useful for planners, and using a related database is used to monitor data quality.

  14. Health Information Management System for Elderly Health Sector: A Qualitative Study in Iran

    Science.gov (United States)

    Sadoughi, Farahnaz; Shahi, Mehraban; Ahmadi, Maryam; Davaridolatabadi, Nasrin

    2016-01-01

    Background: There are increasing change and development of information in healthcare systems. Given the increase in aging population, managers are in need of true and timely information when making decision. Objectives: The aim of this study was to investigate the current status of the health information management system for the elderly health sector in Iran. Materials and Methods: This qualitative study was conducted in two steps. In the first step, required documents for administrative managers were collected using the data gathering form and observed and reviewed by the researcher. In the second step, using an interview guide, the required information was gathered through interviewing experts and faculty members. The convenience, purposeful and snowball sampling methods were applied to select interviewees and the sampling continued until reaching the data saturation point. Finally, notes and interviews were transcribed and content analysis was used to analyze them. Results: The results of the study showed that there was a health information management system for the elderly health sector in Iran. However, in all primary health care centers the documentation of data was done manually; the data flow was not automated; and the analysis and reporting of data are also manually. Eventually, decision makers are provided with delayed information. Conclusions: It is suggested that the steward of health in Iran, the ministry of health, develops an appropriate infrastructure and finally puts a high priority on the implementation of the health information management system for elderly health sector in Iran. PMID:27186383

  15. Mental health system historians: adults with schizophrenia describe changes in community mental health care over time.

    Science.gov (United States)

    Stein, Catherine H; Leith, Jaclyn E; Osborn, Lawrence A; Greenberg, Sarah; Petrowski, Catherine E; Jesse, Samantha; Kraus, Shane W; May, Michael C

    2015-03-01

    This qualitative study examined changes in community mental health care as described by adults diagnosed with schizophrenia with long-term involvement in the mental health system to situate their experiences within the context of mental health reform movements in the United States. A sample of 14 adults with schizophrenia who had been consumers of mental health services from 12 to 40 years completed interviews about their hospital and outpatient experiences over time and factors that contributed most to their mental health. Overall, adults noted gradual changes in mental health care over time that included higher quality of care, more humane treatment, increased partnership with providers, shorter hospital stays, and better conditions in inpatient settings. Regardless of the mental health reform era in which they were hospitalized, participants described negative hospitalization experiences resulting in considerable personal distress, powerlessness, and trauma. Adults with less than 27 years involvement in the system reported relationships with friends and family as most important to their mental health, while adults with more than 27 years involvement reported mental health services and relationships with professionals as the most important factors in their mental health. The sample did not differ in self-reported use of services during their initial and most recent hospitalization experiences, but differences were found in participants' reported use of outpatient services over time. Findings underscore the importance of the lived experience of adults with schizophrenia in grounding current discourse on mental health care reform.

  16. Household portfolio choices, health status and health care systems: A cross-country analysis based on SHARE.

    Science.gov (United States)

    Atella, Vincenzo; Brunetti, Marianna; Maestas, Nicole

    2012-05-01

    Health risk is increasingly viewed as an important form of background risk that affects household portfolio decisions. However, its role might be mediated by the presence of a protective full-coverage national health service that could reduce households' probability of incurring current and future out-of-pocket medical expenditures. We use SHARE data to study the influence of current health status and future health risk on the decision to hold risky assets, across ten European countries with different health systems, each offering a different degree of protection against out-of-pocket medical expenditures. We find robust empirical evidence that perceived health status matters more than objective health status and, consistent with the theory of background risk, health risk affects portfolio choices only in countries with less protective health care systems. Furthermore, portfolio decisions consistent with background risk models are observed only with respect to middle-aged and highly-educated investors.

  17. The contribution of childhood circumstances, current circumstances and health behaviour to educational health differences in early adulthood

    Directory of Open Access Journals (Sweden)

    Härkänen Tommi

    2009-05-01

    Full Text Available Abstract Background The life course approach emphasises the contribution of circumstances in childhood and youth to adult health inequalities. However, there is still a lot to know of the contribution of living conditions in childhood and youth to adult health inequalities and how later environmental and behavioural factors are connected with the effects of earlier circumstances. This study aims to assess a how much childhood circumstances, current circumstances and health behaviour contribute to educational health differences and b to which extent the effect of childhood circumstances on educational health differences is shared with the effects of later living conditions and health behaviour in young adults. Methods The data derived from the Health 2000 Survey represent the Finnish young adults aged 18–29 in 2000. The analyses were carried out on 68% (n = 1282 of the sample (N = 1894. The cross-sectional data based on interviews and questionnaires include retrospective information on childhood circumstances. The outcome measure was poor self-rated health. Results Poor self-rated health was much more common among subjects with primary education only than among those in the highest educational category (OR 4.69, 95% CI 2.63 to 8.62. Childhood circumstances contributed substantially (24% to the health differences between these educational groups. Nearly two thirds (63% of this contribution was shared with behavioural factors adopted by early adulthood, and 17% with current circumstances. Health behaviours, smoking especially, were strongly contributed to educational health differences. Conclusion To develop means for avoiding undesirable trajectories along which poor health and health differences develop, it is necessary to understand the pathways to health inequalities and know how to improve the living conditions of families with children.

  18. Current status of health technology reassessment of non-drug technologies: survey and key informant interviews

    Directory of Open Access Journals (Sweden)

    Leggett Laura E

    2012-12-01

    Full Text Available Abstract Background Health Technology Reassessment (HTR is a structured, evidence-based assessment of the clinical, social, ethical and economic effects of a technology currently used in the health care system, to inform optimal use of that technology in comparison to its alternatives. Little is known about current international HTR practices. The objective of this research was to summarize experience-based information gathered from international experts on the development, initiation and implementation of a HTR program. Methods A mixed methods approach, using a survey and in-depth interviews, was adopted. The survey covered 8 concepts: prioritization/identification of potentially obsolete technologies; program development; implementation; mitigation; program championing; stakeholder engagement; monitoring; and reinvestment. Members of Health Technology Assessment International (HTAi and the International Network of Agencies for Health Technology Assessment (INAHTA formed the sampling frame. Participation was solicited via email and the survey was administered online using SurveyMonkey. Survey results were analyzed using descriptive statistics. To gather more in-depth knowledge, semi-structured interviews were conducted among organizations with active HTR programs. Interview questions were developed using the same 8 concepts. The hour-long interviews were recorded, transcribed and analyzed using constant comparative analysis. Results Ninety-five individuals responded to the survey: 49 were not discussing HTR, 21 were beginning to discuss HTR, nine were imminently developing a program, and 16 participants had programs and were completing reassessments. The survey results revealed that methods vary widely and that although HTR is a powerful tool, it is currently not being used to its full potential. Of the 16 with active programs, nine agreed to participate in follow-up interviews. Interview participants identified early and extensive stakeholder

  19. Consultation on the Libyan health systems: towards patient-centred services

    Directory of Open Access Journals (Sweden)

    Reida M. El Oakley

    2013-01-01

    Full Text Available The extra demand imposed upon the Libyan health services during and after the Libyan revolution in 2011 led the ailing health systems to collapse. To start the planning process to re-engineer the health sector, the Libyan Ministry of Health in collaboration with the World Health Organisation (WHO and other international experts in the field sponsored the National Health Systems Conference in Tripoli, Libya, between the 26th and the 30th of August 2012. The aim of this conference was to study how health systems function at the international arena and to facilitate a consultative process between 500 Libyan health experts in order to identify the problems within the Libyan health system and propose potential solutions. The scientific programme adopted the WHO health care system framework and used its six system building blocks: i Health Governance; ii Health Care Finance; iii Health Service Delivery; iv Human Resources for Health; v Pharmaceuticals and Health Technology; and vi Health Information System. The experts used a structured approach starting with clarifying the concepts, evaluating the current status of that health system block in Libya, thereby identifying the strengths, weaknesses, and major deficiencies. This article summarises the 500 health expert recommendations that seized the opportunity to map a modern health systems to take the Libyan health sector into the 21st century.

  20. [Use of geographic information systems in public health].

    Science.gov (United States)

    Morozova, L F

    2014-01-01

    To enhance the efficiency of epidemiological surveillance by the countrywide use of current information telecommunication technologies, diagnostic systems based on monitoring is one of the tasks of the Russian Federal Service for Consumer Rights Protection and Human Health Control in the control and prevention of parasitic diseases. The epidemiological surveillance system for parasitosis encompasses not only the monitoring and assessment of the situation, but also necessary measures if epidemic complications occur. Geographic information systems (GIS) may be successfully used for this purpose. GIS-based interactive health atlases have been created and put on the Internet and researches made.

  1. Unraveling Uses and Effects of an Interactive Health Communication System

    Science.gov (United States)

    Han, Jeong Yeob; Hawkins, Robert P.; Shaw, Bret R.; Pingree, Suzanne; McTavish, Fiona; Gustafson, David H.

    2012-01-01

    By developing a number of measures distinguishing amount, type of content, and when and how that content is used, the current study revealed effective patterns of use that are associated with quality of life benefits during an eHealth intervention. Results generally suggest that the benefits depend on how a patient uses the system, far more than on sheer amount of exposure or even what type of content is chosen. The next generation of eHealth system should focus on providing new and varying content over time, but even more on encouraging intensity of use and long-term commitment to the system. PMID:23172985

  2. Welcome to health information science and systems.

    Science.gov (United States)

    Zhang, Yanchun

    2013-01-01

    Health Information Science and Systems is an exciting, new, multidisciplinary journal that aims to use technologies in computer science to assist in disease diagnoses, treatment, prediction and monitoring through the modeling, design, development, visualization, integration and management of health related information. These computer-science technologies include such as information systems, web technologies, data mining, image processing, user interaction and interface, sensors and wireless networking and are applicable to a wide range of health related information including medical data, biomedical data, bioinformatics data, public health data.

  3. Ontology-driven health information systems architectures.

    Science.gov (United States)

    Blobel, Bernd; Oemig, Frank

    2009-01-01

    Following an architecture vision such as the Generic Component Model (GCM) architecture framework, health information systems for supporting personalized care have to be based on a component-oriented architecture. Representing concepts and their interrelations, the GCM perspectives system architecture, domains, and development process can be described by the domains' ontologies. The paper introduces ontology principles, ontology references to the GCM as well as some practical aspects of ontology-driven approaches to semantically interoperable and sustainable health information systems.

  4. Digital health and the challenge of health systems transformation.

    Science.gov (United States)

    Alami, Hassane; Gagnon, Marie-Pierre; Fortin, Jean-Paul

    2017-01-01

    Information and communication technologies have transformed all sectors of society. The health sector is no exception to this trend. In light of "digital health", we see multiplying numbers of web platforms and mobile health applications, often brought by new unconventional players who produce and offer services in non-linear and non-hierarchal ways, this by multiplying access points to services for people. Some speak of a "uberization" of healthcare. New realities and challenges have emerged from this paradigm, which question the abilities of health systems to cope with new business and economic models, governance of data and regulation. Countries must provide adequate responses so that digital health, based increasingly on disruptive technologies, can benefit for all.

  5. Periodontal Disease and Systemic Health

    Science.gov (United States)

    ... Gum Disease and Other Diseases Gum Disease and Diabetes Gum Disease and Heart Disease Gum Disease and Other Systemic ... Gum Disease and Other Diseases Gum Disease and Diabetes Gum Disease and Heart Disease Gum Disease and Other Systemic ...

  6. Alternating Current All-electrical Gun Control System in Tanks

    Directory of Open Access Journals (Sweden)

    Zang Kemao

    2004-07-01

    Full Text Available The ac all-electrical gun control system is composed of permanent magnetic synchronous machine-drive control systems and the ball-screw by replacing the complicated electrohydraulic systems. At the same time, the variable-structure system with sliding modes makes the gun control systems to have higher performances using the only rate flexure gyroscope. Thereby, vehicle hull gyroscope and angular gyroscope are left out.The new ac all-electrical gun control systems developed are reduced by 40 per cent in weight, decreased by 30 per cent in volume, increased by 35 per cent in efficiency, and enhanced by three times in service life as compared to the current gun control systems.

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

    Science.gov (United States)

    Fulop, Tamas; Roemer, Milton I.

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

  8. Current fluctuations in stochastic systems with long-range memory

    Energy Technology Data Exchange (ETDEWEB)

    Harris, R J; Touchette, H [School of Mathematical Sciences, Queen Mary University of London, Mile End Road, London, E1 4NS (United Kingdom)], E-mail: rosemary.harris@qmul.ac.uk, E-mail: h.touchette@qmul.ac.uk

    2009-08-28

    We propose a method to calculate the large deviations of current fluctuations in a class of stochastic particle systems with history-dependent rates. Long-range temporal correlations are seen to alter the speed of the large deviation function in analogy with long-range spatial correlations in equilibrium systems. We give some illuminating examples and discuss the applicability of the Gallavotti-Cohen fluctuation theorem. (fast track communication)

  9. [Transforming health systems based on primary care].

    Science.gov (United States)

    Durán-Arenas, Luis; Salinas-Escudero, Guillermo; Granados-García, Víctor; Martínez-Valverde, Silvia

    2012-01-01

    Access to health services is a social basic determinant of health in Mexico unlike what happens in developed countries. The demand for health services is focused on primary care, but the design meets only the supply of hospital care services. So it generates a dissonance between the needs and the effective design of health services. In addition, the term affiliation refers to population contributing or in the recruitment process, that has been counted as members of these social security institutions (SS) and Popular Insurance (SP). In the case of Instituto Mexicano del Seguro Social (IMSS) three of four contributors are in contact with health services; while in the SP, this indicator does not exist. Moreover, the access gap between health services is found in the health care packages so that members of the SS and SP do not have same type of coverage. The question is: which model of health care system want the Mexicans? Primary care represents the first choice for increasing the health systems performance, as well as to fulfill their function of social protection: universal access and coverage based on needs, regardless whether it is a public or private health insurance. A central aspect for development of this component is the definition of the first contact with the health system through the creation of a primary health care team, led by a general practitioner as the responsible of a multidisciplinary health team. The process addresses the concepts of primary care nursing, consumption of inputs (mainly medical drugs), maintenance and general services. Adopting a comprehensive strategy that will benefit all Mexicans equally and without discrimination, this primary care system could be financed with a total operating cost of approximately $ 22,809 million by year.

  10. 3-dimensional current collection model. [of Tethered Satellite System 1

    Science.gov (United States)

    Hwang, Kai-Shen; Shiah, A.; Wu, S. T.; Stone, N.

    1992-01-01

    A three-dimensional, time dependent current collection model of a satellite has been developed for the TSS-1 system. The system has been simulated particularly for the Research of Plasma Electrodynamics (ROPE) experiment. The Maxwellian distributed particles with the geomagnetic field effects are applied in this numerical simulation. The preliminary results indicate that a ring current is observed surrounding the satellite in the equatorial plane. This ring current is found between the plasma sheath and the satellite surface and is oscillating with a time scale of approximately 1 microsec. This is equivalent to the electron plasma frequency. An hour glass shape of electron distribution was observed when the viewing direction is perpendicular to the equatorial plane. This result is consistent with previous findings from Linson (1969) and Antoniades et al. (1990). Electrons that are absorbed by the satellite are limited from the background ionosphere as indicated by Parker and Murphy (1967).

  11. A Neuron Model Based Ultralow Current Sensor System for Bioapplications

    Directory of Open Access Journals (Sweden)

    A. K. M. Arifuzzman

    2016-01-01

    Full Text Available An ultralow current sensor system based on the Izhikevich neuron model is presented in this paper. The Izhikevich neuron model has been used for its superior computational efficiency and greater biological plausibility over other well-known neuron spiking models. Of the many biological neuron spiking features, regular spiking, chattering, and neostriatal spiny projection spiking have been reproduced by adjusting the parameters associated with the model at hand. This paper also presents a modified interpretation of the regular spiking feature in which the firing pattern is similar to that of the regular spiking but with improved dynamic range offering. The sensor current ranges between 2 pA and 8 nA and exhibits linearity in the range of 0.9665 to 0.9989 for different spiking features. The efficacy of the sensor system in detecting low amount of current along with its high linearity attribute makes it very suitable for biomedical applications.

  12. LLNL current meter array--concept and system description

    Energy Technology Data Exchange (ETDEWEB)

    Mantrom, D.D. [Lawrence Livermore National Lab., CA (United States)

    1994-11-15

    A measurement capability using a horizontal array of 10 S4 current meters mounted on a stiff floating structure with 35 m aperture has been developed to support interpretation of radar imaging of surface effects associated with internal waves. This system has been fielded three times and most recently, has collected data alongside the sea-surface footprint of a land-fixed radar imaging ship-generated internal waves. The underlying need for this measurement capability is described. The specifications resulting from this need are presented and the engineering design and deployment procedures of the platform and systems that resulted are described The current meter data are multiplexed along with meteorological and system status data on board the floating platform and are telemetered to a shore station and on to a data acquisition system. The raw data are recorded, and are then processed to form space-time images of current and strain rate (a spatial derivative of the current field). Examples of raw and processed data associated with ship-generated internal waves are presented.

  13. Current Strategic Business Plan for the Implementation of Digital Systems.

    Science.gov (United States)

    Library of Congress, Washington, DC. National Library Service for the Blind and Physically Handicapped.

    This document presents a current strategic business plan for the implementation of digital systems and services for the free national library program operated by the National Library Service for the Blind and Physically Handicapped, Library of Congress, its network of cooperating regional and local libraries, and the United States Postal Service.…

  14. [eHealth and mHealth: current developments in 2014 and perspectives in oncology].

    Science.gov (United States)

    Brouard, Benoît; Bardo, Pascale; Vignot, Marina; Bonnet, Clément; Vignot, Stéphane

    2014-10-01

    New information technologies and communication in health or "eHealth" is a way of improvement for management of chronic diseases. EHealth can improve patient care and care coordination especially in cancer patients who require a multidisciplinary approach. Treatments in oncology are complex and can result in new toxicities. Information of patients and of caregivers is a crucial issue. The patients require to be monitored and the caregivers need up-to-date information. The mobile component of eHealth: the mobile health or "mHealth" could provide to this need. This paper proposes to expose the principles of eHealth and its mobile component mHealth then to discuss their place in the management of cancer, for patients and caregivers.

  15. Breast Health Belief System Study

    Science.gov (United States)

    2001-08-01

    advantages: cultural and geographic familiarity, interinstitutional collaboration , and cost effectiveness in terms of controlling per diem and travel...providers of the significance of beliefs on health practices. Collaborators in this study included Georgia State, Albany State, Fort Valley State, and...Georgia counties. As the map on the following pages shows, many of Georgia’s southern counties are in economic decline. Collaborators are Georgia

  16. Enhancing Health-Care Services with Mixed Reality Systems

    Science.gov (United States)

    Stantchev, Vladimir

    This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.

  17. A Scoping Study on the Ethics of Health Systems Research.

    Science.gov (United States)

    Bachani, Abdulgafoor M; Rattani, Abbas; Hyder, Adnan A

    2016-12-01

    Currently, health systems research (HSR) is reviewed by the same ethical standards as clinical research, which has recently been argued in the literature to be an inappropriate standard of evaluation. The issues unique to HSR warrant a different review by research ethics committees (RECs), as it does not impose the same risks to study participants as other types of clinical or public health research. However, there are limited tools and supporting documents that clarify the ethical considerations. Therefore, there is a need for additional reflection around ethical review of HSR and their consideration by RECs. The purpose of this paper is to review, understand, and synthesize the current state of literature and practice to inform these deliberations and the larger discourse on ethics review guidelines for HSR. This paper presents a review of the literature on ethics of HSR in the biomedical, public health, and implementation research to identify ethical considerations specific to HSR; and to identify examples of commonly available guidance and/or tools for the ethical review of HSR studies. Fifteen articles were identified on HSR ethics issues, and forty-two international academic institutions were contacted (of the responses (n=29), no institution had special ethical guidelines for reviewing HSR) about their HSR ethics review guidelines. There appears to be a clear gap in the current health research ethics discourse around health systems research ethics. This review serves as a first step (to better understand the current status) towards a larger dialogue on the topic.

  18. Convergence creates opportunities across health care system.

    Science.gov (United States)

    Fox, Brent I; Felkey, Bill G

    2014-04-01

    Industrial design students at Auburn do a creativity exercise where they are asked to combine a common household appliance with an animal. Have you seen a snake light? In health technology, we have a similar opportunity. In the connection between jewelry and vital sign monitoring technology or household security and health status monitoring, we are witnessing active convergence that will benefit patients, providers, and health systems.

  19. Cognitive systems engineering in health care

    CERN Document Server

    Bisantz, Ann M; Fairbanks, Rollin J

    2014-01-01

    Cognitive Engineering for Better Health Care Systems, Ann M. Bisantz, Rollin J. Fairbanks, and Catherine M. BurnsThe Role of Cognitive Engineering in Improving Clinical Decision Support, Anne Miller and Laura MilitelloTeam Cognitive Work Analysis as an Approach for Understanding Teamwork in Health Care, Catherine M. BurnsCognitive Engineering Design of an Emergency Department Information System, Theresa K. Guarrera, Nicolette M. McGeorge, Lindsey N. Clark, David T. LaVergne, Zachary A. Hettinger, Rollin J. Fairbanks, and Ann M. BisantzDisplays for Health Care Teams: A Conceptual Framework and Design Methodology, Avi ParushInformation Modeling for Cognitive Work in a Health Care System, Priyadarshini R. PennathurSupport for ICU Clinician Cognitive Work through CSE, Christopher Nemeth, Shilo Anders, Jeffrey Brown, Anna Grome, Beth Crandall, and Jeremy PamplinMatching Cognitive Aids and the "Real Work" of Health Care in Support of Surgical Microsystem Teamwork, Sarah Henrickson Parker and Shawna J. PerryEngageme...

  20. Health education in the Spanish education system

    Directory of Open Access Journals (Sweden)

    Pedrero-García Encarnación

    2017-01-01

    Full Text Available Health education is an instrument of Health Promotion that seeks to influence the development of healthy lifestyles by eliminating risk factors and thus influencing in a positive way the health of the population. One of the objectives of the educational system is to educate for the development of the integral health of the students as well as to provide the appropriate formation so that they have a healthy vital development from a physical perspective like psychological. To this end, the Ministry of Education, Culture and Sport and in collaboration with the Ministry of Health, Social Services and Equality work on the development of actions and the implementation of stable programs of education and health promotion in the school environment With the purpose of fomenting and supporting an educational model directed to the development of the integral health of the whole educative community.

  1. Training of Community Health Agents in health hearing children: current perspectives.

    Science.gov (United States)

    Castro, Taís Teixeira de Oliveira; Zucki, Fernanda

    2015-01-01

    To characterize the training of Community Health Workers in the field of child hearing health. A systematic literature review on Biblioteca Virtual em Saúde (BVS) and Biblioteca Digital de Teses e Dissertações of USP databases was performed. The search strategy was oriented by the specific question: "How have the Community Health Workers been trained to work in the field of child hearing health?" The study selection criteria involved consistency with the proposed theme, belonging to the category of scientific papers, dissertation or thesis, and publication in Brazilian Portuguese. A total of 2,687 studies were found. After analyzing the title and abstract, eight studies were chosen for full reading, however, only four of them met the proposed criteria and were included in the review. The studies indicated live and virtual classes with the use of video conferencing or CD-ROM as training strategies for Community Health Workers. Trainings were effective. Only one questionnaire about hearing and language monitoring was described. Different possibilities for the activities of Community Health Workers were identified. Different learning methodologies have been used for training the Community Health Worker in the field of child hearing health, and all of have proven effective for knowledge acquisition. Community Health Workers play an important role in promoting and monitoring child hearing health.

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

    OpenAIRE

    2015-01-01

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

  3. Self-Organizing Maps-based ocean currents forecasting system

    Science.gov (United States)

    Vilibić, Ivica; Šepić, Jadranka; Mihanović, Hrvoje; Kalinić, Hrvoje; Cosoli, Simone; Janeković, Ivica; Žagar, Nedjeljka; Jesenko, Blaž; Tudor, Martina; Dadić, Vlado; Ivanković, Damir

    2016-03-01

    An ocean surface currents forecasting system, based on a Self-Organizing Maps (SOM) neural network algorithm, high-frequency (HF) ocean radar measurements and numerical weather prediction (NWP) products, has been developed for a coastal area of the northern Adriatic and compared with operational ROMS-derived surface currents. The two systems differ significantly in architecture and algorithms, being based on either unsupervised learning techniques or ocean physics. To compare performance of the two methods, their forecasting skills were tested on independent datasets. The SOM-based forecasting system has a slightly better forecasting skill, especially during strong wind conditions, with potential for further improvement when data sets of higher quality and longer duration are used for training.

  4. Veneto Region, Italy. Health system review.

    Science.gov (United States)

    Toniolo, Franco; Mantoan, Domenico; Maresso, Anna

    2012-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. This HiT is one of the first to be written on a subnational level of government and focuses on the Veneto Region of northern Italy. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Veneto Region is one of Italy's richest regions and the health of its resident population compares favourably with other regions in Italy. Life expectancy for both men and women, now at 79.1 and 85.2 years, respectively, is slightly higher than the national average, while mortality rates are comparable to national ones. The major causes of death are tumours and cardiovascular diseases. Under Italy's National Health Service, the organization and provision of health care is a regional responsibility and regions must provide a nationally defined (with regional input) basic health benefit package to all of their citizens; extra services may be provided if budgets allow. Health care is mainly financed by earmarked central and regional taxes, with regions receiving their allocated share of resources from the National Health Fund. Historically, health budget deficits have been a major problem in most Italian regions, but since the early 2000s the introduction of efficiency measures and tighter procedures on financial management have contributed to a significant decrease in the Veneto Regions health budget deficit.The health system is governed by the Veneto Region government (Giunta) via the Departments of Health and Social Services, which receive technical support from a single General Management Secretariat. Health care is

  5. The current state of electronic consultation and electronic referral systems in Canada: an environmental scan.

    Science.gov (United States)

    Liddy, Clare; Hogel, Matthew; Blazkho, Valerie; Keely, Erin

    2015-01-01

    Access to specialist care is a point of concern for patients, primary care providers, and specialists in Canada. Innovative e-health platforms such as electronic consultation (eConsultation) and referral (eReferral) can improve access to specialist care. These systems allow physicians to communicate asynchronously and could reduce the number of unnecessary referrals that clog wait lists, provide a record of the patient's journey through the referral system, and lead to more efficient visits. Little is known about the current state of eConsultation and eReferral in Canada. The purpose of this work was to identify current systems and gain insight into the design and implementation process of existing systems. An environmental scan approach was used, consisting of a systematic and grey literature review, and targeted semi-structured key informant interviews. Only three eConsultation/eReferral systems are currently in operation in Canada. Four themes emerged from the interviews: eReferral is an end goal for those provinces without an active eReferral system, re-organization of the referral process is a necessity prior to automation, engaging the end-user is essential, and technological incompatibilities are major impediments to progress. Despite the acknowledged need to improve the referral system and increase government spending on health information technology, eConsultation and eReferral systems remain scarce as Canada lags behind the rest of the developed world.

  6. Curing Germany's health care system by mandatory health premia?

    Science.gov (United States)

    Schubert, Stefanie; Schnabel, Reinhold

    2009-09-01

    A current proposal for reforming the German statutory health insurance suggests replacing earnings-related contributions by per-capita health premia. Combining a computable general equilibrium analysis with abundant empirical data on heterogenous household types, we investigate both the distributional and allocative impact of such a reform proposal. Our results indicate efficiency gains in terms of GDP and employment. This is because employed households of all skill types would increase their labour supply. Yet, while these household types would benefit from introducing health premia, others, such as those including pensioners or unemployed individuals, may suffer in terms of equivalent variations, despite tax-financed compensating transfers to these low-income households. Nonetheless, such transfers are an essential part of the reform proposal in order to mitigate redistributional effects. By comparing two different compensation schemes, we find that higher transfers go along with higher GDP and employment. This result may indicate that more redistribution comes at no efficiency costs.

  7. Electronic Health Records and US Public Health: Current Realities and Future Promise

    Science.gov (United States)

    Parrish, R. Gibson; Ross, David A.

    2013-01-01

    Electronic health records (EHRs) could contribute to improving population health in the United States. Realizing this potential will require understanding what EHRs can realistically offer to efforts to improve population health, the requirements for obtaining useful information from EHRs, and a plan for addressing these requirements. Potential contributions of EHRs to improving population health include better understanding of the level and distribution of disease, function, and well-being within populations. Requirements are improved population coverage of EHRs, standardized EHR content and reporting methods, and adequate legal authority for using EHRs, particularly for population health. A collaborative national effort to address the most pressing prerequisites for and barriers to the use of EHRs for improving population health is needed to realize the EHR’s potential. PMID:23865646

  8. Implementing the learning health care system.

    NARCIS (Netherlands)

    Verheij, R.; Barten, D.J.; Hek, K.; Nielen, M.; Prins, M.; Zwaanswijk, M.; Bakker, D. de

    2014-01-01

    Background: As computerisation of primary care facilities is rapidly increasing, a wealth of data is created in routinely recorded electronic health records (EHRs). This data can be used to create a true learning health care system, in which routinely available data are processed and analysed in ord

  9. Quality systems in Dutch health care institutions.

    NARCIS (Netherlands)

    Casparie, A.F.; Sluijs, E.M.; Wagner, C.; Bakker, D.H. de

    1997-01-01

    The implementation of quality systems in Dutch health care was supervised by a national committee during 1990-1995. To monitor the progress of implementation a large survey was conducted in the beginning of 1995. The survey enclosed all subsectors in health care. A postal questionnaire-derived fr

  10. Big Data: Implications for Health System Pharmacy.

    Science.gov (United States)

    Stokes, Laura B; Rogers, Joseph W; Hertig, John B; Weber, Robert J

    2016-07-01

    Big Data refers to datasets that are so large and complex that traditional methods and hardware for collecting, sharing, and analyzing them are not possible. Big Data that is accurate leads to more confident decision making, improved operational efficiency, and reduced costs. The rapid growth of health care information results in Big Data around health services, treatments, and outcomes, and Big Data can be used to analyze the benefit of health system pharmacy services. The goal of this article is to provide a perspective on how Big Data can be applied to health system pharmacy. It will define Big Data, describe the impact of Big Data on population health, review specific implications of Big Data in health system pharmacy, and describe an approach for pharmacy leaders to effectively use Big Data. A few strategies involved in managing Big Data in health system pharmacy include identifying potential opportunities for Big Data, prioritizing those opportunities, protecting privacy concerns, promoting data transparency, and communicating outcomes. As health care information expands in its content and becomes more integrated, Big Data can enhance the development of patient-centered pharmacy services.

  11. Redesigning Health Information Systems in Developing Countries

    DEFF Research Database (Denmark)

    Mengiste, Shegaw Anagaw; Kimaro, Honest; Aanestad, Margunn

    2008-01-01

    Despite widespread aims to strengthen the Health Information System (HIS) as a tool for decentralised health care, there is a strong tendency in most developing countries that the HIS continues to reflect the central level's needs and requirements. The traditional design approach with little...

  12. Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector

    Directory of Open Access Journals (Sweden)

    Abiiro Gilbert

    2012-10-01

    Full Text Available Abstract Background Globally, extending financial protection and equitable access to health services to those outside the formal sector employment is a major challenge for achieving universal coverage. While some favour contributory schemes, others have embraced tax-funded health service cover for those outside the formal sector. This paper critically examines the issue of how to cover those outside the formal sector through the lens of stakeholder views on the proposed one-time premium payment (OTPP policy in Ghana. Discussion Ghana in 2004 implemented a National Health Insurance Scheme, based on a contributory model where service benefits are restricted to those who contribute (with some groups exempted from contributing, as the policy direction for moving towards universal coverage. In 2008, the OTPP system was proposed as an alternative way of ensuring coverage for those outside formal sector employment. There are divergent stakeholder views with regard to the meaning of the one-time premium and how it will be financed and sustained. Our stakeholder interviews indicate that the underlying issue being debated is whether the current contributory NHIS model for those outside the formal employment sector should be maintained or whether services for this group should be tax funded. However, the advantages and disadvantages of these alternatives are not being explored in an explicit or systematic way and are obscured by the considerable confusion about the likely design of the OTPP policy. We attempt to contribute to the broader debate about how best to fund coverage for those outside the formal sector by unpacking some of these issues and pointing to the empirical evidence needed to shed even further light on appropriate funding mechanisms for universal health systems. Summary The Ghanaian debate on OTPP is related to one of the most important challenges facing low- and middle-income countries seeking to achieve a universal health care system. It

  13. [Development and Current Status of the Health Education Curriculum of the German Pension Insurance].

    Science.gov (United States)

    Worringen, Ulrike; Meng, Karin; Bitzer, Eva-Maria; Brandes, Iris; Faller, Hermann

    2017-08-01

    The health education curriculum of the German pension insurance comprises 27 patient education programs that are mostly indication-based. The curriculum aims to support the implementation of patient-oriented patient education in German rehabilitation centers. The effectiveness of several of the educational programs was evaluated in controlled trials with heterogeneous results. Overall, the dissemination of the evaluated programs in rehabilitation practice can be recommended. They constitute an essential part of the overall treatment concept, but are often modified in clinical practice. In particular, the physician led modules are frequently conducted in larger group settings. It is currently considered how these routine working conditions might be reflected in the quality assurance system of the German pension insurance and a cross-organizational conceptual framework. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Social capital to strengthen health policy and health systems.

    Science.gov (United States)

    Ogden, Jessica; Morrison, Ken; Hardee, Karen

    2014-12-01

    This article recounts the development of a model for social capital building developed over the course of interventions focused on HIV-related stigma and discrimination, safe motherhood and reproductive health. Through further engagement with relevant literature, it explores the nature of social capital and suggests why undertaking such a process can enhance health policy and programmes, advocacy and governance for improved health systems strengthening (HSS) outcomes. The social capital process proposed facilitates the systematic and effective inclusion of community voices in the health policy process-strengthening programme effectiveness as well as health system accountability and governance. Because social capital building facilitates communication and the uptake of new ideas, norms and standards within and between professional communities of practice, it can provide an important mechanism for integration both within and between sectors-a process long considered a 'wicked problem' for health policy-makers. The article argues that the systematic application of social capital building, from bonding through bridging into linking social capital, can greatly enhance the ability of governments and their partners to achieve their HSS goals.

  15. Remote forcing of subsurface currents and temperatures near the northern limit of the California Current System

    Science.gov (United States)

    Engida, Zelalem; Monahan, Adam; Ianson, Debby; Thomson, Richard E.

    2016-10-01

    Local and remote wind forcing of upwelling along continental shelves of coastal upwelling regions play key roles in driving biogeochemical fluxes, including vertical net fluxes of carbon and nutrients. These fluxes are responsible for high primary productivity, which in turn supports a lucrative fishery in these regions. However, the relative contributions of local versus remote wind forcing are not well quantified or understood. We present results of coherence analyses between currents at a single mooring site (48.5°N, 126°W) in the northern portion of the California Current System (CalCS) from 1989 to 2008 and coincident time series of North America Regional Reanalysis (NARR) 10 m wind stress within the CalCS (36-54°N, 120-132°W). The two-decade-long current records from the three shallowest depths (35, 100, and 175 m) show a remote response to winds from south as far as 36°N. In contrast, only temperatures at the deepest depth (400 m) show strong coherences with remote winds. Weaker local wind influence is observed in both the currents and 400 m temperatures but is mostly due to the large spatial coherence within the wind field itself. Lack of coherence between distal winds and the 400 m currents suggests that the temperature variations at that depth are driven by vertical motion resulting from poleward travelling coastal trapped waves (CTWs). Understanding the effects of remote forcing in coastal upwelling regions is necessary for determining the occurrence and timing of extreme conditions in coastal oceans, and their subsequent impact on marine ecosystems.

  16. 'I think it will eventually be done away with': Attitudes among healthcare professionals towards the current system of animal experimentation.

    Science.gov (United States)

    Dignon, Andrée

    2016-08-01

    This article describes a study of attitudes to the current system of animal experimentation (for the production of health interventions) among 52 UK healthcare professionals. These healthcare professionals participated in three separate focus groups (of 18, 17 and 17 participants) and were invited to respond to the question 'what is your opinion about the current system of animal testing?' The study focused specifically on their views of the current system (rather than their views of animal testing in general). The healthcare professionals were critical of the current system, particularly with regard to regulation, secrecy, validity, unnecessary suffering and welfare. © The Author(s) 2014.

  17. Architecture for Integrated System Health Management Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Managing the health of vehicle, crew, and habitat systems is a primary function of flight controllers today. We propose to develop an architecture for automating...

  18. Capital structure strategy in health care systems.

    Science.gov (United States)

    Wheeler, J R; Smith, D G; Rivenson, H L; Reiter, K L

    2000-01-01

    The capital structures (the relative use of debt and equity to support assets) of leading health care systems are viewed as a strategic component of their financial plans. While not-for-profit hospitals as a group have maintained nearly constant levels of debt over the past decade, investor-owned hospitals and a group of leading health care systems have reduced their relative use of debt. Chief financial officers indicated that in addition to reducing debt because of less favorable reimbursement incentives, there was a focus on maintaining high bond ratings. Debt levels have not been reduced as sharply in these health care systems as they have in investor-owned hospitals, in part due to the use of debt to support investments in financial markets. Because these health care systems do not have easy access to equity, high bond ratings and solid investment earnings are central to their capital structure policies of preserving access to debt markets.

  19. A situational analysis of ocular health promotion in the South African primary health-care system.

    Science.gov (United States)

    Sithole, Hlupheka Lawrence

    2017-03-01

    South Africa has a serious burden of avoidable blindness and visual impairment, which may be due to poor ocular health promotional policies and programs or implementation. Therefore, this paper sought to critically analyse the South African primary health-care policies and programs, to identify the components of ocular health promotional policies and programs as well as how they are currently being implemented and to suggest areas that can be improved in order to minimise the burden of blindness and visual impairment. Triangulated quantitative and qualitative research methods were used in the study. Questionnaire and interviews were used to solicit data from national and provincial managers of different health directorates. Eye-care managers from each province also completed the questionnaire. Furthermore, relevant health policy and program documents from national and provincial departments of health were studied to identify areas relating to ocular health promotion. The study found varying degrees of implementation of various ocular health promotional activities in the provinces with the majority of respondents (62 per cent) indicating that ocular health promotion was not part of their responsibility and another 81 per cent revealing that vision screening does not form part of their health promotional programs. It further revealed a lack of a dedicated directorate for ocular health-care issues and the absence of an integrated ocular health promotional policy. Ocular health promotional activities were absent in other provinces. This may be a major contributing factor to poor ocular health promotion in South Africa and hence, the high prevalence of blindness and visual impairment. Therefore, it is recommended that an integrated ocular health promotional model (directorate and policies) be developed and be part of the South African primary health-care system. © 2016 Optometry Australia.

  20. Role of government in public health: Current scenario in India and future scope

    Directory of Open Access Journals (Sweden)

    Subitha Lakshminarayanan

    2011-01-01

    Full Text Available The new agenda for Public Health in India includes the epidemiological transition, demographical transition, environmental changes and social determinants of health. Based on the principles outlined at Alma-Ata in 1978, there is an urgent call for revitalizing primary health care in order to meet these challenges. The role of the government in influencing population health is not limited within the health sector but also by various sectors outside the health systems. This article is a literature review of the existing government machinery for public health needs in India, its success, limitations and future scope. Health system strengthening, human resource development and capacity building and regulation in public health are important areas within the health sector. Contribution to health of a population also derives from social determinants of health like living conditions, nutrition, safe drinking water, sanitation, education, early child development and social security measures. Population stabilization, gender mainstreaming and empowerment, reducing the impact of climate change and disasters on health, improving community participation and governance issues are other important areas for action. Making public health a shared value across the various sectors is a politically challenging strategy, but such collective action is crucial.

  1. Health-system strengthening and tuberculosis control.

    Science.gov (United States)

    Atun, Rifat; Weil, Diana E C; Eang, Mao Tan; Mwakyusa, David

    2010-06-19

    Weak health systems are hindering global efforts for tuberculosis care and control, but little evidence is available on effective interventions to address system bottlenecks. This report examines published evidence, programme reviews, and case studies to identify innovations in system design and tuberculosis control to resolve these bottlenecks. We outline system bottlenecks in relation to governance, financing, supply chain management, human resources, health-information systems, and service delivery; and adverse effects from rapid introduction of suboptimum system designs. This report also documents innovative solutions for disease control and system design. Solutions pursued in individual countries are specific to the nature of the tuberculosis epidemic, the underlying national health system, and the contributors engaged: no one size fits all. Findings from countries, including Bangladesh, Cambodia, India, Tanzania, Thailand, and Vietnam, suggest that advances in disease control and system strengthening are complementary. Tuberculosis care and control are essential elements of health systems, and simultaneous efforts to innovate systems and disease response are mutually reinforcing. Highly varied and context-specific responses to tuberculosis show that solutions need to be documented and compared to develop evidence-based policies and practice.

  2. Health Information Systems (HIS): Concept and Technology

    CERN Document Server

    Almunawar, Mohammad Nabil

    2012-01-01

    A health information system (HIS) is the intersection of between healthcare's business process, and information systems to deliver better healthcare services. The nature of healthcare industry, which is highly influenced by economic, social, politic, and technological factors, has changed over time. This paper will address some important concepts of healthcare and related terminologies to provide a holistic view for HIS. Related technological milestones and major events are briefly summarized. The trends and rapid development of health information technologies are also discussed.

  3. A microbeam slit system for high beam currents

    Science.gov (United States)

    Vallentin, T.; Moser, M.; Eschbaumer, S.; Greubel, C.; Haase, T.; Reichart, P.; Rösch, T.; Dollinger, G.

    2015-04-01

    A new microbeam slit system for high beam currents of 10 μA was built up to improve the brightness transport of a proton beam with a kinetic energy of up to 25 MeV into the microprobe SNAKE. The new slit system features a position accuracy of less than 1 μm under normal operating conditions and less than 2 μm if the beam is switched on and off. The thermal management with a powerful watercooling and potential-free thermocouple feedback controlled heating cables is optimized for constant slit aperture at thermal power input of up to 250 W. The transparent zone is optimized to 0.7 μm due to the use of tungsten formed to a cylindrical surface with a radius r = 100 mm and mechanically lapped surface to minimize small angle scattering effects and to minimize the number of ions passing the slits with low energy loss. Electrical isolation of the slit tip enables slit current monitoring, e.g. for tandem accelerator feedback control. With the ability to transport up to 10 μA of protons with the new microslit system, the brightness Bexp transported into the microprobe was increased by a factor of 2 compared to low current injection using the old slit system.

  4. 76 FR 38399 - Assessing the Current Research, Policy, and Practice Environment in Public Health Genomics

    Science.gov (United States)

    2011-06-30

    ... HUMAN SERVICES Centers for Disease Control and Prevention Assessing the Current Research, Policy, and..., and other information helpful to assess the current research, policy, and practice environment in... Control and Prevention (CDC) has worked to integrate genomics into public health research, policy,...

  5. The association between current unemployment and clinically determined poor oral health.

    Science.gov (United States)

    Al-Sudani, Fouad Y H; Vehkalahti, Miira M; Suominen, Anna L

    2015-08-01

    The aim of this study was to assess whether current unemployment was associated with poor oral health and whether there was a difference in oral health according to the duration of the current unemployment. As part of the Health 2000 Survey in Finland (a nationwide comprehensive health examination survey), we used its data based on interviews, questionnaires, and clinical oral examinations of the 30- to 63-year-old respondents (n = 4773). Current employment status was measured in its dichotomous form, employed versus unemployed, and length of current unemployment was classified into four categories. We measured oral health in terms of numbers of missing teeth, of sound teeth, of filled teeth, of decayed teeth, and of teeth with deepened periodontal pockets (≥4 mm, ≥6 mm). Poisson regression models were fitted for all oral health outcomes except number of decayed teeth, for which negative binomial regression model was used. Oral health-related behaviors and sociodemographic and socioeconomic factors were added to the analyses. The unemployed subjects had higher numbers of missing teeth, of decayed teeth, and of teeth with periodontal pockets than the employed ones. The association remained consistent even after adjustments. Oral health-related behaviors seemed to mediate the association. We found no association between unemployment and number of sound teeth. Current long-term unemployment showed stronger association with poor oral health than short-term among women. The unemployed can be considered as a risk group for poor oral health. Oral healthcare should be reoriented toward those who are unemployed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Monitoring Health, Activity and Fitness in Physical Education: Its Current and Future State of Health

    Science.gov (United States)

    Cale, Lorraine; Harris, Jo; Chen, Ming Hung

    2014-01-01

    Various government policies, strategies and responses in England over the years have highlighted schools and physical education to be instrumental in addressing health and the focus on health has been strengthened within subsequent revisions of the National Curriculum. Whilst this might seem encouraging, concerns have been expressed that such…

  7. Comparative Study of Children's Current Health Conditions and Health Education in New Zealand and Japan

    Science.gov (United States)

    Watanabe, Kanae; Dickinson, Annette

    2015-01-01

    In New Zealand (NZ) and Japan, despite comprehensive national health and physical education (HPE) curriculums in schools, there continues to be significant health issues for children. A qualitative interpretative descriptive research method was used to compare how primary school teachers taught HPE in both countries. In NZ, there is some freedom…

  8. Asymmetry-induced electric current rectification in permselective systems.

    Science.gov (United States)

    Green, Yoav; Edri, Yaron; Yossifon, Gilad

    2015-09-01

    For a symmetric ion permselective system, in terms of geometry and bulk concentrations, the system response is also symmetric under opposite electric field polarity. In this work we derive an analytical solution for the concentration distribution, electric potential, and current-voltage response for a four-layered system comprised of two microchambers connected by two permselective regions of varying properties. It is shown that any additional asymmetry in the system, in terms of the geometry, bulk concentration, or surface charge property of the permselective regions, results in current rectification. Our work is divided into two parts: when both permselective regions have the same surface charge sign and the case of opposite signs. For the same sign case we are able to show that the system behaves as a dialytic battery while accounting for field-focusing effects. For the case of opposite signs (i.e., bipolar membrane), our system exhibits the behavior of a bipolar diode where the magnitude of the rectification can be of order 10^{2}-10^{3}.

  9. Exact temporal eddy current compensation in magnetic resonance imaging systems.

    Science.gov (United States)

    Morich, M A; Lampman, D A; Dannels, W R; Goldie, F D

    1988-01-01

    A step-response method has been developed to extract the properties (amplitudes and decay time constants) of intrinsic-eddy-current-sourced magnetic fields generated in whole-body magnetic resonance imaging systems when pulsed field gradients are applied. Exact compensation for the eddy-current effect is achieved through a polynomial rooting procedure and matrix inversion once the 2 N properties of the N-term decay process are known. The output of the inversion procedure yields the required characteristics of the filter for spectrum magnitude and phase equalization. The method is described for the general case along with experimental results for one-, two-, and three-term inversions. The method's usefulness is demonstrated for the usually difficult case of long-term (200-1000-ms) eddy-current compensation. Field-gradient spectral flatness measurements over 30 mHz-100 Hz are given to validate the method.

  10. [Masculinity and Meat Consumption--Historical Approchaes to a Current Health Issue].

    Science.gov (United States)

    Fischer, Ole

    2015-01-01

    In current health debates meat is often discussed as a health risk. Statistically, men consume more meat than women. Therefore they often appear as an especially vulnerable risk group. Based on current discussions about an increased health risk for men because of an above-average consumption of meat, this paper outlines aspects of the historical development of the relationship between masculinity and meat consumption from the 19th to the 21st century and emphasizes the importance of cultural constructed gender expectations for the eating habits of many men.

  11. Health Systems Innovation at Academic Health Centers: Leading in a New Era of Health Care Delivery.

    Science.gov (United States)

    Ellner, Andrew L; Stout, Somava; Sullivan, Erin E; Griffiths, Elizabeth P; Mountjoy, Ashlin; Phillips, Russell S

    2015-07-01

    Challenged by demands to reduce costs and improve service delivery, the U.S. health care system requires transformational change. Health systems innovation is defined broadly as novel ideas, products, services, and processes-including new ways to promote healthy behaviors and better integrate health services with public health and other social services-which achieve better health outcomes and/or patient experience at equal or lower cost. Academic health centers (AHCs) have an opportunity to focus their considerable influence and expertise on health systems innovation to create new approaches to service delivery and to nurture leaders of transformation. AHCs have traditionally used their promotions criteria to signal their values; creating a health systems innovator promotion track could be a critical step towards creating opportunities for innovators in academic medicine. In this Perspective, the authors review publicly available promotions materials at top-ranked medical schools and find that while criteria for advancement increasingly recognize systems innovation, there is a lack of specificity on metrics beyond the traditional yardstick of peer-reviewed publications. In addition to new promotions pathways and alternative evidence for the impact of scholarship, other approaches to fostering health systems innovation at AHCs include more robust funding for career development in health systems innovation, new curricula to enable trainees to develop skills in health systems innovation, and new ways for innovators to disseminate their work. AHCs that foster health systems innovation could meet a critical need to contribute both to the sustainability of our health care system and to AHCs' continued leadership role within it.

  12. Requirements and Solutions for Personalized Health Systems.

    Science.gov (United States)

    Blobel, Bernd; Ruotsalainen, Pekka; Lopez, Diego M; Oemig, Frank

    2017-01-01

    Organizational, methodological and technological paradigm changes enable a precise, personalized, predictive, preventive and participative approach to health and social services supported by multiple actors from different domains at diverse level of knowledge and skills. Interoperability has to advance beyond Information and Communication Technologies (ICT) concerns, including the real world business domains and their processes, but also the individual context of all actors involved. The paper introduces and compares personalized health definitions, summarizes requirements and principles for pHealth systems, and considers intelligent interoperability. It addresses knowledge representation and harmonization, decision intelligence, and usability as crucial issues in pHealth. On this basis, a system-theoretical, ontology-based, policy-driven reference architecture model for open and intelligent pHealth ecosystems and its transformation into an appropriate ICT design and implementation is proposed.

  13. Is Health Related Quality of Life (HRQoL) a valid indicator for health systems evaluation?

    Science.gov (United States)

    Romero, Martin; Vivas-Consuelo, David; Alvis-Guzman, Nelson

    2013-12-11

    The purpose of this review is to do a discussion about the use of the HRQoL as a health measure of the populations that enable to analyze its potential use as a measure of development and efficiency of health systems. The principal use of the HRQoL is in health technologies economics evaluation; however this measure can be use in public health when need to know the health state of population. The WHO recognizes its potential use but its necessary to do a discussion about your difficulties for its application and restrictions for its use as a performance indicator for the health systems. The review show the different aspects about the use of HRQoL how a measure of efficiency ot the health system, each aspect identified in the literature is analyzed and discussed, developing the pros and cons of their possible use, especially when it comes as a cardinal measure. The analysis allows recognize that measuring HRQoL in countries could serve as a useful indicator, especially when it seeks to measure the level of health and disease, as do most of the indicators of current use. However, the methodological constraints that do not allow comparability between countries especially when you have large socioeconomic differences have yet to be resolved to allow comparison between different regions.

  14. Proposed hybrid superconducting fault current limiter for distribution systems

    Energy Technology Data Exchange (ETDEWEB)

    Elmitwally, A. [Elect. Eng. Dept., Mansoura University, Mansoura 35516 (Egypt)

    2009-11-15

    In this paper, a new hybrid fault current limiter is proposed for primary distribution systems. It incorporates a high temperature superconducting element in parallel with other two branches. The first is an inductive impedance to share the fault current with. The second branch is a gate-turn-off thyristor switch controlled to work in either of two modes. For the main mode, it controls the temperature of the superconducting element and protect it against damaging excessive heating. Instead, it keeps the device applicable without that superconducting element in the auxiliary operation mode. The design, control and operation of the device is addressed. Its performance in 11 kV distribution systems with DG is investigated. The factors affecting the device behavior for different scenarios are explored. (author)

  15. Symmetry and the thermodynamics of currents in open quantum systems

    Science.gov (United States)

    Manzano, Daniel; Hurtado, Pablo I.

    2014-09-01

    Symmetry is a powerful concept in physics, and its recent application to understand nonequilibrium behavior is providing deep insights and groundbreaking exact results. Here we show how to harness symmetry to control transport and statistics in open quantum systems. Such control is enabled by a first-order-type dynamic phase transition in current statistics and the associated coexistence of different transport channels (or nonequilibrium steady states) classified by symmetry. Microreversibility then ensues, via the Gallavotti-Cohen fluctuation theorem, a twin dynamic phase transition for rare current fluctuations. Interestingly, the symmetry present in the initial state is spontaneously broken at the fluctuating level, where the quantum system selects the symmetry sector that maximally facilitates a given fluctuation. We illustrate these results in a qubit network model motivated by the problem of coherent energy harvesting in photosynthetic complexes, and introduce the concept of a symmetry-controlled quantum thermal switch, suggesting symmetry-based design strategies for quantum devices with controllable transport properties.

  16. Challenges for the German Health Care System.

    Science.gov (United States)

    Dietrich, C F; Riemer-Hommel, P

    2012-06-01

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

  17. 78 FR 32234 - Notice of Request for Extension of a Currently Approved Information Collection: Public Health...

    Science.gov (United States)

    2013-05-29

    ... Collection: Public Health Information System--Animal Disposition Reporting AGENCY: Food Safety and Inspection... meat, poultry, exotic animal, and rabbit slaughter for the Public Health Information System--Animal..., South Building, Washington, DC 20250; (202) 720-0345. SUPPLEMENTARY INFORMATION: Title: Public...

  18. Prevention of Overweight and Obesity: How Effective is the Current Public Health Approach

    Directory of Open Access Journals (Sweden)

    Jean Woo

    2010-02-01

    Full Text Available Obesity is a public health problem that has become epidemic worldwide. Substantial literature has emerged to show that overweight and obesity are major causes of co-morbidities, including type II diabetes, cardiovascular diseases, various cancers and other health problems, which can lead to further morbidity and mortality. The related health care costs are also substantial. Therefore, a public health approach to develop population-based strategies for the prevention of excess weight gain is of great importance. However, public health intervention programs have had limited success in tackling the rising prevalence of obesity. This paper reviews the definition of overweight and obesity and the variations with age and ethnicity; health consequences and factors contributing to the development of obesity; and critically reviews the effectiveness of current public health strategies for risk factor reduction and obesity prevention.

  19. An Integrated Health Monitoring System for Fission Surface Power

    Science.gov (United States)

    Hashemian, H. M.; Shumaker, B. D.; McCulley, J. R.; Morton, G. W.

    Based on such criteria as safety and mission success, programmatic risk, affordability, and extensibility/flexibility, the National Aeronautics and Space Administration (NASA) has chosen fission surface power (FSP) as the primary energy source for building a sustained human presence on the Moon, exploring Mars, and extremely long-duration space missions. The current benchmark FSP system has a mission life of at least 8 years during which time there is no opportunity for repair, sensor calibrations, or periodic maintenance tasks that are normally performed on terrestrial-based nuclear power plants during scheduled outages. Current technology relies heavily on real-time human interaction, monitoring and control. However; due to the long communication times between the Earth and Moon, or Mars, real-time human control is not possible, resulting in a critical need to develop autonomous health monitoring technology for FSP systems.This paper describes the design and development of an autonomous health monitoring system that will (1) provide on-line calibration monitoring, (2) reduce uncertainties in sensor measurements, and (3) provide sensor validation and fault detection capabilities for the control systems of various FSP subsystems. The health monitoring system design integrates a number of signal processing algorithms and techniques such as cross-calibration, empirical modeling using neural networks, and physical modeling under a modular signal processing platform that will enable robust sensor and system monitoring without the need for human interaction. Prototypes of the health monitoring system have been tested and validated on data acquired from preliminary subsystem testing of NASA's FSP Technology Demonstration Unit (TDU) as well as simulated laboratory data. Results from this testing have demonstrated the utility and benefits that such autonomous health monitoring systems can provide to FSP subsystems and other potential applications within NASA such as launch

  20. Valve-"Health"-Monitoring System

    Science.gov (United States)

    Jensen, Scott L.; Drouant, George J.

    2009-01-01

    A system that includes sensors and data acquisition, wireless data-communication, and data-processing subsystems has been developed as a means of both real-time and historical tracking of information indicative of deterioration in the mechanical integrity and performance of a highgeared ball valve or a linearly actuated valve that operates at a temperature between cryogenic and ambient.

  1. The chinese health care system

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter Raahave; Yu, Yi

    2011-01-01

    We describe the structure and present situation of the Chinese healthcare system and discuss its primary problems and challenges. We discuss problems with inefficient burden sharing, adverse provider incentives and huge inequities, and seek explanations in the structural features of the Chinese...

  2. The Optimal Taxation and the Current Tax System

    OpenAIRE

    Ioannis N. Kallianiotis

    2015-01-01

    Purpose:The paper discusses the current U.S. tax system, which reduces the disposable income and makes savings negative (dissaving or borrowing). This has increased the debt of individuals and the low taxes on businesses have magnified the budget deficits and the national debt. Methodology:People are borrowing the present value of their uncertain future wealth and their high debt and low income raise the risk and this high risk premium heighten the interest rate on loans, especially on credit...

  3. Current Fluctuations in Nonequilibrium Diffusive Systems: An Additivity Principle

    Science.gov (United States)

    Bodineau, T.; Derrida, B.

    2004-05-01

    We formulate a simple additivity principle allowing one to calculate the whole distribution of current fluctuations through a large one dimensional system in contact with two reservoirs at unequal densities from the knowledge of its first two cumulants. This distribution (which in general is non-Gaussian) satisfies the Gallavotti-Cohen symmetry and generalizes the one predicted recently for the symmetric simple exclusion process. The additivity principle can be used to study more complex diffusive networks including loops.

  4. The health production function of oral health services systems

    DEFF Research Database (Denmark)

    Vlad, R.S.; Petersen, P.E.

    2000-01-01

    Attitudes, dental status, socioeconomic factors, oral health care, production of oral health, health status, quality of life......Attitudes, dental status, socioeconomic factors, oral health care, production of oral health, health status, quality of life...

  5. An introduction to the health system in Vietnam.

    Science.gov (United States)

    Matsuda, S

    1997-10-01

    After independence, the Vietnamese government made an enormous effort to construct a comprehensive health care network from the central down to the grass roots levels, however, the health situation of the population has not improved as much as was expected. The most fundamental cause is poverty, as it is in other developing countries. Because of poverty, the means to achieve a safer environment such as sanitation, safe drinking, water and adequate nutrition, is often absent. Inefficient administration due to the sectionalism among different organizations makes the situation worse.With the introduction of a market policy in 1986, privatization has been introduced into the health sector in order to address some of the inadequacies inherent in the current system. Although privatization might reduce public health expenditures by reducing utilization pressure on public facilities, it deprives the most vulnerable inhabitants of health services.

  6. Optimizing health system response to patient's needs: an argument for the importance of functioning information.

    Science.gov (United States)

    Hopfe, Maren; Prodinger, Birgit; Bickenbach, Jerome E; Stucki, Gerold

    2017-06-06

    Current health systems are increasingly challenged to meet the needs of a growing number of patients living with chronic and often multiple health conditions. The primary outcome of care, it is argued, is not merely curing disease but also optimizing functioning over a person's life span. According to the World Health Organization, functioning can serve as foundation for a comprehensive picture of health and augment the biomedical perspective with a broader and more comprehensive picture of health as it plays out in people's lives. The crucial importance of information about patient's functioning for a well-performing health system, however, has yet to be sufficiently appreciated. This paper argues that functioning information is fundamental in all components of health systems and enhances the capacity of health systems to optimize patients' health and health-related needs. Beyond making sense of biomedical disease patterns, health systems can profit from using functioning information to improve interprofessional collaboration and achieve cross-cutting disease treatment outcomes. Implications for rehabilitation Functioning is a key health outcome for rehabilitation within health systems. Information on restoring, maintaining, and optimizing human functioning can strengthen health system response to patients' health and rehabilitative needs. Functioning information guides health systems to achieve cross-cutting health outcomes that respond to the needs of the growing number of individuals living with chronic and multiple health conditions. Accounting for individuals functioning helps to overcome fragmentation of care and to improve interprofessional collaboration across settings.

  7. Electric machine and current source inverter drive system

    Science.gov (United States)

    Hsu, John S

    2014-06-24

    A drive system includes an electric machine and a current source inverter (CSI). This integration of an electric machine and an inverter uses the machine's field excitation coil for not only flux generation in the machine but also for the CSI inductor. This integration of the two technologies, namely the U machine motor and the CSI, opens a new chapter for the component function integration instead of the traditional integration by simply placing separate machine and inverter components in the same housing. Elimination of the CSI inductor adds to the CSI volumetric reduction of the capacitors and the elimination of PMs for the motor further improve the drive system cost, weight, and volume.

  8. Current status and challenges in PEMFC stacks, systems and commercialization

    Institute of Scientific and Technical Information of China (English)

    任远; 曹广益; 朱新坚

    2006-01-01

    The current status of worldwide developments of polymer electrolyte membrane fuel cell (PEMFC) stacks and system,research activities in resent years to analyze the cost of PEMFC stacks and systems, the remaining research and development issues that should be resolved before the PEMFC available for commercial application were discussed. The two main problems that challenge the PEMFC commercialization were cost and fuel supply infrastructure. The ways to lower the cost, to choose the fuel and improve the efficiency and reliability were described. To research the cost target of 125 kW and stack lifetime of 40 000 ~ 100 000h, basic research in PEMFC was indispensable.

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

    Directory of Open Access Journals (Sweden)

    Janice Katherine Kopinak, MHSc, MSc., RN

    2014-12-01

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

  10. Fast isolation of faults in transmission systems using current transients

    Energy Technology Data Exchange (ETDEWEB)

    Perera, N.; Rajapakse, A.D. [University of Manitoba, Department of Electrical and Computer Engineering, Engineering Building, 15 Gillson Street, Winnipeg, Manitoba (Canada)

    2008-09-15

    This paper presents a protection scheme that is capable of very fast isolation of faults in high voltage transmission systems. Proposed scheme comprises set of relays connected through a telecommunication network, located at different nodes of the system. Relays use wavelet coefficients of current signals to identify the fault directions relative to their location. Fault directions identified at different locations in the system can be combined to determine the faulted line (or busbar) and isolate it. A robust single ended traveling wave based fault distance estimation approach is proposed as a backup in case of communication failure. Investigations were carried out using time domain simulations in PSCAD/EMTDC for a high voltage transmission system. (author)

  11. Data liquidity in health information systems.

    Science.gov (United States)

    Courtney, Paul K

    2011-01-01

    In 2001, the Institute of Medicine report Crossing the Quality Chasm and the National Committee on Vital and Health Statistics report Information for Health were released, and they provided the context for the development of information systems used to support health-supporting processes. Both had as their goals, implicit or explicit, to ensure the right data are provided to the right person at the right time, which is one definition of "data liquidity." This concept has had some traction in recent years as a shorthand way to express a system property for health information technology, but there is not a well-defined characterization of what properties of a system or of its components give it better or worse data liquidity. This article looks at some recent work that help to identify those properties and perhaps can help to ground the concept with metrics that are assessable.

  12. Priorities in the Polish health care system.

    Science.gov (United States)

    Nieszporska, Sylwia

    2017-01-01

    Since 1999, Polish health policy has changed, the quality of services has increased, and also the level of financing, mainly from public benefits. Despite constant growth of indexes reflecting the health status of Polish society, such as life expectancy, quality of life, or decreasing index of deaths at birth, just as in the majority of European countries, in Poland the society is growing older, which implies the necessity to reorganize the system. In this paper, the author has described the most important factors that determine the operation of the health system in Poland, as well as presents the ways it was restructured over the last few years, taking into consideration the structural, legislative, financial, organizational, and quantitative aspects. Also, the latest trends in Polish health policy, which take into account new goals of the system, have been presented within.

  13. Methodology for simulation of geomagnetically induced currents in power systems

    Directory of Open Access Journals (Sweden)

    Boteler David

    2014-07-01

    Full Text Available To assess the geomagnetic hazard to power systems it is useful to be able to simulate the geomagnetically induced currents (GIC that are produced during major geomagnetic disturbances. This paper examines the methodology used in power system analysis and shows how it can be applied to modelling GIC. Electric fields in the area of the power network are used to determine the voltage sources or equivalent current sources in the transmission lines. The power network can be described by a mesh impedance matrix which is combined with the voltage sources to calculate the GIC in each loop. Alternatively the power network can be described by a nodal admittance matrix which is combined with the sum of current sources into each node to calculate the nodal voltages which are then used to calculate the GIC in the transmission lines and GIC flowing to ground at each substation. Practical calculations can be made by superposition of results calculated separately for northward and eastward electric fields. This can be done using magnetic data from a single observatory to calculate an electric field that is a uniform approximation of the field over the area of the power system. It is also shown how the superposition of results can be extended to use data from two observatories: approximating the electric field by a linear variation between the two observatory locations. These calculations provide an efficient method for simulating the GIC that would be produced by historically significant geomagnetic storm events.

  14. Research on Low Power Marine Current Power Generation System

    Directory of Open Access Journals (Sweden)

    Dongkai Peng

    2013-09-01

    Full Text Available This study proposes a simple topological structure and power control method for a small scale stand alone marine current system, in which a diode rectifier, DC/DC boost converter for the maximum power control, battery as a storage element and a single phase inverter to link with load. The study establishes the steady-state mathematical model of marine current power generation system and derives the formula between the maximum power point and dc battery voltage. Then use the measurements of DC voltage and DC current to obtain Maximum Power Point Tracking (MPPT by controlling the duty cycle of the boost converter switch in order to simplify the system structure and the control strategies. In this case, the hill climbing searching algorithm is employed to get maximum power point and the double closed loops control strategy is used to improve the dynamic and static performance of single phase inverter. The simulation model is developed in MATLAB/Simulink. And the control method is executed in dSPACE1104 real-time platform. The simulation and experimental results demonstrate the feasibility and validity of the proposed control strategies.

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mohammad Akhtar Hussain

    2011-01-01

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

  17. [Health education for major parasitic diseases in rural community of China: current status and future development].

    Science.gov (United States)

    Zhang, Jing; Lin, Dan-dan

    2013-08-01

    Owing to human parasitic diseases being related to behavior, the health education as an important measure to prevent parasite infections through human behavior intervention, has played an important role in the process of parasitic disease prevention and control in rural area of China. This paper comments on the development history of the health education for parasitic disease prevention and control, current intervention modes and the effect of the health education for parasitic diseases in rural area. This paper also summarizes the role and impact of different modes of the health education for parasitic disease prevention and control and gives some suggestions to future development of the health education in rural area under current prevalent situation of parasitic diseases.

  18. Evaluation of computerized health management information system for primary health care in rural India

    Directory of Open Access Journals (Sweden)

    Singh Satyavir

    2010-11-01

    Full Text Available Abstract Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS, New Delhi has a computerized Health Management Information System (HMIS since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR 1674,217 (USD 35,622. Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213. The annual savings is around INR 894,283 (USD 11,924. Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision.

  19. Evaluation of computerized health management information system for primary health care in rural India

    Science.gov (United States)

    2010-01-01

    Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS), New Delhi has a computerized Health Management Information System (HMIS) since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors) and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR) 1674,217 (USD 35,622). Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213). The annual savings is around INR 894,283 (USD 11,924). Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision. PMID:21078203

  20. System of Natural Health Products

    Directory of Open Access Journals (Sweden)

    Angelica Paoletti

    2011-01-01

    Full Text Available Introduction. The safety of vitamin K antagonists (VKA use can be compromised by many popular herbal supplements taken by individuals. The literature reports that 30% of warfarin-treated patients self-medicates with herbs. Possible interactions represent an health risk. We aimed to identify all herbs-oral anticoagulants interactions collected in the Italian database of suspected adverse reactions to “natural health” products. Methods. The Italian database of spontaneous reports of suspected adverse reactions to natural products was analyzed to address herb-VKAs interactions. Results. From 2002 to 2009, we identified 12 reports with 7 cases of INR reduction in patients treated with warfarin (n=3 and acenocoumarol (n=4, and 5 cases of INR increase (all warfarin associated. It was reported 8 different herbal products as possibly interacting. Discussion. Our study confirms the risk of interactions, highlighting the difficulty to characterize them and their mechanisms and, finally, prevent their onset. The reported data underline the urgent need of healthcare providers being aware of the possible interaction between natural products and VKA, also because of the critical clinical conditions affecting patients. This is the first step to have the best approach to understand possible INR alterations linked to herb-VKA interaction and to rightly educate patients in treatment with VKA.

  1. [Health literacy as an element of the Polish occupational health system].

    Science.gov (United States)

    Dobras, Maciej

    Nowadays it is believed that a comprehensive approach towards one's health requires the development and subsequent mastering of health literacy. Although this term has no Polish equivalent, it applies to the ability of individuals to access, analyze and understand information necessary to make informed health decisions. In this publication it is suggested that 'biegłość zdrowotna' can be used as a corresponding Polish term. This publication is based on the review of the available literature (in Polish and in English) on health literacy. To illustrate the hypothetical level of health literacy among Polish employers and employees reports of the Chief Labour Inspectorate and individual items from the Second European Survey of Enterprises on New and Emerging Risks (ESENER-2) were used. The analysis proves that health literacy is a multidimensional concept which has been studied and investigated so far only in relation to chosen nosological units, but practically it does not appear in relation to occupational health. There are reasons to believe that in Poland the low level of health literacy among both employers and employees, lies at the forefront of a passive approach towards the safeguarding of workers health. The concept of health literacy needs further dissemination in Poland, whereas the main area of future research should be the design of the Polish tool for assessing health literacy. The national system of occupational health seems to offer a possible ground for implementing such a concept, especially bearing in mind that within the current system there are several entities and services, which have the legal mandate to undertake informative and advisory duties - exactly those, which help build and master health literacy skills. Med Pr 2016;67(5):681-689.

  2. A regional climatology of the Humboldt Current System

    Science.gov (United States)

    Grados Quispe, M.; Chaigneau, A.; Blanco, J.; Vasquez, L.; Dominguez, N.

    2009-12-01

    A 3-dimensional, high-resolution, regional climatology of the Humboldt Current System (HCS) north of 25°S is presented. The methodology is based on a four-dimensional ocean interpolation scheme using locally weighted least square fitting, as developed by Dunn and Ridgway [2001] and Ridgway et al. [2002] in the Australian Seas. The method is applied to all the available historical profiles from the National Oceanographic Data Center [WOD05, Boyer et al., 2006], ARGO buoy profiles [http://www.argo.ucsd.edu] for 2000-2007 and historical in situ long-term information from the Peruvian Marine Research Institute (IMARPE) and Fisheries Development Institute (IFOP) for the period 1960-2008. The regional climatology, which extends from the equator to 25°S and from the coast to 8° offshore with a resolution of 0.1°x0.1°, is thus constructed from more than 70 000 temperature profiles, 38 000 salinity profiles and 43 000 oxygen profiles to form a seasonal climatology of temperature and salinity along Peru and northern Chile. The resulting maps depict interesting small-scales coastal properties such as clear distinct upwelling centers and frontal zones. Geostrophic currents relative to 500 m depth are also computed from the density field, highlighting new circulation features. This study provides a contemporaneous view of the circulation and the water masses characteristics in the Humboldt Current System at seasonal scales. This regional climatology represents coastal boundary features (upwelling cells, frontal regions) better than other climatologies. In view of on-going international research efforts to understand the coastal upwelling and coastal currents in the southern ocean off Peru, the main characteristics of the upwelling cell, currents and coastal winds variability of the Pisco (13°S)-San Juan (15°S) region are presented. This improved gridded product is expected to be used for initializing and validating high resolution regional numerical models.

  3. Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems.

    Science.gov (United States)

    Stucki, Gerold; Bickenbach, Jerome; Melvin, John

    2016-12-15

    A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

  4. Child Poverty and the Health Care System.

    Science.gov (United States)

    Racine, Andrew D

    2016-04-01

    The persistence of child poverty in the United States and the pervasive health consequences it engenders present unique challenges to the health care system. Human capital theory and empirical observation suggest that the increased disease burden experienced by poor children originates from social conditions that provide suboptimal educational, nutritional, environmental, and parental inputs to good health. Faced with the resultant excess rates of pediatric morbidity, the US health care system has developed a variety of compensatory strategies. In the first instance, Medicaid, the federal-state governmental finance system designed to assure health insurance coverage for poor children, has increased its eligibility thresholds and expanded its benefits to allow greater access to health services for this vulnerable population. A second arm of response involves a gradual reengineering of health care delivery at the practice level, including the dissemination of patient-centered medical homes, the use of team-based approaches to care, and the expansion of care management beyond the practice to reach deep into the community. Third is a series of recent experiments involving the federal government and state Medicaid programs that includes payment reforms of various kinds, enhanced reporting, concentration on high-risk populations, and intensive case management. Fourth, pediatric practices have begun to make use of specific tools that permit the identification and referral of children facing social stresses arising from poverty. Finally, constituencies within the health care system participate in enhanced advocacy efforts to raise awareness of poverty as a distinct threat to child health and to press for public policy responses such as minimum wage increases, expansion of tax credits, paid family leave, universal preschool education, and other priorities focused on child poverty.

  5. Systems Thinking for Transformational Change in Health

    Science.gov (United States)

    Willis, Cameron D.; Best, Allan; Riley, Barbara; Herbert, Carol P.; Millar, John; Howland, David

    2014-01-01

    Incremental approaches to introducing change in Canada's health systems have not sufficiently improved the quality of services and outcomes. Further progress requires 'large system transformation', considered to be the systematic effort to generate coordinated change across organisations sharing a common vision and goal. This essay draws on…

  6. A programmable low power current source for bioimpedance measurement: Towards a wearable personalized health assistant.

    Science.gov (United States)

    Hamed, Zaid; Tenhunen, Hannu; Yang, Geng

    2015-01-01

    Bioimpedance is a noninvasive measurement method that facilitates body composition analysis, besides being indicative of many other health parameters. In this work a novel programmable, low complexity, high output impedance, high voltage compliance and wideband current source for bioimpedance applications is presented. Previously, we designed, fabricated and tested in vivo a bio-patch for acquisition of multiple bio-signals. Upon integration with our previous work, this circuit is envisioned to constitute part of a personalized health assistant. Simulation at worst case corners and real operation conditions was carried out using UMC-180 nm 1 poly 6 metal CMOS process. Full duty cycle, shortened or stepped square waves can be generated. Amplitude control of 8 different current levels is supported. Frequency can be tuned up to 1 MHz and an output impedance of 2.8 MO @ 250 KHz is achieved at full current capacity. Total current consumption is comparable to the injected current, making the circuit highly efficient.

  7. Explaining health care system change: problem pressure and the emergence of "hybrid" health care systems.

    Science.gov (United States)

    Schmid, Achim; Cacace, Mirella; Götze, Ralf; Rothgang, Heinz

    2010-08-01

    In this article, we will further the explanation of the state's changing role in health care systems belonging to the Organisation for Economic Cooperation and Development (OECD). We build on our analysis of twenty-three OECD countries, which reveals broad trends regarding governments' role in financing, service provision, and regulation. In particular, we identified increasing similarities between the three system types we delineate as National Health Service (NHS), social health insurance, and private health insurance systems. We argue that the specific health care system type is an essential contributor to these changes. We highlight that health care systems tend to feature specific, type-related deficiencies, which cannot be solved by routine mechanisms. As a consequence, non-system-specific elements and innovative policies are implemented, which leads to the emergence of "hybrid" systems and indicates a trend toward convergence, or increasing similarities. We elaborate this hypothesis in two steps. First, we describe system-specific deficits of each health care system type and provide an overview of major adaptive responses to these deficits. The adaptive responses can be considered as non-system-specific interventions that broaden the portfolio of regulatory policies. Second, we examine diagnosis-related groups (DRGs) as a common approach for financing hospitals efficiently, which are nevertheless shaped by type-specific deficiencies and reform requirements. In the United States' private insurance system, DRGs are mainly used as a means of hierarchical cost control, while their implementation in the English NHS system is to increase productivity of hospital services. In the German social health insurance system, DRGs support competition as a means to control self-regulated providers. Thus, DRGs contribute to the hybridization of health care systems because they tend to strengthen coordination mechanisms that were less developed in the existing health care

  8. CRISPR system in filamentous fungi: Current achievements and future directions.

    Science.gov (United States)

    Deng, Huaxiang; Gao, Ruijie; Liao, Xiangru; Cai, Yujie

    2017-09-05

    As eukaryotes, filamentous fungi share many features with humans, and they produce numerous active metabolites, some of which are toxic. Traditional genetic approaches are generally inefficient, but the clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 system that has been widely used for basic research on bacteria, mammals and plants offers a simple, fast, versatile technology for systemic research on filamentous fungi. In this review, we summarized the current knowledge on Cas9 and its variants, various selective markers used to screen positive clones, different ways used to detect off-target mutations, and different approaches used to express and transform the CRISPR complex. We also highlight several methods that improve the nuclease specificity and efficiency, and discuss current and potential applications of CRISPR/Cas9 system in filamentous fungi for pathogenesis decoding, confirmation of the gene and pathway, bioenergy process, drug discovery, and chromatin dynamics. We also describe how the synthetic gene circuit of CRISPR/Cas9 systems has been used in the response to various complex environmental signals to redirect metabolite flux and ensure continuous metabolite biosynthesis. Copyright © 2017. Published by Elsevier B.V.

  9. The current situation of treatment systems for alcoholism in Korea.

    Science.gov (United States)

    Kim, Jee Wook; Lee, Boung Chul; Kang, Tae-Cheon; Choi, Ihn-Geun

    2013-02-01

    Alcoholism is becoming one of the most serious issues in Korea. The purpose of this review article was to understand the present status of the treatment system for alcoholism in Korea compared to the United States and to suggest its developmental direction in Korea. Current modalities of alcoholism treatment in Korea including withdrawal treatment, pharmacotherapy, and psychosocial treatment are available according to Korean evidence-based treatment guidelines. Benzodiazepines and supportive care including vitamin and nutritional support are mainly used to treat alcohol withdrawal in Korea. Naltrexone and acamprosate are the drugs of first choice to treat chronic alcoholism. Psychosocial treatment methods such as individual psychotherapy, group psychotherapy, family therapy, cognitive behavior therapy, cue exposure therapy, 12-step facilitation therapy, self-help group therapy, and community-based treatment have been carried out to treat chronic alcoholism in Korea. However, current alcohol treatment system in Korea is not integrative compared to that in the United States. To establish the treatment system, it is important to set up an independent governmental administration on alcohol abuse, to secure experts on alcoholism, and to conduct outpatient alcoholism treatment programs and facilities in an open system including some form of continuing care.

  10. A dynamic human health risk assessment system.

    Science.gov (United States)

    Prasad, Umesh; Singh, Gurmit; Pant, A B

    2012-05-01

    An online human health risk assessment system (OHHRAS) has been designed and developed in the form of a prototype database-driven system and made available for the population of India through a website - www.healthriskindia.in. OHHRAS provide the three utilities, that is, health survey, health status, and bio-calculators. The first utility health survey is functional on the basis of database being developed dynamically and gives the desired output to the user on the basis of input criteria entered into the system; the second utility health status is providing the output on the basis of dynamic questionnaire and ticked (selected) answers and generates the health status reports based on multiple matches set as per advise of medical experts and the third utility bio-calculators are very useful for the scientists/researchers as online statistical analysis tool that gives more accuracy and save the time of user. The whole system and database-driven website has been designed and developed by using the software (mainly are PHP, My-SQL, Deamweaver, C++ etc.) and made available publically through a database-driven website (www.healthriskindia.in), which are very useful for researchers, academia, students, and general masses of all sectors.

  11. A SUSTAINABLE HEALTH CARE SYSTEM REQUIRES MANAGEMENT TRANSFORMATION

    Directory of Open Access Journals (Sweden)

    Kanellopoulos Dimitros

    2011-12-01

    Full Text Available In order to be the health care system sustainable , management transformations must be based on very precise diagnostic analysis that includes complete and current information. It is necessary to implement an information system that collects information in real time, that watches the parameters that significantly influence the sustainability of the system. Such an information system should point out a radiography(a scan of the system at some time under following aspects:: 1. An overview of system; 2 An overview of the economic situation; 3 A technical presentation ;4. A legal overview; 5. A social overview ; 6. A management overview .Based on these Xrays of the health system, it outlines a series of conclusions and recommendations together with a SWOT analysis that highlights the potential internal (strengths and weaknesses and external potential (opportunities and threats. Based on this analysis and recommendations, the management is going to redesign the system in order to be adapted to the changing environmental requirements. Management transformation is recommended to be by following steps. :1. The development of a new management system that would make a positive change in the health care system 2. Implementation of the new management system 3. Assessment of the changes

  12. Patterns and processes in the California Current System

    Science.gov (United States)

    Checkley, David M., Jr.; Barth, John A.

    2009-12-01

    The California Current System (CCS) is forced by the distribution of atmospheric pressure and associated winds in relation to the west coast of North America. In this paper, we begin with a simplified case of winds and a linear coast, then consider variability characteristic of the CCS, and conclude by considering future change. The CCS extends from the North Pacific Current (∼50°N) to off Baja California, Mexico (∼15-25°N) with a major discontinuity at Point Conception (34.5°N). Variation in atmospheric pressure affects winds and thus upwelling. Coastal, wind-driven upwelling results in nutrification and biological production and a southward coastal jet. Offshore, curl-driven upwelling results in a spatially large, productive habitat. The California Current flows equatorward and derives from the North Pacific Current and the coastal jet. Dominant modes of spatial and temporal variability in physical processes and biological responses are discussed. High surface production results in deep and bottom waters depleted in oxygen and enriched in carbon dioxide. Fishing has depleted demersal stocks more than pelagic stocks, and marine mammals, including whales, are recovering. Krill, squid, and micronekton are poorly known and merit study. Future climate change will differ from past change and thus prediction of the CCS requires an understanding of its dynamics. Of particular concern are changes in winds, stratification, and ocean chemistry.

  13. The Current State and Perspectives of Systems Biology

    Institute of Scientific and Technical Information of China (English)

    Tielui Shi; Yixue Li

    2006-01-01

    Emerging as a new field in biology recently, Systems Biology provides a branch new way to study the biological activities in organisms. In order to decode the complexity of life systematically,systems biology integrates the "-omics" and uses the high throughput methods from transcriptomics,protomics and metabonomics to detect the dynamic activities in cell; and then, it incorporates bioinformatics methods to integrate and analyze those data, and simulate the biological processes based on the model built from those integrated data. In this paper, the current state, the research field and the methods for the Systems Biology are introduced briefly, and then, several ideas about future development in this field are also proposed.

  14. Development of high current beam ns pulsed system

    CERN Document Server

    Shen Guan Ren; Gao Fu; Guan Xia Ling; LiuNaiYi

    2001-01-01

    The development of high current beam ns pulsed system of CPNG and its characteristic, main technological performance and application are introduced. Firstly, important parameters of the system are calculated using theoretical model, the design requirements of some important parts are understood. Some mistakes in physics conception are corrected. Second, the chopper is designed for parallel plate deflector, chopping aperture and sine wave voltage sweeping device. It is emphasized that the conception of parallel plate load impedance is the capacitance load, but not the 50 ohm load impedance. The dynamic capacitance value has been measured. The output emphasizes the output voltage amplitude, but not the output power for sweeping device. The display system of output sweeping voltage was set up and it is sure that the maximum output voltage(V-V) is >=4000 V. The klystron buncher are re-designed. It is emphasized to overcome difficulty of support high voltage electrode in the klystron and insulator of input sine wa...

  15. Health Care Performance and Health Financing Systems in Countries from Central and Eastern Europe

    Directory of Open Access Journals (Sweden)

    Sorin Gabriel ANTON

    2012-02-01

    Full Text Available A common feature of all health systems from emerging economies is the shortage of financial resources. This fact is currently exacerbated by the economic crisis that has led many governments to reconsider the level of public spending in the health sector. Starting from the Romanian experience, the paper aims to highlight the linkage between the performance of the health system and the total health spending for selected countries from Central and Eastern Europe. Romania has the lowest level of health expenditure as percentage of GDP in Europe, even if its growth rate for 2003-2008 was the highest. In addition, empirical evidence shows that these resources are used inefficiently. Despite the increasing resources allocated to the health sector, statistical analysis shows that health system efficiency, as measured by under-5 (child mortality rate, is still low. We use regression analysis based on crosssection data in order to explain the differences in health expenditure and their implication on the system efficiency. Health data have been provided by international organizations. Crosssection regression results suggest that totalhealth spending and GDP per capita are the most important factors explaining differences in health status across Central and Eastern European countries, though other lifestyle factors could play important roles.

  16. Physical Violence and Some Reproductive Health Variables among Currently Married Egyptian Women.

    Science.gov (United States)

    Afifi, Mustafa

    2008-01-01

    This study investigates the relationship between women exposure to marital physical violence and some reproductive health variables including the number of ANC visits during the last pregnancy, intended pregnancy, reporting of STDs symptoms and visiting governmental health facility in the past 6 months prior to the survey. The study was conducted on the EDHS, 2005 data. A sub-sample of 5249 currently- married women were investigated for both ever and the 12 months prior to survey exposure to physical violence by their current husbands, and its association with the aforementioned variables adjusting for the effect of respondents' age, education, work, residence, wealth index, number of children ever borne, and empowerment in household decisions. Around 29.4% of the studied women have been ever exposed to physical violence by their current husbands; of them 60% have been subjected to it in the 12 months prior to the survey. Logistic regression models showed that exposure to physical violence predicted lower number of ANC visits, unintended pregnancy, reporting of STDs symptoms, and utilization of governmental health facility in the past 6 months prior to the survey. The relationship between exposure to physical violence and poor reproductive health outcomes was strong to hold, adjusting for other covariates. The increased likelihood of visiting governmental health facilities by physically abused wives supports the recommendation to use public health services as entry point for management of violence against women (VAW), and to develop a comprehensive health sector response to various impacts of VAW.

  17. Health systems integration: state of the evidence

    Directory of Open Access Journals (Sweden)

    Gail D. Armitage

    2009-06-01

    Full Text Available Introduction: Integrated health systems are considered a solution to the challenge of maintaining the accessibility and integrity of healthcare in numerous jurisdictions worldwide. However, decision makers in a Canadian health region indicated they were challenged to find evidence-based information to assist with the planning and implementation of integrated healthcare systems. Methods: A systematic literature review of peer-reviewed literature from health sciences and business databases, and targeted grey literature sources. Results: Despite the large number of articles discussing integration, significant gaps in the research literature exist. There was a lack of high quality, empirical studies providing evidence on how health systems can improve service delivery and population health. No universal definition or concept of integration was found and multiple integration models from both the healthcare and business literature were proposed in the literature. The review also revealed a lack of standardized, validated tools that have been systematically used to evaluate integration outcomes. This makes measuring and comparing the impact of integration on system, provider and patient level challenging. Discussion and conclusion: Healthcare is likely too complex for a one-size-fits-all integration solution. It is important for decision makers and planners to choose a set of complementary models, structures and processes to create an integrated health system that fits the needs of the population across the continuum of care. However, in order to have evidence available, decision makers and planners should include evaluation for accountability purposes and to ensure a better understanding of the effectiveness and impact of health systems integration.

  18. Citizen participation and discontent in three Southern European health systems.

    Science.gov (United States)

    Serapioni, Mauro; Matos, Ana Raquel

    2014-12-01

    Participation has featured in political agendas in recent decades and the domain of healthcare has not been indifferent to its appeal. Although emerging later than in other European regions, the involvement of civil society in healthcare decision-making procedures has proved one of the biggest challenges facing Southern European health systems. The health systems of the countries considered in this analysis - Italy, Portugal and Spain - underwent reforms that brought citizen participation to the forefront of the health system. Through national laws or health plans, each of these countries has recognised the need to promote participation in order to 'give a voice' to citizens in the health sector. Accordingly, a range of significant activities have been implemented in the region, although they have been developed unequally within national territories, at different paces and involving the mobilisation of different actors. This article focuses on the most relevant experiences of citizen participation designed and implemented in the three selected countries, describing their key features and potential, as well as the main critical issues and contradictions that have emerged over time. Particular emphasis is given to the impact of the current financial crisis on Southern European national health systems, especially in terms of participatory methods, the way in which citizen participation is progressing and civil society's reaction to these important changes.

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

    Science.gov (United States)

    Chandra, Ashish; Frank, Zachary D

    2004-01-01

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

  20. Level of Integration of Community Health Workers in Missouri Health Systems.

    Science.gov (United States)

    Rhodes, Darson; Visker, Joseph; Cox, Carol; Banez, J Christian; Wang, Anna

    2016-11-16

    The purpose of this study was to describe the level of integration of community health workers (CHWs) into Missouri public healthcare systems using a cross-sectional survey research design. Representatives of all Missouri Local Public Health Agencies, Rural Health Clinics, and Federally Qualified Health Centers were pre-contacted by telephone to provide the electronic mail of the most knowledgeable person in the facility/location to complete a brief electronic survey on their use of CHWs. 103 representatives of the 273 (37.7% response rate) contacted from the health systems completed the Profile of Community Health Workers in Missouri Health Systems to assess role, professional development, and information needs of CHWs used in the key informants' agencies. An Abridged Survey was created for participants who responded to the survey but indicated that CHWs were not currently working for their organization. Descriptive statistics and measures of central tendency were computed. Only 16% (16/103) of participants noted that CHWs were employed in their organizations; and most CHWs connected people with services, served low-income and rural populations, and addressed heart disease issues. Participants who did not currently employ CHWs indicated they did not anticipate needing them in the near future. Of those utilizing CHWs, most perceived CHWs have a vital role in healthcare (M = 4.27/5.0, SD = 0.64) but securing sustainable funding for CHWs was challenging (M = 4.18/5.0, SD = 0.87). Utilization of CHWs in Missouri healthcare systems is limited. If their role in Missouri healthcare systems is to expand, a campaign to educate on their role and value is needed.

  1. Simple Augmented Current Controller with OHC Technique for grid current compensation in the Distribution System

    Directory of Open Access Journals (Sweden)

    S. Rajalingam

    2014-05-01

    Full Text Available This paper presents a novel control technique on four leg inverter with which the distribution grid is interconnected with the domestic houses. Most of the houses in the distribution side possess inverter for the usage of Electricity. With the advancement in Solar & wind, it will become easy to see houses, often with solar & a small Wind power system. The excess power generated can be exchanged with the Electricity Board for providing uninterruptible power supply. During this exchange there may be a deterioration in the quality of power, most often the grid current gets affected with a large harmonic distortion, and also there exists unbalanced grid currents. Thus, it is necessary to provide uninterruptible power supply with good quality of power. In spite of several controllers, the proposed augmented controller has its own reliability & quick response with Overall Harmonic Compensation (OHC technique which relies on DSP based filter. This Augmented based control technique with OHC is demonstrated extensively with MATLAB/Simulink simulation.

  2. The Italian health-care system.

    Science.gov (United States)

    France, George; Taroni, Francesco; Donatini, Andrea

    2005-09-01

    Italy's national health service is statutorily required to guarantee the uniform provision of comprehensive care throughout the country. However, this is complicated by the fact that, constitutionally, responsibility for health care is shared between the central government and the 20 regions. There are large and growing differences in regional health service organisation and provision. Public health-care expenditure has absorbed a relatively low share of gross domestic product, although in the last 25 years it has consistently exceeded central government forecasts. Changes in payment systems, particularly for hospital care, have helped to encourage organisational appropriateness and may have contributed to containing expenditure. Tax sources used to finance the Servizio Sanitario Nazionale (SSN) have become somewhat more regressive. The limited evidence on vertical equity suggests that the SSN ensures equal access to primary care but lower income groups face barriers to specialist care. The health status of Italians has improved and compares favourably with that in other countries, although regional disparities persist.

  3. United Kingdom (Northern Ireland): Health system review.

    Science.gov (United States)

    O'Neill, Ciaran; McGregor, Pat; Merkur, Sherry

    2012-01-01

    The political context within which Northern Irelands integrated health and social care system operates has changed since the establishment of a devolved administration (the Northern Ireland Assembly, set up in 1998 but suspended between 2002 and 2007). A locally elected Health Minister now leads the publicly financed system and has considerable power to set policy and, in principle, to determine the operation of other health and social care bodies. The system underwent major reform following the passing of the Health and Social Care (Reform) Act (Northern Ireland) in 2009. The reform maintained the quasi purchaser provider split already in place but reduced the number and increased the size of many of the bodies involved in purchasing (known locally as commissioning) and delivering services. Government policy has generally placed greater emphasis on consultation and cooperation among health and social care bodies (including the department, commissioners and care providers) than on competition. The small size of the population (1.8 million) and Northern Irelands geographical isolation from the rest of the United Kingdom provide a rationale for eschewing a more competitive model. Without competition, effective control over the system requires information and transparency to ensure provider challenge, and a body outside the system to hold it to account. The restoration of the locally elected Assembly in 2007 has created such a body, but it remains to be seen how effectively it will exercise accountability.

  4. Mental health surveillance and information systems.

    Science.gov (United States)

    Gater, R; Chisholm, D; Dowrick, C

    2015-09-28

    Routine information systems for mental health in many Eastern Mediterranean Region countries are rudimentary or absent, making it difficult to understand the needs of local populations and to plan accordingly. Key components for mental health surveillance and information systems are: national commitment and leadership to ensure that relevant high quality information is collected and reported; a minimum data set of key mental health indicators; intersectoral collaboration with appropriate data sharing; routine data collection supplemented with periodic surveys; quality control and confidentiality; and technology and skills to support data collection, sharing and dissemination. Priority strategic interventions include: (1) periodically assessing and reporting the mental health resources and capacities available using standardized methodologies; (2) routine collection of information and reporting on service availability, coverage and continuity, for priority mental disorders disaggregated by age, sex and diagnosis; and (3) mandatory recording and reporting of suicides at the national level (using relevant ICD codes).

  5. [Citizens: allies of the health system].

    Science.gov (United States)

    Venne, Michel

    2014-03-01

    Many international declarations recognize citizen participation as an important driver of success for health policy; however, in most countries the implementation of this principle has been delayed. Yet well-known phenomena, like ageing and incurred costs, should motivate decision makers to rely more on citizens and make them allies of the system, giving them power and responsibility. Citizens can first exercise this responsibility within the areas of prevention and health promotion. This responsibility then expands to include mutual assistance between community members. It is called upon in the definition of new social norms. It is recognized by the participation of citizens in health care decision-making bodies. Lastly, this responsibility applies when the time comes to choose which health services will be covered by the public system and which will be sent on to private insurers. The reasons to create a space for citizens are many. The methods to do it exist. What is needed is political willpower and means.

  6. The right to health, health systems development and public health policy challenges in Chad.

    Science.gov (United States)

    Azétsop, Jacquineau; Ochieng, Michael

    2015-02-15

    There is increasing consensus that the right to health can provide ethical, policy and practical groundings for health systems development. The goals of the right to health are congruent with those of health systems development, which are about strengthening health promotion organizations and actions so as to improve public health. The poor shape and performance of health systems in Chad question the extent of realization of the right to health. Due to its comprehensiveness and inclusiveness, the right to health has the potential of being an organizational and a normative backbone for public health policy and practice. It can then be understood and studied as an integral component of health systems development. This paper uses a secondary data analysis of existing documents by the Ministry of Public Health, Institut National de la Statistique, des Etudes Economiques et Démographiques (INSEED), the Ministry of Economy and Agence Française de Cooperation to analyze critically the shape and performance of health systems in Chad based on key concepts and components of the right to health contained in article 12 of the International Covenant on Economic, Social and Cultural Rights, and on General Comment 14. The non-realization of the right to health, even in a consistently progressive manner, raises concerns about the political commitment of state officials to public health, about the justice of social institutions in ensuring social well-being and about individual and public values that shape decision-making processes. Social justice, democratic rule, transparency, accountability and subsidiarity are important groundings for ensuring community participation in public affairs and for monitoring the performance of public institutions. The normative ideals of health systems development are essentially democratic in nature and are rooted in human rights and in ethical principles of human dignity, equality, non-discrimination and social justice. These ideals are grounded

  7. Comparing current cluster, massively parallel, and accelerated systems

    Energy Technology Data Exchange (ETDEWEB)

    Barker, Kevin J [Los Alamos National Laboratory; Davis, Kei [Los Alamos National Laboratory; Hoisie, Adolfy [Los Alamos National Laboratory; Kerbyson, Darren J [Los Alamos National Laboratory; Pakin, Scott [Los Alamos National Laboratory; Lang, Mike [Los Alamos National Laboratory; Sancho Pitarch, Jose C [Los Alamos National Laboratory

    2010-01-01

    Currently there is large architectural diversity in high perfonnance computing systems. They include 'commodity' cluster systems that optimize per-node performance for small jobs, massively parallel processors (MPPs) that optimize aggregate perfonnance for large jobs, and accelerated systems that optimize both per-node and aggregate performance but only for applications custom-designed to take advantage of such systems. Because of these dissimilarities, meaningful comparisons of achievable performance are not straightforward. In this work we utilize a methodology that combines both empirical analysis and performance modeling to compare clusters (represented by a 4,352-core IB cluster), MPPs (represented by a 147,456-core BG/P), and accelerated systems (represented by the 129,600-core Roadrunner) across a workload of four applications. Strengths of our approach include the ability to compare architectures - as opposed to specific implementations of an architecture - attribute each application's performance bottlenecks to characteristics unique to each system, and to explore performance scenarios in advance of their availability for measurement. Our analysis illustrates that application performance is essentially unrelated to relative peak performance but that application performance can be both predicted and explained using modeling.

  8. Engineering performant, innovative and sustainable health systems

    OpenAIRE

    Wouters, Raphael

    2016-01-01

    Background: In a time of growing health expenditures and inefficiencies, ageing populations, rise of chronic diseases, co-morbity and technical evolutions, there is a worldwide quest for performant, innovative and sustainable health systems that are, a.o. effective and cost-efficient, patient-centric and co-creative and able to deal with the growing society dynamics.Problem statement: Effectively implementing strategic initiatives that tackle these challenges appears a frightening task since ...

  9. Redesigning Health Information Systems in Developing Countries

    DEFF Research Database (Denmark)

    Mengiste, Shegaw Anagaw; Kimaro, Honest; Aanestad, Margunn

    2008-01-01

    Despite widespread aims to strengthen the Health Information System (HIS) as a tool for decentralised health care, there is a strong tendency in most developing countries that the HIS continues to reflect the central level's needs and requirements. The traditional design approach with little...... or no end user involvement results in a centralised HIS with an extensive, somewhat inappropriate, but also inflexible set of standards. Consequently, the HIS is not very useful for the wished-for decentralisation of health services, and there is an urgent need to redesign the existing HIS in order to make...

  10. Quantum Q systems: from cluster algebras to quantum current algebras

    Science.gov (United States)

    Di Francesco, Philippe; Kedem, Rinat

    2017-02-01

    This paper gives a new algebraic interpretation for the algebra generated by the quantum cluster variables of the A_r quantum Q-system (Di Francesco and Kedem in Int Math Res Not IMRN 10:2593-2642, 2014). We show that the algebra can be described as a quotient of the localization of the quantum algebra U_{√{q}}({n}[u,u^{-1}])subset U_{√{q}}(widehat{{sl}}_2), in the Drinfeld presentation. The generating current is made up of a subset of the cluster variables which satisfy the Q-system, which we call fundamental. The other cluster variables are given by a quantum determinant-type formula, and are polynomials in the fundamental generators. The conserved quantities of the discrete evolution (Di Francesco and Kedem in Adv Math 228(1):97-152, 2011) described by quantum Q-system generate the Cartan currents at level 0, in a non-standard polarization. The rest of the quantum affine algebra is also described in terms of cluster variables.

  11. Quantum Q systems: from cluster algebras to quantum current algebras

    Science.gov (United States)

    Di Francesco, Philippe; Kedem, Rinat

    2016-11-01

    This paper gives a new algebraic interpretation for the algebra generated by the quantum cluster variables of the A_r quantum Q-system (Di Francesco and Kedem in Int Math Res Not IMRN 10:2593-2642, 2014). We show that the algebra can be described as a quotient of the localization of the quantum algebra U_{√{q}}({{n}}[u,u^{-1}])subset U_{√{q}}(widehat{{{sl}}}_2) , in the Drinfeld presentation. The generating current is made up of a subset of the cluster variables which satisfy the Q-system, which we call fundamental. The other cluster variables are given by a quantum determinant-type formula, and are polynomials in the fundamental generators. The conserved quantities of the discrete evolution (Di Francesco and Kedem in Adv Math 228(1):97-152, 2011) described by quantum Q-system generate the Cartan currents at level 0, in a non-standard polarization. The rest of the quantum affine algebra is also described in terms of cluster variables.

  12. Fuzzy Controller based Neutral Current Harmonic Suppression in Distribution System

    Directory of Open Access Journals (Sweden)

    T.Guna Sekar

    2013-10-01

    Full Text Available Recent surveys of three-phase four-wire electric systems, buildings and industrial plants with computers and non-linear loads shows the excessive currents in the neutral conductor. This is mainly due to unbalancing system and non-linear loads. Third order harmonics are much dominant in the neutral conductor due to the presence of zero sequence components. In response to this concern, this paper presents a concept of series active filter scheme to suppress the neutral current harmonics to reduce the burden of the secondary of the distribution transformer. In this scheme, the series active filteris connected in series with the neutral conductor to eliminate the zero sequence components in the neutral conductor. In this paper, Fuzzy based controller is used to extract the harmonic component in the neutral conductor. The proposed method improves the overall performance of the system and eliminates the burden of the neutral conductor. To validate the proposed simulation results, a scale-down prototype experimental model is developed.

  13. Understanding the current status and exploring the potential for distance education in public health in India.

    Science.gov (United States)

    Sharma, Kavya; George, Sunil; Zodpey, Sanjay

    2011-01-01

    Continuing education of health care providers plays an important role in producing a health work force that is efficient and effective. In India public health education has primarily relied on conventional methods of training. However, such methods have limitations in equipping the health workforce of a vast and varied country like India. This paper analyzes the current status of distance education in public health and lists the various courses that are presently available in India through the distance education mode. Presently 25 institutions in India are offering 69 courses in various domains of public health through distance education. The providers of these programs comprised both government and private educational institutions. This paper also points out the role and importance of various stakeholders in the design and delivery of distance education programs in public health and raises key areas that need attention in the governance of such programs. It urges the use of digital technology in the delivery of distance education programs and points out how distance education that is designed and delivered using the latest technology could address the current gap in training human resources for health in India.

  14. Health and Gross National Happiness: review of current status in Bhutan

    Directory of Open Access Journals (Sweden)

    Torres CE

    2011-08-01

    Full Text Available Tashi Tobgay1, Ugen Dophu1, Cristina E Torres2, Kesara Na-Bangchang31Department of Public Health, Ministry of Health, Kawajangsa, Bhutan; 2Forum for Ethical Review Committees in Asian and Western Pacific Region, Clinical Coordination and Training Center, 3Thailand Center of Excellence on Drug Discovery and Development (TCEDDD, Thammasat University, Rangsit Campus, ThailandAbstract: Worldwide, contemporary measures of the success of health development programs have been mostly in terms of the reduction of mortality and morbidity as well as increasing longevity. While these goals have yielded much-needed health improvements, the subjective outcomes of these improvements, as experienced by individuals and the communities, have not been considered. Bhutan, under the overarching policy of Gross National Happiness, has provided due consideration to these subjective indicators. Here, we report on the current status of health and happiness in Bhutan as revealed by conventional objective indicators and subjective Gross National Happiness indicators. The current literature on health in Bhutan in relation to the Gross National Happiness Survey conducted by the Centre of Bhutan Studies has been reviewed. Bhutan has made great strides within a short period of modernization, as shown by both objective and subjective indicators. Tremendous challenges lie ahead to achieve the ultimate goal of health and happiness, and how Bhutan articulates its path to modernization may be a lesson for the rest of the world.Keywords: Bhutan, happiness, health, indicators

  15. The importance of health advocacy in Canadian postgraduate medical education: current attitudes and issues

    Directory of Open Access Journals (Sweden)

    Alexander Poulton

    2015-12-01

    Full Text Available Background: Health advocacy is currently a key component of medical education in North America. In Canada, Health Advocate is one of the seven roles included in the Royal College of Physicians and Surgeons of Canada’s CanMEDS competency framework. Method: A literature search was undertaken to determine the current state of health advocacy in Canadian postgraduate medical education and to identify issues facing educators and learners with regards to health advocacy training. Results:  The literature revealed that the Health Advocate role is considered among the least relevant to clinical practice by educators and learners and among the most challenging to teach and assess. Furthermore learners feel their educational needs are not being met in this area. A number of key barriers affecting health advocacy education were identified including limited published material on the subject, lack of clarity within the role, insufficient explicit role modeling in practice, and lack of a gold standard for assessment. Health advocacy is defined and its importance to medical practice is highlighted, using pediatric emergency medicine as an example. Conclusions: Increased published literature and awareness of the role, along with integration of the new 2015 CanMEDS framework, are important going forward to address concerns regarding the quality of postgraduate health advocacy education in Canada.

  16. Ethical assessment of national health insurance system of Korea.

    Science.gov (United States)

    Lee, Yuri; Kim, Soyoon; Kim, Ganglip

    2012-09-01

    The current adverse effects of the health insurance system in Korea are considered to be problems that arise from an insufficient reflection of the notion of respecting human rights. The ethical principles most commonly suggested and used in public health are the 4 principles suggested by Beauchamp and Childress in 1994. From the perspective of the community, these 4 principles of medical ethics can be expanded to resolve problems surrounding existing social systems from a socialistic standpoint. This article describes a flexible, easy-to-use model for incorporating the 4 medical ethics principles into the National Health Insurance System (NHIS). First, the principle of respect for autonomy involves respecting the decision-making capacities of autonomous medical consumers and providers and enabling individuals to make reasoned and informed choices. Second is the principle of good practice. The government and medical institutions should act in a way that benefits the health care consumers. The principle of prohibiting bad practice involves avoiding causing health problems. The National Health Insurance Corporation and health care providers should not harm the health care consumers. Finally, the principle of justice is concerned with distributing benefits, risks, and costs fairly-that is, the notion that patients in similar positions should be treated in a similar manner. If these problems are solved, health system quality could be better and more accessible and sustainable. The ethical assessment of the NHIS could be a trial to match the 4 medical ethics principles and the NHIS. It can be applied internationally to relevant policy makers in different settings.

  17. Design of smart neonatal health monitoring system using SMCC.

    Science.gov (United States)

    De, Debashis; Mukherjee, Anwesha; Sau, Arkaprabha; Bhakta, Ishita

    2017-02-01

    Automated health monitoring and alert system development is a demanding research area today. Most of the currently available monitoring and controlling medical devices are wired which limits freeness of working environment. Wireless sensor network (WSN) is a better alternative in such an environment. Neonatal intensive care unit is used to take care of sick and premature neonates. Hypothermia is an independent risk factor for neonatal mortality and morbidity. To prevent it an automated monitoring system is required. In this Letter, an automated neonatal health monitoring system is designed using sensor mobile cloud computing (SMCC). SMCC is based on WSN and MCC. In the authors' system temperature sensor, acceleration sensor and heart rate measurement sensor are used to monitor body temperature, acceleration due to body movement and heart rate of neonates. The sensor data are stored inside the cloud. The health person continuously monitors and accesses these data through the mobile device using an Android Application for neonatal monitoring. When an abnormal situation arises, an alert is generated in the mobile device of the health person. By alerting health professional using such an automated system, early care is provided to the affected babies and the probability of recovery is increased.

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

    Science.gov (United States)

    Hanney, Stephen R; González-Block, Miguel A

    2014-09-23

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

  19. Personal Care in Learning Health Care Systems.

    Science.gov (United States)

    Miller, Franklin G; Kim, Scott Y H

    2015-12-01

    The idea of a "learning health care system"--one that systematically integrates clinical research with medical care--has received considerable attention recently. Some commentators argue that under certain conditions pragmatic comparative effectiveness randomized trials can be conducted ethically within the context of a learning health care system without the informed consent of patients for research participation. In this article, we challenge this perspective and contend that conducting randomized trials of individual treatment options without consent is neither necessary nor desirable to promote and sustain learning health care systems. Our argument draws on the normative conception of personal care developed by Charles Fried in a landmark 1974 book on the ethics of randomized controlled trials.

  20. Scientometric trends and knowledge maps of global health systems research

    Science.gov (United States)

    2014-01-01

    Background In the last few decades, health systems research (HSR) has garnered much attention with a rapid increase in the related literature. This study aims to review and evaluate the global progress in HSR and assess the current quantitative trends. Methods Based on data from the Web of Science database, scientometric methods and knowledge visualization techniques were applied to evaluate global scientific production and develop trends of HSR from 1900 to 2012. Results HSR has increased rapidly over the past 20 years. Currently, there are 28,787 research articles published in 3,674 journals that are listed in 140 Web of Science subject categories. The research in this field has mainly focused on public, environmental and occupational health (6,178, 21.46%), health care sciences and services (5,840, 20.29%), and general and internal medicine (3,783, 13.14%). The top 10 journals had published 2,969 (10.31%) articles and received 5,229 local citations and 40,271 global citations. The top 20 authors together contributed 628 papers, which accounted for a 2.18% share in the cumulative worldwide publications. The most productive author was McKee, from the London School of Hygiene & Tropical Medicine, with 48 articles. In addition, USA and American institutions ranked the first in health system research productivity, with high citation times, followed by the UK and Canada. Conclusions HSR is an interdisciplinary area. Organization for Economic Co-operation and Development countries showed they are the leading nations in HSR. Meanwhile, American and Canadian institutions and the World Health Organization play a dominant role in the production, collaboration, and citation of high quality articles. Moreover, health policy and analysis research, health systems and sub-systems research, healthcare and services research, health, epidemiology and economics of communicable and non-communicable diseases, primary care research, health economics and health costs, and pharmacy of

  1. Scientometric trends and knowledge maps of global health systems research.

    Science.gov (United States)

    Yao, Qiang; Chen, Kai; Yao, Lan; Lyu, Peng-hui; Yang, Tian-an; Luo, Fei; Chen, Shan-quan; He, Lu-yang; Liu, Zhi-yong

    2014-06-05

    In the last few decades, health systems research (HSR) has garnered much attention with a rapid increase in the related literature. This study aims to review and evaluate the global progress in HSR and assess the current quantitative trends. Based on data from the Web of Science database, scientometric methods and knowledge visualization techniques were applied to evaluate global scientific production and develop trends of HSR from 1900 to 2012. HSR has increased rapidly over the past 20 years. Currently, there are 28,787 research articles published in 3,674 journals that are listed in 140 Web of Science subject categories. The research in this field has mainly focused on public, environmental and occupational health (6,178, 21.46%), health care sciences and services (5,840, 20.29%), and general and internal medicine (3,783, 13.14%). The top 10 journals had published 2,969 (10.31%) articles and received 5,229 local citations and 40,271 global citations. The top 20 authors together contributed 628 papers, which accounted for a 2.18% share in the cumulative worldwide publications. The most productive author was McKee, from the London School of Hygiene & Tropical Medicine, with 48 articles. In addition, USA and American institutions ranked the first in health system research productivity, with high citation times, followed by the UK and Canada. HSR is an interdisciplinary area. Organization for Economic Co-operation and Development countries showed they are the leading nations in HSR. Meanwhile, American and Canadian institutions and the World Health Organization play a dominant role in the production, collaboration, and citation of high quality articles. Moreover, health policy and analysis research, health systems and sub-systems research, healthcare and services research, health, epidemiology and economics of communicable and non-communicable diseases, primary care research, health economics and health costs, and pharmacy of hospital have been identified as the

  2. Current approach for urinary system stone disease in pregnant women

    Directory of Open Access Journals (Sweden)

    Orcun Celik

    2016-01-01

    Full Text Available Urinary system stones can be classified according to size, location, X-ray characteristics, aetiology of formation, composition, and risk of recurrence. Especially urolithiasis during pregnancy is a diagnostic and therapeutic challenge. In most cases, it becomes symptomatic in the second or third trimester. Diagnostic options in pregnant women are limited due to the possible teratogenic, carcinogenic, and mutagenic risk of foetal radiation exposure. Clinical management of a pregnant urolithiasis patient is complex and demands close collaboration between patient, obstetrician and urologist. We would like to review current diagnosis and treatment modalities of stone disease of pregnant woman.

  3. Eddy current system for inspection of train hollow axles

    Energy Technology Data Exchange (ETDEWEB)

    Chady, Tomasz; Psuj, Grzegorz; Sikora, Ryszard; Kowalczyk, Jacek; Spychalski, Ireneusz [Department of Electrical and Computer Engineering, Faculty of Electrical Engineering, West Pomeranian University of Technology, Szczecin (Poland)

    2014-02-18

    The structural integrity of wheelsets used in rolling stock is of great importance to the safety. In this paper, electromagnetic system with an eddy current transducer suitable for the inspection of hollow axles have been presented. The transducer was developed to detect surface braking defects having depth not smaller than 0.5 mm. Ultrasound technique can be utilized to inspect the whole axle, but it is not sufficiently sensitive to shallow defects located close to the surface. Therefore, the electromagnetic technique is proposed to detect surface breaking cracks that cannot be detected by ultrasonic technique.

  4. Current approach for urinary system stone disease in pregnant women.

    Science.gov (United States)

    Celik, Orcun; Türk, Hakan; Cakmak, Ozgur; Budak, Salih; Ekin, Rahmi Gokhan; Keskin, Mehmet Zeynel; Yildiz, Guner; Ilbey, Yusuf Ozlem

    2016-01-14

    Urinary system stones can be classified according to size, location, X-ray characteristics, aetiology of formation, composition, and risk of recurrence. Especially urolithiasis during pregnancy is a diagnostic and therapeutic challenge. In most cases, it becomes symptomatic in the second or third trimester. Diagnostic options in pregnant women are limited due to the possible teratogenic, carcinogenic, and mutagenic risk of foetal radiation exposure. Clinical management of a pregnant urolithiasis patient is complex and demands close collaboration between patient, obstetrician and urologist. We would like to review current diagnosis and treatment modalities of stone disease of pregnant woman.

  5. Meeting current public health needs: optical biosensors for pathogen detection and analysis

    Science.gov (United States)

    Yang, Minghui; Sapsford, Kim E.; Sergeev, Nikolay; Sun, Steven; Rasooly, Avraham

    2009-02-01

    Pathogen detection and analysis is critical for medicine, food safety, agriculture, public health and biosecurity. Many current microbial detection approaches are based on century-old culturing methods which, while reliable, are slow, provide relatively little information about the pathogens and are not adaptable to high throughput operations. Optical biodetection represents a potential alternative. Most ELISA and chromatography systems are based on optical methods that are also used for analysis of molecular interactions, such as DNA hybridization and protein-protein interactions (e.g. microarrays or SPR biosensors). Various optical biosensor platforms have been developed that have many of the characteristics essential for modern pathogen molecular analysis including sensitivity, speed of analysis, multi-channel capability, relative simplicity and low cost. Here we provide several examples of the use of optical biosensor technology for pathogen detection and analysis including high throughput DNA microarray analysis, SPR-based rapid direct detection of bacterial toxins, CCD-based fluorescent activity analysis of microbial toxins and a simple ECL-based CCD detection system. However, while effective for molecular analysis, most of these technologies are not as sensitive as traditional culturing methods for detecting microorganisms. There is a need to combine optical biosensors with traditional methods to speed culture-based detection and to provide more information regarding the pathogens.

  6. The frontoparietal control system: A central role in mental health

    Science.gov (United States)

    Cole, Michael W.; Repovs, Grega; Anticevic, Alan

    2014-01-01

    Recent findings suggest the existence of a frontoparietal control system consisting of ‘flexible hubs’ that regulate distributed systems (e.g., visual, limbic, motor) according to current task goals. A growing number of studies are reporting alterations of this control system across a striking range of mental diseases. We suggest this may reflect a critical role for the control system in promoting and maintaining mental health. Specifically, we propose that this system implements feedback control to regulate symptoms as they arise (e.g., excessive anxiety reduced via regulation of amygdala), such that an intact control system is protective against a variety of mental illnesses. Consistent with this possibility, recent results indicate that several major mental illnesses involve altered brain-wide connectivity of the control system, likely altering its ability to regulate symptoms. These results suggest that this ‘immune system of the mind’ may be an especially important target for future basic and clinical research. PMID:24622818

  7. eHealth strategy for the Americas region: current situation and perspectives

    OpenAIRE

    D’Agostino, Marcelo; Organización Panamericana de la Salud, Organización Mundial de la Salud.

    2015-01-01

    The main objective of the Strategy and Plan of Action on eHealth (2012-2017) is to contribute to sustainable developmentof health systems of member states. Its adoption aims to improve quality and access to health services through the use ofinformation and communication technologies (ICT), the implementation of digital literacy programs and access to qualityinformation to advance towards more informed, equitable, competitive and democratic societies. PAHO/WHO considers thatin society, free an...

  8. Gastric Antral Vascular Ectasia in Systemic Sclerosis: Current Concepts

    Directory of Open Access Journals (Sweden)

    Raphael Hernando Parrado

    2015-01-01

    Full Text Available Introduction. Gastric antral vascular ectasia (GAVE is a rare entity with unique endoscopic appearance described as “watermelon stomach.” It has been associated with systemic sclerosis but the pathophysiological changes leading to GAVE have not been explained and still remain uncertain. Methods. Databases Medline, Scopus, Embase, PubMed, and Cochrane were searched for relevant papers. The main search words were “Gastric antral vascular ectasia,” “Watermelon Stomach,” “GAVE,” “Scleroderma,” and “Systemic Sclerosis.” Fifty-four papers were considered for this review. Results. GAVE is a rare entity in the spectrum of manifestations of systemic sclerosis with unknown pathogenesis. Most patients with systemic sclerosis and GAVE present with asymptomatic anemia, iron deficiency anemia, or heavy acute gastrointestinal bleeding. Symptomatic therapy and endoscopic ablation are the first-line of treatment. Surgical approach may be recommended for patients who do not respond to medical or endoscopic therapies. Conclusion. GAVE can be properly diagnosed and treated. Early diagnosis is key in the management of GAVE because it makes symptomatic therapies and endoscopic approaches feasible. A high index of suspicion is critical. Future studies and a critical review of the current findings about GAVE are needed to understand the role of this condition in systemic sclerosis.

  9. Gastric Antral Vascular Ectasia in Systemic Sclerosis: Current Concepts.

    Science.gov (United States)

    Parrado, Raphael Hernando; Lemus, Hernan Nicolas; Coral-Alvarado, Paola Ximena; Quintana López, Gerardo

    2015-01-01

    Introduction. Gastric antral vascular ectasia (GAVE) is a rare entity with unique endoscopic appearance described as "watermelon stomach." It has been associated with systemic sclerosis but the pathophysiological changes leading to GAVE have not been explained and still remain uncertain. Methods. Databases Medline, Scopus, Embase, PubMed, and Cochrane were searched for relevant papers. The main search words were "Gastric antral vascular ectasia," "Watermelon Stomach," "GAVE," "Scleroderma," and "Systemic Sclerosis." Fifty-four papers were considered for this review. Results. GAVE is a rare entity in the spectrum of manifestations of systemic sclerosis with unknown pathogenesis. Most patients with systemic sclerosis and GAVE present with asymptomatic anemia, iron deficiency anemia, or heavy acute gastrointestinal bleeding. Symptomatic therapy and endoscopic ablation are the first-line of treatment. Surgical approach may be recommended for patients who do not respond to medical or endoscopic therapies. Conclusion. GAVE can be properly diagnosed and treated. Early diagnosis is key in the management of GAVE because it makes symptomatic therapies and endoscopic approaches feasible. A high index of suspicion is critical. Future studies and a critical review of the current findings about GAVE are needed to understand the role of this condition in systemic sclerosis.

  10. Multiple planetary systems: Properties of the current sample

    Science.gov (United States)

    Hobson, Melissa J.; Gomez, Mercedes

    2017-08-01

    We carry out analyses on stellar and planetary properties of multiple exoplanetary systems in the currently available sample. With regards to the stars, we study their temperature, distance from the Sun, and metallicity distributions, finding that the stars that harbour multiple exoplanets tend to have subsolar metallicities, in contrast to metal-rich Hot Jupiter hosts; while non-Hot Jupiter single planet hosts form an intermediate group between these two, with approximately solar metallicities. With regards to the planetary systems, we select those with four or more planets and analyse their configurations in terms of stability (via Hill radii), compactness, and size variations. We find that most planetary pairs are stable, and that the compactness correlates to the size variation: More compact systems have more similarly sized planets and vice versa. We also investigate the spectral energy distributions of the stars hosting multiple exoplanetary systems, seeking infra-red excesses that could indicate the presence of debris disks. These disks would be leftovers from the planetary formation process, and could be considered as analogues of the Solar System's Asteroid or Kuiper belts. We identify potential candidates for disks that are good targets for far infra-red follow-up observations to confirm their existence.

  11. Mini Solar and Sea Current Power Generation System

    Science.gov (United States)

    Almenhali, Abdulrahman; Alshamsi, Hatem; Aljunaibi, Yaser; Almussabi, Dheyab; Alshehhi, Ahmed; Hilal, Hassan Bu

    2017-07-01

    The power demand in United Arab Emirates is increased so that there is a consistent power cut in our region. This is because of high power consumption by factories and also due to less availability of conventional energy resources. Electricity is most needed facility for the human being. All the conventional energy resources are depleting day by day. So we have to shift from conventional to non-conventional energy resources. In this the combination of two energy resources is takes place i.e. wind and solar energy. This process reviles the sustainable energy resources without damaging the nature. We can give uninterrupted power by using hybrid energy system. Basically this system involves the integration of two energy system that will give continuous power. Solar panels are used for converting solar energy and wind turbines are used for converting wind energy into electricity. This electrical power can utilize for various purpose. Generation of electricity will be takes place at affordable cost. This paper deals with the generation of electricity by using two sources combine which leads to generate electricity with affordable cost without damaging the nature balance. The purpose of this project was to design a portable and low cost power system that combines both sea current electric turbine and solar electric technologies. This system will be designed in efforts to develop a power solution for remote locations or use it as another source of green power.

  12. Comments on Current Space Systems Observing the Climate

    Science.gov (United States)

    Fisk, L. A.

    2016-07-01

    The Global Climate Observing System (GCOS), which was established in 1992, has been effective in specifying the observations needed for climate studies, and advocating that these observations be made. As a result, there are essential climate variables being observed, particularly from space, and these have formed the basis for our ever-improving models of how the Earth system functions and the human impact on it. We cannot conclude, however, that the current observing system in space is adequate. Climate change is accelerating, and we need to ensure that our observations capture, with completeness and with proper resolution and cadence, the most important changes. Perhaps of most significance, we need to use observations from space to guide the mitigation and adaptation strategies on which at last our civilization seems prepared to embark. And we need to use our observations to educate particularly policy makers on the reality of climate change, so that none deny the need to act. COSPAR is determined to play its part in highlighting the need to strengthen the climate observing system and notably its research component. This is being accomplished through events like the present roundtable, through the work of its Scientific Commission A, its Task Group on GEO (where COSPAR is serving as a member of its Program Board), and by promoting among space agencies and policy-makers the recently released scientific roadmap on Integrated Earth System Science for the period 2016-2025.

  13. Poverty and health disparities for American Indian and Alaska Native children: current knowledge and future prospects.

    Science.gov (United States)

    Sarche, Michelle; Spicer, Paul

    2008-01-01

    This report explores the current state of knowledge regarding inequalities and their effect on American Indian and Alaska Native children, underscoring gaps in our current knowledge and the opportunities for early intervention to begin to address persistent challenges in young American Indian and Alaska Native children's development. This overview documents demographic, social, health, and health care disparities as they affect American Indian and Alaska Native children, the persistent cultural strengths that must form the basis for any conscientious intervention effort, and the exciting possibilities for early childhood interventions.

  14. Early Stage Health Technology Assessment for Precision Biomarkers in Oral Health and Systems Medicine.

    Science.gov (United States)

    Steuten, Lotte M G

    2016-01-01

    Health technology assessment (HTA) is a crucial science that influences the responsible and evidence-based transition of new discoveries from laboratory to applications in the clinic and society. HTA has recently moved "upstream" so as to assess technologies from their onset at their discovery, design, or planning phase. Biomarker research is relatively recent in oral health, but growing rapidly with investments made to advance dentistry and oral health and importantly, to build effective bridges between oral health and systems medicine since what happens in oral health affects systems pathophysiology, and vice versa. This article offers a synthesis of the latest trends and approaches in early phase HTA, with a view to near future applications in oral health, systems medicine, and biomarker-guided precision medicine. In brief, this review underscores that demonstrating health outcomes of biomarkers and next-generation diagnostics is particularly challenging because they do not always influence long-term outcomes directly, but rather impact subsequent care processes. Biomarker testing costs are typically less of a barrier to uptake in practice than the biomarker's impact on longer term health outcomes. As a single biomarker or next-generation diagnostic in oral health can inform decisions about numerous downstream diagnosis-treatment combinations, early stage "upstream" HTA is crucial in prioritizing the most valuable diagnostic applications to pursue first. For the vast array of oral health biomarkers currently developed, early HTA is necessary to timely and iteratively assess their comparative effectiveness and anticipate the inevitable questions about value for money from regulators and payers.

  15. Uncomfortable trade-offs: Canadian policy makers' perspectives on setting objectives for their health systems.

    Science.gov (United States)

    Abelson, Julia; Allin, Sara; Grignon, Michel; Pasic, Dianna; Walli-Attaei, Marjan

    2017-01-01

    Although a wide range of health system performance indicators are commonly reported on, there has been little effort to establish their relevance to the objectives that health systems actually pursue. The aim of this study was to identify, explore and better understand health policy makers' views regarding the objectives and outcomes for their health systems, how they are prioritized, and the underlying processes that yield them to inform the development of health system efficiency measures. A descriptive, qualitative methodology was employed using key informant interviews with 17 current and former senior health ministry officials in 8 Canadian provinces and 2 territories. Health ministries have clearly stated objectives for health systems focused on the achievement of health system delivery and population health goals and, increasingly, public, patient and financial accountability. Acute care objectives are routinely prioritized over population health objectives and viewed as resulting from challenges associated with difficult trade-off decisions shaped by organized interests and the media rather than explicit, evidence-based processes. This study provides insights beyond publicly available documents to explore the processes that underlie simple statements of health system objectives. Our findings suggest that despite respondents giving priority to improving individual and population health, it is more commonly portrayed as an ideal objective than as a realistic one. By understanding what lies behind statements about what health systems are striving for, we offer a more robust avenue for increasing the uptake of future studies of health system performance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. A versatile approach to health system evaluation.

    Science.gov (United States)

    Beghin, D; Dujardin, B; Wollast, E

    1989-01-01

    Although problems in the relationships between different levels of health care systems in developing countries have a significant influence on efficiency, they have not been clearly defined. In the present article a simple method is described for assessing certain aspects of these problems. It is shown that data collected in a hospital can be used not only to highlight inadequate management of patients at the community level, but also to identify deficiencies at the community/hospital interface. The method is inexpensive and easy to understand, and could easily be adapted for every interface in a system and for all stages of health service development.

  17. Biogeochemical properties of eddies in the California Current System

    Science.gov (United States)

    Chenillat, Fanny; Franks, Peter J. S.; Combes, Vincent

    2016-06-01

    The California Current System (CCS) has intense mesoscale activity that modulates and exports biological production from the coastal upwelling system. To characterize and quantify the ability of mesoscale eddies to affect the local and regional planktonic ecosystem of the CCS, we analyzed a 10 year-long physical-biological model simulation, using eddy detection and tracking to isolate the dynamics of cyclonic and anticyclonic eddies. As they propagate westward across the shelf, cyclonic eddies efficiently transport coastal planktonic organisms and maintain locally elevated production for up to 1 year (800 km offshore). Anticyclonic eddies, on the other hand, have a limited impact on local production over their ~6 month lifetime as they propagate 400 km offshore. At any given time ~8% of the model domain was covered by eddy cores. Though the eddies cover a small area, they explain ~50 and 20% of the transport of nitrate and plankton, respectively.

  18. A compact analytical formalism for current transients in electrochemical systems

    CERN Document Server

    Nair, Pradeep R

    2011-01-01

    Micro and nanostructured electrodes form an integral part of a wide variety of electrochemical systems for biomolecule detection, batteries, solar cells, scanning electrochemical microscopy, etc. Given the complexity of the electrode structures, the Butler-Volmer formalism of redox reactions, and the diffusion transport of redox species, it is hardly surprising that only a few problems are amenable to closed form, compact analytical solutions. While numerical solutions are widely used, it is often difficult to integrate the insights gained to the design and optimization of electrochemical systems. In this article, we develop a comprehensive analytical formalism for current transients that not only anticipate the response of complex electrode structures to complicated voltammetry measurements, but also intuitively interpret diverse experiments such as redox detection of molecules at nanogap electrodes, scanning electrochemical microscopy, etc. The results from the analytical model, well supported through detai...

  19. Electric machine and current source inverter drive system

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, John S

    2014-06-24

    A drive system includes an electric machine and a current source inverter (CSI). This integration of an electric machine and an inverter uses the machine's field excitation coil for not only flux generation in the machine but also for the CSI inductor. This integration of the two technologies, namely the U machine motor and the CSI, opens a new chapter for the component function integration instead of the traditional integration by simply placing separate machine and inverter components in the same housing. Elimination of the CSI inductor adds to the CSI volumetric reduction of the capacitors and the elimination of PMs for the motor further improve the drive system cost, weight, and volume.

  20. Spin-current Seebeck effect in quantum dot systems.

    Science.gov (United States)

    Yang, Zhi-Cheng; Sun, Qing-Feng; Xie, X C

    2014-01-29

    We first bring up the concept of the spin-current Seebeck effect based on a recent experiment (Vera-Marun et al 2012 Nature Phys. 8 313), and investigate the spin-current Seebeck effect in quantum dot (QD) systems. Our results show that the spin-current Seebeck coefficient S is sensitive to different polarization states of the QD, and therefore can be used to detect the polarization state of the QD and monitor the transitions between different polarization states of the QD. The intradot Coulomb interaction can greatly enhance S due to the stronger polarization of the QD. By using the parameters for a typical QD whose intradot Coulomb interaction U is one order of magnitude larger than the linewidth Γ, we demonstrate that the maximum value of S can be enhanced by a factor of 80. On the other hand, for a QD whose Coulomb interaction is negligible, we show that one can still obtain a large S by applying an external magnetic field.

  1. A see through future: augmented reality and health information systems.

    Science.gov (United States)

    Monkman, Helen; Kushniruk, Andre W

    2015-01-01

    Augmented Reality (AR) is a method whereby virtual objects are superimposed on the real world. AR technology is becoming increasingly accessible and affordable and it has many potential health applications. This paper discusses current research on AR health applications such as medical education and medical practice. Some of the potential future uses for this technology (e.g., health information systems, consumer health applications) will also be presented. Additionally, there will be a discussion outlining some of usability and human factors challenges associated with AR in healthcare. It is expected that AR will become increasingly prevalent in healthcare; however, further investigation is required to demonstrate that they provide benefits over traditional methods. Moreover, AR applications must be thoroughly tested to ensure they do not introduce new errors into practice and have patient safety implications.

  2. Using interorganizational partnerships to strengthen public health laboratory systems.

    Science.gov (United States)

    Hsieh, Kristina; Kimsey, Paul; Buehring, Gertrude

    2013-01-01

    Due to the current economic environment, many local and state health departments are faced with budget reductions. Health department administrators and public health laboratory (PHL) directors need to assess strategies to ensure that their PHLs can provide the same level of service with decreased funds. Exploratory case studies of interorganizational partnerships among local PHLs in California were conducted to determine the impact on local PHL testing services and capacity. Our findings suggest that interorganizational forms of cooperation among local PHLs can help bolster laboratory capacity by capturing economies of scale, leveraging scarce resources, and ensuring access to affordable, timely, and quality laboratory testing services. Interorganizational partnerships will help local and state public health departments continue to maintain a strong and robust laboratory system that supports their role in communicable disease surveillance.

  3. 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.

  4. Probing other solar systems with current and future adaptive optics

    Energy Technology Data Exchange (ETDEWEB)

    Macintosh, B; Marois, C; Phillion, D; Poyneer, L; Graham, J; Zuckerman, B; Gavel, D; Veran, J; Wilhelmsen-Evans, J; Mellis, C

    2008-09-08

    Over the past decade, the study of extrasolar planets through indirect techniques--primarily Doppler measurements--has revolutionized our understanding of other solar systems. The next major step in this field will be the direct detection and characterization, via imaging and spectroscopy, of the planets themselves. To achieve this, we must separate the light from the faint planet from the extensive glare of its parent star. We pursued this goal using the current generation of adaptive optics (AO) systems on large ground-based telescopes, using infrared imaging to search for the thermal emission from young planets and developing image processing techniques to distinguish planets from telescope-induced artifacts. Our new Angular Differential Imaging (ADI) technique, which uses the sidereal rotation of the Earth and telescope, is now standard for ground-based high-contrast imaging. Although no young planets were found in our surveys, we placed the strongest limits yet on giant planets in wide orbits (>30 AU) around young stars and characterized planetary companion candidates. The imaging of planetary companions on solar-system-like scales (5-30 AU) will require a new generation of advanced AO systems that are an order of magnitude more powerful than the LLNL-built Keck AO system. We worked to develop and test the key technologies needed for these systems, including a spatially-filtered wavefront sensor, efficient and accurate wavefront reconstruction algorithms, and precision AO wavefront control at the sub-nm level. LLNL has now been selected by the Gemini Observatory to lead the construction of the Gemini Planet Imager, a $24M instrument that will be the most advanced AO system in the world.

  5. Probing other solar systems with current and future adaptive optics

    Energy Technology Data Exchange (ETDEWEB)

    Macintosh, B; Marois, C; Phillion, D; Poyneer, L; Graham, J; Zuckerman, B; Gavel, D; Veran, J; Wilhelmsen-Evans, J; Mellis, C

    2008-09-08

    Over the past decade, the study of extrasolar planets through indirect techniques--primarily Doppler measurements--has revolutionized our understanding of other solar systems. The next major step in this field will be the direct detection and characterization, via imaging and spectroscopy, of the planets themselves. To achieve this, we must separate the light from the faint planet from the extensive glare of its parent star. We pursued this goal using the current generation of adaptive optics (AO) systems on large ground-based telescopes, using infrared imaging to search for the thermal emission from young planets and developing image processing techniques to distinguish planets from telescope-induced artifacts. Our new Angular Differential Imaging (ADI) technique, which uses the sidereal rotation of the Earth and telescope, is now standard for ground-based high-contrast imaging. Although no young planets were found in our surveys, we placed the strongest limits yet on giant planets in wide orbits (>30 AU) around young stars and characterized planetary companion candidates. The imaging of planetary companions on solar-system-like scales (5-30 AU) will require a new generation of advanced AO systems that are an order of magnitude more powerful than the LLNL-built Keck AO system. We worked to develop and test the key technologies needed for these systems, including a spatially-filtered wavefront sensor, efficient and accurate wavefront reconstruction algorithms, and precision AO wavefront control at the sub-nm level. LLNL has now been selected by the Gemini Observatory to lead the construction of the Gemini Planet Imager, a $24M instrument that will be the most advanced AO system in the world.

  6. [Magnetoreception systems in birds: a review of current research].

    Science.gov (United States)

    Kishkinev, D A; Chernetsov, N S

    2014-01-01

    Currently at least two independent systems of magnetoreception are believed to exist in birds, based on different biophysical principles, located in different parts of their bodies, and having different innervation. One magnetoreceptory system is located in the retina and may be based on photo-induced biradical chemical reactions on the basis of cryptochrome. Information from these receptors is processed in a specialized part of visual Wulst, the so-called Cluster N. There are good reasons to believe that this visual magnetoreceptor processes compass magnetic information which is necessary for migratory orientation. The second magnetoreceptory system is probably iron-based (biogenic magnetite), is located somewhere in the upper beak (its exact location and ultrastructure of receptors remain unknown), and is innervated by the ophthalmic branch of trigeminal nerve. It cannot be ruled out that this system participates in spatial representation and helps forming either a kind of map or more primitive signposts, based on regular spatial variation of the geomagnetic field. The magnetic map probably governs navigation of migrating birds across hundreds and thousands of kilometers. Apart from these two systems whose existence may be considered to be convincingly shown (even if their details are not yet fully clear), there are data on the existence of magnetoreceptors based on the vestibular system. It cannot be ruled out that iron-based magnetoreception takes place in lagena (a structure homologous to cochlea of marsupials and eutherians), and the information perceived is processes in vestibular nuclei. The very existence of this magnetoreception system needs verification, and its function remains completely open.

  7. Method and system for a gas tube-based current source high voltage direct current transmission system

    Energy Technology Data Exchange (ETDEWEB)

    She, Xu; Chokhawala, Rahul Shantilal; Bray, James William; Sommerer, Timothy John; Zhou, Rui; Zhang, Di

    2017-08-29

    A high-voltage direct-current (HVDC) transmission system includes an alternating current (AC) electrical source and a power converter channel that includes an AC-DC converter electrically coupled to the electrical source and a DC-AC inverter electrically coupled to the AC-DC converter. The AC-DC converter and the DC-AC inverter each include a plurality of legs that includes at least one switching device. The power converter channel further includes a commutating circuit communicatively coupled to one or more switching devices. The commutating circuit is configured to "switch on" one of the switching devices during a first portion of a cycle of the H-bridge switching circuits and "switch off" the switching device during a second portion of the cycle of the first and second H-bridge switching circuits.

  8. Mediterranea Forecasting System: a focus on wave-current coupling

    Science.gov (United States)

    Clementi, Emanuela; Delrosso, Damiano; Pistoia, Jenny; Drudi, Massimiliano; Fratianni, Claudia; Grandi, Alessandro; Pinardi, Nadia; Oddo, Paolo; Tonani, Marina

    2016-04-01

    The Mediterranean Forecasting System (MFS) is a numerical ocean prediction system that produces analyses, reanalyses and short term forecasts for the entire Mediterranean Sea and its Atlantic Ocean adjacent areas. MFS became operational in the late 90's and has been developed and continuously improved in the framework of a series of EU and National funded programs and is now part of the Copernicus Marine Service. The MFS is composed by the hydrodynamic model NEMO (Nucleus for European Modelling of the Ocean) 2-way coupled with the third generation wave model WW3 (WaveWatchIII) implemented in the Mediterranean Sea with 1/16 horizontal resolution and forced by ECMWF atmospheric fields. The model solutions are corrected by the data assimilation system (3D variational scheme adapted to the oceanic assimilation problem) with a daily assimilation cycle, using a background error correlation matrix varying seasonally and in different sub-regions of the Mediterranean Sea. The focus of this work is to present the latest modelling system upgrades and the related achieved improvements. In order to evaluate the performance of the coupled system a set of experiments has been built by coupling the wave and circulation models that hourly exchange the following fields: the sea surface currents and air-sea temperature difference are transferred from NEMO model to WW3 model modifying respectively the mean momentum transfer of waves and the wind speed stability parameter; while the neutral drag coefficient computed by WW3 model is passed to NEMO that computes the turbulent component. In order to validate the modelling system, numerical results have been compared with in-situ and remote sensing data. This work suggests that a coupled model might be capable of a better description of wave-current interactions, in particular feedback from the ocean to the waves might assess an improvement on the prediction capability of wave characteristics, while suggests to proceed toward a fully

  9. Accessibility and use of essential medicines in health care: Current progress and challenges in India.

    Science.gov (United States)

    Bansal, Dipika; Purohit, Vilok K

    2013-01-01

    Essential Medicine Concept, a major breakthrough in health care, started in 1977 when World Health Organization (WHO) published its first list. Appropriate use of essential medicines is one of the most cost-effective components of modern health care. The selection process has evolved from expert evaluation to evidence-based selection. The first Indian list was published in 1996 and the recent revision with 348 medicines was published in 2011 after 8 years. Health expenditure is less in India as compared to developed countries. India faces a major challenge in providing access to medicines for its 1.2 billion people by focusing on providing essential medicines. In the future, countries will face challenges in selecting high-cost medicines for oncology, orphan diseases and other conditions. There is a need to develop strategies to improve affordable access to essential medicines under the current health care reform.

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

    Science.gov (United States)

    Greenley, J R

    1992-10-01

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

  11. Human resources for mental health care: current situation and strategies for action.

    Science.gov (United States)

    Kakuma, Ritsuko; Minas, Harry; van Ginneken, Nadja; Dal Poz, Mario R; Desiraju, Keshav; Morris, Jodi E; Saxena, Shekhar; Scheffler, Richard M

    2011-11-05

    A challenge faced by many countries is to provide adequate human resources for delivery of essential mental health interventions. The overwhelming worldwide shortage of human resources for mental health, particularly in low-income and middle-income countries, is well established. Here, we review the current state of human resources for mental health, needs, and strategies for action. At present, human resources for mental health in countries of low and middle income show a serious shortfall that is likely to grow unless effective steps are taken. Evidence suggests that mental health care can be delivered effectively in primary health-care settings, through community-based programmes and task-shifting approaches. Non-specialist health professionals, lay workers, affected individuals, and caregivers with brief training and appropriate supervision by mental health specialists are able to detect, diagnose, treat, and monitor individuals with mental disorders and reduce caregiver burden. We also discuss scale-up costs, human resources management, and leadership for mental health, particularly within the context of low-income and middle-income countries.

  12. Developing district health systems in the rural Transvaal Issues ...

    African Journals Online (AJOL)

    Developing district health systems in the rural Transvaal Issues arising from the ... as a foundation for national health services based on primary health care. ... Close attention needs to be given to districtlevel health management, the ...

  13. A telemedicine health care delivery system

    Science.gov (United States)

    Sanders, Jay H.

    1991-01-01

    The Interactive Telemedicine Systems (ITS) system was specifically developed to address the ever widening gap between our medical care expertise and our medical care delivery system. The frustrating reality is that as our knowledge of how to diagnose and treat medical conditions has continued to advance, the system to deliver that care has remained in an embryonic stage. This has resulted in millions of people being denied their most basic health care needs. Telemedicine utilizes an interactive video system integrated with biomedical telemetry that allows a physician at a base station specialty medical complex or teaching hospital to examine and treat a patient at multiple satellite locations, such as rural hospitals, ambulatory health centers, correctional institutions, facilities caring for the elderly, community hospital emergency departments, or international health facilities. Based on the interactive nature of the system design, the consulting physician at the base station can do a complete history and physical examination, as if the patient at the satellite site was sitting in the physician's office. This system is described.

  14. Vitamin D in ocular and systemic health

    Directory of Open Access Journals (Sweden)

    Solani D. Mathebula

    2015-03-01

    Full Text Available Accumulated data supports the argument that vitamin D possesses several biological and molecular actions apart from its role in calcium absorption and facilitation of gene expression. Vitamin D deficiency has been an associated risk factor for cardiovascular disease,metabolic syndrome and ocular complications. The aim of this review is to summarise the most relevant data regarding these associations and to try to clarify whether, and to what extent, oral vitamin D supplementation could be used as a beneficial intervention in such diseases.Vitamin D is produced in skin exposed to sunlight UVB radiation and is then metabolised by the kidney into calciferol, which is an active form. The main function of vitamin D is to promote calcium and phosphorus absorption, and studies have shown that a lack of itplays an important role in ocular conditions, such as age-related macular degeneration and diabetic retinopathy. Recent studies have suggested that vitamin D may protect the diabetic retina; however, other vitamin D-associated conditions (diabetes, hypertension and cardiovascular diseases may result in secondary ocular manifestations and the potential forsight-threatening complications. The purpose of this review is to describe the current literature on the role of vitamin D in ocular and systemic wellness. However, more research is needed to determine if increasing levels of this vitamin can assist in preventing age-related macular degeneration or diabetic retinopathy. Since vitamin D is a circulating steroid hormone, its receptors are found in almost every cell in the human body, and this suggests that vitamin D might have a very broad role for overall health. However, there is still demand for further research to clarify the clinical use of vitamin D in the prevention and treatment of various chronic diseases.

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

    Directory of Open Access Journals (Sweden)

    Elesban Kihuba

    2016-06-01

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

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

    Science.gov (United States)

    Kihuba, Elesban; Gheorghe, Adrian; Bozzani, Fiammetta; English, Mike; Griffiths, Ulla K

    2016-01-01

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

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

    Science.gov (United States)

    Kihuba, Elesban; Gheorghe, Adrian; Bozzani, Fiammetta; English, Mike; Griffiths, Ulla K.

    2016-01-01

    Background Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. Design We reviewed policy documents, and conducted field observations and semi-structured interviews with key informants in the health sector. We used an adapted Human, Organization and Technology fit (HOT-fit) framework to analyze the components and standards of a cost accounting system. Results Among the opportunities for a viable cost accounting system, we identified a supportive broad policy environment, political will, presence of a national data reporting architecture, good implementation experience with electronic medical records systems, and the availability of patient clinical and resource use data. However, several practical issues need to be considered in the design of the system, including the lack of a framework to guide the costing process, the lack of long-term investment, the lack of appropriate incentives for ground-level staff, and a risk of overburdening the current health management information system. Conclusion To facilitate the implementation of cost accounting into the health sector, the design of any proposed system needs to remain simple and attuned to the local context. PMID:27357072

  18. Leveraging health informatics to foster a smart systems response to health disparities and health equity challenges.

    Science.gov (United States)

    Carney, Timothy Jay; Kong, Amanda Y

    2017-04-01

    Informaticians are challenged to design health information technology (IT) solutions for complex problems, such as health disparities, but are achieving mixed results in demonstrating a direct impact on health outcomes. This presentation of collective intelligence and the corresponding terms of smart health, knowledge ecosystem, enhanced health disparities informatics capacities, knowledge exchange, big-data, and situational awareness are a means of demonstrating the complex challenges informatics professionals face in trying to model, measure, and manage an intelligent and smart systems response to health disparities. A critical piece in our understanding of collective intelligence for public and population health rests in our understanding of public and population health as a living and evolving network of individuals, organizations, and resources. This discussion represents a step in advancing the conversation of what a smart response to health disparities should represent and how informatics can drive the design of intelligent systems to assist in eliminating health disparities and achieving health equity. Copyright © 2017. Published by Elsevier Inc.

  19. Systems Science: A Good Investment for the Public's Health

    Science.gov (United States)

    Mabry, Patricia L.; Kaplan, Robert M.

    2013-01-01

    This supplement of "Health Education & Behavior" showcases the current state of the field of systems science applications in health promotion and public health. Behind this work lies a steady stream of public dollars at the federal level. This perspective details nearly a decade of investment by the National Institutes of…

  20. Social Media, Big Data, and Mental Health: Current Advances and Ethical Implications.

    Science.gov (United States)

    Conway, Mike; O'Connor, Daniel

    2016-06-01

    Mental health (including substance abuse) is the fifth greatest contributor to the global burden of disease, with an economic cost estimated to be US $2.5 trillion in 2010, and expected to double by 2030. Developing information systems to support and strengthen population-level mental health monitoring forms a core part of the World Health Organization's Comprehensive Action Plan 2013-2020. In this paper, we review recent work that utilizes social media "big data" in conjunction with associated technologies like natural language processing and machine learning to address pressing problems in population-level mental health surveillance and research, focusing both on technological advances and core ethical challenges.

  1. Integrated Systems Health Management (ISHM) Toolkit

    Science.gov (United States)

    Venkatesh, Meera; Kapadia, Ravi; Walker, Mark; Wilkins, Kim

    2013-01-01

    A framework of software components has been implemented to facilitate the development of ISHM systems according to a methodology based on Reliability Centered Maintenance (RCM). This framework is collectively referred to as the Toolkit and was developed using General Atomics' Health MAP (TM) technology. The toolkit is intended to provide assistance to software developers of mission-critical system health monitoring applications in the specification, implementation, configuration, and deployment of such applications. In addition to software tools designed to facilitate these objectives, the toolkit also provides direction to software developers in accordance with an ISHM specification and development methodology. The development tools are based on an RCM approach for the development of ISHM systems. This approach focuses on defining, detecting, and predicting the likelihood of system functional failures and their undesirable consequences.

  2. FAILSAFE Health Management for Embedded Systems

    Science.gov (United States)

    Horvath, Gregory A.; Wagner, David A.; Wen, Hui Ying; Barry, Matthew

    2010-01-01

    The FAILSAFE project is developing concepts and prototype implementations for software health management in mission- critical, real-time embedded systems. The project unites features of the industry-standard ARINC 653 Avionics Application Software Standard Interface and JPL s Mission Data System (MDS) technology (see figure). The ARINC 653 standard establishes requirements for the services provided by partitioned, real-time operating systems. The MDS technology provides a state analysis method, canonical architecture, and software framework that facilitates the design and implementation of software-intensive complex systems. The MDS technology has been used to provide the health management function for an ARINC 653 application implementation. In particular, the focus is on showing how this combination enables reasoning about, and recovering from, application software problems.

  3. Proximity systems: Analysis of health risks; Varchi magneticianalysis of health risks

    Energy Technology Data Exchange (ETDEWEB)

    Barbaro, V.; Bartolini, P.; Donato, A. [Istituto Superiore di Sanita`, Rome (Italy). Lab. di Ingegneria Biomedica; Militello, C.; Polichetti, A.; Vecchia, P. [Istituto Superiore di Sanita`, Rome (Italy). Lab. di Fisica

    1996-03-01

    The results of a study on the magnetic fields generated by proximity systems for the controlled access of personnel are reported. Besides data from experimental measurements, the results are presented of theoretical calculations of induced currents inside the body. Health risks are also evaluated based on a comparison with the most advanced international standards. Finally, possible effects of interference with implanted pacemakers are analyzed in detail.

  4. Scaling Health Information Systems in Developing Countries

    DEFF Research Database (Denmark)

    Mengiste, Shegaw Anagaw; Neilsen, Petter

    2006-01-01

    This article addresses the issues of scaling health information system in the context of developing countries by taking a case study from Ethiopia. Concepts of information infrastructure have been used as an analytical lens to better understand scaling of Health Information systems. More...... specifically, we question the fruitfulness of focusing on not being installed base hostile and suggest focusing on how to be installed base “friendly” by underscoring how the installed base can also be draw upon and shaped by human agents. The paper conceptualizes health information infrastructure (HII...... to the installed base. The relative strength between the proponents of a HIS and the installed base will vary and thus require different approaches. While the II may develop and evolve as it is out of control from time to time, this study shows that there is also room for II building activities at certain points...

  5. Sustainable public health systems for rare diseases.

    Science.gov (United States)

    Ferrelli, Rita Maria; Gentile, Amalia Egle; De Santis, Marta; Taruscio, Domenica

    2017-01-01

    In the framework of the Joint Action for Rare Diseases (RD-ACTION), a specific task was defined to identify mechanisms influencing sustainability, equity and resilience of health systems for rare diseases (RDs). Literature narrative review on health systems sustainability and resilience for RDs. Years: 2000-2015. Databases: PubMed, Scopus, EBSCOHost, EMBAL, PASCAL, EMBASE, STN International and GoogleScholar. interpretive synthesis concept and thematic analysis (Dixon-Wood, et al.). 97 papers and 4 grey literature publications were identified. Two main topics stand out: economic evaluation and networks. The first topic did not identify widely accepted criterion to assign more weight to individuals with greater health needs. Healthcare network are identified as increasingly important for sustainability and resilience, in all of their aspects: professional "expertise", "experience" networks of users and carers; policy, learning, and interest networks. Possible mechanisms for ensuring sustainability can be identified in networking, patients' empowerment and reorienting healthcare towards integrated community and home care.

  6. A Critique of Health System Performance Measurement.

    Science.gov (United States)

    Lynch, Thomas

    2015-01-01

    Health system performance measurement is a ubiquitous phenomenon. Many authors have identified multiple methodological and substantive problems with performance measurement practices. Despite the validity of these criticisms and their cross-national character, the practice of health system performance measurement persists. Theodore Marmor suggests that performance measurement invokes an "incantatory response" wrapped within "linguistic muddle." In this article, I expand upon Marmor's insights using Pierre Bourdieu's theoretical framework to suggest that, far from an aberration, the "linguistic muddle" identified by Marmor is an indicator of a broad struggle about the representation and classification of public health services as a public good. I present a case study of performance measurement from Alberta, Canada, examining how this representational struggle occurs and what the stakes are.

  7. Health Information Systems (HIS): Concept and Technology

    OpenAIRE

    Almunawar, Mohammad Nabil; Anshari, Muhammad

    2012-01-01

    A health information system (HIS) is the intersection of between healthcare's business process, and information systems to deliver better healthcare services. The nature of healthcare industry, which is highly influenced by economic, social, politic, and technological factors, has changed over time. This paper will address some important concepts of healthcare and related terminologies to provide a holistic view for HIS. Related technological milestones and major events are briefly summarized...

  8. Different approaches to contracting in health systems.

    Science.gov (United States)

    Perrot, Jean

    2006-11-01

    Contracting is one of the tools increasingly being used to enhance the performance of health systems in both developed and developing countries; it takes different forms and cannot be limited to the mere purchase of services. Actors adopt contracting to formalize all kinds of relations established between them. A typology for this approach will demonstrate its diversity and provide a better understanding of the various issues raised by contracting. In recent years the way health systems are organized has changed significantly. To remedy the under-performance of their health systems, most countries have undertaken reforms that have resulted in major institutional overhaul, including decentralization of health and administrative services, autonomy for public service providers, separation of funding bodies and service providers, expansion of health financing options and the development of the profit or nonprofit private sector. These institutional reshuffles lead not only to multiplication and diversification of the actors involved, but also to greater separation of the service provision and administrative functions. Health systems are becoming more complex and can no longer operate in isolation. Actors are gradually realizing that they need to forge relations. The simplest way to do that is through dialogue, although some prefer a more formal commitment. Interaction between actors may take various forms and be on different scales. There are several types of contractual relations: some are based on the nature of the contract (public or private), others on the parties involved and yet others on the scope of the contract. Here they are classified into three categories according to the object of the contract: delegation of responsibility, act of purchase of services, or cooperation.

  9. American Society of Health-System Pharmacists

    Science.gov (United States)

    ... My Account Member Benefits ASHP Careers Business Opportunities Advertising Corporate Support Policy FAQs Contact Us 1-866-279-0681 Contact Directory ASHP 7272 Wisconsin Avenue Bethesda, Maryland 20814 YouTube LinkedIn Twitter Facebook ASHP Connect ©2016 American Society of Health-System ...

  10. Health Education and the Political System.

    Science.gov (United States)

    Butler, J. Thomas

    1983-01-01

    David Easton's model describing how political systems operate can help health educators initiate improvements and resist harmful changes. The Memphis (Tennessee) Board of Education's experience with the adoption of family life education is cited as an example of a constructive political strategy. (PP)

  11. Health Occupations Module. The Integumentary System.

    Science.gov (United States)

    Temple Univ., Philadelphia, PA. Div. of Vocational Education.

    This module on the integumentary system is one of eight modules designed for individualized instruction in health occupations education programs at both the secondary and postsecondary levels. This module contains an introduction to the module topic, objectives (e.g., list and describe the types of glands formed in the skin, and explain the…

  12. Physiological effects of oral glucosamine on joint health: Current status and consensus on future research priorities

    NARCIS (Netherlands)

    Y. Henrotin (Yves); B. Chevalier (Bernard); G. Herrero-Beaumont; T. McAlindon (Timothy); A. Mobasheri (Ali); K. Pavelka (Karel); C. Schön (Christiane); H.H. Weinans (Harrie); H. Biesalski (Hans)

    2013-01-01

    textabstractThe aim of this paper was to provide an overview of the current knowledge and understanding of the potential beneficial physiological effects of glucosamine (GlcN) on joint health. The objective was to reach a consensus on four critical questions and to provide recommendations for future

  13. Current Levels of Perceived Stress among Mental Health Social Workers Who Work with Suicidal Clients

    Science.gov (United States)

    Ting, Laura; Jacobson, Jodi M.; Sanders, Sara

    2011-01-01

    Mental health social workers are at increased risk of being confronted with fatal and nonfatal client suicidal behavior (CSB). Research has documented personal and professional reactions to CSB; however, empirical evidence describing the potential long-term effects is scarce. This study examined current reactions of perceived stress and continual…

  14. Current Technology Trends and Issues among Health and Physical Education Professionals

    Science.gov (United States)

    Krause, Jennifer M.; Franks, Hillary; Lynch, Brandy

    2017-01-01

    Health and physical education professionals who implement technology appropriately can contribute to helping students become physically educated individuals (NASPE, 2009). It is imperative that professionals be knowledgeable and resourceful in how to integrate technology effectively, but it is unclear what current challenges professionals face in…

  15. The development and implementation of a public health strategy : cost and health system analysis of intermittent preventive treatment in infants

    OpenAIRE

    Manzi, Fatuma

    2010-01-01

    The achievements of the health Millennium Development Goal of reducing child mortality (MDG 4) depend on the massive scaling-up of new and available health interventions. Evidence shows that effective interventions to attain MDG 4 are available; however coverage rates are currently low. The health systems in developing countries lack the necessary capacity to deliver the interventions to those in need. These factors among others are the cause of millions of preventable child deaths every year...

  16. Working towards a national health information system in Australia.

    Science.gov (United States)

    Bomba, B; Cooper, J; Miller, M

    1995-01-01

    One of the major administrative dilemmas facing the Australian national health care system is the need to reform practices associated with massive data-information overload. The current system is burdened with paper-based administrative forms, patient record files, referral notes and other manual methods of data organisation. An integrated computer-based information system may be perceived as an attractive solution to such burdens. However, computerisation must not be seen as a panacea with the possibility of exacerbating information overload and accentuating privacy concerns. Recent surveys in Australia [1] and the US [2] indicate a perceived causal link between computers and privacy invasion. Any moves toward a national health information system must counter this perception through macro-level education schemes of affected parties and micro-level mechanisms such as the establishment of hospital privacy officers. Such concerns may be viewed as a subset of the wider privacy debate, and information policy development should address such considerations to develop policies to prevent unauthorized access to personal information and to avoid the extraction and sale of sensitive health data. Conservative in nature and slow to change the health care sector may be forced to adopt more efficient work practices through the increasing proliferation of information technology (IT) in health care delivery and an escalating emphasis upon accountability and efficiency of the public health care dollar. The economic rationalist stance taken by governments in Australia and other nations generally will also force health care workers to adopt and develop more efficient information management practices, health indicators and best practice care methods than presently employed by this sector The benefits of a national health information system are far reaching, particularly in developing a more effective health care system through better identifying and understanding community health care

  17. Visualization of e-Health Research Topics and Current Trends Using Social Network Analysis.

    Science.gov (United States)

    Son, Youn-Jung; Jeong, Senator; Kang, Byeong-Gwon; Kim, Sun-Hyung; Lee, Soo-Kyoung

    2015-05-01

    E-health has been grown rapidly with significant impact on quality and safety of healthcare. However, there is a large gap between the postulated and empirically demonstrated benefits of e-health technologies and a need for a clearer mapping of its conceptual domains. Therefore, this study aimed to critically review the main research topics and trends of international e-health through social network analysis. Medical subject heading terms were used to retrieve 3,023 research articles published from 1979 through 2014 in the PubMed database. We extracted n-grams from the corpus using a text analysis program, generated co-occurrence networks, and then analyzed and visualized the networks using Pajek software. The hub and authority measures identified the most important research topics in e-health. Newly emerging topics by 4-year period units were identified as research trends. The most important research topics in e-health are personal health records (PHR), health information technology, primary care, mobile health, clinical decision support systems (CDSS), and so on. The eight groups obtained through ego network analysis can be divided into four semantically different areas, as follows: information technology, infrastructure, services, and subjects. Also, four historical trends in e-health research are identified: the first focusing on e-health and telemedicine; the second, PHR and monitoring; the third, CDSS and alert; and the fourth, mobile health and health literacy. This study promotes a systematic understanding of e-health by identifying topic networks, thereby contributing to the future direction of e-health research and education.

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

    Science.gov (United States)

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

    2015-11-01

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

  19. [Information system in primary health care].

    Science.gov (United States)

    Stevanović, Ranko; Stanić, Arsen; Varga, Sinisa

    2005-01-01

    The Croatian Ministry of Health started a health care system computerization project aimed at strengthening the collaboration among health care institutions, expert groups and individual health care providers. A tender for informatic system for Primary Health Care (PHC) general practice, pediatrics and gynecology, a vital prerequisite for project realization, has now been closed. Some important reasons for undertaking the project include rationalization of drug utilization, savings through a reduced use of specialists, consultants and hospitalization, then achievement of better cooperation, work distribution, result linking, data quality improvement (by standardization), and ensuring proper information-based decision making. Keeping non-standardized and thus difficult to process data takes too much time of the PHC team time. Since, however, a vast amount of data are collected on only a few indicators, some important information may remain uncovered. Although decisions made by health authorities should rely on evidence and processed information, the authorities spend most of the time working with raw data from which their decisions ultimately derive. The Informatic Technology (IT) in PHC is expected to enable a different approach. PHC teams should be relieved from the tedious task of data gathering and the authorities enabled to work with the information rather than data. The Informatics Communication Technology (ICT) system consists of three parts: hardware (5000 personal computers for work over the Internet), operative system with basic software (editor, etc.), and PHC software for PHC teams. At the national level (National Public Health Informatics System), a software platform will be built for data collection, analysis and distribution. This data collection will be based on the International Classification of Primary Care (ICPC-2) standard to ensure the utilization of medical records and quality assessment. The system permits bi-directional data exchange between

  20. The current status of mHealth for diabetes: will it be the next big thing?

    Science.gov (United States)

    Klonoff, David C

    2013-05-01

    mHealth is an emerging concept in health care and uses mobile communications devices for health services and information. Mobile phones, patient monitoring devices, tablets, personal digital assistants, and other wireless devices can be part of mHealth systems. With mHealth systems, glucose data can now be automatically collected, transmitted, aggregated with other physiologic data, analyzed, stored, and presented as actionable information. mHealth systems use mobile decision support software applications (or apps) to assist or direct health care professionals to make decisions, or they can assist or direct patients to make decisions without waiting for input from a clinician. With real-time decision support for patients, appropriate actions can be taken in real time without waiting to see a clinician. Decisions can be personalized if individual treatment goals and personal preferences for treatment are inputted into an app. Few mHealth apps for diabetes have been rigorously tested. Outcome studies of the use of mHealth for diabetes from the literature have shown the potential for benefits, but higher-quality studies are needed. Regulatory approval of mHealth products will require demonstration of safety and effectiveness, especially where information and trends are not just presented to patients, but used to make treatment recommendations. Three additional hurdles must be overcome to facilitate widespread adoption of this technology, including demonstration of the following: (1) privacy to satisfy regulators, (2) clinical benefit to satisfy clinicians, and (3) economic benefit to satisfy payers. mHealth for diabetes is making rapid strides and is expected to be a transforming technology that will be the next big thing.