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Sample records for danish primary health

  1. The Danish National Health Service Register

    DEFF Research Database (Denmark)

    Andersen, John Sahl; Olivarius, Niels de Fine; Krasnik, Allan

    2011-01-01

    Abstract Introduction: To describe the Danish National Health Service Register in relation to research. Content: The register contains data collected for administrative and scientific purposes from health contractors in primary health care. It includes information about citizens, providers...

  2. The Danish National Health Service Register (NHSR) as a Source for Research on Primary Care

    DEFF Research Database (Denmark)

    Andersen, John Sahl; Olivarius, Niels de Fine; Krasnik, Allan

    the following is registered: 1. The citizen: The unique personal identification number and the allocation to a general practice. The number make it possible to register the age and sex of the citizen, follow the individual contacts with health care over time and merge with other registers. 2. The provider......: Identification number of the practice, referral to specialist and fees. 3. The service: Consultations, telephone consultations, home visits, e-mail consultations and preventive consultations. Also laboratory and additional services like anti-conception counselling are registered. The clinical information...... is small or absent. The possibilities for linking to other registers containing health and social information or with ad hoc collected data make NHSR an interesting research tool. Validity and coverage: All citizens registers with the personal identification number when contacting the health care system...

  3. Drug prescriptions in Danish out-of-hours primary care

    DEFF Research Database (Denmark)

    Christensen, Morten Bondo; Nørøxe, Karen Busk; Moth, Grete

    2016-01-01

    OBJECTIVE: General practitioners are the first point of contact in Danish out-of-hours (OOH) primary care. The large number of contacts implies that prescribing behaviour may have considerable impact on health-care expenditures and quality of care. The aim of this study was to examine...... the prevailing practices for medication prescription in Danish OOH with a particular focus on patient characteristics and contact type. DESIGN AND SETTING: A one-year population-based retrospective observational study was performed of all contacts to OOH primary care in the Central Denmark Region using registry...... data. MAIN OUTCOME MEASURES: Prescriptions were categorised according to Anatomical Therapeutic Chemical Classification (ATC) codes and stratified for patient age, gender and contact type (telephone consultation, clinic consultation or home visit). Prescription rates were calculated as number...

  4. Physical Literacy in Danish Primary School

    DEFF Research Database (Denmark)

    Jensen, Jens-Ole

    2016-01-01

    In the last decade there has been an increasing international interest in the concept of physical literacy as a way to articulate the objectives of physical education and as a way to verbalize the idea of being physically educated throughout life. In general, research on the concept of physical...... the demand of verbalization. Anyway, a new school law was implemented in the Danish primary and secondary school system in August 2014. The main purposes of the law is to challenge every pupil to become as skilled as possible, lower the consequences of social background in order to achieve better results...... in the late afternoon. The observations were mainly non-participating but at some occasions the researcher was participating in activities and games. The observations were written down as field notes (Emerson et al. 2011) and photos were taken to support the field notes. During the observation a special...

  5. Health disparities between immigrant and Danish cleaners

    DEFF Research Database (Denmark)

    Jørgensen, Marie B; Rasmussen, Charlotte D N; Carneiro, Isabella G

    2011-01-01

    ability, self-rated health, and musculoskeletal symptoms). In order to investigate differences between Danish and immigrant cleaners, logistic regression analyses and General Linear Models were performed. RESULTS: When controlling for age, sex, workplace, job seniority, and smoking, more Danish compared...... hundred and fifty-one cleaners, consisting of 166 Danes (88% women) and 179 immigrants (74% women) (6 with unknown ethnicity), from 9 workplaces in Denmark participated in the study. Health and work ability were obtained by objective (e.g., BMI and blood pressure) and self-reported measures (e.g., work...

  6. Comparison of the Five Danish Regions Regarding Demographic Characteristics, Healthcare Utilization, and Medication Use

    DEFF Research Database (Denmark)

    Henriksen, Daniel Pilsgaard; Rasmussen, Lotte; Hansen, Morten Rix;

    2015-01-01

    nationwide registers: The Danish National Patient Register, The Danish Civil Registration System, The Danish Register of Medicinal Product Statistics, and The Danish National Health Service Register for Primary Care. We compared the Danish regions regarding demographic and socioeconomic characteristics...

  7. Patient involvement in Danish health care

    DEFF Research Database (Denmark)

    Vrangbaek, Karsten

    2015-01-01

    PURPOSE: The purpose of this paper is to investigate different types of patient involvement in Denmark, and to discuss the potential implications of pursuing several strategies for patient involvement simultaneously. DESIGN/METHODOLOGY/APPROACH: The paper presents a preliminary framework...... for analysis of patient involvement in health care. This framework is used to analyze key governance features of patient involvement in Denmark based on previous research papers and reports describing patient involvement in Danish health care. FINDINGS: Patient involvement is important in Denmark...... implications for the development of patient involvement in health care. ORIGINALITY/VALUE: This paper fulfills a need to study different types of patient involvement and to develop a theoretical framework for characterizing and analyzing such involvement strategies....

  8. Medical appropriateness of adult calls to Danish out-of-hours primary care

    DEFF Research Database (Denmark)

    Nørøxe, Karen Busk; Huibers, Linda; Moth, Grete

    2017-01-01

    BACKGROUND: Optimal utilisation of the out-of-hours primary care (OOH-PC) services remains a concern in public health policy. We need more knowledge on potentially avoidable contacts. This study examines the frequency of medically assessed inappropriate OOH-PC calls from adults, explores factors...... triage delivered by a general practitioner (GP), we included only telephone contacts. A contact was characterised as medically inappropriate when the triage GP assessed that the request from a medical perspective should have been directed to daytime primary care. Appropriateness was examined in relation...... associated with such assessment, and examines the relation to patient-assessed severity of health problem and fulfilment of expectations. METHODS: We performed secondary analyses of data from a large cross-sectional survey on contacts to Danish OOH-PC. As access to Danish OOH-PC is provided through telephone...

  9. Local enactments of national health promotion policies: A Danish case

    DEFF Research Database (Denmark)

    Wimmelmann, Camilla Lawaetz

    2017-01-01

    organisational levels. Visiting, observing and interviewing 15 policy workers from 10 municipalities during a two-year period, this study investigated what happened to a Danish national health promotion policy as it was put into practice and managed in the Danish municipalities. The analysis reveals...

  10. The predictive and external validity of the STarT Back Tool in Danish primary care

    DEFF Research Database (Denmark)

    Morsø, Lars; Kent, Peter; Albert, Hanne B;

    2013-01-01

    PURPOSE: The STarT Back Tool (SBT) was recently translated into Danish and its concurrent validity described. This study tested the predictive validity of the Danish SBT. METHODS: Danish primary care patients (n = 344) were compared to a UK cohort. SBT subgroup validity for predicting high activity...... limitation at 3 months' follow-up was assessed using descriptive proportions, relative risks, AUC and odds ratios. RESULTS: The SBT had a statistically similar predictive ability in Danish primary care as in UK primary care. Unadjusted relative risks for poor clinical outcome on activity limitation...

  11. Economies of scope in Danish primary care practices

    DEFF Research Database (Denmark)

    Kristensen, Troels; Rose Olsen, Kim

    2011-01-01

    Aim: We analyze total operating costs and activities in Danish General Practice units to assess whether there are unexploited economies of scope in the production of primary care services. Methods: We apply stochastic frontier analysis to derive cost functions and associated cost complementarities...... between GP services and overall economies of scope. Data: Cross-section data for a sample of 331 primary care practices with 1-8 GPs from the year 2006. This is a unique combined dataset consisting of survey and register data. Results: We find a trend towards cost complementarities between the production...... economies of scope in the production of GP services. Conclusions: Our preliminary results show that there were overall economies of scope associated with the joint production of a) standard consultations, b) email/phone consultations and c) home visits. Cost complementarities between standard consultations...

  12. Accountability Practices in the History of Danish Primary

    DEFF Research Database (Denmark)

    Ydesen, Christian; Andreasen, Karen Egedal

    2014-01-01

    between different national settings. Furthermore, accountability measures and practices have an impact on both the ways and means by which societies approach their educational systems. Hence there is a need to clarify the characteristics and traits connected with the concept. One way of approaching......This paper focuses on primary education accountability as a concept and as an organizational practice in the histo-ry of Danish public education. Contemporary studies of education policy often address questions of accountability, but the manifestations of school accountability differ significantly...... this endeavor is to turn to the history of education, because the discourse and practice of accountability incorporates numerous historical antecedents, technologies, and arguments. Based on primary as well as secondary sources this article presents the case of Denmark, analyzing the period from 1660...

  13. Accountability Practices in the History of Danish Primary

    DEFF Research Database (Denmark)

    Ydesen, Christian; Andreasen, Karen Egedal

    2014-01-01

    This paper focuses on primary education accountability as a concept and as an organizational practice in the histo-ry of Danish public education. Contemporary studies of education policy often address questions of accountability, but the manifestations of school accountability differ significantly...... between different national settings. Furthermore, accountability measures and practices have an impact on both the ways and means by which societies approach their educational systems. Hence there is a need to clarify the characteristics and traits connected with the concept. One way of approaching...... this endeavor is to turn to the history of education, because the discourse and practice of accountability incorporates numerous historical antecedents, technologies, and arguments. Based on primary as well as secondary sources this article presents the case of Denmark, analyzing the period from 1660...

  14. The Danish patient safety experience: the Act on Patient Safety in the Danish Health care system

    DEFF Research Database (Denmark)

    Lundgaard, Mette; Rabøl, Louise; Jensen, Elisabeth Agnete Brøgger

    2005-01-01

    This paper describes the process that lead to the passing of the Act for Patient Safety in the Danisk health care sytem, the contents of the act and how the act is used in the Danish health care system. The act obligates frontline health care personnel to report adverse events, hospital owners...... to act on the reports and the National Board of Health to commuicate the learning nationally. The act protects health care providers from sanctions as a result of reporting. In January 2004, the Act on Patient Safety in the Danish health care system was put into force. In the first twelve months 5740...... adverse events were reported. the reports were analyzed locally (hospital and region), anonymized ad then sent to the National Board af Health. The Act on Patient Safety has driven the work with patient safety forward but there is room for improvement. Continuous and improved feedback from all parts...

  15. Udder health in a Danish compost bedded pack barn

    DEFF Research Database (Denmark)

    Svennesen, Line; Enevoldsen, Carsten; Bjerg, Bjarne Schmidt

    Besides welfare advantages of the compost bedded pack system (CBP) there could be a negative effect of the organic bedding on udder health. Our objectives were to evaluate the effects of a CBP on udder health compared to a free stall system (FS) with sand bedded cubicles. Within the same Danish...

  16. [Attitude of Danish physicians to the health care services].

    Science.gov (United States)

    Andreassen, U K; Hein, E

    1993-01-25

    In recent years, Danish society has focused on the service and the information available for patients in health care. A test sample out of 1,000 members of the Danish Medical Association selected at random revealed that the majority had positive attitudes to service and information in health care. The study also indicated that doctors do not consider that any particular dress code is particularly appropriate but consider that personal appearance and the way patients are addressed are individual matters. This individualistic attitude which is consistent with Mintzberg's sociological structural theory does not invariably seem appropriate.

  17. Quality improvement and accountability in the Danish health care system.

    Science.gov (United States)

    Mainz, Jan; Kristensen, Solvejg; Bartels, Paul

    2015-12-01

    Denmark has unique opportunities for quality measurement and benchmarking since Denmark has well-developed health registries and unique patient identifier that allow all registries to include patient-level data and combine data into sophisticated quality performance monitoring. Over decades, Denmark has developed and implemented national quality and patient safety initiatives in the healthcare system in terms of national clinical guidelines, performance and outcome measurement integrated in clinical databases for important diseases and clinical conditions, measurement of patient experiences, reporting of adverse events, national handling of patient complaints, national accreditation and public disclosure of all data on the quality of care. Over the years, Denmark has worked up a progressive and transparent just culture in quality management; the different actors at the different levels of the healthcare system are mutually attentive and responsive in a coordinated effort for quality of the healthcare services. At national, regional, local and hospital level, it is mandatory to participate in the quality initiatives and to use data and results for quality management, quality improvement, transparency in health care and accountability. To further develop the Danish governance model, it is important to expand the model to the primary care sector. Furthermore, a national quality health programme 2015-18 recently launched by the government supports a new development in health care focusing upon delivering high-quality health care-high quality is defined by results of value to the patients. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  18. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Department of Community Health & Primary Care, College of Medicine, University of Lagos, Idi-Araba, P.M.B. ... the child's health, culturally based beliefs and ..... immunization safety as this was a rural ... Charles SW, Olalekan AU, Peter MN,.

  19. Implementation of health impact assessment in Danish municipal context

    DEFF Research Database (Denmark)

    Kraemer, Stella R. J.; Nikolajsen, Louise Theilgaard; Gulis, Gabriel

    2014-01-01

    Aims: Implementation of Health Impact Assessment (HIA) in Danish municipalities has been analyzed using the Roger's Diffusion of Innovation Theory. Municipalities were chosen from among those who presented their health policies on websites according to the status of inclusion of HIA into health...... and organizational structure of a municipality, and a lack of capacities were enlisted as most relevant. The last one is a crucial factor of an internal social system of a municipality. With regards to communication channels, reporting and presentation skills of implementers and doers are of key importance....... Conclusions: Systematic and sustainable capacity building is needed to achieve high level implementation of HIA in Danish municipalities. Development of validated tools, most importantly screening tools with focus on priorities of national public health policy would enhance implementation on municipal level....

  20. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    Cervical cancer remains a major public health challenge in developing countries ... relation to knowledge on cervical cancer, primary level of education ... Latin America and Southeast Asia. ... practices such as level of awareness, educational.

  1. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Journal of Community Medicine and Primary Health Care. ... This is one of the factors that determine whether or ..... Expired vaccines found in fridge / cold box .... date vaccine temperature monitoring charts. were stored on refrigerator door ...

  2. Development of health and depressive symptoms among Danish adolescents

    DEFF Research Database (Denmark)

    Andersen, Johan Hviid; Labriola, Merete; Lund, Thomas

    2013-01-01

    in a cohort study of Danish adolescents. Methods: The cohort comprised 3,681 individuals born in 1989, 3058 individuals answered the baseline questionnaire in 2004, and 2400 responded to a follow-up questionnaire in 2007, with 2181 individuals participating in both rounds (59% of the original cohort). Social......) deteriorated slightly in adolescents (-0.24; 95% CI = -0.28 to -0.19) across all socioeconomic status (SES) groups and depressive symptoms increased (0.64; 95% CI = 0.52 to 0.75). High household income was protective for decrease in SRH (0.62; 0.43 - 0.91). Negative life-style changes were associated...... with poorer SRH and more depressive symptoms. Conclusions: Self-rated health and depressive symptoms changed to the worse among Danish adolescents from age 15 to 18 years. Negative changes in several lifestyle factors were found to accompany the deterioration of health. This result stresses the intrinsic...

  3. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    2Department of Health Policy and Management, Faculty of Public Health, College of Medicine and University ... 86 (21%) had primary school education, 210 (51.3%) were married, and 357 (87.3%) were employed. ...... patient satisfaction and behavioral intentions in. 5. .... Psychological Assessment 1995; 7 (3):309-319.

  4. Can casemix-systems be applied in Danish primary care?

    DEFF Research Database (Denmark)

    Halling, Anders; Kristensen, Troels

    -sectional study uses individual data on gender, age and diagnoses for the year 2013 from the Danish General Practice Database (DAMD) to make ACG groupings of a sample of 700,443 citizens of Zealand in Denmark. The Johns Hopkins Adjusted Clinical Groups ACG software, Version 10 December 2011 was applied to make...

  5. Danish health professionals' experiences of being coached

    DEFF Research Database (Denmark)

    Ammentorp, Jette; Jensen, Hanne I; Uhrenfeldt, Lisbeth

    2013-01-01

    In recent years, coaching, as a supplement to professional development, has received increased attention, especially in nursing. Still, only little is known about how health professionals experience participating in coaching sessions. The purpose of this pilot study was to describe and analyze he...... health professionals' experiences from coaching-what coaching meant to them and how it influenced different aspects of their lives....

  6. Danish cancer patients’ perspective on health care

    DEFF Research Database (Denmark)

    Sandager, Mette; Sperling, Cecilie; Jensen, Henry

    2015-01-01

    of the health care they have received, in regard to access to diagnostics, coordination and continuity of care, information and communication and involvement of patients and relatives. Questions and the opportunity to comment in free text were distributed to 6,720 newly diagnosed cancer patients in the summer...... and better involvement of patient and relatives. The study indicates that women, younger and higher educated patients tend to be less satisfied with the health care they received. This study shows that even though the majority of patients are satisfied with the quality of health care, there is room...... for improvements with regard to better access to diagnostics, healthcare professionals’ responsiveness to patients, improved coordination and involvement of patient and relatives. There is a need to focus more on individual needs and patient-centered care....

  7. Health and School Performance amongst Danish adolescents

    DEFF Research Database (Denmark)

    Hansen, Claus D.; Andersen, Johan Hviid

    2009-01-01

    to school performance and subsequent educational achievements. The aim of this study was to examine the impact of health measures on school performance at the end of compulsory school (9 years of school). Methods Information from a birth cohort study of adolescents born in 1989 (n = 3058) living...... and depressive symptoms. If parents report health problems for the participant between ages 7 and 14, grades decrease with 0.89 (95% CI 0.44 to 1.32). Conclusions Frequent headache, perceived stress and depressive symptoms contributes to lower grades at the end of compulsory school, thereby indicating...

  8. Existing data sources for clinical epidemiology: Danish Cancer in Primary Care cohort

    Directory of Open Access Journals (Sweden)

    Jensen H

    2014-07-01

    Full Text Available Henry Jensen,1,2 Marie Louise Tørring,1 Mette Bach Larsen,3 Peter Vedsted11Research Unit for General Practice, Research Centre for Cancer Diagnosis in Primary Care, 2Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus C, 3Department of Public Health Programs, Randers Regional Hospital, Randers NOE, Denmark Background: In this paper, we describe the settings, content, and possibilities of the Danish Cancer in Primary Care (CaP cohort as well as some of the key findings so far. Further, we describe the future potential of the cohort as an international resource for epidemiological and health services research studies. Methods: The CaP cohort comprises information from three Danish subcohorts set up in 2004–2005, 2007–2008, and 2010 on newly diagnosed cancer patients aged 18 years or older. General practitioner (GP-reported and patient-reported data from six questionnaires generated information on causes and consequences of delayed diagnosis of cancer, and these data were supplemented with complete information on, eg, death, migration, health care utilization, medication use, and socioeconomic data from Denmark's comprehensive health and administrative registers. The cohort is followed up in terms of emigration, death, hospitalization, medication, and socioeconomics, and data are updated regularly. Results: In total, we identified 22,169 verified incident cancer cases. Completed GP questionnaires were returned for 17,566 (79% of the verified cases, and patient questionnaires were completed by 8,937 (40% respondents. Patients with participating GPs did not differ from patients with nonparticipating GPs in regard to one-year survival, comorbidity, or educational level. However, compared with nonparticipating GPs, patients listed with participating GPs were more likely to be women, younger, to have a higher disposable income, to have more regional or distant spread of tumors, were also more likely to have

  9. Health and School Performance amongst Danish adolescents

    DEFF Research Database (Denmark)

    Hansen, Claus D.; Andersen, Johan Hviid

    2009-01-01

    to school performance and subsequent educational achievements. The aim of this study was to examine the impact of health measures on school performance at the end of compulsory school (9 years of school). Methods Information from a birth cohort study of adolescents born in 1989 (n = 3058) living...... years has between 0.27 [95% confidence interval (CI) 0.13 to 0.40] and 0.34 (95% CI 0.21 to 0.48) lower grades, adjusted for a range of other factors influencing school performance. Specific symptoms leading to poorer school performance includes frequent headaches, high levels of perceived stress...... and depressive symptoms. If parents report health problems for the participant between ages 7 and 14, grades decrease with 0.89 (95% CI 0.44 to 1.32). Conclusions Frequent headache, perceived stress and depressive symptoms contributes to lower grades at the end of compulsory school, thereby indicating...

  10. Health Promotion Challenges at Sea - a Danish Case

    DEFF Research Database (Denmark)

    Hjarnø, Lulu

    previous studies have documented increased mortality and morbidity (incidences) among seafarers, not only due to accidents but also to lifestyle like cardiovascular disease, lung cancer and diseases related to alcohol. These diseases are related to factors like alcohol consumption, obesity, physical...... inactivity and smoking, which for the latter three are factors highly represented in the maritime industry. The aim of this study is to identify the current health status of seafarers and to detect, strengths and weaknesses of health promotion interventions implemented in this target group. METHODS: A 1 year...... follow-up study was conducted within two Danish shipping companies aiming to collect information on the seafarers’ health, wellbeing, diet, smoking, alcohol and physical activity. Within this period, health promotion interventions were offered; health profile (physiological measurements/tests), smoking...

  11. The Danish health care system from a British perspective.

    Science.gov (United States)

    Hurst, Jeremy

    2002-02-01

    The organisation and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of strengths, weakness, opportunities and threats) by a panel of five members with a background in health economics. The evaluation was based on reading an extensive amount of selected documents and literature on the Danish health care system, and a one-week visit to health care authorities, providers and key persons. The present paper includes the main findings by one of the panel members. The dominance of tax financing helps to achieve control over the level of health care expenditure, as well as securing equity in financing the services. The reliance on local government for financing and running health care has both advantages and disadvantages, and the split between county and municipal responsibility leads to problems of co-ordination. The remuneration of general practitioners by a mix of capitation payment and fee for services has the advantage of capping expenditure whilst leaving the GPs with an incentive to compete for patients by providing them with good services. The GP service is remarkably economical. The hospital sector displays much strength, but there seem to be problems with respect to: (i) perceived lack of resources and waiting lists; (ii) impersonal care, lack of continuity of care and failures in communication between patients and staff; (iii) management problems and sometimes demotivated staff. The relationship between patients and providers is facilitated by free access to GPs and absence of any charges for hospital treatment. The biggest threat is continuation of avoidable illness caused by poor health habits in the population. The biggest opportunity is to strengthen public health measures to tackle these poor health habits.

  12. Findings from the oral health study of the Danish Health Examination Survey 2007-2008

    DEFF Research Database (Denmark)

    Kongstad, Johanne; Ekstrand, Kim; Qvist, Vibeke

    2013-01-01

    Abstract Objective. The aims of the oral part of the Danish Health Examination Survey (DANHES 2007-2008) were (1) to establish an oral health database for adult Danes and (2) to explore the influence of general diseases and lifestyle on oral health. This paper presents the study population, exami...

  13. Primary health care.

    Science.gov (United States)

    Kitai, A

    1986-07-01

    Development of primary care in Japan in still relatively unorganized and unstructured. As mentioned above, the author describes some strengths and weaknesses of the Japanese primary care system. In addressing the weaknesses the following suggestions are offered for the Japanese primary care delivery system: Increase the number of emergency rooms for all day, especially on holidays and at night. Introduce an appointment system. Introduce an open system of hospitals. Coordinate with public hospitals and primary care clinics. Organize the referral system between private practitioners and community hospitals. Increase the number of paramedical staff. Strengthen group practice among primary care physicians. Increase the establishment of departments of primary care practice with government financial incentives to medical schools and teaching hospitals. Develop a more active and direct teaching role for primary care practice or family practice at undergraduate, graduate, and postgraduate levels. Improve and maintain present health insurance payment method, shifting from quantity of care to quality and continuity of care. Introduce formal continuing education. Introduce formal training programs of primary care and strengthen ambulatory care teaching programs.

  14. Field Experience from Li-Ion BESS Delivering Primary Frequency Regulation in the Danish Energy Market

    DEFF Research Database (Denmark)

    Swierczynski, Maciej Jozef; Stroe, Daniel Ioan; Lærke, Rasmus

    2014-01-01

    In this paper it is presented the practical experience from operating a 1.6 MW/ 0.4 MWh lithium ion battery energy storage system, which is providing primary frequency regulation service on the Danish energy market. Aspects of the battery system requirements and the used control strategy...

  15. Danish nationwide registers for public health and health-related research

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Fedyszyn, Izabela

    2015-01-01

    AIMS: The Nordic countries have a strong tradition of using nationwide social and health registers for research purposes. The aim of the current paper is to provide an overview of the Danish population-based registers in public health and health-related research, and to discuss their strengths...... and limitations. METHODS: Danish registers on somatic and psychiatric hospital contacts as well as care provided by general practitioners were reviewed. The availability of demographic, individual-level variables of relevance for health-related research was summarized. RESULTS: Since 1968, every person living...... in Denmark has a unique identifier. This identifier is listed in Danish registers enabling linkage of information from a range of registers on an individual level. The nationwide coverage of all patient contacts at somatic and psychiatric hospitals, consultations with general practitioners, purchases...

  16. The Danish Health Examination Survey 2007-2008 (DANHES 2007-2008)

    DEFF Research Database (Denmark)

    Eriksen, Louise; Grønbæk, Morten; Helge, Jørn Wulff;

    2011-01-01

    The Danish Health Examination Survey (DANHES 2007-2008) was carried out by the National Institute of Public Health, University of Southern Denmark, in 13 Danish municipalities in 2007-2008. The focus of the survey was diet, smoking, alcohol, and physical activity. The aim of the survey...

  17. Can casemix-systems be applied in Danish primary care?

    DEFF Research Database (Denmark)

    Halling, Anders; Kristensen, Troels

    Background: New technology in terms of IT systems, better data infrastructure and improved registrations of health data provide new opportunities for health care systems to improve the care experience of individual patients, improve public health and reduce healthcare costs. Application of "Big...

  18. Primary percutaneous coronary intervention as a national Danish reperfusion strategy of ST-elevation myocardial infarction

    DEFF Research Database (Denmark)

    Sørensen, Jacob Thorsted; Steengaard, Carsten; Holmvang, Lene

    2013-01-01

    The use of primary percutaneous coronary intervention (PCI) as the preferred reperfusion strategy in ST-elevation myocardial infarction (STEMI) requires optimal systems-of-care and logistics in order to enable rapid treatment of all patients. In Denmark, this has been achieved through prehospital...... electrocardiogram diagnosis, field triage and dedicated PCI centres 24/7. Today, primary PCI is an option for all Danish patients with STEMI, regardless of the distance to a PCI centre. This has led to a decline in both mortality and morbidity....

  19. Summary of the SWOT panel's evaluation of the organisation and financing of the Danish health care system.

    Science.gov (United States)

    Christiansen, Terkel

    2002-02-01

    The organisation and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of strengths, weaknesses, opportunities and threats) by a panel of five members with a background in health economics. This paper systematically summarises the panel's assessments, within the framework of the triangular model of health care. The members of the panel are in agreement on a number of aspects, while their views on other aspects differ. In general they find many strength in the way the system is organised and financed more so in the primary sector than in the hospital sector.

  20. Health profile for Danish adults with activity limitation and/or physical disability

    DEFF Research Database (Denmark)

    Johnsen, Nina Føns; Davidsen, Michael; Juel, Knud

    of Southern Denmark, Copenhagen, Denmark Background Studies in Canada, UK, Sweden and Norway have indicated that people with disabilities die earlier and experience a poorer health than the general population. In addressing the Danish National Government’s focus on equality in health, this study investigated...... 35 factors related to health and well-being, health behavior, social relations and use of health care services among Danish people with activity limitation and/or physical disabilities. Methods This study was based on data from the Danish Health and Morbidity Survey (DHMS) 2013 where 25,000 men...... had moderate or severe difficulties with seeing or reading, hearing, or walking or carrying things. Selected results The proportion of individuals with good or superior health among people with activity limitation was one third of the proportion with good or superior health among people without...

  1. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    payment for health care services; a widely used strategy to supplement ... and opportunities for sustainable health care financing for low income communities in sub-. Saharan ..... funding and rising costs for health care services, More so, evidence from research studies have ... provider payment method has the potential to.

  2. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    2Department of Community Health, University of Benin, Benin City, Nigeria. ... public health problem that can lead to a great burden of disability in the community. ..... women. Equally worthy of note, is the fact that a higher proportion of females ...

  3. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    be used to design policies and programmes to help workers identify environmental health risks, and improve their ... and his/her co-workers, who are subject to (SHE) departments and the Staff Clinic. It ... television and internet sources.

  4. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    catastrophic health expenditures (CHE) and risk of being impoverished as a result of cost of care were assessed. Statistical ... Impact and contributors to cost of managing long term conditions in a ... sectors is ongoing, it has become clear that.

  5. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    This was a cross-sectional, multi clinic study involving 265 mothers whose children had erupted at least a tooth and attending the ... parents, health care workers and personal experiences were the sources of beliefs ..... Ethiopians abroad.

  6. A SWOT analysis of the organization and financing of the Danish health care system.

    Science.gov (United States)

    Christiansen, Terkel

    2002-02-01

    The organization and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of Strengths, Weaknesses, Opportunities and Threats) by a panel of five members with a background in health economics. The present paper describes the methods and materials used for the evaluation: selection of panel members, structure of the evaluation task according to the health care triangle model, selection of background material consisting of documents and literature on the Danish health care system, and a 1-week study visit.

  7. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Lifestyle Changes and the Risk of Colorectal Cancer among. Immigrants in the United .... food rich in red meat, animal fat, sugars and refined of CRC in Africa .... region to improve health care delivery and secure the is obtainable in the UK, ...

  8. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Tobacco is a risk factor Organization (WHO) at World Health Assembly for six of the ... information. Stata statistical software version 11 was used to describe the data and determine ... Only 5% of respondents ever received training on tobacco control. .... Pharmacist. 54. 23.2 .... and dental students surveyed in Lagos by .15.

  9. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    2012-05-01

    May 1, 2012 ... quality service delivery as perceived by the respondents', however it remains ... However, there remain the problems of inequities in tertiary ... unrelenting struggle in financing health households to the financial risk ... other things improve efficiency in utilization of Using a cross-sectional approach, this study.

  10. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    eligible patients as they emerged from the pharmacy with their ... compare proportions while student's t-test was used to compare .... preference between the free and B.I. health services in an LGA in ... and training manual for the development.

  11. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    study assessed the knowledge and practice of disease surveillance and notification ... for active surveillance especially if an outbreak Health workers play a key role in .... ethical clearance was obtained from the ethics and Eighty one percent of .... Salami S. Knowledge of disease notification among New York: John Wiley ...

  12. Health promotion innovation in primary health care

    OpenAIRE

    Alexandra McManus

    2013-01-01

    Previously, the main focus of primary health care practices was to diagnose and treat patients. The identification of risk factors for disease and the prevention of chronic conditions have become a part of everyday practice. This paper provides an argument for training primary health care (PHC) practitioners in health promotion, while encouraging them to embrace innovation within their practice to streamline the treatment process and improve patient outcomes. Electronic modes of communication...

  13. Poster Determinants for Oral-Health-Related Quality of Life among Danish adults

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Hede, Børge; Fiehn, Nils-Erik

    Objectives To identify and analyze determinants for oral-health-related quality of life among adults admitted to a Danish research program on general health and lifestyle (DANHES 2007-2008) Materials and methods Study population of the present (dental) study: 4402 volunteers invited among...... participants of main study (n18065) covering 12 different Danish cities. Age 18-96 years (average 54) Structured interviews (from main study and dental study) and clinical oral examination Oral-Health-Related Quality of Life measured by a 10 item index Non-parametric statistical methods, chi-square, simple...... and multivariate logistic regression Data are not representative to the Danish population, however, associations between outcome and independent variables are considered valid. Regular dental visits and high number of natural teeth are determinants for a high level of Oral-Health-Related Quality of Life Untreated...

  14. State and Insurance : The Long-Term Trends in Danish Health Policy from 1672 to 1973

    Directory of Open Access Journals (Sweden)

    Løkke, Anne

    2007-07-01

    Full Text Available This paper discuss the path dependency of the Danish tax financed, egalitarian health policy. It is argued, that the Danish health policy of today can not be understood separately from its history. The principles of universalism and decommodification have roots that go back to experiences from nearly 200 years of absolutist, patriarchal biopolitics, including poor laws, educated, authorised and publicly-paid midwives, publicly-paid district surgeons et cetera. The route from absolutist biopolitics to modern welfare state went through enormous, voluntary civic engagement by non-profit health insurance societies (sygekasser, formed in the mid-nineteenth century and controlled and subsidised by the state from 1892.

  15. Health-related phenotypes and longevity in Danish twins

    DEFF Research Database (Denmark)

    Kulminski, Alexander M; Arbeev, Konstantin G; Culminskaya, Irina V

    2009-01-01

    . A promising approach is to select intermediate phenotypes using information on longevity measured in related individuals. We evaluated feasibility of this approach focusing on 32 geriatric diseases as potential intermediate phenotypes of longevity assessed in the Longitudinal Study of Aging Danish Twins. Our...

  16. From Doctor to Nurse Triage in the Danish Out-of-Hours Primary Care Service

    DEFF Research Database (Denmark)

    Moth, Grete; Huibers, Linda; Vedsted, Peter

    2013-01-01

    be reduced by 26.2% though excluding administrative costs of a new organisation. Conclusion. Substituting GPs with nurses in OOH primary care may increase the cost in fees compared to a model with only GPs. Further research is needed involving more influencing factors, such as costs due to nurse training......Introduction. General practitioners (GP) answer calls to the Danish out-of-hours primary care service (OOH) in Denmark, and this is a subject of discussions about quality and cost-effectiveness. The aim of this study was to estimate changes in fee costs if nurses substituted the GPs. Methods. We...... applied experiences from The Netherlands on nurse performance in the OOH triage concerning the number of calls per hour. Using the 2011 number of calls in one region, we examined three hypothetical scenarios with nurse triage and calculated the differences in fee costs. Results. A new organisation with 97...

  17. The Danish National Health Survey 2010. Study design and respondent characteristics

    DEFF Research Database (Denmark)

    Christensen, Anne Illemann; Ekholm, Ola; Glümer, Charlotte;

    2012-01-01

    In 2010 the five Danish regions and the National Institute of Public Health at the University of Southern Denmark conducted a national representative health survey among the adult population in Denmark. This paper describes the study design and the sample and study population as well as the content...... of the questionnaire....

  18. Identifying dietary patterns and associated health-related lifestyle factors in the adult Danish population

    DEFF Research Database (Denmark)

    Knudsen, Vibeke Kildegaard; Matthiessen, Jeppe; Biltoft-Jensen, Anja Pia

    2014-01-01

    Background/objectives:To identify and describe dietary patterns in Danish adults and to examine which demographic and health-related lifestyle factors are associated with dietary patterns.Subjects/methods:Data derived from the Danish national survey of diet and physical activity collected in 2003......, potatoes and gravy, and cake and biscuits; a 'health-conscious' pattern correlated with coarse bread, fruit, vegetables, low-fat dairy, nuts, water and tea; and a 'fast food' pattern correlated with pizza, hamburger/spring rolls, crisps, rice and pasta, sugar-sweetened soft drinks and sweets...

  19. Health profile for Danish adults with activity limitation and/or physical disability

    DEFF Research Database (Denmark)

    Johnsen, Nina Føns; Davidsen, Michael; Juel, Knud

    proportion of Danish adults with activity limitation and/or physical disabilities experiences a good health and well-being, a larger proportion has an unhealthy lifestyle, poor social relations and uses the health care system frequently, as compared to adults without activity limitation and/or physical...... limitation and/or disabilities have a poor health and social contact. Availability and flexibility of health care services and prevention programs should be prioritized....

  20. The struggle of ideas in Danish primary school policy in the wake of PISA

    DEFF Research Database (Denmark)

    Gustafsson, Line

    In this paper, it is argued that a better understanding of the struggle of ideas is needed. While ideas can have impact on policy design, the struggle over ideas to a large extent determine which ideas come to have policy influence. Based on the papers theoretical framework of ideas as well...... as the logic of process tracing, a conceptual model for studying the struggle of ideas has been developed. The model should make it more tangible to trace the process of ideational struggle by analyzing it in a two-level game. The analytical framework will be applied on the case of Danish primary schooli...... change came as liberals contested the existing policies based on the ideas of progressive education as cause of the policy failure illuminated by the PISA investigations. As proponents of competitive education they pointed to the lack of accountability and argued for the need of measurable targets...

  1. Children’s play with digital media in a Danish pre-primary school

    DEFF Research Database (Denmark)

    Jørgensen, Helle Hovgaard

    2016-01-01

    Danish schools are obliged to work ‘in a playful way’ with digital media according to the demands in the descriptions of the curricula for pre-primary education (Undervisningsministeriet, 2015). Much money has been spent on digital infrastructure, but still professionals in preprimary education say...... that they are short of time, experience and knowledge when it comes to actual implementation of new media in everyday school life. On the other hand, most children come from media-rich homes. This article addresses the gap between in and out of school from a child’s perspective. The key concepts are play and media...... literacy, and the project’s take on play is inspired by the paradigmatic change towards a participatory and child-oriented scientific position. The understanding of media literacy is narrowed down to a trichotomy that implies having access to media, understanding media and creating/ expressing oneself...

  2. From Doctor to Nurse Triage in the Danish Out-of-Hours Primary Care Service: Simulated Effects on Costs

    NARCIS (Netherlands)

    Moth, G.; Huibers, L.; Vedsted, P.

    2013-01-01

    Introduction. General practitioners (GP) answer calls to the Danish out-of-hours primary care service (OOH) in Denmark, and this is a subject of discussions about quality and cost-effectiveness. The aim of this study was to estimate changes in fee costs if nurses substituted the GPs. Methods. We app

  3. Accountability Practices in the History of Danish Primary Public Education from the 1660s to the Present

    Science.gov (United States)

    Ydesen, Christian; Andreasen, Karen E.

    2014-01-01

    This paper focuses on primary education accountability as a concept and as an organizational practice in the history of Danish public education. Contemporary studies of education policy often address questions of accountability, but the manifestations of school accountability differ significantly between different national settings. Furthermore,…

  4. Exploring barriers for health visitors' adaption of the Danish children's database

    DEFF Research Database (Denmark)

    Pape-Haugaard, Louise; Haugaard, Karin; Carøe, Per;

    2013-01-01

    Denmark has unique health informatics databases such as “The Children's Database” (CDB), which since 2009 has held data on all Danish children from birth until 17 years of age. In the current set-up a number of potential sources of error exist – both technical and human – which means that the data...

  5. Psychometric analysis of the Patient Health Questionnaire in Danish patients with an implantable cardioverter defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Mathiasen, Kim; Christensen, Karl Bang

    2016-01-01

    OBJECTIVE: To assess the psychometric properties of the Patient Health Questionnaire (PHQ-9), a measure of depressive symptoms, in a large Danish national cohort of patients with heart disease, implanted with an implantable cardioverter defibrillator (ICD), using item response theory. METHODS...

  6. Poster: Oral-Health-Related Quality of Life among Danish adults

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Hede, Børge; Fiehn, Nils-Erik

    Objectives Identify and analyze determinants for oral-health-related quality of life among adults admitted to a Danish research program on general health and lifestyle (DANHES 2007-2008) Materials and methods Study population: 4402 volunteers invited among participants of main study (n=18065) in 12...... Danish cities. Age 18-96 years (average 54) Structured interviews (from main study and dental study) and clinical oral examination Oral-health-related quality of life measured by a 10 item index Non-parametric statistical methods, chi-square, simple and multivariate logistic regression Conclusions...... Regular dental visits and high number of natural teeth are determinants for high level of oral-health-related quality of life Untreated caries, wearing dentures and high caries experience are determinants for reduced oral-health-related quality of life Results 33 persons were edentulous, 7 % wore dentures...

  7. Explaining Quality Management in the Danish and Swedish Public Health Sectors

    DEFF Research Database (Denmark)

    Örnerheim, Mattias; Triantafillou, Peter

    2016-01-01

    This article examines the development of diverse quality systems in the otherwise quite similar Danish and Swedish public health sectors. After decades of numerous piecemeal medical and managerial quality development programs in both countries, a nationwide mandatory accreditation system was intr......This article examines the development of diverse quality systems in the otherwise quite similar Danish and Swedish public health sectors. After decades of numerous piecemeal medical and managerial quality development programs in both countries, a nationwide mandatory accreditation system...... was introduced in the Danish health services in 2009. Nationwide quality indicator projects are also found in Sweden, but there has been political attempt to introduce a compulsory system. This article seeks to explain this difference. It argues, first, that resistance from the medical professions blocked...... the introduction of compulsory, nationwide quality systems in both countries for decades. Second, the implementation of the Danish accreditation system was triggered by a combination of unintended policy learning produced by local reforms in two counties and of the Ministry of Health’s carefully orchestrated...

  8. Phytotherapy in primary health care

    Directory of Open Access Journals (Sweden)

    Gisele Damian Antonio

    2014-06-01

    Full Text Available OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population.

  9. Phytotherapy in primary health care

    Science.gov (United States)

    Antonio, Gisele Damian; Tesser, Charles Dalcanale; Moretti-Pires, Rodrigo Otavio

    2014-01-01

    OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population. PMID:25119949

  10. primary health care in nigeria

    African Journals Online (AJOL)

    user1

    2014-07-31

    Jul 31, 2014 ... Key Words: Primary Health Care, Strategies for implementation, Constraints, Alma Ata Declaration, Nigeria. 4th June, 2014. Accepted: ... including family planning; immunization against the ... evolved to meet the challenges associated with these diversities. .... and urban areas in Nigeria with the intention of.

  11. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    Journal of Community Medicine and Primary Health Care. 26 (1) 96-107 ... obesity. Specific criteria for MetS developed by. 19 of hypertension. .... Triglycerides 150 mg/dL or more or on Christians 329 (96.2%); and lower grade income.

  12. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    4 and optimal use. In Nigeria, despite the The main objective of this study is therefore to .... Islam. Others. 185. 205. 5. 46.8. 51.9. 1.3. Utilization (use) of PHC Services and educational qualifications and of low socio-economic .... other zones except in the south-east region. .... primary health care interventions, the evidence is.

  13. Health promotion innovation in primary health care

    Directory of Open Access Journals (Sweden)

    Alexandra McManus

    2013-01-01

    Full Text Available Previously, the main focus of primary health care practices was to diagnose and treat patients. The identification of risk factors for disease and the prevention of chronic conditions have become a part of everyday practice. This paper provides an argument for training primary health care (PHC practitioners in health promotion, while encouraging them to embrace innovation within their practice to streamline the treatment process and improve patient outcomes. Electronic modes of communication, education and training are now commonplace in many medical practices. The PHC sector has a small window of opportunity in which to become leaders within the current model of continuity of care by establishing their role as innovators in the prevention, treatment and management of disease. Not only will this make their own jobs easier, it has the potential to significantly impact patient outcomes.

  14. [Animal health and primary health care].

    Science.gov (United States)

    Moro, M

    1983-01-01

    As part of the primary care strategy, the Governments of the Americas have included the agricultural and animal health sectors among the public health activities of the Plan of Action. This means that both sectors--agricultural and veterinary--must be guided in their work by a multidisciplinary and multisectoral approach, with full community participation. Hence, it is certain that both the study of veterinary medicine and the practice of the profession in the Region will have to be reoriented so that they may be more fully integrated with the primary care strategy. The reorientation of animal health activities is the subject of this paper. There can be no doubt that animal health has a vital part to play in improving the quality of human life and that veterinary practice itself offers excellent opportunities for building a sense of personal and community responsibility for the promotion, care, and restoration of health. Through their contact with the rural population while caring for their livestock (an integral part of the rural socioeconomic structures), the veterinarian and animal health assistant establish close bonds of trust not only with farmers, but with their families and the entire community as well; they are thus well placed to enlist community participation in a variety of veterinary public health activities such as zoonoses control, hygiene programs, and so forth. While the goal of the Plan of action is to extend primary care to the entire population, the lack of material and human resources requires that priority attention be given to the needs of the more vulnerable groups, including the extremely poor living in rural and urban areas. These are the groups at greatest risk from the zoonoses still present in the Americas. In the face of these facts, it is clear that primary care in the animal health field should be based on the application in each country of proven, effective, appropriate technology by personnel who, whether new or retrained, are well

  15. The Danish Shoulder Arthroplasty Registry: clinical outcome and short-term survival of 2,137 primary shoulder replacements

    OpenAIRE

    Jeppe V Rasmussen; Jakobsen,John; Brorson, Stig; Olsen, Bo S

    2012-01-01

    The Danish Shoulder Arthroplasty Registry (DSR) was established in 2004. Data are reported electronically by the surgeons. Patient-reported outcome is collected 10–14 months postoperatively using the Western Ontario osteoarthritis of the shoulder index (WOOS). 2,137 primary shoulder arthroplasties (70% women) were reported to the registry between January 2006 and December 2008. Mean age at surgery was 69 years (SD 12). The most common indications were a displaced proximal humeral fracture (54...

  16. Differences in uptake of immunisations and health examinations among refugee children compared to Danish-born children

    DEFF Research Database (Denmark)

    Moller, Sanne Pagh; Hjern, Anders; Andersen, Anne-Marie Nybo

    2016-01-01

    of uptake among refugee children. Refugee children (n = 16,701) who, between January 1993 and December 2010, obtained residency permits in Denmark were included and matched in a 1:6 ratio on age and sex with Danish-born children (n = 100,206). Personal identification numbers were cross......Refugee children and their families constitute a vulnerable group regarding health and access to care. In a register-based cohort design, we examined differences in uptake of immunisations and child health examinations between refugee children and Danish-born children, including predictors......-linked to the National Danish Health Service Register, identifying all contacts for immunisation and child health examinations. We estimated hazard ratios (HR) of uptake. Refugee children had a lower uptake of all immunisations compared to Danish-born children. The lowest uptake was found for immunisation against...

  17. Quality in the Danish health care sector – patient identity in transition?

    DEFF Research Database (Denmark)

    Ottesen, Aase Marie; Strunck, Jeanne; Lassen, Inger Marie

    2015; Ministry of Health 2015). The change implies a gradual transition from an evidence based activity model to a value based quality model centered on patient involvement (Mainz et al 2015; Porter 2010; Rostgaard 2015). As a parallel trend over the past 30 years, welfare state ideology seems to have...... come under rising pressure by economic rationales combined with ideas of lean management and New Public Management (Valgårda 2003; Niklassson 2006; Lassen, Ottesen and Strunck 2015). Seeing that shifting quality perceptions and a stronger focus on patient involvement invites questions about the role...... of the patient in the Danish welfare system, we ask: 1) how is patient identity construed in selected legislation, steering instruments and reports issued by the Danish Board of Health, and 2) how may variation in the construal of patient identity be indicative of discursive struggle at the level of national...

  18. The study design and characteristics of the Danish national health interview surveys

    DEFF Research Database (Denmark)

    Ekholm, Ola; Hesse, Ulrik; Davidsen, Michael;

    2009-01-01

    AIMS: The Danish National Institute of Public Health, University of Southern Denmark has carried out national representative health interview surveys among adult Danes in 1987, 1994, 2000 and 2005. The aim of this study is to describe the characteristics of the design, including the response rate...... to the Danish population. However, these surveys are essential, as the information collected cannot be gathered by means of official statistical registers. Hence, efforts to increase the response rate will be important in the forthcoming surveys....... of the four surveys. METHODS: The samples in 1987 and 1994 are based on simple random sampling. The samples in 2000 and 2005 are based on stratified random sampling. In addition, all invited to the survey in 1994 were re-invited in both 2000 and 2005. Data were collected via face-to-face interview...

  19. Chiropractor perceptions and practices regarding interprofessional service delivery in the Danish primary care context

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Christensen, Henrik Wulff; Fogh-Schultz, Anders Lyck

    2014-01-01

    in practice alongside chiropractors, these being massage therapists (82%), physiotherapists (58%) and acupuncturists (37%). Interestingly only 11% considered a medical practitioner to be an active participant in their current interprofessional service delivery. Danish chiropractors consider interprofessional...

  20. Socio-Economic Consequences of Improved Indoor Air Quality in Danish Primary Schools

    DEFF Research Database (Denmark)

    Wargocki, Pawel; Foldbjerg, Peter; Eriksen, Kurt Emil;

    2014-01-01

    This paper reports an attempt to estimate the socio-economic effects of upgrading the indoor air quality in Danish schools to the level of Swedish schools. The OECD “PISA” score is used to quantify the effects together with the Danish Rational Economic Agent Model (DREAM). The following effects a...... in the Gross Domestic Product (GDP) of €173 million per annum, and in the public finances of €37 million per annum...

  1. Health Promotion in Danish schools: local priorities, policies and practices

    DEFF Research Database (Denmark)

    Simovska, Venka; Nordin, Lone Lindegard; Madsen, Katrine Dahl

    2016-01-01

    of school-based health promotion is underpinned by high level policy documents, declarations and agreements between and within governments. International organizations, such as the World Health Organization, have long called upon governments throughout Europe and globally to incorporate health......-related knowledge, skills and attitudes in their education systems from an early age and to provide a foundation for the promotion of lifelong health and wellbeing (e.g. WHO, 1986; 1991; 1997; 1999; 2014). One question that could be asked in this respect is what happens when these political initiatives...... with the drive to increase the quality and effectiveness of health promotion in schools while remaining loyal to the main principles of the critical, socio-ecological paradigm of the Health Promoting Schools initiative (Green and Tones, 2010). In the following, we first present the conceptual framework, context...

  2. Danish studies on exposure of geogenic elements in drinking water and public health

    DEFF Research Database (Denmark)

    Hansen, Birgitte; Schullehner, Jörg; Kristiansen, Søren Munch

    -available database JUPITER. Assessing the health impacts of geogenic natural occurring elements in drinking water requires sufficient data on life-long exposures. Thus, high-quality data on both spatial and temporal variation of drinking water quality are of paramount importance when assessing public health related...... the last almost 100 years and show how the amount of data increased since the 1980s. The aim is to combine drinking water quality data in the Danish geo-database JUPITER with the health data available at the National Centre for Integrated Register-based Research at Aarhus University (CIRRAU). Finally we...

  3. Selecting new health technologies for evaluation:Can clinical experts predict which new anticancer drugswill impact Danish health care?

    DEFF Research Database (Denmark)

    Douw, Karla; Vondeling, Hindrik

    2007-01-01

    source of information on new health technologies, but research on the relevance of their input is scarce. In 2000, we asked six Danish expert oncologists to predict whether a sample of 19 new anticancer drugs would impact Danish health care over the next 5 years. In 2005, we assessed the accuracy...... that clinical experts have the ability to predict which new anticancer drugs are unlikely to have an impact. This information can be used to increase the efficiency of selecting new technologies for evaluation. As the experts missed 37% of drugs that are in need of guidance, they should not be relied upon......Several countries have systems in place to support the managed entry of new health technologies. The big challenge for these so-called horizon-scanning systems is to select those technologies that require decision support by means of an early evaluation. Clinical experts are considered a valuable...

  4. Health promotion and primary health care: examining the discourse.

    Science.gov (United States)

    Ashcroft, Rachelle

    2015-01-01

    The health promotion discourse is comprised of assumptions about health and health care that are compatible with primary health care. An examination of the health promotion discourse illustrates how assumptions of health can help to inform primary health care. Despite health promotion being a good fit for primary health care, this analysis demonstrates that the scope in which it is being implemented in primary health care settings is limited. The health promotion discourse appears largely compatible with primary health care-in theory and in the health care practices that follow. The aim of this article is to contribute to the advancement of theoretical understanding of the health promotion discourse, and the relevance of health promotion to primary health care.

  5. Health promotion viewed as processes of subjectification in the education of Danish Social and Healthcare Workers

    DEFF Research Database (Denmark)

    Lehn-Christiansen, Sine

    2011-01-01

    analysis and post-structuralist theory, the article explores the processes of subjectification that result from the practices of health promotion within this particular educational setting. The article reveals how health promotion is transformed into an educational technology and is thus utilised to solve...... problems of both a social and moral character. It is shown how health promotion has a thorough impact on the students' possibilities of coming into being as ( professional) subjects. The article points to the conclusion that in this particular educational setting, health promotion constitutes......This article explores how health promotion is practised within a specific educational setting: the Danish Social and Health Education Programme. Here, health promotion is formally conceived as a strategy aimed at citizens - not at the students themselves. However, the students are generally...

  6. National indicators of health literacy: ability to understand health information and to engage actively with healthcare providers - a population-based survey among Danish adults.

    Science.gov (United States)

    Bo, Anne; Friis, Karina; Osborne, Richard H; Maindal, Helle Terkildsen

    2014-10-22

    Health literacy is a multidimensional concept covering a range of cognitive and social skills necessary for participation in health care. Knowledge of health literacy levels in general populations and how health literacy levels impacts on social health inequity is lacking. The primary aim of this study was to perform a population-based assessment of dimensions of health literacy related to understanding health information and to engaging with healthcare providers. Secondly, the aim was to examine associations between socio-economic characteristics with these dimensions of health literacy. A population-based survey was conducted between January and April 2013 in the Central Denmark Region. Postal invitations were sent to a random sample of 46,354 individuals >25 years of age. Two health literacy dimensions were selected from the Health Literacy Questionnaire (HLQ™): i) Understanding health information well enough to know what to do (5 items), and ii) Ability to actively engage with health care providers (5 items). Response options ranged from 1 (very difficult) to 4 (very easy). We investigated the level of perceived difficulty of each task, and the associations between the two dimensions and socio-economic characteristics. A total of 29,473 (63.6%) responded to the survey. Between 8.8%, 95% CI: 8.4-9.2 and 20.2%, 95% CI: 19.6-20.8 of the general population perceived the health literacy tasks as difficult or very difficult at the individual item level. On the scale level, the mean rating for i) understanding health information was 3.10, 95% CI: 3.09-3.10, and 3.07, 95% CI: 3.07-3.08 for ii) engagement with health care providers. Low levels of the two dimensions were associated with low income, low education level, living alone, and to non-Danish ethnicity. Associations with sex and age differed by the specific health literacy dimension. Estimates on two key dimensions of health literacy in a general population are now available. A substantial proportion of the

  7. Worksite dining as a collective good or individualization of health - a Danish perspective

    DEFF Research Database (Denmark)

    Jørgensen, Michael Søgaard; Mikkelsen, Bent Egberg; Thorsen, Anne Vibeke

    The paper is based on a survey of Danish literature about worksite eating carried out as a part of the project ‘Food at work around the clock?’ carried by Lunds University and Technical University of Denmark and financed by Øresund Food Network. The focus has especially been on the relations....... The few analyses which have been conducted show that negative and long-term stress, where the employee lack influence and control on own work may cause health problems and changes in body weight, so that slim persons become slimmer and the obese become more obese. A small interview survey shows...... that the type and the organization of work influence how the worksite eating is organized. Especially in the service sector it is difficult for the employees to eat at the same time. The eating schedule is negotiated among the employees according to the needs of the individual employee. An area with Danish...

  8. Diabetes, diabetes treatment, and mammographic density in Danish Diet, Cancer, and Health cohort

    DEFF Research Database (Denmark)

    Buschard, Karsten; Thomassen, Katrin; Lynge, Elsebeth;

    2017-01-01

    /dense breasts (2.08; 0.68-6.35). There was no effect modification of these associations by menopausal status or BMI. CONCLUSIONS: Having diabetes controlled by diet or oral antidiabetic agents is associated with a decrease in MD, whereas taking insulin is associated with an increase in MD.......PURPOSE: We examined whether diabetes and diabetes treatment are associated with MD in a cohort study of Danish women above age of 50 years. METHODS: Study cohort consisted of 5,644 women (4,500 postmenopausal) who participated in the Danish Diet, Cancer, and Health cohort (1993......-1997) and subsequently attended mammographic screening in Copenhagen (1993-2001). We used MD assessed at the first screening after the cohort entry, defined as mixed/dense or fatty. Diabetes diagnoses and diabetes treatments (diet, insulin, or oral antidiabetic agents) were self-reported at the time of recruitment (1993...

  9. Chiropractic practice in the Danish public health care sector

    DEFF Research Database (Denmark)

    Myburgh, Corrie

    2009-01-01

    and defined. Furthermore, a contextually relevant definition of an integral health care service is presented; and the professional importance for chiropractic in providing such services is also discussed. Finally, salient questions requiring empirical investigation in this context are posed; and selected...

  10. General practice and primary health care in Denmark

    DEFF Research Database (Denmark)

    Møller Pedersen, Kjeld; Andersen, John Sahl; Søndergård, Jens

    2012-01-01

    General practice is the corner stone of Danish primary health care. General practitioners (GPs) are similar to family physicians in the United States. On average, all Danes have 6.9 contacts per year with their GP (in-person, telephone, or E-mail consultation). General practice is characterized...... education. The contract is (re)negotiated every 2 years. General practice is embedded in a universal tax-funded health care system in which GP and hospital services are free at the point of use. The current system has evolved over the past century and has shown an ability to adapt flexibly to new challenges....... Practice units are fairly small: close to 2 GPs per unit plus nurses and secretaries. The units are fully computerized, that is, with computer-based patient records and submission of prescriptions digitally to pharmacies etc. Over the past few years a decrease in solo practices has been seen...

  11. Commissioning services and Primary Health Networks.

    Science.gov (United States)

    Booth, Mark; Boxall, Anne-Marie

    2016-01-01

    Commissioning is set to become a stronger feature in the Australian health system as Primary Health Networks embrace it as a tool for improving population health outcomes. International experience shows that developing into a commissioning organisation is not always easy. Drawing on international experiences of commissioning, as well as those from the Australian hospital sector, will help smooth the path for Primary Health Networks.

  12. Health promotion viewed as processes of subjectification in the education of Danish social and health care workers

    DEFF Research Database (Denmark)

    Lehn-Christiansen, Sine

    2011-01-01

    This article explores how health promotion is practiced within a specific educational setting: the Danish Social and Health Education Programme. Here, health promotion is formally conceived as a strategy aimed at citizens - not at the students themselves. However, the students are generally...... perceived as being incapable of taking care of their own health and therefore also as being too far from the role model figure inherent in the discourse of professional health promotion work. Practices targeting students’ physical health are induced both in- and outside the curriculum. Based on empirical...... analysis and post-structuralist theory, the article explores the processes of subjectification that result from the practices of health promotion within this particular educational setting. The article reveals how health promotion is transformed into an educational technology and is thus utilized to solve...

  13. Health behaviour among non-Western immigrants with Danish citizenship

    DEFF Research Database (Denmark)

    Hansen, Anne R; Ekholm, Ola; Kjøller, Mette

    2008-01-01

    or BMI> or =30. CONCLUSIONS: The non-Western immigrants are healthier in terms of alcohol and vegetable consumption and unhealthier with regard to leisure-time physical activity. The non-Western immigrants are less likely to report that their own effort is important in maintaining good health....... background for reporting sedentary spare-time activities (OR 2.96, 95% CI 1.96-4.17), daily consumption of boiled vegetables (OR 2.50, 95% CI 1.77-3.53), and daily consumption of salad/raw vegetables (OR 2.84, 95% CI 2.02-3.99). We found no differences in daily smoking, daily fruit consumption, BMI> or =25...

  14. Job mobility and health in the Danish workforce

    DEFF Research Database (Denmark)

    Hougaard, Charlotte Ørsted; Nygaard, Else; Holm, Astrid Ledgaard

    2017-01-01

    AIMS: The globalized economy has stimulated mobility in the labour market in many countries and Denmark has one of the highest rates of mobility between workplaces among the OECD countries. This raises the question of the potential health effects of mobility and the effect of disease on mobility...... confounders, an exposure-response relationship was seen between mobility and the incidence of ischaemic heart disease, stroke, duodenal ulcer, anxiety/depression and, most strongly, with alcohol-related disorders. The effects were not very strong, however, with odds ratios varying from 1.2 to 1.6. As expected......, no effect was seen for colorectal cancer. We also found an effect of both somatic and mental disorders on mobility, but not for the two cancer types. Mobility did not seem to prevent being out of the labour force after diagnosis. CONCLUSIONS FREQUENT MOBILITY IN THE LABOUR MARKET INCREASES THE RISK...

  15. Health promotion viewed as processes of subjectification in the education of Danish social and health care workers

    DEFF Research Database (Denmark)

    Lehn-Christiansen, Sine

    2011-01-01

    analysis and post-structuralist theory, the article explores the processes of subjectification that result from the practices of health promotion within this particular educational setting. The article reveals how health promotion is transformed into an educational technology and is thus utilized to solve...... problems of both a social and moral character. It is shown how health promotion has a thorough impact on the students’ possibilities of coming into being as (professional) subjects. The article points to the conclusion that in this particular educational setting, health promotion constitutes......This article explores how health promotion is practiced within a specific educational setting: the Danish Social and Health Education Programme. Here, health promotion is formally conceived as a strategy aimed at citizens - not at the students themselves. However, the students are generally...

  16. Improving primary health care through technological innovation.

    NARCIS (Netherlands)

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

    1989-01-01

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

  17. Primary care NPs: Leaders in population health.

    Science.gov (United States)

    Swartwout, Kathryn D

    2016-08-18

    A 2012 Institute of Medicine report calls primary and public healthcare workers to action, tasking them with working together to improve population health outcomes. A Practical Playbook released in 2014 enables this public health/primary care integration. Primary care NPs are in an excellent position to lead the charge and make this integration happen.

  18. [The concept of insanity in Danish penal and mental health codes].

    Science.gov (United States)

    Brandt-Christensen, Mette; Bertelsen, Aksel

    2010-04-26

    The medical terms insanity and psychosis are used synonymously to describe a condition with substantial changes in the "total" personality and loss of realism. In the 10th revision of the diagnostic classification system ICD-10 (1994) the intention was to replace the term "psychosis" with "psychotic" to indicate the presence of hallucinations and delusions. However, in Danish legislation - most importantly in the penal code and the Mental Health Act - the term "insanity" is still in use. This difference has lead to diagnostic uncertainty, especially in clinical and forensic psychiatric practice.

  19. Integrated care: a Danish perspective

    DEFF Research Database (Denmark)

    Rudkjøbing, Andreas; Olejaz, Maria; Birk, Hans Okkels

    2012-01-01

    that it generally provides high quality services and patient satisfaction with primary care and hospital services is high. Nevertheless, despite a raft of policies aimed at integrating health services, the Danish system still suffers from a lack of coordination of care. Although Denmark’s health information systems...... are widely admired, barriers to integration include organisational fragmentation, perverse financial incentives, and the absence of a single electronic medical record....

  20. The entrance of "the economic man" in Health Care Quality - a Danish case study

    DEFF Research Database (Denmark)

    Peyton, Margit Malmmose

    qualitative to quantitative outputs. The output measures form the foundation for a number of decisions such as allocation of human resources and funding. The purpose of this paper is to show how performance measurements have had a dominant impact on different stakeholders and their influences, which...... furthermore has had an impact on the perceived concept of service and service quality. The following research questions will be addressed: Is there a change in the relative power construction of stakeholders within the Danish health care system over the period of 2002-2008? If so, what effect has this change...... influences the other discourses and the text written on health care. The economic focus on numbers and quantitative output seems to have a large effect on the concept of service quality from being qualitative to becoming quantitative. This seems to work against the initial aim of restructuring the health...

  1. The Danish Inguinal Hernia database

    DEFF Research Database (Denmark)

    Friis-Andersen, Hans; Bisgaard, Thue

    2016-01-01

    of hernia, primary or recurrent, type of surgical repair procedure, mesh and mesh fixation methods. DESCRIPTIVE DATA: According to the Danish National Health Act, surgeons are obliged to register all hernia repairs immediately after surgery (3 minute registration time). All institutions have continuous...... access to their own data stratified on individual surgeons. Registrations are based on a closed, protected Internet system requiring personal codes also identifying the operating institution. A national steering committee consisting of 13 voluntary and dedicated surgeons, 11 of whom are unpaid, handles...... the medical management of the database. RESULTS: The Danish Inguinal Hernia Database comprises intraoperative data from >130,000 repairs (May 2015). A total of 49 peer-reviewed national and international publications have been published from the database (June 2015). CONCLUSION: The Danish Inguinal Hernia...

  2. The growth pattern of 0-1-year-old Danish children, when screened by public health nurses--the Copenhagen County Child Cohort 2000

    DEFF Research Database (Denmark)

    Olsen, Else Marie; Petersen, Janne; Skovgaard, Anne Mette

    2005-01-01

    Using inadequate growth references when screening child health could lead to false conclusions concerning individual growth. We were concerned that this might apply to the official Danish growth reference.......Using inadequate growth references when screening child health could lead to false conclusions concerning individual growth. We were concerned that this might apply to the official Danish growth reference....

  3. Short- and long-term mortality following primary total hip replacement for osteoarthritis: a Danish nationwide epidemiological study

    DEFF Research Database (Denmark)

    Pedersen, Alma Becic; Baron, J A; Overgaard, S

    2011-01-01

    -term mortality in subjects under 60 years old, and among THR patients without comorbidity. Long-term mortality was lower among THR patients than in controls (mortality rate ratio 0.7; 95% confidence interval 0.7 to 0.7). Overall, THR was associated with lower short- and long-term mortality among patients......We evaluated the short-term of 0 to 90 days and the longer term, up to 12.7 years, mortality for patients undergoing primary total hip replacement (THR) in Denmark in comparison to the general population. Through the Danish Hip Arthroplasty Registry we identified all primary THRs undertaken...... for osteoarthritis between 1 January 1995 and 31 December 2006. Each patient (n = 44 558) was matched at the time of surgery with three people from the general population (n = 133 674). We estimated mortality rates and mortality rate ratios with 95% confidence intervals for THR patients compared with the general...

  4. Integrated primary health care in Australia

    Directory of Open Access Journals (Sweden)

    Gawaine Powell Davies

    2009-10-01

    Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

  5. The effect of multiple reminders on response patterns in a Danish health survey

    DEFF Research Database (Denmark)

    Christensen, Anne I; Ekholm, Ola; Kristensen, Peter L;

    2015-01-01

    BACKGROUND: Reminders are routinely applied in surveys to increase response rates and reduce the possibility of bias. This study examines the effect of multiple reminders on the response rate, non-response bias, prevalence estimates and exposure-outcome relations in a national self......-administered health survey. METHODS: Data derive from the Danish National Health Survey 2010, in which 298 550 individuals (16 years of age or older) were invited to participate in a cross-sectional survey using a mixed-mode approach (paper and web questionnaires). At least two reminders were sent to non-respondents......, and 177 639 individuals completed the questionnaire (59.5%). Response patterns were compared between four groups of individuals (first mailing respondents, second mailing respondents, third mailing respondents and non-respondents). RESULTS: Multiple reminders led to an increase in response rate from 36...

  6. Childhood social circumstances and health behaviour in midlife: the Metropolit 1953 Danish male birth cohort

    DEFF Research Database (Denmark)

    Osler, Merete; Godtfredsen, Nina S; Prescott, Eva

    2008-01-01

    BACKGROUND: It has been suggested that the association between social disadvantage in childhood and adult mortality could come about through processes related to the family environment in which the child is raised. This study examines the relationship of fathers' social class with health behaviour...... in middle age and assesses the potential mediating role of cognitive function, educational status and social integration in young adulthood in these relationships. METHODS: We used data from the Metropolit cohort which includes 11 532 Danish men born in 1953 with information on fathers' social class...... at participants' birth and assessments of cognitive performance, education and social integration in early adulthood. In 2004, 6292 of these men participated in a follow-up survey on health and behaviour. Logistic regression was used to investigate the association of father's social class with smoking, alcohol...

  7. Marital status and twins' health and behavior: an analysis of middle-aged Danish twins

    DEFF Research Database (Denmark)

    Osler, Merete; McGue, Matt; Lund, Rikke

    2008-01-01

    divorce with depression and smoking in Danish twins are due to the stressful effects of marital dissolution, but that marital differences in other health and behavioral outcomes are most consistent with selection effects related to genetic or rearing environmental factors....... mass index (BMI), depression symptoms, self-rated health, cognitive function, physical activity, smoking, and alcohol intake. RESULTS: Among all 2350 individual twins, men who were divorced/widowed or never married had higher depression scores, lower cognitive test scores, lower physical activity...... scores, and were also less often moderate drinkers and nonsmokers compared with married men. Divorced/widowed women had higher depression scores and those divorced/widowed or never married were more often smokers than married women. Within twin pairs discordant on marital status, the divorced...

  8. Linkage between the Danish National Health Service Prescription Database, the Danish Fetal Medicine Database, and other Danish registries as a tool for the study of drug safety in pregnancy

    Directory of Open Access Journals (Sweden)

    Pedersen LH

    2016-05-01

    Full Text Available Lars H Pedersen,1,2 Olav B Petersen,1,2 Mette Nørgaard,3 Charlotte Ekelund,4 Lars Pedersen,3 Ann Tabor,4 Henrik T Sørensen3 1Department of Clinical Medicine, Aarhus University, 2Department of Obstetrics and Gynecology, 3Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, 4Department of Fetal Medicine, Rigshospitalet, Copenhagen, Denmark Abstract: A linked population-based database is being created in Denmark for research on drug safety during pregnancy. It combines information from the Danish National Health Service Prescription Database (with information on all prescriptions reimbursed in Denmark since 2004, the Danish Fetal Medicine Database, the Danish National Registry of Patients, and the Medical Birth Registry. The new linked database will provide validated information on malformations diagnosed both prenatally and postnatally. The cohort from 2008 to 2014 will comprise 589,000 pregnancies with information on 424,000 pregnancies resulting in live-born children, ~420,000 pregnancies undergoing prenatal ultrasound scans, 65,000 miscarriages, and 92,000 terminations. It will be updated yearly with information on ~80,000 pregnancies. The cohort will enable identification of drug exposures associated with severe malformations, not only based on malformations diagnosed after birth but also including those having led to termination of pregnancy or miscarriage. Such combined data will provide a unique source of information for research on the safety of medications used during pregnancy. Keywords: malformations, teratology, therapeutic drug monitoring, epidemiological methods, registries

  9. Linkage between the Danish National Health Service Prescription Database, the Danish Fetal Medicine Database, and other Danish registries as a tool for the study of drug safety in pregnancy

    Science.gov (United States)

    Pedersen, Lars H; Petersen, Olav B; Nørgaard, Mette; Ekelund, Charlotte; Pedersen, Lars; Tabor, Ann; Sørensen, Henrik T

    2016-01-01

    A linked population-based database is being created in Denmark for research on drug safety during pregnancy. It combines information from the Danish National Health Service Prescription Database (with information on all prescriptions reimbursed in Denmark since 2004), the Danish Fetal Medicine Database, the Danish National Registry of Patients, and the Medical Birth Registry. The new linked database will provide validated information on malformations diagnosed both prenatally and postnatally. The cohort from 2008 to 2014 will comprise 589,000 pregnancies with information on 424,000 pregnancies resulting in live-born children, ∼420,000 pregnancies undergoing prenatal ultrasound scans, 65,000 miscarriages, and 92,000 terminations. It will be updated yearly with information on ∼80,000 pregnancies. The cohort will enable identification of drug exposures associated with severe malformations, not only based on malformations diagnosed after birth but also including those having led to termination of pregnancy or miscarriage. Such combined data will provide a unique source of information for research on the safety of medications used during pregnancy. PMID:27274312

  10. The Danish Pathology Register

    DEFF Research Database (Denmark)

    Bjerregaard, Beth; Larsen, Ole B

    2011-01-01

    The National Board of Health, Denmark in 1997 published guidelines for reporting of pathology data and the Danish Pathology Register (DPR) was established.......The National Board of Health, Denmark in 1997 published guidelines for reporting of pathology data and the Danish Pathology Register (DPR) was established....

  11. Validating the Danish adaptation of the World Health Organization's International Classification for Patient Safety classification of patient safety incident types

    DEFF Research Database (Denmark)

    Mikkelsen, Kim Lyngby; Thommesen, Jacob; Andersen, Henning Boje

    2013-01-01

    Objectives Validation of a Danish patient safety incident classification adapted from the World Health Organizaton's International Classification for Patient Safety (ICPS-WHO). Design Thirty-three hospital safety management experts classified 58 safety incident cases selected to represent all types...

  12. Trends in geographic and socioeconomic inequalities in oral health among 15-year-old Danish adolescents during 1995–2013

    DEFF Research Database (Denmark)

    Sengupta, Kaushik; Christensen, Lisa Bøge; Mortensen, Laust Hvas

    2017-01-01

    Objectives: This study examines the geographic variation and trends in the distribution of dental caries among adolescents in Danish municipalities between 1995 and 2013. Moreover, the study explores the trends in the association between childhood socioeconomic position (SEP) and dental caries...... obtained from the national dental register of the Danish Health Authority. Data on individual-level social variables (childhood SEP, immigration status, country of origin, number of children and persons in the family, and household type) were obtained from administrative registers at Statistics Denmark...

  13. The association between fluoride in drinking water and dental caries in Danish children. Linking data from health registers, environmental registers and administrative registers.

    Science.gov (United States)

    Kirkeskov, Lilli; Kristiansen, Eva; Bøggild, Henrik; von Platen-Hallermund, Frants; Sckerl, Halfdan; Carlsen, Anders; Larsen, M Joost; Poulsen, Sven

    2010-06-01

    To study the association between fluoride concentration in drinking water and dental caries in Danish children. The study linked registry data on fluoride concentration in drinking water over a 10-year period with data on dental caries from the Danish National Board of Health database on child dental health for 5-year-old children born in 1989 and 1999, and for 15-year-old children born in 1979 and 1989. The number of children included in the cohorts varied between 41.000 and 48.000. Logistic regression was used to assess the correlations, adjusting for gender and taxable family income as a proxy variable for socioeconomic status.   Fluoride concentration in drinking water varied considerably within the country from very low (Dental caries in both 5-year-olds and 15-year-olds decreased over the study period. An inverse relation between the risk of dental caries and fluoride concentration in drinking water was found in both primary and permanent teeth. The risk was reduced by approximately 20% already at the lowest level of fluoride exposure (0.125-0.25mg/l). At the highest level of fluoride exposure (>1 mg/l), a reduction of approximately 50% was found. Similar findings were found if analysis was limited to children residing in the same place during the entire study period. The study confirmed previous findings of an inverse relation between fluoride concentration in the drinking water and dental caries in children. This correlation was found in spite of the extensive use of fluoridated toothpaste and caries-preventive programs implemented by the municipal dental services in Denmark. Linking Danish health registers with environmental and administrative registers offers an opportunity for obtaining sample sizes large enough to identify health effect, which otherwise could not be identified. © 2010 John Wiley & Sons A/S.

  14. Established and Outsider relations among students involved in a Health promotion intervention in a Danish high school

    DEFF Research Database (Denmark)

    Nielsen, Stine Frydendal; Ottesen, Laila; Thing, Lone Friis

    Established and the Outsiders” (Elias and Scotson, 1994). The study shows that some of the “health ambassador”-students found this role and their identity as “sports-students” difficult. They felt that this identity sometimes compromised their social life in the school, which relates to aspects that doesn......Established and outsider relations among students involved in a health promotion intervention in a Danish high school. Stine Frydendal Nielsen1, Laila Ottesen2, Lone Friis Thing2, 1Rysensteen Gymnasium, 2University of Copenhagen The paper considers a study in a Danish high school in which students......’t always correspond with the current health norms (Thing and Ottesen, 2013). Based on “The Established and the Outsiders”, the paper discusses the role of these students in a health promotion intervention. It explores the relations between the “health ambassador”-students and the other students...

  15. A qualitative study of how Danish drug consumption rooms influence health and well-being among people who use drugs

    DEFF Research Database (Denmark)

    Kappel, Nanna; Toth, Eva Charlotte; Tegner, Jette

    2016-01-01

    referred to local health clinics. Members of the staff build bridges for DCR clients by guiding them towards drug treatment programmes and services in the social and the health sectors. Conclusions: The study reveals a consistency between DCR clients and staff members with respect to appraisal......-being of vulnerable citizens and to reduce the number of overdoses. Five Danish DCRs are currently being operated. This article presents results from a national investigation focused on assessing the impact of Danish drug consumption rooms on the health and well-being of DCR clients and factors facilitating...... the acceptance of DCR clients in order to improve their health and Refer them onward to social and health service providers. Methods: We conducted 250 h of participant observation in the DCRs, followed by in-depth qualitative interviews with 42 DCR clients and 25 staff members. Field notes and interviews were...

  16. Studying in-between spaces of the Danish primary and secondary school as spaces of and in transition in the late 20th century

    DEFF Research Database (Denmark)

    Rasmussen, Lisa Rosén

    in-between spaces come into being through specific attention to their danger and potential, but also in relation to the perception and construction of classrooms and school layout. In this the alteration of the in-between spaces pulls together important dynamics in the formation of the Danish primary...

  17. Global health and primary care research

    NARCIS (Netherlands)

    Beasley, John W.; Starfield, Barbara; van Weel, Chris; Rosser, Walter W.; Haq, Cynthia L.

    2007-01-01

    A strong primary health care system is essential to provide effective and efficient health care in both resource-rich and resource-poor countries. Although a direct link has not been proven, we can reasonably expect better economic status when the health of the population is improved. Research in pr

  18. Global health and primary care research.

    NARCIS (Netherlands)

    Beasley, J.W.; Starfield, B.; Weel, C. van; Rosser, W.W.; Haq, C.L.

    2007-01-01

    A strong primary health care system is essential to provide effective and efficient health care in both resource-rich and resource-poor countries. Although a direct link has not been proven, we can reasonably expect better economic status when the health of the population is improved. Research in pr

  19. Global health and primary care research.

    NARCIS (Netherlands)

    Beasley, J.W.; Starfield, B.; Weel, C. van; Rosser, W.W.; Haq, C.L.

    2007-01-01

    A strong primary health care system is essential to provide effective and efficient health care in both resource-rich and resource-poor countries. Although a direct link has not been proven, we can reasonably expect better economic status when the health of the population is improved. Research in

  20. Characteristics of non-response in the Danish Health Interview Surveys, 1987-1994

    DEFF Research Database (Denmark)

    Kjøller, Mette; Thoning, Henrik

    2005-01-01

    -response biased the estimated population prevalence of morbidity when solely based on responders. METHODS: The data were for the 23,096 adults sampled for the Danish Health Interview Surveys in 1987, 1991 and 1994. All were followed using the National Patient Registry to obtain such information as hospital...... data collection. CONCLUSIONS: Although admission rates differed between respondents and non-respondents these differences were too small to bias the estimated population prevalence of morbidity when solely based on respondents....... admissions. RESULTS: Non-response increased from 20.0% in 1987 to 22.6% in 1994. Four combinations of background variables characterized the non-response: gender and age; gender and civil status; county of residence and age; survey year and age. Non-respondents and respondents had identical gender- and age...

  1. The entrance of "the economic man" in Health Care Quality - a Danish case study

    DEFF Research Database (Denmark)

    Peyton, Margit Malmmose

    qualitative to quantitative outputs. The output measures form the foundation for a number of decisions such as allocation of human resources and funding. The purpose of this paper is to show how performance measurements have had a dominant impact on different stakeholders and their influences, which...... furthermore has had an impact on the perceived concept of service and service quality. The following research questions will be addressed: Is there a change in the relative power construction of stakeholders within the Danish health care system over the period of 2002-2008? If so, what effect has this change...... of relative power had on the concept of service quality? Using Politt et al (1995) framework for the concept of service quality along with Lukes (1974/2005) third dimensional power concept, news media text is analysed in order to identify the dominant discursive power represented and its effect on the concept...

  2. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    For effective malaria control in Nigeria, free or subsidized malaria treatment and rural health insurance scheme ... triggers productive asset sales or high levels of debt,. Cost of malaria ..... November, 2012. Insurance Schemes and promotion/.

  3. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    birth attendants, and if there is a proper division of labour amongst the three tiers of the health system. 3 ... Obstetric. Care,. Traditional. Birth. Attendants,. Maternal. Mortality,. Neonatal ..... interview believed that sudden onset of labor and.

  4. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    Knowledge about andropause is better among older men (p<0.05) but educational status ... erectile dysfunction, changes in mood (depression ... quality of life [Karazindiyanoglu 2008]. represented ... with older patients about sexual health.

  5. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    satisfy the perceived needs of the clients they serve. age (15-45years) is put at .... Table 3: ANC clients' satisfaction of interpersonal relationship with Health .... listening to them, provider understanding their complaints are usually lodged, ...

  6. [Renewing primary health care in the Americas].

    Science.gov (United States)

    Macinko, James; Montenegro, Hernán; Nebot Adell, Carme; Etienne, Carissa

    2007-01-01

    At the 2003 meeting of the Directing Council of the Pan American Health Organization (PAHO), the PAHO Member States issued a mandate to strengthen primary health care (Resolution CD44. R6). The mandate led in 2005 to the document "Renewing Primary Health Care in the Americas. A Position Paper of the Pan American Health Organization/WHO [World Health Organization]," and it culminated in the Declaration of Montevideo, an agreement among the governments of the Region of the Americas to renew their commitment to primary health care (PHC). Scientific data have shown that PHC, regarded as the basis of all the health systems in the Region, is a key component of effective health systems and can be adapted to the range of diverse social, cultural, and economic conditions that exist. The new, global health paradigm has given rise to changes in the population's health care needs. Health services and systems must adapt to address these changes. Building on the legacy of the International Conference on Primary Health Care, held in 1978 in Alma-Ata (Kazakhstan, Union of Soviet Socialist Republics), PAHO proposes a group of strategies critical to adopting PHC-based health care systems based on the principles of equity, solidarity, and the right to the highest possible standard of health. The main objective of the strategies is to develop and/or strengthen PHC-based health systems in the entire Region of the Americas. A substantial effort will be required on the part of health professionals, citizens, governments, associations, and agencies. This document explains the strategies that must be employed at the national, subregional, Regional, and global levels.

  7. [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.

  8. Research in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Armando Henrique Norman

    2013-04-01

    ferramenta metodológica prática para o desenvolvimento de pesquisa usando a CIAP e formulários de papel e o artigo Assessment of pre-test probability in Primary Health Care using International Classification of Primary Care 2 (ICPC -2 refere-se à aplicação dessa metodologia em um serviço da APS brasileira. Convém ressaltar que a maioria das pesquisas realizadas na APS foram produzidas em uma era em que a coleta de dados era feita em papel, mesmo assim, pioneiros como William Pickles – em sua descrição das doenças infecciosas – são exemplos de como a pesquisa em APS auxiliou a modificar a face da medicina8. Desse modo, esses artigos visam possibilitar, mesmo em serviços de APS sem o uso de prontuários eletrônicos, o desenvolvimento de pesquisas que possam contribuir para o entendimento da realidade local de saúde. Como afirmou Bentsen9, [...] na prática médica, um diagnóstico é um rótulo que anexamos às pessoas enfermas. Usamos esses rótulos como a base prática para o tratamento e, se possível, para o diagnóstico. Se as terminologias diagnósticas estão relacionadas com a necessidade de pesquisa, então elas adquirem uma outra dimensão. Elas passam a ser ferramentas necessárias para a análise dos problemas, ou seja, para a pesquisa em epidemiologia, na clínica, nos processos operacionais ou na medicina social. De acordo com Starfield1, no intervalo de um ano, 75% a 85% da população necessitam apenas de cuidados primários de saúde, sendo que, do remanescente, 10% a 12% precisam de cuidados secundários e 5% a 10% requerem cuidados terciários, ou seja, a grande maioria dos pacientes recebe atendimento médico em ambulatório ou clínicas da atenção primária à saúde. Entretanto, a maior parte das pesquisas ocorre fora desses cenários de prática, criando uma distorção que dificulta a boa prática em medicina de modo geral e na medicina de família em particular4. Por fim, espera-se que a leitura do conteúdo da presente edi

  9. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    availability and affordability of ACTs in Secondary Health Care (SHC) facilities in Lagos State and ... percent (37.5%) of the hospitals did not have the drug in stock at the time of visit and drugs had been out of .... Only one in the community pharmacies as single dose .... funding and international competitive bidding for.

  10. & PRIMARY HEALTH CARE COMMUNITY MEDICINE

    African Journals Online (AJOL)

    users of the services, desire for more children, fear of side effects and partner's ... It confers important health and potential to control population growth and in the ... number of children, thereby enhance reproductive planning would avert a total of ..... collection of the data. review and recommendation for future policy decision.

  11. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Breastfeeding is the super food for babies and is sufficient if given exclusively in the ... Approximately 90% of all mothers interviewed had heard about EBF, although with .... formula for proportion was used to estimate a total ..... diseases was one important benefit mentioned in ... and her health are different, he is healthier.

  12. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    western Nigeria to Participate in Community Based Health Insurance. 1. 2 ..... Islam. Others. 159. 225. 3. 41.1. 58.1. 0.8. Marital status. Single. Married. 96. 287. 24.8 ..... services in southeast Nigeria. ... and the poor: evidence from Nigeria",.

  13. The origins of primary health care and selective primary health care.

    Science.gov (United States)

    Cueto, Marcos

    2004-11-01

    I present a historical study of the role played by the World Health Organization and UNICEF in the emergence and diffusion of the concept of primary health care during the late 1970s and early 1980s. I have analyzed these organizations' political context, their leaders, the methodologies and technologies associated with the primary health care perspective, and the debates on the meaning of primary health care. These debates led to the development of an alternative, more restricted approach, known as selective primary health care. My study examined library and archival sources; I cite examples from Latin America.

  14. Why health improves: defining the issues concerning 'comprehensive primary health care' and 'selective primary health care'.

    Science.gov (United States)

    Rifkin, S B; Walt, G

    1986-01-01

    What is the impact of technology on improving the life situations of people, especially the poor? How is this impact analyzed in terms of health improvements? These questions are paramount in the minds of health planners as they pursue national policies of primary health care, a policy popularized by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) and accepted by over 150 governments at Alma Ata in 1978. The purpose of this paper is to explore these questions in depth. It begins by giving the background to the debate, then examines the origins of two concepts which have dominated the field, those of 'primary health care' and 'selective primary health care.' On this basis it suggests areas of differences in the two concepts and discusses the policy and practical implications of confusing the two approaches. The paper suggests that the differences are firstly who controls the outcome of technological interventions and the perceived time frame in which plans can be carried out.

  15. From Doctor to Nurse Triage in the Danish Out-of-Hours Primary Care Service: Simulated Effects on Costs

    Directory of Open Access Journals (Sweden)

    Grete Moth

    2013-01-01

    Full Text Available Introduction. General practitioners (GP answer calls to the Danish out-of-hours primary care service (OOH in Denmark, and this is a subject of discussions about quality and cost-effectiveness. The aim of this study was to estimate changes in fee costs if nurses substituted the GPs. Methods. We applied experiences from The Netherlands on nurse performance in the OOH triage concerning the number of calls per hour. Using the 2011 number of calls in one region, we examined three hypothetical scenarios with nurse triage and calculated the differences in fee costs. Results. A new organisation with 97 employed nurses would be needed. Fewer telephone consultations may result in an increase of face-to-face contacts, resulting in an increase of 23.6% in costs fees. Under optimal circumstances (e.g., a lower demand for OOH services, a high telephone termination rate, and unchanged GP fees the costs could be reduced by 26.2% though excluding administrative costs of a new organisation. Conclusion. Substituting GPs with nurses in OOH primary care may increase the cost in fees compared to a model with only GPs. Further research is needed involving more influencing factors, such as costs due to nurse training and running the organisation.

  16. Use of national data base for strategic management of municipal oral health services for Danish children and adolescents

    DEFF Research Database (Denmark)

    Hansen, I.; Foldspang, Anders; Poulsen, S.

    2001-01-01

    Abstract –Objective: To evaluate the use of a national register for strategic management of dental health services for 0–17-year-old Danish children and to identify determinants for their use of the system as a strategic tool in management of the services. Methods: During the period December 1997......) the population and the socio-economic, cultural and political environment of the municipality; and 2) dental morbidity was collected as antecedent data from various official sources. Results: Seventy-seven percent of municipalities with public clinics and 68% of municipalities without public clinics used SCOR...... decreased from 1995 to 1996. Otherwise no associations between dental health and use of the system could be demonstrated. Conclusions: SCOR is widely used as a strategic planning instrument concerning the Danish dental services for children and adolescents. The predictors associated with its use are partly...

  17. Determinants for employer-paid health insurance coverage: a population-based study of the Danish labour force

    DEFF Research Database (Denmark)

    Christensen, Ann Demant; Søgaard, Rikke

    2013-01-01

    AIM: In 2002, the Danish tax law was changed, giving employees a tax exemption on supplemental, employer-paid health insurance. This might have conflicted with one of the key foundations of the healthcare system, namely equal access for equal needs. The aim of this study was to investigate...... determinants for employer-paid health insurance coverage. Because the policy change affected only people who were part of the labour force and because the public sector at that time had no tradition of providing fringe benefits, the analysis was restricted to the private labour force. METHOD: The analysis...... was based on data from a range of Danish person-level and company-level registers (explanatory variables). These data were combined with information on insurance status obtained from the trade organisation for insurance (dependent variable). A logistic regression was performed to estimate the odds of having...

  18. Severe obesity in young women and reproductive health: the Danish National Birth Cohort.

    Directory of Open Access Journals (Sweden)

    Ellen A Nohr

    Full Text Available BACKGROUND: Little is known about reproductive health in severely obese women. In this study, we present associations between different levels of severe obesity and a wide range of health outcomes in the mother and child. METHODS: From the Danish National Birth Cohort, we obtained self-reported information about prepregnant body mass index (BMI for 2451 severely obese women and 2450 randomly selected women from the remaining cohort who served as a comparison group. Information about maternal and infant outcomes was also self-reported or came from registers. Logistic regression was used to estimate the association between different levels of severe obesity and reproductive outcomes. PRINCIPAL FINDINGS: Subfecundity was more frequent in severely obese women, and during pregnancy, they had an excess risk of urinary tract infections, gestational diabetes, preeclampsia and other hypertensive disorders which increased with severity of obesity. They tended to have a higher risk of both pre- and post-term birth, and risk of cesarean and instrumental deliveries increased across obesity categories. After birth, severely obese women more often failed to initiate or sustain breastfeeding. Risk of weight retention 1.5 years after birth was similar to that of other women, but after adjustment for gestational weight gain, the risk was increased, especially in women in the lowest obesity category. In infants, increasing maternal obesity was associated with decreased risk of a low birth weight and increased risk of a high birth weight. Estimates for ponderal index showed the same pattern indicating an increasing risk of neonatal fatness with severity of obesity. Infant obesity measured one year after birth was also increased in children of severely obese mothers. CONCLUSION: Severe obesity is correlated with a substantial disease burden in reproductive health. Although the causal mechanisms remain elusive, these findings are useful for making predictions and

  19. The Danish Inguinal Hernia Database

    Directory of Open Access Journals (Sweden)

    Friis-Andersen H

    2016-10-01

    Full Text Available Hans Friis-Andersen1,2, Thue Bisgaard2,3 1Surgical Department, Horsens Regional Hospital, Horsens, Denmark; 2Steering Committee, Danish Hernia Database, 3Surgical Gastroenterological Department 235, Copenhagen University Hospital, Hvidovre, Denmark Aim of database: To monitor and improve nation-wide surgical outcome after groin hernia repair based on scientific evidence-based surgical strategies for the national and international surgical community. Study population: Patients ≥18 years operated for groin hernia. Main variables: Type and size of hernia, primary or recurrent, type of surgical repair procedure, mesh and mesh fixation methods. Descriptive data: According to the Danish National Health Act, surgeons are obliged to register all hernia repairs immediately after surgery (3 minute registration time. All institutions have continuous access to their own data stratified on individual surgeons. Registrations are based on a closed, protected Internet system requiring personal codes also identifying the operating institution. A national steering committee consisting of 13 voluntary and dedicated surgeons, 11 of whom are unpaid, handles the medical management of the database. Results: The Danish Inguinal Hernia Database comprises intraoperative data from >130,000 repairs (May 2015. A total of 49 peer-reviewed national and international publications have been published from the database (June 2015. Conclusion: The Danish Inguinal Hernia Database is fully active monitoring surgical quality and contributes to the national and international surgical society to improve outcome after groin hernia repair. Keywords: nation-wide, recurrence, chronic pain, femoral hernia, surgery, quality improvement

  20. 76 FR 68198 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2011-11-03

    ... Administration Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage... designated as primary medical care, mental health, and dental health professional shortage areas (HPSAs) as... seven health professional types (primary medical care, dental, psychiatric, vision care,...

  1. Do Teachers Leave Their Ethics at the School Gate? Social Practice Research in a Danish Primary School

    Directory of Open Access Journals (Sweden)

    Karen-Lis Kristensen

    2013-08-01

    Full Text Available This study addresses teachers' ethical dilemmas in everyday participation in school structures in a Danish Primary School. It focuses in particular on their relations with 'disturbing children'. The author and four first grade teachers work in a research team, documenting and analysing the teachers’ interactions in the classroom. This paper focuses on the interactions between two of the teachers and one of the students. The research team focuses on the teachers’ struggles with stress and burnout symptoms that they impute to students’ misbehaviour. Through their work together, documenting what happens in the classroom, and then working together in collective biography workshops, the research team reveals the contradictory conditions of teachers’ work. They find that following current guidelines for good classroom management, and accepting without question current discourses on ADHD, places the teachers in a double-bind, with teachers and children in opposition to each other, and both teachers and children being judged and found wanting.  The paper seeks new ways of thinking/doing classroom interaction that challenges some of the binds of current management practices.

  2. Do Teachers Leave Their Ethics at the School Gate? Social Practice Research in a Danish Primary School

    Directory of Open Access Journals (Sweden)

    Karen-Lis Kristensen

    2013-08-01

    Full Text Available This study addresses teachers' ethical dilemmas in everyday participation in school structures in a Danish Primary School. It focuses in particular on their relations with 'disturbing children'. The author and four first grade teachers work in a research team, documenting and analysing the teachers’ interactions in the classroom. This paper focuses on the interactions between two of the teachers and one of the students. The research team focuses on the teachers’ struggles with stress and burnout symptoms that they impute to students’ misbehaviour. Through their work together, documenting what happens in the classroom, and then working together in collective biography workshops, the research team reveals the contradictory conditions of teachers’ work. They find that following current guidelines for good classroom management, and accepting without question current discourses on ADHD, places the teachers in a double-bind, with teachers and children in opposition to each other, and both teachers and children being judged and found wanting.  The paper seeks new ways of thinking/doing classroom interaction that challenges some of the binds of current management practices.

  3. Chocolate intake and risk of clinically apparent atrial fibrillation: the Danish Diet, Cancer, and Health Study.

    Science.gov (United States)

    Mostofsky, Elizabeth; Berg Johansen, Martin; Tjønneland, Anne; Chahal, Harpreet S; Mittleman, Murray A; Overvad, Kim

    2017-08-01

    To evaluate the association between chocolate intake and incident clinically apparent atrial fibrillation or flutter (AF). The Danish Diet, Cancer, and Health Study is a large population-based prospective cohort study. The present study is based on 55 502 participants (26 400 men and 29 102 women) aged 50-64 years who had provided information on chocolate intake at baseline. Incident cases of AF were ascertained by linkage with nationwide registries. During a median of 13.5 years there were 3346 cases of AF. Compared with chocolate intake less than once per month, the rate of AF was lower for people consuming 1-3 servings/month (hazard ratio (HR) 0.90, 95% confidence interval (CI) 0.82 to 0.98), 1 serving/week (HR 0.83, 95% CI 0.74 to 0.92), 2-6 servings/week (HR 0.80, 95% CI 0.71 to 0.91) and ≥1 servings/day (HR 0.84, 95% CI 0.65 to 1.09; p-linear trend chocolate intake may be inversely associated with AF risk, although residual confounding cannot be ruled out. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Cigarette smoking and mammographic density in the Danish Diet, Cancer and Health cohort

    DEFF Research Database (Denmark)

    Jacobsen, Katja Kemp; Lynge, Elsebeth; Vejborg, Ilse

    2016-01-01

    between smoking and MD was strongest in women who initiated smoking before age of 16 years (0.79, 0.64-0.96), smoked ≥15 cigarettes/day (0.83, 0.71-0.98), smoked ≥5 pack-years (0.62, 0.43-0.89), smoked >30 years (0.86, 0.75-0.99), and smoked ≥11 years before first childbirth (0.70, 0.51-0.96). Association......PURPOSE: Smoking before first childbirth increases breast cancer risk, but the biological mechanism remains unknown and may involve mammographic density (MD), one of the strongest biomarkers of breast cancer risk. We aimed to examine whether active smoking and passive smoking were associated...... with MD. METHODS: For the 5,356 women (4,489 postmenopausal) from the Danish Diet, Cancer and Health cohort (1993-1997) who attended mammographic screening in Copenhagen (1993-2001), we used MD (mixed/dense or fatty) assessed at the first screening after cohort entry. Active smoking (status, duration...

  5. Journal of Community Medicine and Primary Health Care

    African Journals Online (AJOL)

    Journal of Community Medicine and Primary Health Care. ... of research findings, reviews, theories and information on all aspects of public health. ... health planning and management, health policy, health care financing, public health nutrition, ...

  6. Validity of physical activity and cardiorespiratory fitness in the Danish cohort 'Diet, Cancer and Health - Next Generations'

    DEFF Research Database (Denmark)

    Lerche, Lene; Olsen, Anja; Petersen, Kristina Elin Nielsen

    2017-01-01

    the Danish step test, the physical activity questionnaire Active-Q and self-rated fitness against directly measured maximal oxygen uptake (VO2 max). A population based subsample (n=125) was included from the 'Diet, Cancer and Health - Next Generations' (DCH-NG) cohort which is under establishment. Validity......). When validating the questionnaire-derived measures of PA, leisure time physical activity was not correlated with VO2 max. Positive correlations were found for sports overall, but these were only significant for men: total hours per week of sports (r=0.26), MET-hours per week of sports (r=0.......28) and vigorous sports (0.28) alone were positively correlated with VO2 max. Finally, the percentage of misclassification was low for self-rated fitness (women: 9% and men: 13%). Thus, self-rated fitness was found to be a superior method to the Danish step test, as well as being less cost prohibitive and more...

  7. Effectiveness of oral health education among primary health care workers at the primary health center in Nellore district, Andhra Pradesh

    Directory of Open Access Journals (Sweden)

    Muthyala Pavana Sandhya

    2014-01-01

    Full Text Available Background: Primary dental care can be a way of achieving good oral health for the community. This can be achieved by integration of oral health care with the existing primary health care activities through training of primary health care workers on aspects of oral health. Objective: To assess the effectiveness of oral health education among primary health care workers at the primary health center (PHC in Nellore district, Andhra Pradesh. Materials and Methods: Descriptive longitudinal study was conducted from June 2010 to August 2010 at a PHC. Knowledge about oral health among primary health care workers was pretested using a self-administered questionnaire prepared in local language (Telugu. Later after a month health education was provided to the health workers, and pamphlets with information on oral health were distributed. Posttest assessment was done 1-month after providing health education using the same questionnaire. Statistical analysis was performed using the SPSS 12.0 software, Student′s t-test was used to compare knowledge scores between pre and posttests. Results: A total of 118 Primary Health Care Workers with the majority in the 20-30 years age group participated in the study. Posttest assessment showed a change in knowledge level with an overall increase in knowledge level of primary health care workers with a mean difference of 12.56 ± 3.23, which was highly significant (P < 0.001. Conclusion: The knowledge about oral health was poor, and it improved after providing health education to primary health care workers. Change in knowledge was appreciable and may play a key role in oral health promotion of the vast majority of the rural population.

  8. Development and evaluation of an "emergency access button" in Danish out-of-hours primary care: a study protocol of a randomized controlled trial.

    Science.gov (United States)

    Ebert, J F; Huibers, L; Lippert, F K; Christensen, B; Christensen, M B

    2017-05-31

    Out-of-hours (OOH) health care for acute medical problems is often challenged by long waiting time for callers in need of advice and triage. Allowing patients to bypass the OOH telephone waiting line may increase patient satisfaction and provide them with a feeling of safety. We aimed to develop an "emergency access button" enabling patients to bypass the normal telephone waiting line in out-of-hours primary care (OOH-PC) if they perceive their condition to be critical and to evaluate the effect of introducing the button in terms of patient satisfaction and their feeling of safety. All patients calling the OOH-PC in two different Danish health care regions during three months will be included in this randomized controlled trial. Data will be collected through two questionnaires developed for this study: a pop-up questionnaire on the relevance of bypassing the normal waiting line to be completed by triage professionals after patient contact and a paper/electronic questionnaire on perceived safety and satisfaction with the emergency access button to be completed by the callers. These questionnaires were developed and validated using external and internal expert feedback, focus group interviews and a two-week field test. The study will be conducted over three months with an estimated user-rate of the emergency access button of 3%. We have developed an emergency access button and we now want to investigate whether this new option will influence upon the level of satisfaction and the feeling of safety in the calling patients. Additionally, the study will reveal the assessed relevance of the decision to bypass the line by triage professionals. Registered as NCT02572115 at Clinicaltrials.gov on October 5(th) 2015.

  9. Exploring barriers for health visitors’ adaption of the Danish Children’s Database through an empirical study

    DEFF Research Database (Denmark)

    Pape-Haugaard, Louise; Haugaard, Karin; Carøe, Per;

    2013-01-01

    Denmark has unique health informatics databases such as “The Children’s Database” (CDB), which since 2009 has held data on all Danish children from birth until 17 years of age. In the current set-up a number of potential sources of error exist - both technical and human - which means that the data...... analysis. The data show redundant records. This redundancy can be explained by multiple transmissions conducted by end users or systems, or a lack of validation methods in the National CDB. In our results three types of cases are presented: from health visitors at school, from health visitors visiting...... families and from health visitors at central health offices. Results are discussed from a socio-technical perspective using Schein’s cultural theory to understand the interaction between the health visitors and the information technology used for collecting data. Cultural theory is used to explain...

  10. Danish Cool

    DEFF Research Database (Denmark)

    Toft, Anne Elisabeth

    2016-01-01

    Danish Cool. Keld Helmer-Petersen, Photography and the Photobook Handout exhibition text in English and Chinese by Anne Elisabeth Toft, Curator The exhibition Danish Cool. Keld Helmer-Petersen, Photography and the Photobook presents the ground-breaking work of late Danish photographer Keld Helmer...

  11. Primary health care nurses' promotion of involuntary migrant families' health.

    Science.gov (United States)

    Samarasinghe, K; Fridlund, B; Arvidsson, B

    2010-06-01

    Involuntary migrant families in cultural transition face a number of challenges to their health and to family cohesion. Primary health care nurses (PHCNs) therefore play a vital role in the assessment and promotion of their health. The aim of this study was to describe the promotion of health in involuntary migrant families in cultural transition as conceptualized by Swedish PHCNs. Interviews were conducted with 34 strategically chosen PHCNs covering the entire range of the primary health care sector in two municipalities of Southern Sweden. A contextual approach with reference to phenomenography was used in interpreting the data. There are three qualitatively different descriptive categories epitomizing the characteristics of the PHCNs' promotion of health: (1) an ethnocentric approach promoting physical health of the individual, (2) an empathic approach promoting mental health of the individual in a family context, and (3) a holistic approach empowering the family to function well in everyday life. For nurses to promote involuntary migrant families'health in cultural transition, they need to adopt a holistic approach. Such an approach demands that nurses cooperate with other health care professionals and community authorities, and practise family-focused nursing; it also demands skills in intercultural communication paired with cultural self-awareness in interacting with these families. Adequate knowledge regarding these skills should therefore be included in the education of nurses, both at under- and at post-graduate level.

  12. Primary health care in South Africa.

    Science.gov (United States)

    Buch, E

    1989-01-01

    Even though most countries have committed to primary health care (PHC), South Africa, a middle-income country, has an inadequate PHC system. The poor system has roots in the colonial period and apartheid reinforces this system. Race, class, and place of residence determine the type of health care individuals receive. South Africa falls far short of all 5 principles of PHC. Just 12% of the health budget goes to 40% of the population who live in the homelands which shows the inequitable distribution of health care resources and inadequate quality health care for all. Similarly, South Africa has not altered its communication and education techniques to improve preventive and promotive health services. It has not implemented any successful national campaigns such as a campaign against diarrhea deaths. South Africa does not make good use of available appropriate technology such as breast feeding, oral rehydration, refrigeration, and the ventilated improved pit latrine which lead to health for all. People in South Africa discuss community participation but it is not likely to occur without general political democracy. Some people have made local attempts at community participation but they tend to use inflexible means and request either cash or contributions in kind from people who have little. The elite in South Africa has not recognized the need to correct socioeconomic inequalities. The Population Development Plan Programme among white farmer-owners has showed some support for a multisectoral approach to improve health care, however. For example, it acknowledges that non-health-care interventions such as better salaries, literacy, and living conditions, lead to better health. The Department of National Health has discussed improved coordination of the budget to allow priority determination of national PHD and manpower plans. Nongovernmental organizations are beginning to use the PHC approach instead of the charitable approach.

  13. Danish Vernacular

    DEFF Research Database (Denmark)

    Hyams, Inger Louise Berling

    2014-01-01

    Despite the number of internationally successful Danish architects like Jacobsen, Utzon and in recent years Ingels just to name a few, Danish architecture has always leaned greatly on international architectural history and theory. This is only natural for a small nation. However, since the begin...... the teachers had on their students. Such a perspective does not just inform us of past practices but could inspire to new ones....... the beginning of Danish architecture as a professional discipline, there has also been a formation of a certain Danish vernacular. This paper explores how the teaching of and interest in Danish historical buildings could have marked the education of Danish architecture students. Through analysis of the drawings...... of influential teachers in the Danish school, particularly Nyrop, this development is tracked. This descriptive and analytic work concludes in a perspective on the backdrop of Martin Heidegger’s differentiation between Historie and Geschichte – how history was used in the curriculum and what sort of impact...

  14. [Community health in primary health care teams: a management objective].

    Science.gov (United States)

    Nebot Adell, Carme; Pasarin Rua, Maribel; Canela Soler, Jaume; Sala Alvarez, Clara; Escosa Farga, Alex

    2016-12-01

    To describe the process of development of community health in a territory where the Primary Health Care board decided to include it in its roadmap as a strategic line. Evaluative research using qualitative techniques, including SWOT analysis on community health. Two-steps study. Primary care teams (PCT) of the Catalan Health Institute in Barcelona city. The 24 PCT belonging to the Muntanya-Dreta Primary Care Service in Barcelona city, with 904 professionals serving 557,430 inhabitants. Application of qualitative methodology using SWOT analysis in two steps (two-step study). Step 1: Setting up a core group consisting of local PCT professionals; collecting the community projects across the territory; SWOT analysis. Step 2: From the needs identified in the previous phase, a plan was developed, including a set of training activities in community health: basic, advanced, and a workshop to exchange experiences from the PCTs. A total of 80 team professionals received specific training in the 4 workshops held, one of them an advanced level. Two workshops were held to exchange experiences with 165 representatives from the local teams, and 22 PCTs presenting their practices. In 2013, 6 out of 24 PCTs have had a community diagnosis performed. Community health has achieved a good level of development in some areas, but this is not the general situation in the health care system. Its progression depends on the management support they have, the local community dynamics, and the scope of the Primary Health Care. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  15. Work, diabetes and obesity: a seven year follow-up study among Danish health care workers.

    Science.gov (United States)

    Poulsen, Kjeld; Cleal, Bryan; Clausen, Thomas; Andersen, Lars L

    2014-01-01

    The rise in prevalence of diabetes is alarming and research ascribes most of the increase to lifestyle. However, little knowledge exists about the influence of occupational factors on the risk for developing diabetes. This study estimates the importance of work and lifestyle as risk factors for developing diabetes mellitus among healthcare workers and explores the association of work factors and obesity, which is a risk factor for diabetes. Questionnaire-based prospective cohort study among 7,305 health care workers followed for seven years in the Danish National Diabetes Register. We used bivariate comparisons to give an unadjusted estimate of associations, followed by adjusted survival analysis and logistic regression models to estimate the influences of potential risk factors related to job, health and lifestyle on diabetes and obesity. During seven years of follow up, 3.5% of participants developed diabetes, associated with obesity (HR  =  6.53; 95% CI 4.68-9.10), overweight (HR  =  2.89; CI 2.11-3.96) age 50-69 y (HR  =  2.27; 95% CI 1.57-3.43) and high quality of leadership (HR  =  1.60; CI 1.19-2.16). Obesity at baseline was most common among the youngest employees, and was mainly associated with developing diabetes (OR  =  3.84; CI 2.85-5.17), impaired physical capacity and physical inactivity. In the occupational setting, obesity was associated with shift work, severe musculoskeletal pain, low influence, but also by good management, fewer role conflicts and a positive work-life balance. Looking only at non-smokers, removed the influence of age and pain. However, non-smokers also had higher depression scores and more role conflicts. Confirming obesity as the strongest risk factor for developing diabetes, the present study identified few occupational risk factors. However, obesity, the key risk factor for diabetes, had a more variable relation with work than did diabetes.

  16. Mental health stigma and primary health care decisions.

    Science.gov (United States)

    Corrigan, Patrick W; Mittal, Dinesh; Reaves, Christina M; Haynes, Tiffany F; Han, Xiaotong; Morris, Scott; Sullivan, Greer

    2014-08-15

    People with serious mental illness have higher rates of mortality and morbidity due to physical illness. In part, this occurs because primary care and other health providers sometimes make decisions contrary to typical care standards. This might occur because providers endorse mental illness stigma, which seems inversely related to prior personal experience with mental illness and mental health care. In this study, 166 health care providers (42.2% primary care, 57.8% mental health practice) from the Veteran׳s Affairs (VA) medical system completed measures of stigma characteristics, expected adherence, and subsequent health decisions (referral to a specialist and refill pain prescription) about a male patient with schizophrenia who was seeking help for low back pain due to arthritis. Research participants reported comfort with previous mental health interventions. Path analyses showed participants who endorsed stigmatizing characteristics of the patient were more likely to believe he would not adhere to treatment and hence, less likely to refer to a specialist or refill his prescription. Endorsement of stigmatizing characteristics was inversely related to comfort with one׳s previous mental health care. Implications of these findings will inform a program meant to enhance VA provider attitudes about people with mental illness, as well as their health decisions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Influence of health, lifestyle, working conditions and sociodemography on early retirement among nurses. The Danish Nurse Cohort Study

    DEFF Research Database (Denmark)

    Friis, Karina; Ekholm, Ola; Hundrup, Yrsa

    2007-01-01

    AIMS: The aim of the study was to analyze the relationship between health, lifestyle, work-related and sociodemographic factors, and older nurses' exit from the labor market to Post-Employment Wage (PEW). PEW is an early retirement scheme to make it possible for workers to retire at the age of 60....... METHODS: The study was based on 5,538 nurses in the age of 51-59 who in 1993 completed a questionnaire on health, lifestyle, working environment, and sociodemographic factors. The survey information was combined with longitudinal data from the Danish Integrated Database for Labor Market Research compiled...... by Statistics Denmark. The follow-up period was from 1993 to 2002. RESULTS: Nurses who had poor self-rated health were more likely to join PEW compared with nurses who considered their health as good (HR 1.28, 95% CI 1.16-1.41). Low job influence, high workload, and physical job demands only marginally...

  18. Major reproductive health characteristics in male Gulf War Veterans. The Danish Gulf War Study

    DEFF Research Database (Denmark)

    Ishøy, T; Andersson, A M; Suadicani, Poul Vilhelm

    2001-01-01

    The male reproductive system could have been affected by various hazardous agents and exposures during and in the aftermath of the Persian Gulf War scenario. We tested the hypothesis that, compared to controls, male Danish Gulf War Veterans would have adverse sex hormone levels, decreased fertility...

  19. Optimizing the Primary Prevention of Type-2 Diabetes in Primary Health Care

    Science.gov (United States)

    2017-08-18

    Interprofessional Relations; Primary Health Care/Organization & Administration; Diabetes Mellitus, Type 2/Prevention & Control; Primary Prevention/Methods; Risk Reduction Behavior; Randomized Controlled Trial; Life Style

  20. Long-term exposure to air pollution and mammographic density in the Danish Diet, Cancer and Health cohort

    DEFF Research Database (Denmark)

    Huynh, Stephanie; von Euler-Chelpin, My; Raaschou-Nielsen, Ole

    2015-01-01

    BACKGROUND: Growing evidence suggests that air pollution may be a risk factor for breast cancer, but the biological mechanism remains unknown. High mammographic density (MD) is one of the strongest predictors and biomarkers of breast cancer risk, but it has yet to be linked to air pollution. We...... pollution increases breast cancer risk, it is not via MD....... investigated the association between long-term exposure to traffic-related air pollution and MD in a prospective cohort of women 50 years and older. METHODS: For the 4,769 women (3,930 postmenopausal) participants in the Danish Diet, Cancer and Health cohort (1993-1997) who attended mammographic screening...

  1. Established and outsider relations among students involved in a health promotion intervention in a Danish high school

    DEFF Research Database (Denmark)

    Nielsen, Stine Frydendal; Ottesen, Laila; Thing, Lone Friis

    2016-01-01

    The paper considers a study in a Danish high school in which students were involved in enhancing physical activity in their own school. International research points out that adolescents are not as physically active as recommended. Moreover, studies show that maintaining health promotion interven......The paper considers a study in a Danish high school in which students were involved in enhancing physical activity in their own school. International research points out that adolescents are not as physically active as recommended. Moreover, studies show that maintaining health promotion...... and the importance of theoretical pointers to insure that the researcher does not lose herself in the research field. Elias unfolds this methodological approach in “The Established and the Outsiders.” By applying this conceptualization, this study shows that some of the involved students found their role...... and their identity as “sports-students” difficult, and it compromised their social life in the school, which relates to aspects that does not always correspond with the current health norms. The paper discusses the relations between the involved students and the other students in the school, and what consequences...

  2. Outsourcing of Primary Health Cares: Which Activities?

    Directory of Open Access Journals (Sweden)

    Sayed Mahdi Madani

    2016-07-01

    Full Text Available the primary health cares are among the individuals’ primary rights and their outsourcing can pave the way to more suitable use of resources for the field inside and outside of the organization and in this way make possible the better cares. The aim of this study was to determine the type of primary health cares that can be outsourced in Iran; this study embarked upon specifying which one, among the primary health cares, has ability of being outsourced by contractors outside the organization. This applied study has been done by a descriptive and cross-sectional method. According to the other studies at first a general framework was founded; hence the main framework with respect to the opinions of 30 experts. Thereafter a questionnaire was compiled for ensuring its correctness and gathering other experts’ opinions. The method of experts’ judgment was used for validity and for its reliability with distribution of 30 copies the method of calculating Cronbach’ salpha, which was 0.925. Then it was distributed among experts and 786 questionnaires were completed and collected; by using the method of factor of factor and confirmatory analysis as well as the descriptive statistics we embarked upon investigating and deducing the results. For statistical investigation the software SPSS21 and AMOS20 were used. In the factor of outsourcing activities one factor only covering 55.25% of variables variance was discovered. The results suggest that the item q10, “possibility of outsourcing the concrete activities”, with factor load of 0.791 and the item q6, "outsourcing and standardization", with factor load of 0.668 have respectively the highest load and the lowest one in the definition of the factor of cares of outsourcing. The more the primary health cares are more concrete, more simple, more standardized and have the further differentiability, their successful outsourcing is highly possible; in addition only those activities are able to be

  3. Child Health Booklet: experiences of professionals in primary health care

    Directory of Open Access Journals (Sweden)

    Gisele Nepomuceno de Andrade

    2014-10-01

    Full Text Available Objective: Understanding the experiences of health professionals in primary care with the Child Health Booklet in child health care. Method: A qualitative study with a phenomenological approach, in which participated nurses and doctors from six teams of the Family Health Strategy (FHS in Belo Horizonte, MG. In total, were carried out 12 non-directive interviews, using two guiding questions. Results: A comprehensive analysis of the speeches enabled the construction of three categories that signal the experiences of the professionals with the booklet. The experiments revealed difficulties arising from the limitations of knowledge about the instrument; incomplete filling out of the booklet by many professionals that care for children; the daily confrontations of the process and the organization of work teams; disinterest of families with the instrument. Conclusion: The research points possible and necessary ways to improve the use of booklets as an instrument of full child health surveillance.

  4. Health is primary: Family medicine for America's health.

    Science.gov (United States)

    Phillips, Robert L; Pugno, Perry A; Saultz, John W; Tuggy, Michael L; Borkan, Jeffrey M; Hoekzema, Grant S; DeVoe, Jennifer E; Weida, Jane A; Peterson, Lars E; Hughes, Lauren S; Kruse, Jerry E; Puffer, James C

    2014-10-01

    More than a decade ago the American Academy of Family Physicians, American Academy of Family Physicians Foundation, American Board of Family Medicine, Association of Departments of Family Medicine, Association of Family Practice Residency Directors, North American Primary Care Research Group, and Society of Teachers of Family Medicine came together in the Future of Family Medicine (FFM) to launch a series of strategic efforts to "renew the specialty to meet the needs of people and society," some of which bore important fruit. Family Medicine for America's Health was launched in 2013 to revisit the role of family medicine in view of these changes and to position family medicine with new strategic and communication plans to create better health, better health care, and lower cost for patients and communities (the Triple Aim). Family Medicine for America's Health was preceded and guided by the development of a family physician role definition. A consulting group facilitated systematic strategic plan development over 9 months that included key informant interviews, formal stakeholder surveys, future scenario testing, a retreat for family medicine organizations and stakeholder representatives to review strategy options, further strategy refinement, and finally a formal strategic plan with draft tactics and design for an implementation plan. A second communications consulting group surveyed diverse stakeholders in coordination with strategic planning to develop a communication plan. The American College of Osteopathic Family Physicians joined the effort, and students, residents, and young physicians were included. The core strategies identified include working to ensure broad access to sustained, primary care relationships; accountability for increasing primary care value in terms of cost and quality; a commitment to helping reduce health care disparities; moving to comprehensive payment and away from fee-for-service; transformation of training; technology to support

  5. The association between fluoride in drinking water and dental caries in Danish children. Linking data from health registers, environmental registers and administrative registers

    DEFF Research Database (Denmark)

    Kirkeskov, Lilli; Kristiansen, Eva; Bøggild, Henrik

    2010-01-01

    Kirkeskov L, Kristiansen E, Bøggild H, von Platen-Hallermund F, Sckerl H, Carlsen A, Larsen MJ, Poulsen S. The association between fluoride in drinking water and dental caries in Danish children. Linking data from health registers, environmental registers and administrative registers. Community...... Dent Oral Epidemiol 2010. (c) 2010 John Wiley & Sons A/S Abstract - Objectives: To study the association between fluoride concentration in drinking water and dental caries in Danish children. Methods: The study linked registry data on fluoride concentration in drinking water over a 10-year period...... with data on dental caries from the Danish National Board of Health database on child dental health for 5-year-old children born in 1989 and 1999, and for 15-year-old children born in 1979 and 1989. The number of children included in the cohorts varied between 41.000 and 48.000. Logistic regression was used...

  6. [Clinical bioethics for primary health care].

    Science.gov (United States)

    González-de Paz, L

    2013-01-01

    The clinical decision making process with ethical implications in the area of primary healthcare differs from other healthcare areas. From the ethical perspective it is important to include these issues in the decision making model. This dissertation explains the need for a process of bioethical deliberation for Primary Healthcare, as well as proposing a method for doing so. The decision process method, adapted to this healthcare area, is flexible and requires a more participative Healthcare System. This proposal involves professionals and the patient population equally, is intended to facilitate the acquisition of responsibility for personal and community health. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  7. Market demands to Danish pork

    DEFF Research Database (Denmark)

    Bredahl, Lone

    2001-01-01

    . The study focuses on the development on the most important markets for Danish pork. The countries are Denmark, Japan, UK, Germany, Italy, France, USA, Russia and South Korea. The primary purpose is to identify market demands of importance to the Danish pork sector in order to maintain and strengthen its...

  8. Translation and field testing of the family functioning, family health and social support questionnaire in Danish outpatients with heart failure

    DEFF Research Database (Denmark)

    Østergaard, Birte; Pedersen, Karen Steenvinkel; Lauridsen, Jørgen

    2017-01-01

    BACKGROUND: Valid and reliable instruments to assess family functioning, health and social support in families with heart failure constitute a cornerstone in the detection of the families' needs, in improving their functioning and in evaluating the effects of nursing interventions. AIM: To transl......BACKGROUND: Valid and reliable instruments to assess family functioning, health and social support in families with heart failure constitute a cornerstone in the detection of the families' needs, in improving their functioning and in evaluating the effects of nursing interventions. AIM....... The test-retest showed interclass correlation coefficients ranging between 0.69 and 0.86, indicating acceptable test-retest reliability. CONCLUSION: The Danish version of the FAFHES is an instrument that can be used to measure family functioning, family health and social support from the perspective...

  9. Time trends in socioeconomic inequalities in oral health among 15-year-old Danish adolescents during 1995–2013

    DEFF Research Database (Denmark)

    Sengupta, Kaushik; Christensen, Lisa Bøge; Mortensen, Laust Hvas

    Background: Scandinavian welfare states, despite having better population oral health when compared to less egalitarian societies, are characterized by ubiquitous social gradients and large relative socioeconomic inequalities in oral health. However, time trends in these inequalities among......-sectional studies using individual-level data were conducted on all adolescents in Denmark who became 15 years old in 1995, 2003, and 2013 (N=154,750). Dental data were obtained from the SCOR register of the Danish Health Authority while data on social variables were acquired from administrative registers...... at Statistics Denmark. SEP measures included previous year’s parental education (highest attained educational level between the parents), income (equivalized household disposable income), and occupational social class (highest recorded occupational class between the parents). Covariates were immigration status...

  10. The Danish Inguinal Hernia database

    Science.gov (United States)

    Friis-Andersen, Hans; Bisgaard, Thue

    2016-01-01

    Aim of database To monitor and improve nation-wide surgical outcome after groin hernia repair based on scientific evidence-based surgical strategies for the national and international surgical community. Study population Patients ≥18 years operated for groin hernia. Main variables Type and size of hernia, primary or recurrent, type of surgical repair procedure, mesh and mesh fixation methods. Descriptive data According to the Danish National Health Act, surgeons are obliged to register all hernia repairs immediately after surgery (3 minute registration time). All institutions have continuous access to their own data stratified on individual surgeons. Registrations are based on a closed, protected Internet system requiring personal codes also identifying the operating institution. A national steering committee consisting of 13 voluntary and dedicated surgeons, 11 of whom are unpaid, handles the medical management of the database. Results The Danish Inguinal Hernia Database comprises intraoperative data from >130,000 repairs (May 2015). A total of 49 peer-reviewed national and international publications have been published from the database (June 2015). Conclusion The Danish Inguinal Hernia Database is fully active monitoring surgical quality and contributes to the national and international surgical society to improve outcome after groin hernia repair. PMID:27822094

  11. Leadership in primary health care: an international perspective.

    Science.gov (United States)

    McMurray, Anne

    2007-08-01

    A primary health care approach is essential to contemporary nursing roles such as practice nursing. This paper examines the evolution of primary health care as a global strategy for responding to the social determinants of health. Primary health care roles require knowledge of, and a focus on social determinants of health, particularly the societal factors that allow and perpetuate inequities and disadvantage. They also require a depth and breadth of leadership skills that are responsive to health needs, appropriate in the social and regulatory context, and visionary in balancing both workforce and client needs. The key to succeeding in working with communities and groups under a primary health care umbrella is to balance the big picture of comprehensive primary health care with operational strategies for selective primary health care. The other essential element involves using leadership skills to promote inclusiveness, empowerment and health literacy, and ultimately, better health.

  12. Risk of second primary cancer among patients with early operable breast cancer registered or randomised in Danish Breast Cancer cooperative Group (DBCG) protocols of the 77, 82 and 89 programmes during 1977-2001

    DEFF Research Database (Denmark)

    Andersson, M.; Jensen, Maiken Brit; Engholm, G.;

    2008-01-01

    Breast cancer survivors have increased risks of developing second primary cancers due to shared etiology, life style factors but also to primary breast cancer treatment. Among 53 418 patients registered by the population based Danish Breast Cancer Cooperative Group (DBCG) during 1977-2001, 31 818...... rates of the Danish population were used for calculation of standardized incidence ratios (SIRs). Time at risk was from diagnosis of breast cancer+1 year until death or through 2002. Risk for all second primary cancers combined was increased, SIR=1.04 (95% confidence interval 0.99-1.08). Sites...

  13. [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

  14. Danish orientalism

    National Research Council Canada - National Science Library

    Zerlang, Martin

    2006-01-01

    Orientalism became an important current in nineteenth-century Danish culture, but although it was contemporaneous with the orientalism of the leading European nations - Great Britain, France, Germany...

  15. Professionalization of occupational health and safety management in Danish companies and the effects on worker participation

    DEFF Research Database (Denmark)

    Seim, Rikke; Limborg, Hans Jørgen; Jensen, Per Langaa

    2015-01-01

    The development of the internal OHS management is studied in sixty Danish companies, the results indicates an increase in professionalization, where employees - employed specifically with the purpose of managing OHS – are either supplementing or taking over from the mandatory OHS - committees. Th...... leaving the role of employee elected OHS rep as an empty formality without any powers or duties associated with the OHS management and removing initiative and commitment from the OHS reps.......The development of the internal OHS management is studied in sixty Danish companies, the results indicates an increase in professionalization, where employees - employed specifically with the purpose of managing OHS – are either supplementing or taking over from the mandatory OHS - committees...

  16. [People with a background in economic, political science and law have taken over in the Danish health care sector--or have they?].

    Science.gov (United States)

    Bech, Mickael; Arendt, Jacob N; Kronborg, Christian; Lauridsen, Jørgen T

    2010-12-13

    The distribution of power in the Danish health care sector is debated. It is often claimed that persons with a social science background have taken over the most powerful positions. The aim of this study was to test whether doctors have lost their power to people with a background in economic, political science and law. Data of the 100 most powerful people in the health care sector published yearly by the newspaper "Dagens Medicin" from the period 2000-2010 was analysed using multiple regression. The primary independent variable was whether the person was a doctor or had a background in social science. Among the top 10 and the top 30 persons with a background in social science dominated over doctors. In the full top 100 list there was an equal number of doctors and social science educated. There was a tendency in the period that the number of social science educated increased whereas the number of doctors decreased. The multiple regressions showed that there was no difference in the two groups' relative power. Also, it was shown that the two groups' relative power varied in the period but showed the same pattern of variation. Persons with a background in social science seem not to have taken over power from doctors in the health care sector. Both groups have lost power in the period - but to whom is still an unanswered question.

  17. Attitudes towards implantable cardioverter-defibrillator therapy: a national survey in Danish health-care professionals

    DEFF Research Database (Denmark)

    Johansen, Jens B; Mortensen, Peter T; Videbæk, Regitze

    2011-01-01

    Aims The aim of this study was to examine health-care professionals attitudes towards implantable cardioverter-defibrillator (ICD) therapy and issues discussed with patients. Methods and results Survey of 209 health-care professionals providing specialized treatment and care of ICD patients......-physicians. Physicians were less likely to believe that their personal attitude towards ICD treatment has no influence on how they deal professionally with patients (27.8 vs. 43.6%; P = 0.04). Physicians and non-physicians were equally positive towards ICD therapy as primary prophylaxis in ischaemic cardiomyopathy (87...... discussing ICD treatment with candidate patients. At the same time, physicians are more aware that their attitude towards ICD treatment may influence how they deal professionally with patients compared with non-physicians....

  18. [Primary health care product defined by health professionals and users].

    Science.gov (United States)

    Pujol Ribera, Enriqueta; Gené Badia, Joan; Sans Corrales, Mireia; Sampietro-Colom, Laura; Pasarín Rua, María Isabel; Iglesias-Pérez, Begoña; Casajuana-Brunet, Josep; Escaramis-Babiano, Georgia

    2006-01-01

    To identify the components of the primary health care (PHC) product defined by health professionals and users in order to establish indicators for evaluation. Qualitative methodology was used with group techniques: a nominal group (health professionals) and focus groups (users). The study was performed in PHC centers in Catalonia (Spain). There were 7 groups: a) family physicians and pediatricians; b) nurses and social workers; c) staff from admissions units and customer services; d) other medical specialists; e) users; f) managers, pharmacists, pharmacologists, and technicians. Participants responded to the question: "Which features should be evaluated in the services that should be provided by PHC?". A content analysis was performed. Textual data were broken down into units and then grouped into categories, following analogy criteria. The interpretative context of the research team was taken into account. Health professionals and users identified 4 dimensions of the PHC product, coinciding with its basic attributes: a) access to services; b) coordination and continuity of the PHC teams with other levels of healthcare; c) relationship between health professionals and users, and d) scientific-technical quality of the PHC teams and the portfolio of services. Equity, satisfaction and efficiency appeared as keystones in all the components of the product identified. There was broad agreement in the product definition among health professionals and users. The relationship between health professionals and patients was a key element in all groups. The four dimensions should be included in the evaluation of PHC teams.

  19. Mortality, health, social and economic consequences of amyotrophic lateral sclerosis

    DEFF Research Database (Denmark)

    Jennum, Poul; Ibsen, Rikke Falkner; Pedersen, Stephen Wørlich

    2013-01-01

    , gender and geographic area/civil status. Direct costs, including frequencies of primary and sector contacts and procedures, and medication from primary and secondary sectors, were obtained from the Danish Ministry of Health, the Danish Medicines Agency, and the National Health Security. Indirect costs...

  20. Danish Vernacular

    DEFF Research Database (Denmark)

    Hyams, Inger Louise Berling

    2014-01-01

    Despite the number of internationally successful Danish architects like Jacobsen, Utzon and in recent years Ingels just to name a few, Danish architecture has always leaned greatly on international architectural history and theory. This is only natural for a small nation. However, since the begin...

  1. Cultural adaptation and validation of the Health Literacy Questionnaire (HLQ): robust nine-dimension Danish language confirmatory factor model.

    Science.gov (United States)

    Maindal, Helle Terkildsen; Kayser, Lars; Norgaard, Ole; Bo, Anne; Elsworth, Gerald R; Osborne, Richard H

    2016-01-01

    Health literacy is an important construct in population health and healthcare requiring rigorous measurement. The Health Literacy Questionnaire (HLQ), with nine scales, measures a broad perception of health literacy. This study aimed to adapt the HLQ to the Danish setting, and to examine the factor structure, homogeneity, reliability and discriminant validity. The HLQ was adapted using forward-backward translation, consensus conference and cognitive interviews (n = 15). Psychometric properties were examined based on data collected by face-to-face interview (n = 481). Tests included difficulty level, composite scale reliability and confirmatory factor analysis (CFA). Cognitive testing revealed that only minor re-wording was required. The easiest scale to respond to positively was 'Social support for health', and the hardest were 'Navigating the healthcare system' and 'Appraisal of health information'. CFA of the individual scales showed acceptably high loadings (range 0.49-0.93). CFA fit statistics after including correlated residuals were good for seven scales, acceptable for one. Composite reliability and Cronbach's α were >0.8 for all but one scale. A nine-factor CFA model was fitted to items with no cross-loadings or correlated residuals allowed. Given this restricted model, the fit was satisfactory. The HLQ appears robust for its intended application of assessing health literacy in a range of settings. Further work is required to demonstrate sensitivity to measure changes.

  2. Psychological Health, Trauma, Dissociation, Absorption, and Fantasy proneness among Danish Spiritual practitioners

    DEFF Research Database (Denmark)

    Cardena, Etzel; Reijman, Sophie; Wimmelmann, Cathrine Lawaetz

    2015-01-01

    correlated with dissociation, a history of serious trauma and (weakly) with absorption, but not with general trauma or fantasy-proneness. Overall, the results do not support the view that most spiritual practitioners have higher psychological distress or are socially marginal, although there is a subset...... to be in a committed relationship and belong to the Danish National Church, whereas R had a lower level of education and were unlikely to be in a committed relationship or belong to the Church, suggesting social marginality. All groups completed the Brief Symptom Inventory-53 (BSI-53), a measure of psychological...

  3. Welfare assessments based on lifetime health and production data in Danish dairy cows

    DEFF Research Database (Denmark)

    Houe, Hans; Sandøe, Peter; Thomsen, Peter Thorup

    2011-01-01

    more than 22,000 L of milk. The medium number of treatments a cow had received for any disease was 2, but 10% of the cows had received more than 8 treatments for a disease. The study concluded that lifetime description provides a measure of disease occurrence that gives added value of ethical relevance...... or other condition affecting animal welfare is carried by a few individuals or is distributed more evenly. To illustrate this principle, the study obtained data on disease treatment records and production from 392,287 cows from the Danish Cattle Database. The average cow had lived for 5 years and produced...

  4. Positive affect and negative affect correlate differently with distress and health-related quality of life in patients with cardiac conditions: Validation of the Danish Global Mood Scale

    DEFF Research Database (Denmark)

    Spindler, Helle; Denollet, Johan; Kruse, Charlotte

    2009-01-01

    The Global Mood Scale (GMS), assessing negative affect (NA) and positive affect (PA), is sensitive to tapping treatment-related changes in patients with cardiac conditions. We examined the psychometric properties of the Danish GMS and the influence of NA and PA on distress and health-related qual...

  5. The psychosocial work environment and certified occupational health and safety management systems in the public sector – experience from two Danish municipalities

    DEFF Research Database (Denmark)

    Hasle, Peter; Hohnen, Pernille; Helbo, Anne;

    2014-01-01

    Certified occupational health and safety management (OHSM) systems are expected to cover the psychosocial work environment. We studied certified OHSM systems implemented in two medium-sized to large Danish municipalities. The cases show that the process of adopting OHSM systems from their traditi...

  6. Cynical hostility, socioeconomic position, health behaviors, and symptom load: a cross-sectional analysis in a Danish population-based study

    DEFF Research Database (Denmark)

    Christensen, Ulla; Lund, Rikke; Damsgaard, Mogens Trab;

    2004-01-01

    OBJECTIVE: To analyze the cross-sectional association between cynical hostility and high symptom load in a Danish population-based study. Furthermore, the aim was to investigate to what extent health risk behaviors mediated this association. METHODS: Data were based on a postal questionnaire...

  7. 77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2012-06-29

    ..., Mental Health, and Dental Health Professional Shortage Areas AGENCY: Health Resources and Services... primary medical care, mental health, and dental health professional shortage areas (HPSAs) as of April 1... National Health Service Corps (NHSC) personnel to provide primary care, dental, or mental health...

  8. Optimistic and pessimistic self-assessment of own diets is associated with age, self-rated health and weight status in Danish adults

    DEFF Research Database (Denmark)

    Sørensen, Mette Rosenlund; Matthiessen, Jeppe; Holm, Lotte

    2017-01-01

    The aim of this study was to analyse concordance between Danish adults’ recorded diet quality and their own assessment of the healthiness and to examine socio-demographic, health and behavioural characteristics associated with an optimistic or pessimistic self-assessment. Data were derived from...... The Danish National Survey of Diet and Physical Activity 2011-2013 and included a random sample of 3014 adults (18-75 y). Diet quality was evaluated on the basis of seven-day pre-coded food diaries and categorised ‘unhealthy’, ‘somewhat healthy’ and ‘healthy’. Self-assessment of the healthiness of own diets...

  9. [Burnout syndrome in primary health care professionals].

    Science.gov (United States)

    Martins, Leonardo Fernandes; Laport, Tamires Jordão; Menezes, Vinicius de Paula; Medeiros, Priscila Bonfante; Ronzani, Telmo Mota

    2014-12-01

    Burnout is characterized by emotional exhaustion, depersonalization and low occupational performance, which may occur among health professionals. This article evaluates burnout among workers in Primary Health Care (PHC) in three small towns in the Zona da Mata Mineira. The study analyzes associations by logistic regression between burnout, socioeconomic, and demographic aspects of work. A total of 149 professionals were selected, 107 of these responded to all questionnaires. To measure burnout, the Maslach Burnout Inventory (MBI) was used and to characterize the professional, a questionnaire assessing three different issues - namely individual and sociodemographic aspects and team area coverage - was used. 101 professionals were classified with positive indication for burnout. The variables present in the backward stepwise logistic regression model positively associated with indicative of burnout were: being younger than the population average (> 29.5 years) and use of drugs, including sedatives, tranquilizers and sleeping pills. The results contribute to the identification of factors associated with burnout and therefore highlight the need for more detailed investigation.

  10. Leadership for primary health care research.

    Science.gov (United States)

    Pendleton, David

    2012-10-01

    Over the last decade, I have put together a new theory of leadership. This paper describes its four propositions, which are consistent with the research literature but which lead to conclusions that are not commonly held and seldom put into practice. The first proposition is a model describing the territory of leadership that is different from either the Leadership Qualities Framework, 2006 or the Medical Leadership Competency Framework, 2010, both of which have been devised specifically for the NHS (National Health Service). The second proposition concerns the ill-advised attempt of individuals to become expert in all aspects of leadership: complete in themselves. The third suggests how personality and capability are related. The fourth embraces and recommends the notion of complementary differences among leaders. As the NHS seeks increasing leadership effectiveness, these propositions may need to be considered and their implications woven into the fabric of NHS leader selection and development. Primary Health Care research, like all fields of collective human endeavour, is eminently in need of sound leadership and the same principles that facilitate sound leadership in other fields is likely to be relevant to research teams.

  11. Declining trends in conception rates in recent birth cohorts of native Danish women: a possible role of deteriorating male reproductive health

    DEFF Research Database (Denmark)

    Jensen, Tina Kold; Sobotka, Thomás; Hansen, Martin A.

    2008-01-01

    Recent findings of poor semen quality among at least 20% of normal young men in Denmark prompted us to use unique Danish registers on births and induced abortions to evaluate a possible effect of the poor male fecundity on pregnancy rates among their presumed partners - the younger cohorts of women...... of relatively young couples in the later cohorts. Furthermore, the lower rates of induced abortion among the younger birth cohorts, often viewed as a success of health education programs, may not be fully explained by improved use of contraception. It seems more likely that decreased fecundity because....... We have analysed data from the Danish birth and abortion registries as well as the Danish registry for assisted reproduction (ART) and defined a total natural conception rate (TNCR), which is equal to fertility rate plus induced abortion rate minus ART conception rate. A unique personal...

  12. Declining trends in conception rates in recent birth cohorts of native Danish women: a possible role of deteriorating male reproductive health

    DEFF Research Database (Denmark)

    Jensen, T.K.; Sobotka, T.; Hansen, Marc Allan

    2008-01-01

    Recent findings of poor semen quality among at least 20% of normal young men in Denmark prompted us to use unique Danish registers on births and induced abortions to evaluate a possible effect of the poor male fecundity on pregnancy rates among their presumed partners--the younger cohorts of women...... of relatively young couples in the later cohorts. Furthermore, the lower rates of induced abortion among the younger birth cohorts, often viewed as a success of health education programs, may not be fully explained by improved use of contraception. It seems more likely that decreased fecundity because....... We have analysed data from the Danish birth and abortion registries as well as the Danish registry for assisted reproduction (ART) and defined a total natural conception rate (TNCR), which is equal to fertility rate plus induced abortion rate minus ART conception rate. A unique personal...

  13. The effects of the Danish saturated fat tax on food and nutrient intake and modelled health outcomes

    DEFF Research Database (Denmark)

    Smed, Sinne; Scarborough, P.; Rayner, M.

    2016-01-01

    Background/Objective: The World Health Organisation recommends governments to consider the use of fiscal policies to promote healthy eating. However, there is very limited evidence of the effect of food taxation in a real-life setting, as most evidence is based on simulation studies. The objective...... of this study is to evaluate the effect of the Danish tax on saturated fat in terms of changes in nutritional quality of the diet, that is, changes in saturated fat consumption, as well as other non-targeted dietary measures, and to model the associated changes in mortality for different age groups and genders....... Subjects/Methods: On the basis of household scanner data, we estimate the impact of the tax on consumption of saturated fat, unsaturated fat, salt, fruit, vegetables and fibre. The resultant changes in dietary quality are then used as inputs into a comparative risk assessment model (PRIME (Preventable Risk...

  14. Genetic Analysis of Protein Yield, Udder Health, and Female Fertility in First-Parity Danish Holstein Cows

    DEFF Research Database (Denmark)

    Buch, L H; Norberg, E

    2008-01-01

    Genetic parameters for protein yield, clinical mastitis, SCS, number of inseminations (NI), and days from first to last insemination (FLI) were estimated for first-parity Danish Holstein cows. The objective was to estimate genetic correlations between the five traits mentioned above and to study...... whether NI and FLI are measures of the same trait. Records containing information on approximately 200 000 cows were analysed using tri-variate animal models. The genetic correlations between the udder health traits and the fertility traits were favourable and in the range from 0.17 to 0.42, whereas...... the genetic correlations between protein yield and the fertility traits were unfavourable and ranged from 0.43 to 0.52. These results highlight the importance of continuing to emphasize functional traits in future breeding programmes. The genetic correlation between the fertility traits was 0.82. Based...

  15. The Danish Adult Diabetes Registry

    Directory of Open Access Journals (Sweden)

    Jørgensen ME

    2016-10-01

    Full Text Available Marit Eika Jørgensen,1,2 Jette K Kristensen,3 Gitte Reventlov Husted,1 Charlotte Cerqueira,4 Peter Rossing1,3,5 1Steno Diabetes Center, Gentofte, 2National Institute of Public Health, University of Southern Denmark, Odense, 3Aarhus University, Aarhus, 4Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, Capital Region of Denmark, 5University of Copenhagen, Copenhagen, Denmark Aim of the database: The aim of the Danish Adult Diabetes Registry (DADR is to provide data from both the primary health care sector (general practice [GP] and the secondary sector (specialized outpatient clinics to assess the quality of treatment given to patients with diabetes. The indicators represent process and outcome indicators selected from the literature. Study population: The total diabetes population in Denmark is estimated to be ~300,000 adult diabetes patients. Approximately 10% have type 1 diabetes, which is managed mainly in the secondary sector, and 90% have type 2 diabetes with the majority (80% being treated in primary health care. In 2014, DADR included data from a total of 70,826 patients. Main variables: The following variables are assessed: date of analysis as well as the outcome for hemoglobin A1c, blood pressure, lipids, urinary albumin–creatinine ratio, smoking status, glucose-, blood pressure-, and lipid-lowering treatment (yes/no, insulin pump treatment (yes/no, and date of last eye and foot examination. Descriptive data: In 2014, the annual report included data regarding over 38,000 patients from outpatient clinics, which is assumed to have included almost all patients in this setting, and >32,000 from GPs, reflecting improved but still limited coverage from this setting. The annual results are published in a compiled report of Danish Diabetes Care, which included DADR, data from the pediatric diabetes database, and the national ophthalmological diabetes database. The annual report is

  16. A novel index for preoperative, non-invasive prediction of macro-radical primary surgery in patients with stage IIIC-IV ovarian cancer-a part of the Danish prospective pelvic mass study

    DEFF Research Database (Denmark)

    Karlsen, Mona Aarenstrup; Fagö-Olsen, Carsten; Høgdall, Estrid Vilma Solyom;

    2016-01-01

    The purpose of this study was to develop a novel index for preoperative, non-invasive prediction of complete primary cytoreduction in patients with FIGO stage IIIC-IV epithelial ovarian cancer. Prospectively collected clinical data was registered in the Danish Gynecologic Cancer Database. Blood...... samples were collected within 14 days of surgery and stored by the Danish CancerBiobank. Serum human epididymis protein 4 (HE4), serum cancer antigen 125 (CA125), age, performance status, and presence/absence of ascites at ultrasonography were evaluated individually and combined to predict complete tumor.......688 for age. The multivariate model (Cancer Ovarii Non-invasive Assessment of Treatment Strategy (CONATS) index), consisting of HE4, age, and performance status, demonstrated an AUC of 0.853. According to the Danish indicator level, macro-radical PDS should be achieved in 60 % of patients admitted to primary...

  17. Sex-specific associations between birth weight and adult primary liver cancer in a large cohort of Danish children

    DEFF Research Database (Denmark)

    Zimmermann, Esther; Berentzen, Tina L.; Gamborg, Michael

    2016-01-01

    Whether the prenatal period is critical for the development of adult primary liver cancer (PLC) is sparsely investigated. Recently, attention has been drawn to potential sex-differences in the early origins of adult disease. We investigated the association between birth weight and adult PLC...... separately in men and women, using a large cohort of 217,227 children (51% boys), born from 1936 to 1980, from the Copenhagen School Health Records Register, and followed them until 2010 in national registers. Hazard ratios (95% confidence intervals) of PLC (30 years or older) were estimated by Cox...... regression models stratified by birth cohort. During 5.1 million person-years of follow-up, 185 men and 65 women developed PLC. Sex modified the association between birth weight and adult PLC (p-value for interaction=0.0005). Compared with a sex-specific reference group of birth weights between 3.25-3.75 kg...

  18. Development of Dental Health Knowledge Tests for the Primary Grades.

    Science.gov (United States)

    Kleinman, Susan P.

    1981-01-01

    A project was designed to provide evaluation materials for dental health education programs at the primary level. Reliable test instruments that assessed cognitive understanding of dental concepts by primary age children were designed. (JN)

  19. Primary health care: making Alma-Ata a reality.

    Science.gov (United States)

    Walley, John; Lawn, Joy E; Tinker, Anne; de Francisco, Andres; Chopra, Mickey; Rudan, Igor; Bhutta, Zulfiqar A; Black, Robert E

    2008-09-13

    The principles agreed at Alma-Ata 30 years ago apply just as much now as they did then. "Health for all" by the year 2000 was not achieved, and the Millennium Development Goals (MDGs) for 2015 will not be met in most low-income countries without substantial acceleration of primary health care. Factors have included insufficient political prioritisation of health, structural adjustment policies, poor governance, population growth, inadequate health systems, and scarce research and assessment on primary health care. We propose the following priorities for revitalising primary health care. Health-service infrastructure, including human resources and essential drugs, needs strengthening, and user fees should be removed for primary health-care services to improve use. A continuum of care for maternal, newborn, and child health services, including family planning, is needed. Evidence-based, integrated packages of community and primary curative and preventive care should be adapted to country contexts, assessed, and scaled up. Community participation and community health workers linked to strengthened primary-care facilities and first-referral services are needed. Furthermore, intersectoral action linking health and development is necessary, including that for better water, sanitation, nutrition, food security, and HIV control. Chronic diseases, mental health, and child development should be addressed. Progress should be measured and accountability assured. We prioritise research questions and suggest actions and measures for stakeholders both locally and globally, which are required to revitalise primary health care.

  20. Health care encounters in Danish chiropractic practice from a consumer perspectives

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Boyle, Eleanor; Larsen, Johanne Brinch

    2016-01-01

    BACKGROUND: Perceived value is the key ingredient to carving and maintaining a competitive business niche. The opportunities to interact with consumers to understand and enhance perceived value are termed 'touch points'. Due to the out-of-pocket expense incurred by patients, Danish chiropractors...... patients and 36 follow-up patients and finally video recorded 11 new and 24 follow-up consultations. Categorization and analysis led to the emergence six consumer touch point themes: 'the internet', 'the physical environment', 'practice models', 'administrative staff', 'the consultation sequence and timing......' and 'a consultation that adds value'. The Internet functions as a tool when choosing/confirming a clinic as appropriate, developing and initial image and managing appointments. The administrative hub appears integral to the shaping of positive consumer experiences outside of the consultation. Clinic...

  1. Municipalities collaborating in public health: The Danish Smoking Prevention and Cessation Partnership

    DEFF Research Database (Denmark)

    Andersen, Pernille Tanggaard; El Ansari, Walid; Rasmussen, Hanna Barbara

    2010-01-01

    ; and the fourth factor is the bearing of personal/individual factors on the partnership e.g., personal engagement in the project. Early attention to these four factors could contribute to more effective partnership working. Keywords: partnership; coalition; smoking cessation; Denmark; multi-site evaluation......This study explored the Smoking Prevention and Cessation Partnership (SPCP) which builds upon a collaboration between two Danish municipalities targeted at the prevention of tobacco smoking. The aim of the study was to describe the processes of SPCP, to examine the difficulties this collaboration...... faced, and to assess how these experiences could be used to improve future partnership collaboration. We employed qualitative methodology comprising 12 semi-structured one-to-one interviews with SPCP‘s stakeholders and an analysis of the partnership documents and reports. The findings suggested...

  2. Association analysis for udder health based on SNP-panel and sequence data in Danish Holsteins

    DEFF Research Database (Denmark)

    Wu, Xiaoping; Lund, Mogens S; Sahana, Goutam;

    2015-01-01

    for mastitis traits: 54 k markers of a medium-density SNP (single nucleotide polymorphism) chip (MD), imputed 777 k markers of a high-density SNP chip (HD), and imputed whole-genome sequencing data (SEQ). Each dataset contained data for 4496 Danish Holstein cattle. Comparisons were performed using a linear...... when tested using the same statistical model. With the LM model, 120 (MD), 967 (HD), and 7209 (SEQ) SNPs were significantly associated with mastitis, whereas with the BVS model, 43 (MD), 131 (HD), and 1052 (SEQ) significant SNPs (Bayes factor > 3.2) were observed. A total of 26 (MD), 75 (HD), and 465......, LIFR, and EDN3 may be considered as candidate genes for mastitis susceptibility....

  3. Fitness and Health Effects of Frequent Intense Training in 8-10-Year Old Danish Children

    DEFF Research Database (Denmark)

    Larsen, Malte Nejst

    the intervention study demonstrate that significant structural and functional musculoskeletal adaptations can be achieved from well-controlled high-intensity training in a school-based setting, especially from 3x40 minutes of SSG and CST. The overall fitness effects of the low-volume training (5x12 minutes of SSG....... In fact, the evidence of beneficial effects convinced Danish politicians to design a school curriculum with 45 minutes of physical activity every day, which should enable every child to fulfil the recommendations of 60 minutes of moderate to vigorous physical activity (MVPA) every day when supplemented...... with organised and unorganised leisure time activities. The issues addressed in this thesis are the physiological responses to small-sided football and other high-intensity activities. Paper I showed that recreational small-sided football games are highly intense for 9-12-year-old boys and that 5v5 provides...

  4. Health and social status in Danish women surgically treated for ovarian cancer

    DEFF Research Database (Denmark)

    Seibæk, Lene

    .   Results Estimated by ASA scores 39 % of the patients were healthy, forty-seven % were moderate systemic ill and 14 % had severe or life threatening disease. Fifty-three % of the patients had a normal BMI, 43 % in a condition of moderate to severe overweight. Twenty-five % of the patients had borderline...... % in apartments. Thirty-three % were employed and 61 % pensioners.   Conclusions In total the Danish ovarian cancer population is elderly; with moderate systemic illness and a tendency of overweight. Fairly many are pensioners living alone. Knowing that fast track programmes requires professional support before...... and after surgery, co-morbidity and socioeconomic conditions are valuable components in managing treatment and care sufficiently.  ...

  5. Recruitment of ethnic minorities for public health research: An interpretive synthesis of experiences from six interlinked Danish studies.

    Science.gov (United States)

    Nielsen, Annemette Ljungdalh; Jervelund, Signe Smith; Villadsen, Sarah Fredsted; Vitus, Kathrine; Ditlevsen, Kia; TØrslev, Mette Kirstine; Kristiansen, Maria

    2017-03-01

    This paper examines the importance of recruitment site in relation to the recruitment of ethnic minorities into health research. It presents a synthesis of experiences drawn from six interlinked Danish studies which applied different methods and used healthcare facilities and educational settings as sites for recruitment. Inspired by interpretive reviewing, data on recruitment methods from the different studies were synthesized with a focus on the various levels of recruitment success achieved. This involved an iterative process of comparison, analysis and discussion of experiences among the researchers involved. Success in recruitment seemed to depend partly on recruitment site. Using healthcare facilities as the recruitment site and healthcare professionals as gatekeepers was less efficient than using schools and employees from educational institutions. Successful study designs also depended on the possibility of singling out specific locations with a high proportion of the relevant ethnic minority target population. The findings, though based on a small number of cases, indicate that health professionals and healthcare institutions, despite their interest in high-quality health research into all population groups, fail to facilitate research access to some of the most disadvantaged groups, who need to be included in order to understand the mechanisms behind health disparities. This happens despite the genuine wish of many healthcare professionals to help facilitate such research. In this way, the findings indirectly emphasize the specific challenge of accessing more vulnerable and sick groups in research studies.

  6. The Danish Twin Registry

    DEFF Research Database (Denmark)

    Skytthe, Axel; Ohm Kyvik, Kirsten; Vilstrup Holm, Niels

    2011-01-01

    Introduction: The Danish Twin Registry is a unique source for studies of genetic, familial and environmental factors on life events, health conditions and diseases. Content: More than 85,000 twin pairs born 1870-2008 in Denmark. Validity and coverage: Four main ascertainment methods have been emp...

  7. The Danish Welfare State

    DEFF Research Database (Denmark)

    Larsen, Jørgen Elm; Bengtsson, Tea Torbenfeldt; Frederiksen, Morten

    The Danish Welfare State analyzes a broad range of areas, such as globalization, labor marked, family life, health and social exclusion, the book demonstrates that life in a modern welfare state is changing rapidly, creating both challenges and possibilities for future management....

  8. The Danish welfare state

    DEFF Research Database (Denmark)

    Larsen, Jørgen Elm; Bengtsson, Tea Torbenfeldt; Frederiksen, Morten

    The Danish Welfare State analyzes a broad range of areas, such as globalization, labor marked, family life, health and social exclusion, the book demonstrates that life in a modern welfare state is changing rapidly, creating both challenges and possibilities for future management....

  9. Factors shaping intersectoral action in primary health care services.

    Science.gov (United States)

    Anaf, Julia; Baum, Fran; Freeman, Toby; Labonte, Ron; Javanparast, Sara; Jolley, Gwyn; Lawless, Angela; Bentley, Michael

    2014-12-01

    To examine case studies of good practice in intersectoral action for health as one part of evaluating comprehensive primary health care in six sites in South Australia and the Northern Territory. Interviews with primary health care workers, collaborating agency staff and service users (Total N=33); augmented by relevant documents from the services and collaborating partners. The value of intersectoral action for health and the importance of partner relationships to primary health care services were both strongly endorsed. Factors facilitating intersectoral action included sufficient human and financial resources, diverse backgrounds and skills and the personal rewards that sustain commitment. Key constraining factors were financial and time limitations, and a political and policy context which has become less supportive of intersectoral action; including changes to primary health care. While intersectoral action is an effective way for primary health care services to address social determinants of health, commitment to social justice and to adopting a social view of health are constrained by a broader health service now largely reinforcing a biomedical model. Effective organisational practices and policies are needed to address social determinants of health in primary health care and to provide a supportive context for workers engaging in intersectoral action. © 2014 Public Health Association of Australia.

  10. Health profiles of foreigners attending primary care clinics in Malaysia

    National Research Council Canada - National Science Library

    Ab Rahman, Norazida; Sivasampu, Sheamini; Mohamad Noh, Kamaliah; Khoo, Ee Ming

    2016-01-01

    .... Little is known about the health profiles of foreign population in Malaysia. The aim of this study was to provide a detailed description of the health problems presented by foreigners attending primary care clinics in Malaysia...

  11. Attitudes of primary health care providers towards people with ...

    African Journals Online (AJOL)

    among primary health care providers toward mental illness and those who suffer from it. These findings ... measures that tend to restrict civil rights and freedoms of people .... Mental Health Nurse is basically a Registered Nurse who undergoes ...

  12. Metrics for assessing improvements in primary health care.

    Science.gov (United States)

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

    2014-01-01

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

  13. [The Articulator of Primary Health Care Program: an innovative proposal for qualification of Primary Health Care].

    Science.gov (United States)

    Doricci, Giovanna Cabral; Guanaes-Lorenzi, Carla; Pereira, Maria José Bistafa

    2017-06-01

    In 2009, the Secretary of State for Health of Sao Paulo created a Program with a view to qualify the primary care in the state. This proposal includes a new job function, namely the articulator of primary care. Due to the scarcity of information about the practice of these new professionals in the scientific literature, this article seeks to analyze how articulators interpret their function and how they describe their daily routines. Thirteen articulators were interviewed. The interviews were duly analyzed by qualitative delineation. The results describe three themes: 1)Roles of the articulator: technical communicator and political advisor; 2) Activities performed to comply with the expected roles, examples being diagnosis of the municipalities, negotiation of proposals, participation in meetings, visits to municipalities; and 3) Challenges of the role, which are configured as challenges to the health reform process, examples being the lack of physical and human resources, activities of professionals in the medical-centered model, among others. The conclusion drawn is that the Program has great potential to provide input for the development and enhancement of Primary Care. Nevertheless, there are a series of challenges to be overcome, namely challenges to the context per se.

  14. 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.

  15. Vitamin D Status in Danish Children

    DEFF Research Database (Denmark)

    Petersen, Rikke Agnete

    . In addition to skeletal health, vitamin D has also been associated with several extra-skeletal conditions including cardiovascular disease and type II diabetes. Evaluation of Vitamin D status is complex because it is modified by several factors and because the level of optimal vitamin D concentration...... is uncertain. The primary source of vitamin D in humans is believed to be the synthesis that occurs in the skin upon sun exposure while intake from diet, supplements, and potential fortified foods are secondary sources. Yet, synthesis of vitamin D from sun exposure is negligible during winter at northern...... latitudes such as Denmark and low winter concentrations have been observed in Danish children. Also, very few foods are naturally rich in vitamin D and little is known on the effect of dietary vitamin D on children’s vitamin D status. The overall aim of this PhD project was to investigate aspects of Danish...

  16. The Danish Lung Cancer Registry

    DEFF Research Database (Denmark)

    Jakobsen, Erik; Rasmussen, Torben Riis

    2016-01-01

    AIM OF DATABASE: The Danish Lung Cancer Registry (DLCR) was established by the Danish Lung Cancer Group. The primary and first goal of the DLCR was to improve survival and the overall clinical management of Danish lung cancer patients. STUDY POPULATION: All Danish primary lung cancer patients since...... 2000 are included into the registry and the database today contains information on more than 50,000 cases of lung cancer. MAIN VARIABLES: The database contains information on patient characteristics such as age, sex, diagnostic procedures, histology, tumor stage, lung function, performance...... the results are commented for local, regional, and national audits. Indicator results are supported by descriptive reports with details on diagnostics and treatment. CONCLUSION: DLCR has since its creation been used to improve the quality of treatment of lung cancer in Denmark and it is increasingly used...

  17. Health psychology in primary care: recent research and future directions

    Directory of Open Access Journals (Sweden)

    Thielke S

    2011-06-01

    Full Text Available Stephen Thielke1, Alexander Thompson2, Richard Stuart31Psychiatry and Behavioral Sciences, University of Washington, Geriatric Research, Education, and Clinical Center, Puget Sound VA Medical Center, Seattle, WA, USA; 2Group Health Cooperative, Seattle, WA, USA; 3Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USAAbstract: Over the last decade, research about health psychology in primary care has reiterated its contributions to mental and physical health promotion, and its role in addressing gaps in mental health service delivery. Recent meta-analyses have generated mixed results about the effectiveness and cost-effectiveness of health psychology interventions. There have been few studies of health psychology interventions in real-world treatment settings. Several key challenges exist: determining the degree of penetration of health psychology into primary care settings; clarifying the specific roles of health psychologists in integrated care; resolving reimbursement issues; and adapting to the increased prescription of psychotropic medications. Identifying and exploring these issues can help health psychologists and primary care providers to develop the most effective ways of applying psychological principles in primary care settings. In a changing health care landscape, health psychologists must continue to articulate the theories and techniques of health psychology and integrated care, to put their beliefs into practice, and to measure the outcomes of their work.Keywords: health psychology, primary care, integrated care, collaborative care, referral, colocation

  18. Blood borne viral infections among Danish health care workers--frequent blood exposure but low prevalence of infection

    DEFF Research Database (Denmark)

    Fisker, Niels; Mygind, Lone H; Krarup, Henrik B

    2004-01-01

    Denmark is a country with low prevalence and incidence of blood borne viral infections. Among health care workers (HCWs) vaccination for hepatitis B is only offered to high-risk groups. The aims of this cross sectional survey were to determine the prevalence of hepatitis B, -C, and human immunode......Denmark is a country with low prevalence and incidence of blood borne viral infections. Among health care workers (HCWs) vaccination for hepatitis B is only offered to high-risk groups. The aims of this cross sectional survey were to determine the prevalence of hepatitis B, -C, and human...... immunodeficiency virus (HIV) among the staff at a Danish University hospital and to correlate this with risk factors for transmission. Additionally, we wanted to examine the current frequency of blood exposure, reporting habits and hepatitis B vaccination status in the staff. Of 1439 eligible hospital staffs...... included, 960 (67%) were HCWs. The overall human immunodeficiency virus (HIV)-, hepatitis C Virus (HCV)- and hepatitis B Virus (HBV)-prevalence was 0% (0/1439), 0.14% (2/1439) and 1.6% (23/1439), respectively. Twenty-three percent of HCWs were vaccinated against HBV. Age, blood transfusion and stay...

  19. Socioeconomic health inequalities among a nationally representative sample of Danish adolescents

    DEFF Research Database (Denmark)

    Due, P; Lynch, J; Holstein, B

    2003-01-01

    To investigate the role of different types of social relations in adolescent health inequalities.......To investigate the role of different types of social relations in adolescent health inequalities....

  20. Sex-specific associations between birth weight and adult primary liver cancer in a large cohort of Danish children.

    Science.gov (United States)

    Zimmermann, Esther; Berentzen, Tina L; Gamborg, Michael; Sørensen, Thorkild I A; Baker, Jennifer L

    2016-03-15

    Whether the prenatal period is critical for the development of adult primary liver cancer (PLC) is sparsely investigated. Recently, attention has been drawn to potential sex-differences in the early origins of adult disease. The association between birth weight and adult PLC, separately in men and women was investigated, using a large cohort of 217,227 children (51% boys), born from 1936 to 1980, from the Copenhagen School Health Records Register, and followed them until 2010 in national registers. Hazard ratios (95% confidence intervals) of PLC (30 years or older) were estimated by Cox regression models stratified by birth cohort. During 5.1 million person-years of follow-up, 185 men and 65 women developed PLC. Sex modified the association between birth weight and adult PLC (p values for interaction = 0.0005). Compared with a sex-specific reference group of birth weights between 3.25 and 3.75 kg, men with birth weights between 2.00 and 3.25 kg and 3.75-5.50 kg, had HRs of 1.48 (1.06-2.05) and 0.85 (0.56-1.28), respectively. Among women the corresponding HRs were 1.71 (0.90-3.29) and 3.43 (1.73-6.82). Associations were similar for hepatocellular carcinoma only, across year of birth, and after accounting for diagnoses of alcohol-related disorders, viral hepatitis and biliary cirrhosis. Prenatal exposures influenced the risk of adult PLC, and the effects at the high birth weight levels appeared to be sex-specific. These findings underscore the importance of considering sex-specific mechanisms in the early origins of adult PLC. © 2015 UICC.

  1. Genetic parameters for claw and leg health, foot and leg conformation, and locomotion in Danish Holsteins

    DEFF Research Database (Denmark)

    Laursen, M. V.; Boelling, D.; Mark, Thomas

    2009-01-01

    The purpose of this study was to estimate the genetic correlations among claw and leg health and potential indicator traits. Claw health was defined as absence of heel horn erosion, interdigital dermatitis, interdigital phlegmon, interdigital hyperplasia, laminitis, and sole ulcer. Leg health...

  2. Health care encounters in Danish chiropractic practice from a consumer perspectives - a mixed methods investigation.

    Science.gov (United States)

    Myburgh, Corrie; Boyle, Eleanor; Larsen, Johanne Brinch; Christensen, Henrik Wulff

    2016-01-01

    Perceived value is the key ingredient to carving and maintaining a competitive business niche. The opportunities to interact with consumers to understand and enhance perceived value are termed 'touch points'. Due to the out-of-pocket expense incurred by patients, Danish chiropractors are subject to consumer trends and behaviors. The purpose of this investigation was to explore and describe consumer touch points relevant to perceived value through healthcare journeys in chiropractic practices. We designed a convergent parallel, mixed methods study. Our purposive sampling framework identified 11 chiropractic clinics from which we collected observational field notes, video recordings and face-to-face interviews. Data was collected between April 14(th) and June 26(th) 2014. We described the exteriors and interiors of all participant clinics, interviewed 32 staff members, 12 new patients and 36 follow-up patients and finally video recorded 11 new and 24 follow-up consultations. Categorization and analysis led to the emergence six consumer touch point themes: 'the internet', 'the physical environment', 'practice models', 'administrative staff', 'the consultation sequence and timing' and 'a consultation that adds value'. The Internet functions as a tool when choosing/confirming a clinic as appropriate, developing and initial image and managing appointments. The administrative hub appears integral to the shaping of positive consumer experiences outside of the consultation. Clinic location, practice model and interior design may contribute to context effects and thus may influence value perception during the clinical encounter. The duration of hands-on treatment received from the chiropractor is not an apparent consumer focus point. Rather, through a seven stage clinical procedure patients value consultations with clinicians who demonstrate professional competence by effective communication diagnosis/management and facilitating satisfactory treatment outcomes. At least six

  3. Municipalities Collaborating in Public Health: The Danish Smoking Prevention and Cessation Partnership

    Directory of Open Access Journals (Sweden)

    Pernille Tanggaard Andersen

    2010-11-01

    Full Text Available This study explored the Smoking Prevention and Cessation Partnership (SPCP which builds upon a collaboration between two Danish municipalities targeted at the prevention of tobacco smoking. The aim of the study was to describe the processes of SPCP, to examine the difficulties this collaboration faced, and to assess how these experiences could be used to improve future partnership collaboration. We employed qualitative methodology comprising 12 semi-structured one-to-one interviews with SPCP’s stakeholders and an analysis of the partnership documents and reports. The findings suggested that the main potentials of the partnership were the personal relations between the members and stakeholders with the possibilities of the creation of new connections with other actors. Barriers to successful partnership building were the implementation of the new Local Government Reform as a competing task, and that the two municipalities were heterogenic in respect to organizational issues and working methods. Other impediments included the lack of continuity in leadership, the lack of clarity regarding the form of collaboration and roles, as well as different expectations of the stakeholders. We conclude that four factors remain critical for partnerships. The first is the clarity of the collaborative effort. Second, partnerships need to take into account the structural circumstances and culture/value systems of all stakeholders. Third is the impact of contextual factors on the development of the partnership; and the fourth factor is the bearing of personal/individual factors on the partnership e.g., personal engagement in the project. Early attention to these four factors could contribute to more effective partnership working.

  4. Health Literacy in Primary Care Practice.

    Science.gov (United States)

    Hersh, Lauren; Salzman, Brooke; Snyderman, Danielle

    2015-07-15

    Health literacy includes a set of skills needed to make appropriate health decisions and successfully navigate the health care system. These skills include reading, writing, numeracy, communication, and, increasingly, the use of electronic technology. National data indicate that more than one-third of U.S. adults have limited health literacy, which contributes to poor health outcomes and affects patient safety, and health care access and quality. Although there are a number of tools that screen for limited health literacy, they are primarily used for research. Routinely screening patients for health literacy has not been shown to improve outcomes and is not recommended. Instead, multiple professional organizations recommend using universal health literacy precautions to provide understandable and accessible information to all patients, regardless of their literacy or education levels. This includes avoiding medical jargon, breaking down information or instructions into small concrete steps, limiting the focus of a visit to three key points or tasks, and assessing for comprehension. Additionally, printed information should be written at or below a fifth- to sixth-grade reading level. Visual aids, graphs, or pictures can enhance patient understanding, as can more concrete presentation of numerical information.

  5. Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry

    DEFF Research Database (Denmark)

    Paulsen, Aksel; Pedersen, Alma B; Johnsen, Søren P

    2007-01-01

    Arthroplasty Registry (DHR), we identified patients less than 70 years old who had undergone uncemented primary THA during 1997-2005. 4,125 HA-coated and 7,737 non-HA-coated cups and 3,158 HA-coated and 4,749 non-HA-coated stems were available for analysis. The mean follow-up time was 3.4 years for cups and 3.......61-1.1) for HA-coated cups and stems, respectively. INTERPRETATION: In this medium-term follow-up study, the use of HA-coated implants was not associated with any clearly reduced overall risk of revision compared to non-HA-coated implants.......BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip...

  6. The Influence of a Policy Document in the Practice of Intersectorial Collaboration in Danish Health Care

    DEFF Research Database (Denmark)

    Andersen, Anne Bendix; Beedholm, Kirsten; Kolbæk, Raymond

    Background Policy documents are powerful actors in health care, and they play a significant role because they produce certain discursive and non-discursive conditions for intersectorial collaboration. Central documents in Denmark are the Health Agreements. These policy documents set out the premi...... of language, constructs the actors in intersectorial collaboration within the framework of a market-economy understanding, the goal being to increase productivity and efficiency in health care delivery.......Background Policy documents are powerful actors in health care, and they play a significant role because they produce certain discursive and non-discursive conditions for intersectorial collaboration. Central documents in Denmark are the Health Agreements. These policy documents set out...... the premises for collaboration between hospitals, municipalities, and general practitioners in the five regions. This area is traditionally contested, and the intention of the Health Agreements is to be a guideline for the allocation of tasks and responsibilities within the collaboration. Aim • To exemplify...

  7. Danish Experiments

    DEFF Research Database (Denmark)

    The book is presenting the results of studies on culture and social constructions of technology supported by The technology and Society Initiative etablished in 1983 by the Danish Social Science Reseach Council. Peter Duelund was a part of this research eam and has edited the book togather with T...

  8. Danish Ultras

    DEFF Research Database (Denmark)

    Havelund, Jonas; Joern, Lise; Rasmussen, Kristian

    2012-01-01

    is the result of a qualitative study of the self-declared nonviolent segment of the Danish risk supporters, i.e. the ultra culture. The study’s empirical data stems from qualitative interviews and participant observation primarily focusing at matches involving Brøndby IF, the club supported by the interviewees...

  9. Old persons' contact with general practitioners in relation to health: a Danish population study

    DEFF Research Database (Denmark)

    Almind, G; Holstein, B E; Holst, E;

    1991-01-01

    The study describes health, social situation, and contact with general practitioners in a random sample of non-institutionalized persons 70-95 years old in Denmark. There was a strong correlation between health and contact with general practitioners. A small group, 3% of the respondents, had...... no health problems, but had been in contact with a general practitioner within the previous month. This group was characterized by a strong social network and a high degree of life satisfaction. Another small group, including 3% of the respondents, had extensive health problems, but had nevertheless...

  10. Long-term health effects of unintentional injuries in Danish adults

    DEFF Research Database (Denmark)

    Laursen, Bjarne; Møller, Hanne

    2012-01-01

    and Morbidity Survey in Denmark, 14,566 adults aged 16 years or more were asked about long-term health effects of unintentional injuries. Those reporting long-term health effects were asked about the type and duration of these effects and the accompanying limitation of their daily activities. Information...

  11. Objectively measured work load, health status and sickness absence among Danish ambulance personnel. A longitudinal study

    DEFF Research Database (Denmark)

    Hansen, Claus D.

    2013-01-01

    levels of self-rated health (OR: 1.79), higher levels of musculoskeletal pain (OR: 1.16) but was unrelated to mental health. In addition, increasing work load was associated with higher levels of emotional demands and work pace (p

  12. The Danish National Hospital Register. A valuable source of data for modern health sciences

    DEFF Research Database (Denmark)

    Andersen, T F; Madsen, Mette; Jørgensen, J

    1999-01-01

    as in collaboration with international teams, and the LPR is truly a valuable source of data for health sciences, especially in epidemiology, health services research and clinical research. Nearly complete registration of somatic hospital events in Denmark is combined with ideal conditions for longterm follow-up due...

  13. Reconceiving barriers for democratic health education in Danish schools: an analysis of institutional rationales

    DEFF Research Database (Denmark)

    Bruselius-Jensen, Maria; Danielsen, Dina; Laitch, Daniel

    2017-01-01

    Health promotion - and education researchers and practitioners advocate for more democratic approaches to school-based health education, including participatory teaching methods and the promotion of a broad and positive concept of health and health knowledge, including aspects of the German...... educational concept of bildung. Although Denmark, from where the data of this article are derived, has instituted policies for such approaches, their implementation in practice faces challenges. Adopting a symbolic interactionist analytical framework this paper explores and defines two powerful institutional...... rationales connected to formal and informal social processes and institutional purposes of schools, namely conservatism and Neoliberalism. It is empirically described and argued how these institutional rationales discourage teachers and students from including a broad and positive concept of health...

  14. 78 FR 38718 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2013-06-27

    ..., Mental Health, and Dental Health Professional Shortage Areas AGENCY: Health Resources and Services... dental health professional shortage areas (HPSAs) as of May 11, 2013, available on the Health Resources... assignment of National Health Service Corps (NHSC) personnel to provide primary care, ] dental, or...

  15. Recertification of primary health care professionals.

    NARCIS (Netherlands)

    Boeringa, F.H.; Sluijs, E.M.

    1993-01-01

    This bibliography contains literature about certification- and recertification of health care professionals. Certification and recertification are increasingly being used as quality assurance systems for professionals. As such (re)certification does fit in with the current developments towards quali

  16. Integrated primary health care: Finnish solutions and experiences

    Directory of Open Access Journals (Sweden)

    Simo Kokko

    2009-06-01

    Full Text Available Background: Finland has since 1972 had a primary health care system based on health centres run and funded by the local public authorities called ‘municipalities’. On the world map of primary health care systems, the Finnish solution claims to be the most health centre oriented and also the widest, both in terms of the numbers of staff and also of different professions employed. Offering integrated care through multi-professional health centres has been overshadowed by exceptional difficulties in guaranteeing a reasonable access to the population at times when they need primary medical or dental services. Solutions to the problems of access have been found, but they do not seem durable. Description of policy practice: During the past 10 years, the health centres have become a ground of active development structural change, for which no end is in sight. Broader issues of municipal and public administration structures are being solved through rearranging primary health services. In these rearrangements, integration with specialist services and with social services together with mergers of health centres and municipalities are occurring at an accelerated pace. This leads into fundamental questions of the benefits of integration, especially if extensive integration leads into the threat of the loss of identity for primary health care. Discussion: This article ends with some lessons to be learned from the situation in Finland for other countries.

  17. Mental Health Problems in Primary Care: Progress in North America

    Directory of Open Access Journals (Sweden)

    Kathryn M. Magruder

    2007-03-01

    Full Text Available Background and Objectives: Research in the last decade has acknowledged that primary care plays a pivotal role in the delivery of mental health services. The aim of this paper is to review major accomplishments, emerging trends, and continuing gaps concerning mental health problems in primary care in North America. Methods: Literature from North America was reviewed and synthesized. Results: Major accomplishments include: the development and adoption of a number of clinical guidelines specifically for mental health conditions in primary care, the acceptance of the chronic care model as a framework for treating depression in primary care, and the clear adoption of pharmacologic approaches as the predominant mode for treating depression and anxiety. Emerging trends include: the use of non-physician facilitators as care managers in the treatment of depression in primary care, increasing use of technology in the assessment and treatment of mental health conditions in primary care, and dissemination and implementation of integrated mental health treatment approaches. Lingering issues include: the difficulty in moving beyond problem identification and initiation of treatment to sustaining evidence-based treatments, agreement on a common metric to evaluate outcomes, and the stigma still associated with mental illness. Conclusion: Though there now exists a solid and growing evidence base for the delivery of mental health services in primary care, there are still significant challenges which must be overcome in order to make further advances.

  18. Primary health care staff's perception of childhood tuberculosis

    DEFF Research Database (Denmark)

    Bjerrum, Stephanie; Rose, Michala Vaaben; Bygbjerg, Ib Christian;

    2012-01-01

    Background: Diagnosing tuberculosis in children remains a great challenge in developing countries. Health staff working in the front line of the health service delivery system has a major responsibility for timely identification and referral of suspected cases of childhood tuberculosis. This study...... explored primary health care staff’s perception, challenges and needs pertaining to the identification of children with tuberculosis in Muheza district in Tanzania. Methods: We conducted a qualitative study that included 13 semi-structured interviews and 3 focus group discussions with a total of 29 health...... staff purposively sampled from primary health care facilities. Analysis was performed in accordance with the principles of a phenomenological analysis. Results: Primary health care staff perceived childhood tuberculosis to be uncommon in the society and tuberculosis was rarely considered as a likely...

  19. Primary health care staff's perception of childhood tuberculosis

    DEFF Research Database (Denmark)

    Bjerrum, Stephanie; Rose, Michala Vaaben; Bygbjerg, Ib Christian

    2012-01-01

    Background: Diagnosing tuberculosis in children remains a great challenge in developing countries. Health staff working in the front line of the health service delivery system has a major responsibility for timely identification and referral of suspected cases of childhood tuberculosis. This study...... explored primary health care staff’s perception, challenges and needs pertaining to the identification of children with tuberculosis in Muheza district in Tanzania. Methods: We conducted a qualitative study that included 13 semi-structured interviews and 3 focus group discussions with a total of 29 health...... staff purposively sampled from primary health care facilities. Analysis was performed in accordance with the principles of a phenomenological analysis. Results: Primary health care staff perceived childhood tuberculosis to be uncommon in the society and tuberculosis was rarely considered as a likely...

  20. Integrating mental health into primary health care in Zambia: a care provider's perspective

    Directory of Open Access Journals (Sweden)

    Mwanza Jason

    2010-07-01

    Full Text Available Abstract Background Despite the 1991 reforms of the health system in Zambia, mental health is still given low priority. This is evident from the fragmented manner in which mental health services are provided in the country and the limited budget allocations, with mental health services receiving 0.4% of the total health budget. Most of the mental health services provided are curative in nature and based in tertiary health institutions. At primary health care level, there is either absence of, or fragmented health services. Aims The aim of this paper was to explore health providers' views about mental health integration into primary health care. Methods A mixed methods, structured survey was conducted of 111 health service providers in primary health care centres, drawn from one urban setting (Lusaka and one rural setting (Mumbwa. Results There is strong support for integrating mental health into primary health care from care providers, as a way of facilitating early detection and intervention for mental health problems. Participants believed that this would contribute to the reduction of stigma and the promotion of human rights for people with mental health problems. However, health providers felt they require basic training in order to enhance their knowledge and skills in providing health care to people with mental health problems. Recommendations It is recommended that health care providers should be provided with basic training in mental health in order to enhance their knowledge and skills to enable them provide mental health care to patients seeking help at primary health care level. Conclusion Integrating mental health services into primary health care is critical to improving and promoting the mental health of the population in Zambia.

  1. Integrated care: a Danish perspective

    DEFF Research Database (Denmark)

    Rudkjøbing, Andreas; Olejaz, Maria; Birk, Hans Okkels

    2012-01-01

    The Danish health system, in common with most Western health systems, is grappling with the dual challenges of strengthening public health initiatives to prevent disease and providing care to a growing number of patients with chronic disease and comorbidity. A recent review of the system suggests...

  2. Practicing physiotherapy in Danish private practice: an ethical perspective

    DEFF Research Database (Denmark)

    Præstegaard, Jeanette; Gard, Gunvor; Glasdam, Stinne

    2013-01-01

    Despite an increasingly growth of professional guidelines, textbooks and research about ethics in Health care, awareness about ethics in Danish physiotherapy private practice seen vague. This article explores how physiotherapists in Danish private practice, from an ethical perspective, perceive...

  3. Quality of drug prescription in primary health care facilities in ...

    African Journals Online (AJOL)

    DR Marwa

    1Ilemela District Hospital, P.O. Box 735, Mwanza, Tanzania. 2Catholic ... prolonged hospital stay and consequently an increased cost of disease management in patients ... WHO/INRUD primary health facility prescribing indicators that monitor ...

  4. Assessment and treatment of dizzy patients in primary health care.

    OpenAIRE

    Ekvall-Hansson, Eva

    2006-01-01

    Dizziness is a common reason for visits to primary health care, especially among elderly patients. From a physiotherapeutic perspective, this thesis aims to study the assessment and treatment of dizzy patients in primary health care. Interventions in papers I, III and IV comprised a vestibular rehabilitation programme. In paper I, patients with multisensory dizziness were randomized to intervention group or control group. At follow-up after six weeks and three months, the intervention ...

  5. PRIMARY HEALTH CARE, SELECTIVE OR COMPREHENSIVE ...

    African Journals Online (AJOL)

    hi-tech

    2003-01-01

    Jan 1, 2003 ... Objective: To critically review the advantages and disadvantages of selective versus comprehensive ... diarrhoea(16). Levels of malnutrition have risen over the past 10 ... resulted in decline in crude birth rates to below 30 per. 1000 in .... health of their parents, and one cannot expect to achieve significant ...

  6. Oral health status among health personnel of primary health centers in Mathura district

    Directory of Open Access Journals (Sweden)

    Vivek Sharma

    2016-01-01

    Full Text Available Introduction: Health is dynamic and multifactorial in nature. Oral health is an integral part of general health. Health personnel, especially in primary health centers (PHCs, can play an important role in grooming health in their patients. Aim: The aim of this study was to assess the oral health status of health personnel of PHCs. Materials and Methods: A cross-sectional study was carried out among 520 health personnel working in PHCs of Mathura district in the month of September-October 2014. The WHO Oral Health Assessment Form (2013 was used to collect data from each subject. Comparison of oral health status of various health personnel was also done. Results: In the present study, 45 (8.7% belonged to the upper socioeconomic class, 295 (56.7% were from upper-middle socioeconomic class, and 180 (34.6% were from lower-middle socioeconomic class. The mean decayed missing filled teeth was 1.11 ± 2.63 for doctors, 1.24 ± 3.10 for pharmacists, 1.10 ± 3.55 for lab technicians, 1.78 ± 3.80 for ward boys/ward nurses, 0.25 ± 0.50 for lady health visitors, and 1.53 ± 3.16 for auxiliary nurse midwives. The difference among study subjects according to occupation was statistically significant (P = 0.787. Conclusion: The oral health status of health personnel of Mathura district was moderate. These health workers can serve as a valuable resource for population-based health promotion approaches in achieving health for all.

  7. Clinical parameters for assessment of udder health in Danish dairy herds.

    Science.gov (United States)

    Houe, H; Vaarst, M; Enevoldsen, C

    2002-01-01

    This study examined the possibilities of using clinical parameters related to the bovine udder for characterisation of udder health. Five clinicians performed systematic clinical recordings of udder health at 3 visits to 4 dairy herds. Several of the clinical parameters were scored on an ordinal scale. The agreement between clinicians was compared using kappa statistics. Factor analysis was used to identify udder types. The clinical evaluations showed substantial variation among clinicians. Parameters that were not directly related to pathological conditions showed the highest variation e.g. length of the claws, teat shape and hardness of the udder parenchyma. On the other hand, evaluation of pathological parameters such as nodes in the udder, skin lesions and oedema showed good agreement between clinicians. Udder types identified by means of factor analysis were found to be suitable for characterisation of udder health. Especially one factor related to dry quarters and udder asymmetry showed a more consistent relationship to milk yield than traditionally applied udder health parameters such as treatment rate and cell count. It is concluded that there is a considerable need for increased efforts among clinicians in order to standardise clinical recordings. It is further concluded that certain combinations of extended clinical recordings have significant perspectives for future characterisation of udder health.

  8. Primary Hyperparathyroidism: Effects on Bone Health.

    Science.gov (United States)

    Zanocco, Kyle A; Yeh, Michael W

    2017-03-01

    Primary hyperparathyroidism (PHPT) is the most common cause of chronic hypercalcemia. With the advent of routine calcium screening, the classic presentation of renal and osseous symptoms has been largely replaced with mild, asymptomatic disease. In hypercalcemia caused by PHPT, serum parathyroid hormone levels are either high, or inappropriately normal. A single-gland adenoma is responsible for 80% of PHPT cases. Less frequent causes include 4-gland hyperplasia and parathyroid carcinoma. Diminished bone mineral density and nephrolithiasis are the major current clinical sequelae. Parathyroidectomy is the only definitive treatment for PHPT, and in experienced hands, cure rates approach 98%.

  9. The Danish National Chronic Lymphocytic Leukemia Registry

    DEFF Research Database (Denmark)

    da Cunha-Bang, Caspar; Geisler, Christian Hartmann; Enggaard, Lisbeth

    2016-01-01

    AIM: In 2008, the Danish National Chronic Lymphocytic Leukemia Registry was founded within the Danish National Hematology Database. The primary aim of the registry is to assure quality of diagnosis and care of patients with chronic lymphocytic leukemia (CLL) in Denmark. Secondarily, to evaluate...

  10. Perception of elderly men about health and primary health care

    Directory of Open Access Journals (Sweden)

    Camila Polisello

    2014-09-01

    Full Text Available Objective: to understand the perceptions of elderly men about the following themes: “Health”, “Family Health Unit” and “Groups of Health Approaches”. Methods: exploratory and descriptive survey with a qualitative approach, using a convenience sample. Participants were selected from a list of elderly men who used the health unit. A semi-structured interview was designed for data collection. The data were analyzed based on a thematic analysis orientation. Results: eleven men were interviewed. They showed a wide conception of health, considering biopsychosocial factors in their descriptions, as well as a good relationship with the Family Health Unit, where they go for medical appointments and to join health prevention and promotion groups. The participants reported that they did not undergo as many preventive activities as women. They evaluated Groups of Health Approaches as beneficial, with positive implications for health and for life. However some participants have group models from other contexts, especially from the work setting, which do not match the models recommended for Groups of Health Approaches. Conclusion: as the participants are elderly and have more available time and a greater relationship with the unit, they are able to engage in more activities of promotion and prevention at the Family Health Unit. This study also showed that the health unit and the groups act as protective factors for this population; elderly men favor receiving care and engaging in social relations. However, factors associated with gender still hinder a better health care for men.

  11. The Danish preventive child health examination should expand on mental health and the well-being of the family

    DEFF Research Database (Denmark)

    Lykke Nielsen, Kirsten Lykke; Graungaard, Anette Hauskov; Ertmann, Ruth;

    2015-01-01

    health. The aim of this study was to explore how the child's physical, cognitive and psychosocial health are examined and assessed at the health examinations of children aged 0-5 years in general practice. METHODS: Our study employed observations of the consultations as well as individual interviews...... of the health examination. Motor, cognitive, social skills and mental health are assessed globally through observation and communication with the child, and, to a lesser degree, through conversation with the parents. The child health examination rarely has a family perspective, unless the doctor is already...

  12. Localizing the HL7 Personal Health Monitoring Record for Danish Telemedicine

    DEFF Research Database (Denmark)

    Christensen, Henrik Bærbak

    2014-01-01

    Telemedicine holds a promise of lowering cost in health care and improving the life quality of chronic ill patients by allowing monitoring in the home. The Personal Health Monitoring Record (PHMR) is an international HL7 standard data format for encoding measurements made by devices in the home....... However, the standard needs localization to national requirements in order to facilitate semantic interoperability between clinical systems. In this paper, we report experiences and decisions from the current effort to localize PHMR in Denmark, and highlight issues relevant for any adoption...

  13. How traumatic is breast cancer? Posttraumatic stress symptoms (PTSS) and risk factors for severe PTSS at 3 and 15 months after surgery in a nationwide cohort of Danish women treated for primary breast cancer

    DEFF Research Database (Denmark)

    O'Connor, Maja; Christensen, Søren; Jensen, Anders Bonde

    2011-01-01

    The literature shows considerable between-study variation in the prevalence of Post-traumatic Stress Symptoms (PTSS) among women with breast cancer. Our aim was therefore to explore the prevalence of and risk factors for cancer-related PTSS in a nationwide inception cohort of women treated...... for primary breast cancer. Methods: Sixty-eight percent of all Danish women receiving surgery for primary breast cancer between October 2001 to March 2004 completed a questionnaire 3 months post-surgery (n=3343), which included the Impact of Event Scale (IES). Ninety-four percent of the disease-free women...... also completed a follow-up questionnaire 15-months post-surgery. Data on pre-cancer demographic-, socioeconomic-, and psychiatric status were obtained from national registries. The Danish Breast Cancer Cooperative Group and surgical departments provided information on disease variables, treatment...

  14. [Mental health in primary attention: needed constitution of competences].

    Science.gov (United States)

    Neves, Hilton Giovani; Lucchese, Roselma; Munari, Denize Bouttelet

    2010-01-01

    The family/people integrally attention is one of health services and professionals challenges, creating spaces for metal health in the primary level health attention. The aim of this study is to reflect about the constitution necessity of new knowledges/dones to the mental health at the primary attention, taking as perspective the competence referential. Essay developed since the historical assumptions ascertains that contextualize the Family Health Strategy and its interfaces with the psychosocial principles and some nurse background implications since the competence development theoretical intentions. We consider that reality transformation, with the health attention improvement asks for knowledges/dones constitution that attends to the psychosocial attention and the Unique Health System rules.

  15. [Primary health care: challenges for implementation in Latin America].

    Science.gov (United States)

    Giraldo Osorio, Alexandra; Vélez Álvarez, Consuelo

    2013-01-01

    A development process, marked by the re-appearance of the primary health care as the core of health systems, has emerged in Latin America. Governments have made a commitment to renew this strategy as the basis of their health systems. However, these health systems are mainly faced with re-introducing equity values, and there are common challenges such as providing the health systems with trained human resources in sufficient numbers, overcoming the fragmentation/segmentation of the systems, ensuring financial sustainability, improving governance, quality of care and information systems, expanding coverage, preparing to face the consequences of an aging population, the changing epidemiological profile, and increase in the response capacity of the public health system. This article is intended to provide a comprehensive view of the progress and challenges of the inclusion of primary care health systems in Latin American countries. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  16. Prenatal Care for Adolescents and attributes of Primary Health Care

    Directory of Open Access Journals (Sweden)

    Maria Cristina Barbaro

    2014-01-01

    Full Text Available OBJECTIVE: evaluate prenatal care for adolescents in health units, in accordance with the attributes of Primary Health Care (PHC guidelines. METHOD: quantitative study conducted with health professionals, using the Primary Care Assessment Tool-Brazil to assess the presence and extent of PHC attributes. RESULTS: for all the participating units, the attribute Access scored =6.6; the attributes Longitudinality, Coordination (integration of care, Coordination (information systems and Integrality scored =6.6, and the Essential Score =6.6. Comparing basic units with family health units, the attribute scores were equally distributed; Accessibility scored =6.6, the others attributes scored =6.6; however, in the basic units, the Essential Score was =6.6 and, in the family health units, =6.6. CONCLUSION: expanding the coverage of family health units and the training of professionals can be considered strategies to qualify health care.

  17. The Relationship between Health Literacy and Health Behaviour in People with Diabetes: A Danish Population-Based Study.

    Science.gov (United States)

    Friis, Karina; Vind, Benedicte Donslund; Simmons, Rebecca K; Maindal, Helle Terkildsen

    2016-01-01

    Background. People with diabetes who have poor health behaviours are at greater risk for a range of adverse health outcomes. We aimed to investigate the relationship between health literacy and health behaviour (smoking, alcohol, physical activity, and diet) in people with diabetes. Methods. The study was based on respondents aged 25 years or older from a population-based survey in 2013 who reported having diabetes (n = 1685). Two dimensions from the Health Literacy Questionnaire were used: "understand health information" and "actively engage with healthcare providers." We used logistic regression to examine the association between health literacy and health behaviour. Results. After adjustment for sociodemographic factors, individuals with diabetes who found it difficult to understand information about health had higher odds of being physically inactive (OR: 3.43, 95% CI: 2.14-5.51) and having unhealthy dietary habits (OR: 3.01, 95% CI: 1.63-5.58). Similar results were observed for individuals who found it difficult to actively engage with healthcare providers. No associations were found between the two dimensions of health literacy and smoking and alcohol consumption. Conclusion. When developing health services and interventions to improve health behaviour among people with diabetes, our results suggest that they may benefit by including focus on health literacy.

  18. The Relationship between Health Literacy and Health Behaviour in People with Diabetes: A Danish Population-Based Study

    Directory of Open Access Journals (Sweden)

    Karina Friis

    2016-01-01

    Full Text Available Background. People with diabetes who have poor health behaviours are at greater risk for a range of adverse health outcomes. We aimed to investigate the relationship between health literacy and health behaviour (smoking, alcohol, physical activity, and diet in people with diabetes. Methods. The study was based on respondents aged 25 years or older from a population-based survey in 2013 who reported having diabetes (n=1685. Two dimensions from the Health Literacy Questionnaire were used: “understand health information” and “actively engage with healthcare providers.” We used logistic regression to examine the association between health literacy and health behaviour. Results. After adjustment for sociodemographic factors, individuals with diabetes who found it difficult to understand information about health had higher odds of being physically inactive (OR: 3.43, 95% CI: 2.14–5.51 and having unhealthy dietary habits (OR: 3.01, 95% CI: 1.63–5.58. Similar results were observed for individuals who found it difficult to actively engage with healthcare providers. No associations were found between the two dimensions of health literacy and smoking and alcohol consumption. Conclusion. When developing health services and interventions to improve health behaviour among people with diabetes, our results suggest that they may benefit by including focus on health literacy.

  19. The Relationship between Health Literacy and Health Behaviour in People with Diabetes: A Danish Population-Based Study

    Science.gov (United States)

    Simmons, Rebecca K.

    2016-01-01

    Background. People with diabetes who have poor health behaviours are at greater risk for a range of adverse health outcomes. We aimed to investigate the relationship between health literacy and health behaviour (smoking, alcohol, physical activity, and diet) in people with diabetes. Methods. The study was based on respondents aged 25 years or older from a population-based survey in 2013 who reported having diabetes (n = 1685). Two dimensions from the Health Literacy Questionnaire were used: “understand health information” and “actively engage with healthcare providers.” We used logistic regression to examine the association between health literacy and health behaviour. Results. After adjustment for sociodemographic factors, individuals with diabetes who found it difficult to understand information about health had higher odds of being physically inactive (OR: 3.43, 95% CI: 2.14–5.51) and having unhealthy dietary habits (OR: 3.01, 95% CI: 1.63–5.58). Similar results were observed for individuals who found it difficult to actively engage with healthcare providers. No associations were found between the two dimensions of health literacy and smoking and alcohol consumption. Conclusion. When developing health services and interventions to improve health behaviour among people with diabetes, our results suggest that they may benefit by including focus on health literacy.

  20. Psychometric properties of HeartQoL, a core heart disease-specific health-related quality of life questionnaire, in Danish implantable cardioverter defibrillator recipients

    DEFF Research Database (Denmark)

    Zangger, Graziella; Zwisler, Ann-Dorthe; Kikkenborg Berg, Selina

    2017-01-01

    Background Patient-reported health-related quality of life is increasingly used as an outcome measure in clinical trials and as a performance measure to evaluate quality of care. The objective of this study was to assess the psychometric properties of the Danish HeartQoL questionnaire, a core heart...... psychometric attributes of validity and reliability in this implantable cardioverter defibrillator population. This study adds support for the HeartQoL as a core heart-specific health-related quality of life questionnaire in a broad group of patients with heart disease including implantable cardioverter...

  1. The Danish National Chronic Lymphocytic Leukemia Registry

    DEFF Research Database (Denmark)

    da Cunha-Bang, Caspar; Geisler, Christian Hartmann; Enggaard, Lisbeth;

    2016-01-01

    , and for decision on treatment initiation as well as characteristics included in the CLL International Prognostic Index are collected. DESCRIPTIVE DATA: To ensure full coverage of Danish CLL patients in the registry, both continuous queries in case of missing data, and cross-referencing with the Danish National......, 3,082 patients have been registered. CONCLUSION: The Danish National CLL Registry is based within the Danish National Hematology Database. The registry covers a cohort of all patients diagnosed with CLL in Denmark since 2008. It forms the basis for quality assessment of CLL treatment in Denmark......AIM: In 2008, the Danish National Chronic Lymphocytic Leukemia Registry was founded within the Danish National Hematology Database. The primary aim of the registry is to assure quality of diagnosis and care of patients with chronic lymphocytic leukemia (CLL) in Denmark. Secondarily, to evaluate...

  2. Chronicity and primary care: the role of prison health

    Directory of Open Access Journals (Sweden)

    R. Morral-Parente

    2015-10-01

    Full Text Available The Prison Primary Health Care Teams in Catalonia have been integrated into the Catalan Health Institute. This integration shall facilitate¹ training and updating, while eliminating the existing differences between the health services belonging to prison institutions and those of the Catalan Health Service. It shall enable team work and coordination between Primary Health Care Teams in the community and the PHCTs in prisons within the same geographical area by sharing ongoing training, multi-sector work teams and territory-based relations, thereby facilitating continuance in care and complete and integrated treatment of chronicity. The existing information systems in Primary Health Care and the shared clinical history in Catalonia are key factors for this follow up process. Support tools for clinical decision making shall also be shared, which shall contribute towards an increase in quality and clinical safety. These tools include electronic clinical practice guides, therapeutic guides, prescription alert systems, etc. This shall be an opportunity for Prison Health Care Teams to engage in teaching and research, which in turn shall have an indirect effect on improvements in health care quality and the training of professionals in this sector. The critical factor for success is the fact that a unique chronicity health care model shall be shared, where measures for health promotion prevention can be taken, along with multi-sector monitoring of pathologies and with health care information shared between professionals and levels throughout the patient's life, both in and out of the prison environment.

  3. [Chronicity and primary care: the role of prison health].

    Science.gov (United States)

    Morral-Parente, R

    2015-01-01

    The Prison Primary Health Care Teams in Catalonia have been integrated into the Catalan Health Institute. This integration shall facilitate¹ training and updating, while eliminating the existing differences between the health services belonging to prison institutions and those of the Catalan Health Service. It shall enable team work and coordination between Primary Health Care Teams in the community and the PHCTs in prisons within the same geographical area by sharing ongoing training, multi-sector work teams and territory-based relations, thereby facilitating continuance in care and complete and integrated treatment of chronicity. The existing information systems in Primary Health Care and the shared clinical history in Catalonia are key factors for this follow up process. Support tools for clinical decision making shall also be shared, which shall contribute towards an increase in quality and clinical safety. These tools include electronic clinical practice guides, therapeutic guides, prescription alert systems, etc. This shall be an opportunity for Prison Health Care Teams to engage in teaching and research, which in turn shall have an indirect effect on improvements in health care quality and the training of professionals in this sector. The critical factor for success is the fact that a unique chronicity health care model shall be shared, where measures for health promotion prevention can be taken, along with multi-sector monitoring of pathologies and with health care information shared between professionals and levels throughout the patient's life, both in and out of the prison environment.

  4. Time trends in incidence and prognosis of primary liver cancer and liver metastases of unknown origin in a Danish region, 1985-2004

    DEFF Research Database (Denmark)

    Erichsen, Rune; Jepsen, Peter; Jacobsen, Jacob

    2008-01-01

    OBJECTIVES: Changes, over the last 20 years, in the diagnostic procedures and treatment of primary liver cancer (PLC) and liver metastases of unknown origin (LMUO) may have affected the clinical course of both cancers. Few longitudinal studies examined this issue. In a population-based setting, we...... studied changes in the incidence and prognosis of PLC and LMUO over time. METHODS: Between 1985 and 2004, we identified 2675 patients with PLC and LMUO in three Danish counties, with a population of 1.4 million. We computed the standardized incidence rate (SIR), ratio of PLC to LMUO diagnoses, median...... survival, and estimated mortality rate ratio adjusted for age, sex, and comorbidity. RESULTS: The SIR of PLC increased from 3.2 in 1985 to 5.0 in 2003, and the SIR of LMUO increased from 3.7 to 6.4. No increase was noted in the PLC-to-LMUO ratio over time (P=0.1 for trend). From 1985 to 2004, the median...

  5. Overcoming the Barriers to Uptake: A Study of 6 Danish Health-Based Serious Games Projects

    Science.gov (United States)

    Brown, Damian

    2013-01-01

    Serious gaming for health benefits is moving out of the realm of being potentially interesting, and the authors are starting to see a growing maturity in the field. This study of six serious gaming projects based either wholly or partly in Denmark investigates the changes taking place in the healthcare area based on experiences with serious gaming…

  6. The Danish preventive child health examination should expand on mental health and the well-being of the family

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Lykke; Graungaard, Anette Hauskov; Ertmann, Ruth;

    2015-01-01

    . CONCLUSION: The preventive child health examination is animportant platform for examination and dialogue concerninga child’s health. The physical aspect works well, butthere is a need for development of the assessment of thechild’s mental health and the well-being of the family. FUNDING: Postdoctoral...

  7. On Danish Legal Method

    DEFF Research Database (Denmark)

    Schaumburg-Müller, Sten

    2014-01-01

    On the basis on 1) the Danish legal writer A.S.Ørsted (1778-1860) and 2) an enquete among present day Danish legal scholars, the contribution deals with special traits in Danish legal method......On the basis on 1) the Danish legal writer A.S.Ørsted (1778-1860) and 2) an enquete among present day Danish legal scholars, the contribution deals with special traits in Danish legal method...

  8. The Danish preventive child health examination should expand on mental health and the well-being of the family

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Lykke; Graungaard, Anette Hauskov; Ertmann, Ruth

    2015-01-01

    ’sphysical health. The aim of this study was to explore howthe child’s physical, cognitive and psychosocial health areexamined and assessed at the health examinations of childrenaged 0-5 years in general practice. METHODS: Our study employed observations of the consultationsas well as individual interviews. A total...... of ninedoctors from seven clinics participated. We included 21 casesin our study, each consisting of a consultation and subsequentinterviews with the child’s parents and with thedoctor. RESULTS: The examination of the child’s physical health anddevelopment is an important feature of the health examination.......Motor, cognitive, social skills and mental health areassessed globally through observation and communicationwith the child, and, to a lesser degree, through conversationwith the parents. The child health examination rarely has afamily perspective, unless the doctor is already aware ofproblems in the family...

  9. For the sake of health! Reflections on the contemporary use of social capital and empowerment in Danish health promotion policies

    DEFF Research Database (Denmark)

    Andersen, P. T.; Jorgensen, S. K.; Larsen, E. L.

    2011-01-01

    consist of. This may lead health professionals to participate in political projects dressed as pure health promotion that risk neglecting the various ways people may become empowered or socially engaged in their communities. We use two examples to illustrate these tendencies. Both examples arise from......Social capital and empowerment are increasingly used as key concepts integrated into methods of building healthy communities and as means of explaining inequities in health status within the field of Health Promotion. Although applying these concepts in a public health context offers a more...... holistic and socially oriented approach to health, problems arise when they are used in an imprecise and inconsistent manner. Health Promotion ideology tends to be transformed into politico-ideological complexes of power that enforce either a republican or a neoliberal perception of what the good life...

  10. Interactions of Lipid Genetic Risk Scores with Estimates of Metabolic Health in a Danish Population

    DEFF Research Database (Denmark)

    Justesen, Johanne M; Allin, Kristine H; Sandholt, Camilla H

    2015-01-01

    Background—There are several well-established lifestyle factors influencing dyslipidemia and currently; 157 genetic susceptibility loci have been reported to be associated with serum lipid levels at genome-wide statistical significance. However, the interplay between lifestyle risk factors...... and these susceptibility loci has not been fully elucidated. We tested whether genetic risk scores (GRS) of lipid-associated single nucleotide polymorphisms associate with fasting serum lipid traits and whether the effects are modulated by lifestyle factors or estimates of metabolic health. Methods and Results—The single......-cholesterol, high-density lipoprotein-cholesterol, or triglyceride, 4 weighted GRS were constructed. In a cross-sectional design, we investigated whether the effect of these weighted GRSs on lipid levels were modulated by diet, alcohol consumption, physical activity, and smoking or the individual metabolic health...

  11. Danish Claims Data Indicators for Electronic Feedback in Oral-Health Care

    DEFF Research Database (Denmark)

    Rosing, Kasper; Christensen, Lisa Bøge; Listl, Stefan

    Objectives: As part of the “Added Value for Oral Care” (ADVOCATE) project; this subproject aims to construct a preliminary set of indicators of dental clinic service delivery profiles, to be used in a pilot “dashboard.” The dashboard will provide feedback and mirror information about dental care...... were constructed. See Table 1. Combinations of the indicators gave relative measures of the mutual preventive/diagnostic/treatment profiles. For instance ICPS/extractions =(16%/6%)=2.7. Conclusions: The indicators are considered suitable for use in an electronic feedback system for the individual oral...... and universal character. With time the feedback system maybe further developed to adjust for oral health risk status, socioeconomic factors, and patient reported oral health and treatment outcomes, to make the comparisons more relevant. The ADVOCATE project (www.advocateoralhealth.com) has received funding from...

  12. Oral health in the context of primary care in Brazil.

    Science.gov (United States)

    Nascimento, Antonio C; Moysés, Simone T; Werneck, Renata I; Moysés, Samuel J

    2013-10-01

    This article presents an integrative literature review that analyses the advances and challenges in oral health care of the Brazilian primary health care system, based on a political agenda that envisages re-organising the unified health system (SistemaÚnico de Saúde - SUS). It is presumed that the actions suggested by the Alma-Ata Conference of 1978 are still up-to-date and relevant when adapted to the situation in Brazil. Several studies and policies are reviewed, including works demonstrating the importance of primary care as an organising platform in an integrated health-care network, Brazil's strategy for reorganising the primary care network known as the Family Health Strategy, and the National Oral Health Policy. This review discusses results obtained over the last twenty years, with special attention paid to changes in oral health-care practices, as well as the funding of action programmes and assistance cover. The conclusion is that oral healthcare in the Brazilian primary health care system has advanced over the past decades; however, serious obstacles have been experienced, especially with regard to the guarantee of universal access to services and funding. The continuous efforts of public managers and society should focus on the goal of achieving universal coverage for all Brazilians. © 2013 FDI World Dental Federation.

  13. Priorities for health services research in primary care.

    NARCIS (Netherlands)

    Schäfer, W.; Groenewegen, P.P.; Hansen, J.; Black, N.

    2011-01-01

    Background: All European health systems face several common challenges related to increases in lifestyle and chronic diseases, a decreasing future workforce, inequalities in health and the consequences of societal changes. Primary care, which has the potential to help meet these challenges, would be

  14. Immigrants as users of primary health services in Greece

    Directory of Open Access Journals (Sweden)

    Roupa Ε.

    2015-10-01

    Full Text Available The migration is a multidimensional and complex problem of modern times. The social, political, economic and cultural negative circumstances prevailing in many states and communities of the world are pushing people into new places and destinations to permanent or temporary residence. In recent years, Greece is a country of immigration destination resulting in a entrance of people with different national and racial characteristics. The installation of the population in the country and use of structures and services of the state has a big change in the political, economic and social developments affecting major systems and subsystems of the state including the health system.The use of social structures and particularly of Primary Health Care, by immigrants occurs quite reduced compared to the native people. The use of Primary Health Care limited in emergencies situations and less in health prevention. Factors such as language, the high economic cost of providing medical services and remote Primary Health Care services seems to have a negative impact on search on medical treatment and nursing care. Important seen the role of the state and health professionals to use the Primary Health Care services from the immigrant population. Actions such as removing social exclusion and implementation of specialized prevention programs, can contribute greatly to the health of immigrants

  15. Do illness perceptions predict health outcomes in primary care patients?

    DEFF Research Database (Denmark)

    Frostholm, Lisbeth; Oernboel, Eva; Christensen, Kaj S

    2007-01-01

    patients, (2) patients without chronic disorders presenting physical disease, and (3) patients presenting medically unexplained symptoms (MUS). RESULTS: Negative illness perceptions were associated with poor physical and mental health at baseline. They most strongly predicted changes in health status......OBJECTIVE: Little is known about whether illness perceptions affect health outcomes in primary care patients. The aim of this study was to examine if patients' illness perceptions were associated with their self-rated health in a 2-year follow-up period. METHODS: One thousand seven hundred eighty......-five primary care patients presenting a new or recurrent health problem completed an adapted version of the illness perception questionnaire and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) at baseline and 3, 12, and 24 months' follow-up. Linear regressions were performed for (1) all...

  16. Primary care mental health workers: role expectations, conflict and ambiguity.

    Science.gov (United States)

    Bower, Peter; Jerrim, Sophie; Gask, Linda

    2004-07-01

    A number of professionals are involved in mental health in primary care. The NHS Plan proposed the introduction of a new professional, the primary care mental health worker (PCMHW), to improve care in this setting. The present study was conducted to examine pilot PCMHW-type roles currently in existence, to explore staff expectations concerning the new PCMHW role and to consider the issues relating to roles in primary care mental health that are raised by this new worker. The study used a case study design, and involved qualitative interviews with 46 managers and clinicians from primary care and specialist mental health services, including pilot PCMHW-type roles. The key findings were as follows: The pilot PCMHW-type roles were almost exclusively related to client work, whereas respondents had far wider role expectations of the new PCMHWs, relating to perceived gaps in current service provision. This highlights the potential for role conflict. Secondly, there was disagreement and ambiguity among some respondents as to the nature of the new PCMHW's role in client work, and its relationship with the work undertaken by other mental health professionals such as counsellors, psychologists and nurses. Given that multiple professionals are involved in mental health care in primary care, issues relating to roles are likely to be crucial in the effective implementation of the new PCMHWs.

  17. Primary prevention in public health: an analysis of basic assumptions.

    Science.gov (United States)

    Ratcliffe, J; Wallack, L

    1985-01-01

    The common definition of primary prevention is straightforward; but how it is transformed into a framework to guide action is based on personal and societal feelings and beliefs about the basis for social organization. This article focuses on the two contending primary prevention strategies of health promotion and health protection. The contention between the two strategies stems from a basic disagreement about disease causality in modern society. Health promotion is based on the "lifestyle" theory of disease causality, which sees individual health status linked ultimately to personal decisions about diet, stress, and drug habits. Primary prevention, from this perspective, entails persuading individuals to forgo their risk-taking, self-destructive behavior. Health protection, on the other hand, is based on the "social-structural" theory of disease causality. This theory sees the health status of populations linked ultimately to the unequal distribution of social resources, industrial pollution, occupational stress, and "anti-health promotion" marketing practices. Primary prevention, from this perspective, requires changing existing social and, particularly, economic policies and structures. In order to provide a basis for choosing between these contending strategies, the demonstrated (i.e., past) impact of each strategy on the health of the public is examined. Two conclusions are drawn. First, the health promotion strategy shows little potential for improving the public health, because it systematically ignores the risk-imposing, other-destructive behavior of influential actors (policy-makers and institutions) in society. And second, effective primary prevention efforts entail an "upstream" approach that results in far-reaching sociopolitical and economic change.

  18. Experiences with Recruitment of Marginalized Groups in a Danish Health Promotion Program: A Document Evaluation Study

    Science.gov (United States)

    Kristiansen, Tine Mechlenborg; Bak, Carsten Kronborg

    2016-01-01

    Background Studies have found that marginalized groups living in deprived neighborhoods are less likely to participate in health programs compared to the majority of society. This study evaluates recruitment approaches conducted during a national government-funded project in 12 deprived neighborhoods across Denmark between 2010 and 2014. The aim of this study was to understand how recruitment approaches could promote participation in health programs within deprived neighborhoods to reach marginalized groups. Method Documents from all 12 of the included municipalities were collected to conduct a document evaluation. The collected documents consisted of 1,500 pages of written material with 12 project descriptions, three midterm and 10 final evaluations. The collected data were analyzed through a qualitative content analysis. Results The results are based on the fact that only 10 municipalities have developed evaluations related to recruitment, and only three evaluations provided a description of which marginalized groups were recruited. Challenges related to recruitment consist of difficulties involving the target group, including general distrust, language barriers and a lack of ability to cope with new situations and strangers. Additional geographical challenges emerged, especially in rural areas. Positive experiences with recruitment approaches were mainly related to relationship building and trust building, especially through face-to-face contact and the project employees’ presence in the neighborhood. Additionally, adjusting some of the interventions and the recruitment strategy increased participation. Conclusion This study found that relation and trust between the residents and the project employees is an important factor in the recruitment of marginalized groups in deprived neighborhoods as well as adjusting the health interventions or recruitment strategy to the target groups. In future research, it is necessary to examine which recruitment approaches are

  19. Towards the effective introduction of physical activity interventions in primary health care

    NARCIS (Netherlands)

    Huijg, Johanna Maria

    2014-01-01

    Despite the promising findings related to the efficacy of primary health care-based physical activity interventions and recommendations for primary health care professionals to promote physical activity, the introduction of physical activity interventions in routine daily primary health care

  20. Challenge of Primary Voltage Control in Large Scale Wind Integrated Power System: A Danish Power System Case Study

    DEFF Research Database (Denmark)

    Rather, Zakir Hussain; Chen, Zhe; Thøgersen, Paul

    2013-01-01

    Grid integration of Renewable Energy (RE) at large scale poses vast majority of challenges to secure and stable operation of Power System. This paper presents the challenge of short circuit power and primary voltage control of wind integrated power system where majority of conventional generators...... are replaced by wind generators. The impact of large scale wind integration on fast reactive power support is studied in this paper. Considering both technical and economic aspects, alternatives to address the challenge of dynamic voltage support have also been demonstrated in this paper. A case study...

  1. Humanization policy in primary health care: a systematic review

    Science.gov (United States)

    Nora, Carlise Rigon Dalla; Junges, José Roque

    2013-01-01

    OBJECTIVE To analyze humanization practices in primary health care in the Brazilian Unified Health System according to the principles of the National Humanization Policy. METHODS A systematic review of the literature was carried out, followed by a meta-synthesis, using the following databases: BDENF (nursing database), BDTD (Brazilian digital library of theses and dissertations), CINAHL (Cumulative Index to nursing and allied health literature), LILACS (Latin American and Caribbean health care sciences literature), MedLine (International health care sciences literature), PAHO (Pan-American Health Care Organization Library) and SciELO (Scientific Electronic Library Online). The following descriptors were used: Humanization; Humanizing Health Care; Reception: Humanized care: Humanization in health care; Bonding; Family Health Care Program; Primary Care; Public Health and Sistema Único de Saúde (the Brazilian public health care system). Research articles, case studies, reports of experiences, dissertations, theses and chapters of books written in Portuguese, English or Spanish, published between 2003 and 2011, were included in the analysis. RESULTS Among the 4,127 publications found on the topic, 40 studies were evaluated and included in the analysis, producing three main categories: the first referring to the infrastructure and organization of the primary care service, made clear the dissatisfaction with the physical structure and equipment of the services and with the flow of attendance, which can facilitate or make difficult the access. The second, referring to the health work process, showed issues about the insufficient number of professionals, fragmentation of the work processes, the professional profile and responsibility. The third category, referring to the relational technologies, indicated the reception, bonding, listening, respect and dialog with the service users. CONCLUSIONS Although many practices were cited as humanizing they do not produce changes

  2. Hypertension in Danish seafarers

    DEFF Research Database (Denmark)

    Tu, Mingshan; Jepsen, Jørgen Riis

    2016-01-01

    intake, and body mass index. Results: The overall prevalence of hypertension in the study population was 44.7% (95% CI 40.8–48.6). In a comparison sample of adult Danes, the crude rate of hypertension was 12.6%. In addition, 41.8% (95% CI 38.0–45.7) of seafarers were pre-hypertensive. Hypertension......Background: Due to the high prevalence of arterial hypertension and its role in the development of athe- rosclerosis, myocardial infarction and stroke, hypertension is a major public health challenge worldwide. There is limited knowledge of the prevalence of hypertension among seafarers who......, however, are known to have an excess morbidity and mortality from these disorders. This article addresses the prevalence of hypertension among Danish seafarers and discusses potential risk factors for hypertension in maritime settings. Materials and methods: A representative sample of 629 Danish seafarers...

  3. A focus group study on primary health care in Johannesburg Health ...

    African Journals Online (AJOL)

    A focus group study on primary health care in Johannesburg Health District: ... Setting and subjects: Groups of nurse clinicians, clinic managers, senior ... Outcome measures: The content was thematically analysed and a model developed.

  4. Fitness and Health Effects of Frequent Intense Training in 8-10-Year Old Danish Children

    DEFF Research Database (Denmark)

    Larsen, Malte Nejst

    Physical activity for children has been much debated in recent years. Everyone has seemed to agree that it is important for children to exercise for the sake of physiological health, but cognitive functions and psycho-social behaviour are now also considered to be affected by physical activity. I...... other aspects of using small sided ball games in schools as part of physical education.......) compared to children active in other sports. Paper III and IV described the long-term training effects of frequent intense small-sided ball games (SSG), interval running (IT) and circuit strength training (CST) for 8-10-year-old school children. Analysis of baseline-to-10-months change scores showed...

  5. Experiences with recruitment of marginalized groups in a Danish health promotion program

    DEFF Research Database (Denmark)

    Rasmussen, Marianne; Poulsen, Eva Kanstrup; Rytter, Anne Stoffersen

    2016-01-01

    to cope with new situations and strangers. Additional geographical challenges emerged, especially in rural areas. Positive experiences with recruitment approaches were mainly related to relationship building and trust building, especially through face-to-face contact and the project employees' presence...... in the neighborhood. Additionally, adjusting some of the interventions and the recruitment strategy increased participation. CONCLUSION: This study found that relation and trust between the residents and the project employees is an important factor in the recruitment of marginalized groups in deprived neighborhoods...... as well as adjusting the health interventions or recruitment strategy to the target groups. In future research, it is necessary to examine which recruitment approaches are effective under which circumstances to increase participation among marginalized groups....

  6. Health conditions of elderly in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Cenir Gonçalves Tier

    2014-10-01

    Full Text Available This study aimed to identify the health conditions and environmental factors that influence the activities of daily living of elderly people. Cross-sectional epidemiological research conducted with 167 elderly in a municipality of Rio Grande do Sul, Brazil, from May to July 2013, using a structured instrument. Data were grouped for statistical/descriptive treatment. Circulatory diseases were the most frequent. The commonly used drug was aspirin, and falls were prevalent in 65 elderly. There was a significant difference in eating in age group older than 80 years (p=0,002. Dressing had significance in the age group above 80 years old (p=0.010, but was not significant when associated architecture with age. It was concluded that knowledge of the socio-demographic and health characteristics of the elderly enables the implementation of specific actions by health professionals, besides helping managers to formulate health indicators.

  7. [Study of primary care health needs through family health diagnosis].

    Science.gov (United States)

    Torres-Arreola, Laura Pilar; Vladislavovna Doubova, Svetlana; Reyes-Morales, Hortensia; Villa-Barragán, Juan Pablo; Constantino-Casas, Patricia; Pérez-Cuevas, Ricardo

    2006-10-31

    To assess the health needs of the eligible public population of the Mexican Institute of Social Security (IMSS). Observational, descriptive, transversal study. Family Medicine Unit number 8 of the IMSS, in the city of Tlaxcala, Mexico. A sample of 1200 families using multi-stage sampling, between October 1999 and March 2000. The designed and validated questionnaire on "Family health diagnosis" was used. A 19.2% of the families had a very low socio-economic level, and 14.9% of subjects were not entitled to Social Security. Functional illiteracy in at least one member was found in 12.6% of the families. According to the family Apgar, 93% of families were functional and two-thirds of the families were classified as nuclear. About 51.1% and 36.9% of women used programs for detection of cervical/uterine and breast cancer, respectively. Only 25% of the adult population underwent the detection tests for diabetes mellitus and hypertension and 10.9% had a chronic disease. 56.4% of families considered the quality of health care good, and only 18.13% were satisfied with the care received. Identification of health needs through diagnosis of family health is useful as a basis for establishing a hierarchy of problems as well as for developing health programs that may facilitate greater equity in attention.

  8. [Primary health care professionals attitudes towards influenza immunzation in Catalonia].

    Science.gov (United States)

    Torner, Nuria; Godoy, Pere; Soldevila, Núria; Toledo, Diana; Rius, Cristina; Domínguez, Angela

    2016-03-01

    Health personnel are at risk of acquiring influenza infection and of nosocomial influenza transmission. The objective of this study was to assess the relationship between the knowledge and attitudes of primary care health personnel in Catalonia as regards influenza vaccine and the factors related to the uptake of this vaccine. A cross-sectional study using a web survey. Primary care health personnel of the Catalan Health Institute. A total of 1212 primary health care personnel were included in the survey. Those who had medical reasons for being or not being vaccinated were excluded. A total of 423 replies were valid, with a 46.6% overall vaccination coverage. Vaccination rate was higher among 45 to 54 year-olds, paediatricians, those vaccinated in preceding seasons, and those living with chronic patients. There was an association between having received the vaccine and considering vaccination the best preventive action, advocating vaccination to at risk population, concern about acquiring influenza, and considering health personnel vaccination important. Actions taken to increase vaccination rate among health personnel should aim at correcting lack of knowledge and misconceptions about influenza vaccination of health personnel. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  9. The strategy, cost, and progress of primary health care.

    Science.gov (United States)

    Boland, R G; Young, M E

    1982-01-01

    Since the 1978 Alma-Alta International Conference on Primary Health Care, investments in primary health care projects throughout the world have been increasing. However, with the exception of China, no national projects have demonstrated the ability to provide longterm comprehensive primary health care in conditions of chronic proverty with local resources. Programs in China, Cuba, and Tanzania have achieved primary health care coverage for 100% of their populations. These countries have in common strong governments that have been able to implement radical changes in the health system. Individual freedoms in these societies have been restricted in favor of improved health. Programs in Nigeria, India, and Afghanistan have been less successful, although some progress has been made in projects using external funds, inspite of a strong committment by the governments. Efforts to reorganize the health care system have lacked needed political strength. Currently, these systems have resulted in less than complete coverage, without the prospect of attaining acceptable levels of infant mortality, life expectancy and net population growth. Economic, political, and cultural costs may be high as for example, national security or traditional practices are traded to achieve primary health care with 100% coverage. WHO has devised a global strategy which, when translated into operational policies will need to address several unresolved issues. These include recognizing that the goal of comprehensive primary health care may not be justified given the lack of progress to date and that effective, selective primary health care focused on nutrition, immunization, control of endemic diseases, and health education may be a more realistic goal; and that a system of international social security may be an effective means of assuring that the poorest countries are able to provide care. In addition, questions concerning continued funding of programs that can never be locally funded, the role

  10. Patient-related predictors of implant failure after primary total hip replacement in the initial, short- and long-terms. A nationwide Danish follow-up study including 36,984 patients

    DEFF Research Database (Denmark)

    Johnsen, S.P.; Sørensen, H.T.; Lucht, Ulf

    2006-01-01

    We examined the association between patient-related factors and the risk of initial, short- and long-term implant failure after primary total hip replacement. We used data from the Danish Hip Arthroplasty Registry between 1 January 1995 and 31 December 2002, which gave us a total of 36 984 patients....... Separate analyses were carried out for three follow-up periods: 0 to 30 days, 31 days to six months (short term), and six months to 8.6 years after primary total hip replacement (long term). The outcome measure was defined as time to failure, which included re-operation with open surgery for any reason...

  11. The Danish Melanoma Database

    Directory of Open Access Journals (Sweden)

    Hölmich Lr

    2016-10-01

    Full Text Available Lisbet Rosenkrantz Hölmich,1 Siri Klausen,2 Eva Spaun,3 Grethe Schmidt,4 Dorte Gad,5 Inge Marie Svane,6,7 Henrik Schmidt,8 Henrik Frank Lorentzen,9 Else Helene Ibfelt10 1Department of Plastic Surgery, 2Department of Pathology, Herlev-Gentofte Hospital, University of Copenhagen, Herlev, 3Institute of Pathology, Aarhus University Hospital, Aarhus, 4Department of Plastic and Reconstructive Surgery, Breast Surgery and Burns, Rigshospitalet – Glostrup, University of Copenhagen, Copenhagen, 5Department of Plastic Surgery, Odense University Hospital, Odense, 6Center for Cancer Immune Therapy, Department of Hematology, 7Department of Oncology, Herlev-Gentofte Hospital, University of Copenhagen, Herlev, 8Department of Oncology, 9Department of Dermatology, Aarhus University Hospital, Aarhus, 10Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, Glostrup – Rigshospitalet, University of Copenhagen, Glostrup, Denmark Aim of database: The aim of the database is to monitor and improve the treatment and survival of melanoma patients.Study population: All Danish patients with cutaneous melanoma and in situ melanomas must be registered in the Danish Melanoma Database (DMD. In 2014, 2,525 patients with invasive melanoma and 780 with in situ tumors were registered. The coverage is currently 93% compared with the Danish Pathology Register.Main variables: The main variables include demographic, clinical, and pathological characteristics, including Breslow’s tumor thickness, ± ulceration, mitoses, and tumor–node–metastasis stage. Information about the date of diagnosis, treatment, type of surgery, including safety margins, results of lymphoscintigraphy in patients for whom this was indicated (tumors > T1a, results of sentinel node biopsy, pathological evaluation hereof, and follow-up information, including recurrence, nature, and treatment hereof is registered. In case of death, the cause and date

  12. No association between iron status and self-reported health-related quality of life in 16,375 Danish blood donors

    DEFF Research Database (Denmark)

    Rigas, Andreas S; Pedersen, Ole B; Sørensen, Cecilie J

    2015-01-01

    BACKGROUND: Health-related quality of life (HRQL) represents people's subjective assessment of their mental and physical well-being. HRQL is highly predictive of future health. The effect of iron deficiency without anemia induced by blood donation on HRQL is presently unknown. The aim...... used to assess the relationship between iron deficiency (ferritin RESULTS: There was no significant relationship between iron deficiency and self-reported mental or physical health. CONCLUSION: This study...... was to explore the relationship between iron status and self-reported mental component score (MCS; SF-12) and physical component score (PCS; SF-12) in Danish blood donors. STUDY DESIGN AND METHODS: Complete relevant data, including the 12-item short-form health survey (SF-12), plasma ferritin levels, age, body...

  13. Heterosis and Breed Effects for Milk Production, Udder Health and Fertility in Danish Herds applying Systematic Crossbreeding

    DEFF Research Database (Denmark)

    Norberg, Elise; Sørensen, Lydia Henriette; Byskov, Kenneth

    Use of systematic crossbreeding in dairy cattle has been increasing the last decades. The aim of this study was to estimate the effect of breed and heterosis on protein yield (PY), somatic cell score (SCS) and days from calving to first insemination (CFI) in first lactation crosses between Danish...

  14. Baseline prostate-specific antigen measurements and subsequent prostate cancer risk in the Danish Diet, Cancer and Health cohort

    DEFF Research Database (Denmark)

    Larsen, Signe Benzon; Brasso, Klaus; Iversen, Peter;

    2013-01-01

    in the Danish Cancer Registry through 31st December 2007 1:1 age-matched with cancer-free controls. Aggressive cancer was defined as ⩾T3 or Gleason score ⩾7 or N1 or M1. Statistical analyses were based on conditional logistic regression with age as underlying time axis. RESULTS: Total PSA and free-to-total PSA...

  15. The association between health and sickness absence among Danish and non-Western immigrant cleaners in Denmark

    DEFF Research Database (Denmark)

    Carneiro, Isabella G; Rasmussen, Charlotte D N; Jørgensen, Marie B

    2013-01-01

    related to high occurrence of sickness absence. Among Danish cleaners, high blood pressure was related to high occurrence of sickness absence. Among non-Western immigrant cleaners, total body pain and having one or more diagnosed chronic disease were related to high occurrence of sickness absence...

  16. PSA testing without clinical indication for prostate cancer in relation to socio-demographic and clinical characteristics in the Danish Diet, Cancer and Health Study

    DEFF Research Database (Denmark)

    Karlsen, Randi V; Larsen, Signe B; Christensen, Jane

    2013-01-01

    associations between socio-demographic or clinical characteristics and PSA testing without clinical indication. Material and methods. In the Danish Diet, Cancer and Health Cohort, we identified 1051 men with PC diagnosed in 1993-2008. Diagnostic and clinical characteristics were obtained from medical records......, and socio-demographic information was retrieved from administrative registers. We used general logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between socio-demographic or clinical characteristics and PSA testing without clinical indication. Cox...

  17. Adding a dietitian to a Danish Liaison-team after discharge of geriatric patients at nutritional risk may save health care costs

    DEFF Research Database (Denmark)

    Pohju, Anne; Belqaid, Kerstin; Brandt, Christopher Flintenborg

    2016-01-01

    Background: A previous study investigated the value of adding a dietitian to a geriatric discharge Liaison-Team. The scope of this study was to explore the possible economic savings of this. Methods: Patients, 70+ and at nutritional risk, were randomized to receive discharge Liaison-Team either......,416 compared to €1,150 (ONS only) in the CG. For hospitalizations, estimated cost was €92,020 in the IG and €220,025 in the CG. Cost savings added up to €3,048 per patient in the IG. Conclusion: Adding a dietitian to a Danish geriatric discharge Liaison-Team decreased health care costs...

  18. Health actions in primary care to reduce child mortality

    Directory of Open Access Journals (Sweden)

    Camila Marques Careti

    2016-02-01

    Full Text Available Objective: to identify the health actions aimed at reducing child mortality in primary care in a county of São Paulo, Brazil. Methods: an exploratory study with a quantitative approach. 54 health professionals (nurses, doctors and community health agents participated in this study in three health units selected. Results: most participants reported to develop actions to encourage breast-feeding; of the children assisted, 59.3% had their vaccination updated; 72.2% of doctors and nurses confirmed that the children have at least one appointment in their first week of life. For planning in health care, 51.9% reported that sometimes there is health team participation in the meetings. Conclusion: several actions correspond to those recommended by the child-care public policies. However, there are weaknesses pointing at the need to enhance the vision of the health professionals for greater planning, adapting to the needs of the child population in order to reduce the deaths.

  19. Health promotion in primary and secondary schools in Denmark

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Krølner, Rikke; Mortensen, Laust Hvas

    2015-01-01

    BACKGROUND: Schools are important arenas for interventions among children as health promoting initiatives in childhood is expected to have substantial influence on health and well-being in adulthood. In countries with compulsory school attention, all children could potentially benefit from health...... promotion at the school level regardless of socioeconomic status or other background factors. The first aim was to elucidate time trends in the number and types of school health promoting activities by describing the number and type of health promoting activities in primary and secondary schools in Denmark....... The second aim was to investigate which characteristics of schools and students that are associated with participation in many (≥3) versus few (0-2) health promoting activities during the preceding 2-3 years. METHODS: We used cross-sectional data from the 2006- and 2010-survey of the Health Behaviour...

  20. The Danish Shoulder Arthroplasty Registry

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe; Jakobsen, John; Brorson, Stig

    2012-01-01

    The Danish Shoulder Arthroplasty Registry (DSR) was established in 2004. Data are reported electronically by the surgeons. Patient-reported outcome is collected 10-14 months postoperatively using the Western Ontario osteoarthritis of the shoulder index (WOOS). 2,137 primary shoulder arthroplastie...

  1. Brazilian community health agents and qualitative primary healthcare information.

    Science.gov (United States)

    Zanchetta, Margareth S; Pinto, Rogério Meireles; Galhego-Garcia, Wilson; da Cunha, Zeilma; Cordeiro, Hésio A; Fagundes-Filho, Francisco E; Pinho, Mônica A L; Voet, Susan M V; Talbot, Yves; Caldas, Rodrigo S; de Souza, Thiago J; Costa, Edwaldo

    2015-05-01

    The aim of this study was to explore female community health agents' views about the value of recording qualitative information on contextual health issues they observe during home visits, data that are not officially required to be documented for the Brazilian System of Primary Healthcare Information. The study was conducted in community primary healthcare centres located in the cities of Araçatuba and Coroados (state of São Paulo) and Rio de Janeiro (state of Rio de Janeiro), Brazil. The design was a qualitative, exploratory study. The purposeful sampling criteria were being female, with a minimum of three years of continuous service in the same location. Data collection with 62 participants was conducted via 11 focus groups (in 2007 and 2008). Audio files were transcribed and submitted to the method of thematic analysis. Four themes guided the analysis: working with qualitative information and undocumented observation; reflecting on qualitative information; integrating/analysing quantitative and qualitative information; and information-sharing with agents and family health teams. In 2010, 25 community health agents verified the final interpretation of the findings. Participants valued the recording of qualitative, contextual information to expand understanding of primary healthcare issues and as an indicator of clients' improved health behaviour and health literacy. While participants initiated the recording of additional health information, they generally did not inform the family health team about these findings. They perceived that team members devalued this type of information by considering it a reflection of the clientele's social conditions or problems beyond the scope of medical concerns. Documentation of qualitative evidence can account for the effectiveness of health education in two ways: by improving preventative care, and by amplifying the voices of underprivileged clients who live in poverty to ensure the most appropriate and best quality primary

  2. Team effectiveness in academic primary health care teams.

    Science.gov (United States)

    Delva, Dianne; Jamieson, Margaret; Lemieux, Melissa

    2008-12-01

    Primary health care is undergoing significant organizational change, including the development of interdisciplinary health care teams. Understanding how teams function effectively in primary care will assist training programs in teaching effective interprofessional practices. This study aimed to explore the views of members of primary health care teams regarding what constitutes a team, team effectiveness and the factors that affect team effectiveness in primary care. Focus group consultations from six teams in the Department of Family Medicine at Queen's University were recorded and transcribed and qualitative analysis was used to identify themes. Twelve themes were identified that related to the impact of dual goals/obligations of education and clinical/patient practice on team relationships and learners; the challenges of determining team membership including nonattendance of allied health professionals except nurses; and facilitators and barriers to effective team function. This study provides insight into some of the challenges of developing effective primary care teams in an academic department of family medicine. Clear goals and attention to teamwork at all levels of collaboration is needed if effective interprofessional education is to be achieved. Future research should clarify how best to support the changes required for increasingly effective teamwork.

  3. Primary health care: a necessity in developing countries?

    Directory of Open Access Journals (Sweden)

    Evaezi Okpokoro

    2013-12-01

    Full Text Available Resource limited countries continue to be plagued with rising prevalence of malaria, tuberculosis, HIV/AIDS as well as other emerging diseases despite the huge financial support provided by bilateral and multilateral agencies to combat these diseases. While progress may have been made in reducing the global burden caused by these diseases on one hand, there has also been a weakening of the primary health care facility on the other hand which was the hallmark to the Alma Ata declaration of 1978. More attention has been placed on our global health needs while the diverse health needs of every community have been neglected. This fatal neglect at the community level highlights the need for the provision of specialize primary health care (PHC facilities which should not only be affordable, accessible and available, but be appropriate to the priority health needs of the community, especially at the rural level. Hence specialized PHC facilities will be tailored to meet the most pressing health needs of the communities it covers among other diseases. Consequently, this innovative approach will not only strengthen the primary health care system by improving wellbeing especially at the rural level but will also improve the outcome of vertical program at communities where it is most needed.

  4. Revitalizing primary health care--another utopian goal?

    Science.gov (United States)

    Marahatta, Sujan B

    2010-01-01

    The quest for greater efficiency, fairness and responsiveness to the expectation of the people that system serve have brought about three generations of health system reforms in the twentieth century. The first generation saw the founding of national health care systems and extension to middle income nations of social insurance systems in the 1940s and 1950s. By the late 1960s the rising costs of hospital based care, its usage by better off, inaccessibility by the poor and rural population of even the most basic services heralded second generation reforms promoting primary health care as a means of achieving the affordable universal coverage. It included the best public health strategy that is prevention and the highest ethical principle of public health that is equity. It was expected the best system for reaching households with essential and affordable care, and the best route towards universal coverage. The primary health care approach though adopted universally did not materialize its notion of translating ethos of Health for All by 2000. Overall, primary health care movement by the end of 20th century became lifeless. Since the Declaration of Alma-Ata, fundamental changes have occurred affecting health service delivery, such as economic development and financing approaches, globalization of trade and knowledge, and the shift to privatization. This is the time to develop a new vision, taking into consideration the many changes affecting global health and the strategic developments in health of recent years. With this recognition, the third generation of reforms now underway in many countries is driven by the idea of responding more to demand, assuring access for the poor and emphasizing financing rather than just provision within the public sector. The key concern is: how to translate ethos of revitalizing in the reality. Otherwise the revitalizing concept will turn into utopian goal so like HFA by 2000 strategy.

  5. The unique requirements of primary health care in Southern Africa

    Directory of Open Access Journals (Sweden)

    D. P. Knobel

    1986-03-01

    Full Text Available The critical need for primary health care in Southern Africa with special reference to the demands of the heterogenous population is measured against the background of the declaration of Alma Ata at the WHO/UNICEF conference in 1978. In particular the provision of primary health care to the Third World communities of the RSA as an essential part of the security power base of the State is underlined and it is analised in terms of how shortcomings in this service can be exploited in a subversive revolutionary onslaught.

  6. Health promotion interventions to address climate change using a primary health care approach: a literature review.

    Science.gov (United States)

    Walker, Rae; Hassall, John; Chaplin, Sue; Congues, Janet; Bajayo, Rachael; Mason, Wendy

    2011-12-01

    This project explored the literature in which key concepts in primary health care and health promotion are overtly applied to the problem of climate change. This paper contains a discussion of the literature relevant to health promotion principles and intervention strategies for addressing climate change mitigation and adaptation in the primary health care sector. The concept of primary health care is that used by the World Health Organization, based on the Declaration of Alma Ata and often referred to as comprehensive primary health care to differentiate it from primary medical care. This was a review of literature identified in electronic databases using two sets of search terms. Set A consisted of 'climate change or global warming or greenhouse effect' and set B consisted of 11 key concepts in primary health care and health promotion, for example community resilience, health promotion, social change, food security and economic development. Relevant literature was identified at the intersection of search term A with a term from set B. A search was completed for each set B term. This paper reports a discussion of major categories of health promotion interventions, namely health communication, community building and settings approaches and uses examples drawn from literature on community resilience and summer heat. These interventions are all applicable to the primary health care sector. There is a small literature on health promotion interventions for climate change mitigation and adaptation but it is incomplete and scattered across many sources. An important area for further research is to link the logic of service provision in primary health care to the logic of mitigation and adaptation in a changing environment. Interventions that link the logic must also link diverse services to provide coherent action on local and domestic scales, the scales at which primary health care acts. Another research gap is in regard to institutional change in the primary health

  7. [Social constructionism in primary health care: an integrative review].

    Science.gov (United States)

    Cadoná, Eliane; Scarparo, Helena

    2015-09-01

    This study sets out to analyze scientific articles in order to investigate how researchers in the area of Social Constructionism define "health" in Primary Health Care. An integrative review of the literature was conducted along with a decision to concentrate on those works with narrative experiences and research studies. The database researched was the Brazilian Virtual Health Library, with experiences in the scope of Primary Health Care. The effectiveness of this step resulted in 12 articles. Data were analyzed and discussed based on the perspectives of social constructionism, which generated two central themes. They were: citizenship exercises - promoting health in collective spaces; health practices - overcoming the dichotomies and absolute truths. This study revealed the relevance of the notion of shared responsibility on meanings of health contained in the texts analyzed. The researchers claim that it is possible to expand health practices into collective action to facilitate ongoing dialogue between health users and workers. However, the dominance of biomedical discourse is criticized by the researchers, because that paradigm still promotes practices of care focused on illness.

  8. Nursing students and mental health education in primary care

    Directory of Open Access Journals (Sweden)

    Fernanda Tiemi MIYAI

    Full Text Available The University of Sao Paulo School of Nursing (EEUSP went through a period of transition from undergraduate syllabus between the years 2009 and 2010. This change was made to integrate basic and clinical cycles and to reduce fragmentation of the disciplines. The mental health nursing education was included in many modules including the primary care. This qualitative study aimed to identify how the service offered to people with mental illness was performed by 20 undergraduate students in the context of primary care and how they were prepared. Data collection was conducted through semi-structured interviews, in August 2012, in EEUSP. After thematic analysis, we separated in categories: Teaching-learning process, Basic Health Unit and Mental health-illness process. The socially constructed conception of madness added to the problems related to academic training may result in lack of preparation in nursing mental health care.

  9. Patterns of attendance to health checks in a municipality setting: the Danish ‘Check Your Health Preventive Program’

    Directory of Open Access Journals (Sweden)

    Anne-Louise Bjerregaard

    2017-03-01

    More than half of a general population voluntarily attended a general health check, despite a resource intensive offer. People with low resources had lower attendance rates. This study adds a detailed description of mutually exclusive groups of attenders, for use in future planning and implementation of preventive actions.

  10. Children's Health in Brazil: orienting basic network to Primary Health Care.

    Science.gov (United States)

    Damasceno, Simone Soares; Nóbrega, Vanessa Medeiros da; Coutinho, Simone Elizabeth Duarte; Reichert, Altamira Pereira da Silva; Toso, Beatriz Rosana Gonçalves de Oliveira; Collet, Neusa

    2016-09-01

    This is an integrative literature review that analyzed the scientific knowledge produced on the orientation of Brazilian basic care services to primary health care focusing on child health. Searches were carried out in SciELO, Lilacs and Medline databases using descriptors "primary health care", "family health program", "child health" and "evaluation of health services". Studies published in Portuguese, English and Spanish between 2000 and 2013 were selected. A total of 32 studies were chosen and characterized in relation to the features of primary health care, region of the country, type of study and authors' practice area. A thematic review of studies was conducted and resulted in two categories: child care in the context of Brazilian primary health care and primary health care features: limitations to child care. It can be understood that Brazilian primary health care services are heterogeneous regarding the presence and scope of essential child care characteristics. There is a lack of structural and process changes in the services to substantially plan child care actions in basic care.

  11. Community care in practice: social work in primary health care.

    Science.gov (United States)

    Lymbery, M; Millward, A

    2001-01-01

    This paper examines the establishment of social work within primary health care settings in Great Britain, following the passage of the National Health Service and Community Care Act in 1990. Although the improvement of relationships between social workers and primary health care teams has been promoted for a number of years, the advent of formal policies for community care has made this a priority for both social services and health. This paper presents interim findings from the evaluation of three pilot projects in Nottinghamshire, Great Britain. These findings are analysed from three linked perspectives. The first is the extent to which structures and organisations have worked effectively together to promote the location of social workers within health care settings. The second is the impact of professional and cultural factors on the work of the social worker in these settings. The third is the effect of interpersonal relationships on the success of the project. The paper will conclude that there is significant learning from each of these perspectives which can be applied to the future location of social workers to primary health care.

  12. Contributions of Physical Therapists to Primary Preventive Health Care.

    Science.gov (United States)

    Nomura, Takuo

    2016-01-01

    The limitations of what physical therapists can differ from country to country. In Japan, physical therapists are national licensed health care professionals who can help patients improve or restore their mobility. Most Japanese physical therapists provide care for people in health care facilities, medical-welfare transitional facilities, and welfare facilities for the elderly. Currently, physical therapists are unable to sufficiently contribute to primary preventive health care in Japan. However, there are many health problems that physical therapists could help alleviate. For example, low back pain (LBP) more likely than any other condition prevents people from working; thus, making the establishment of effective measures to prevent and reduce LBP vital. An estimated 20,500,000 Japanese individuals have diabetes mellitus (DM) or are at a high risk of developing the disease. DM commonly accompanies stroke and/or heart disease, and is characterized by complications that result from chronic hyperglycemia. Evidence-based physical therapy is effective for the prevention and treatment of LBP and DM. The Japanese Physical Therapy Association established the Japanese Society of Physical Therapy (JSPT) in June 2013. The JSPT has 12 departmental societies and 10 sections. We believe that the JSPT will advance the study of the potential role of physical therapists in primary preventive health care. In the future, it is expected that Japanese physical therapists will contribute to primary preventive health care.

  13. Why did Danish women's life expectancy stagnate?

    DEFF Research Database (Denmark)

    Lindahl-Jacobsen, Rune; Oeppen, James; Rizzi, Silvia

    2016-01-01

    -attributable mortality was excluded, the gap in partial life expectancy at age 50 between Swedish and Danish women diminished substantially. The effect was most pronounced in the interwar generations. The major reason for the stagnation in Danish women's partial life expectancy at age 50 was found to be smoking......The general health status of a population changes over time, generally in a positive direction. Some generations experience more unfavourable conditions than others. The health of Danish women in the interwar generations is an example of such a phenomenon. The stagnation in their life expectancy...... between 1977 and 1995 is thought to be related to their smoking behaviour. So far, no study has measured the absolute effect of smoking on the mortality of the interwar generations of Danish women and thus the stagnation in Danish women's life expectancy. We applied a method to estimate age...

  14. Psychometric properties of HeartQoL, a core heart disease-specific health-related quality of life questionnaire, in Danish implantable cardioverter defibrillator recipients

    DEFF Research Database (Denmark)

    Zangger, Graziella; Zwisler, Ann-Dorthe; Kikkenborg Berg, Selina

    2017-01-01

    Background Patient-reported health-related quality of life is increasingly used as an outcome measure in clinical trials and as a performance measure to evaluate quality of care. The objective of this study was to assess the psychometric properties of the Danish HeartQoL questionnaire, a core heart...... disease-specific health-related quality of life questionnaire, in implantable cardioverter defibrillator recipients. Design This study involved cross-sectional and test-retest study designs. Method Implantable cardioverter defibrillator recipients in the cross-sectional study completed the Heart......QoL, the Short-Form 36 Health Survey, and the Hospital Anxiety and Depression Scale. The HeartQoL structure, construct-related validity (convergent and discriminative) and reliability (internal consistency) were assessed. HeartQoL reproducibility (test-retest) was assessed in an independent sample of implantable...

  15. Public health nurses' primary health care practice: strategies for fostering citizen participation.

    Science.gov (United States)

    Aston, Megan; Meagher-Stewart, Donna; Edwards, Nancy; Young, Linda M

    2009-01-01

    Citizen participation is heralded as a critical element of community health programs that emphasize empowerment and health promotion strategies. Although there is a growing body of research on public health nurses' primary health care practice, few studies have described how public health nurses foster citizen participation. This article presents findings from an interpretive qualitative study of public health nurses' perceptions of their role in fostering citizen participation in an eastern Canadian province at a time of significant health care restructuring. The findings from this study clearly profile public health nurses as integral to the practice of fostering citizen participation.

  16. Diabetes Connect: Developing a Mobile Health Intervention to Link Diabetes Community Health Workers with Primary Care

    OpenAIRE

    Cherrington, Andrea L.; Agne, April A; Lampkin, Yolanda; Birl, Annie; Shelton, Tanya C.; Guzman,Alfredo; Willig, James H.

    2015-01-01

    Community Health Worker (CHW) interventions can help improve diabetes self-management and health outcomes. There is limited evidence on how to effectively integrate CHW programs with primary care efforts. Mobile health technology (mHealth) can connect CHWs to members of the healthcare team and enhance care. We tested a model for the integration of a CHW delivered mHealth intervention to improve diabetes self-management. Seventy-two African American patients with diabetes were followed using t...

  17. Continuous admission to primary school and mental health problems

    NARCIS (Netherlands)

    Reijneveld, S.A.; Wiefferink, C.H.; Brugman, E.; Verhulst, F.C.; Verloove-Vanhorick, S.P.; Paulussen, T.G.W.

    2006-01-01

    Background: Younger children in a school class have higher rates of mental health problems if admission to primary school occurs once a year. This study examines whether this relative age effect also occurs if children are admitted to school continuously throughout the year. Methods: We assessed men

  18. The integration of public health in European primary care systems.

    NARCIS (Netherlands)

    Kringos, D.S.; Bolibar, Y.; Bourgueil, T.; Cartier, T.; Dedeum, T.; Hasvold, A.; Hutchinson, M.; Lember, M.; Oleszczyk, D.; Rotar Pavlick, I.; Svab, P.; Tedeschi, A.; Wilson, S.; Wilm, A.; Windak, A.; Boerma, W.

    2010-01-01

    Background: A strong primary care (PC) system provides accessible, comprehensive care in an ambulatory setting on a continuous basis and by coordinated care processes. These features give PC the opportunity to play a key role in providing public health (PH) services to their practice population. Th

  19. Determinants of increased primary health care use in cancer survivors.

    NARCIS (Netherlands)

    Heins, M.; Schellevis, F.; Rijken, M.; Hoek, L. van der; Korevaar, J.

    2012-01-01

    Purpose: The number of cancer survivors is increasing, and patients with cancer often experience long-lasting consequences of cancer and its treatment. Because of the variety of health problems and high prevalence of comorbidity, primary care physicians (PCPs) seem obvious candidates to take care of

  20. The integration of public health in European primary care systems.

    NARCIS (Netherlands)

    Kringos, D.S.; Bolibar, Y.; Bourgueil, T.; Cartier, T.; Dedeum, T.; Hasvold, A.; Hutchinson, M.; Lember, M.; Oleszczyk, D.; Rotar Pavlick, I.; Svab, P.; Tedeschi, A.; Wilson, S.; Wilm, A.; Windak, A.; Boerma, W.

    2010-01-01

    Background: A strong primary care (PC) system provides accessible, comprehensive care in an ambulatory setting on a continuous basis and by coordinated care processes. These features give PC the opportunity to play a key role in providing public health (PH) services to their practice population. Th

  1. Teaching Strategies for Primary Health Care. A Syllabus.

    Science.gov (United States)

    Durana, Ines

    This book is intended to assist teachers, practitioners, and administrators to develop programs for training nonphysician, primary health care workers in Third World countries. It contains the instructional context of a comprehensive training program, organized into chapters and presented in outline form. Learning strategies follow each section of…

  2. The motivational needs of primary health care nurses to acquire ...

    African Journals Online (AJOL)

    Karien Jooste

    among Primary Health Care (PHC) nurses could have a negative effect on the ... to acquire power in the workplace at mine clinic settings? ... The accessible population in this study was PHC nurses .... comprising elements of the population considered for actual ...... power effectively to manage diversity and job-related.

  3. Primary Principals' Leadership Styles, School Organizational Health and Workplace Bullying

    Science.gov (United States)

    Cemaloglu, Necati

    2011-01-01

    Purpose: The purpose of this paper is to determine the relationships between leadership styles of primary school principals and organizational health and bullying. Design/methodology/approach: Two hypotheses were formulated in relation to the research. Three instruments were used--a multi-level questionnaire for measuring leadership, an…

  4. Primary Health Care Providers' Knowledge Gaps on Parkinson's Disease

    Science.gov (United States)

    Thompson, Megan R.; Stone, Ramona F.; Ochs, V. Dan; Litvan, Irene

    2013-01-01

    In order to determine primary health care providers' (PCPs) knowledge gaps on Parkinson's disease, data were collected before and after a one-hour continuing medical education (CME) lecture on early Parkinson's disease recognition and treatment from a sample of 104 PCPs participating at an annual meeting. The main outcome measure was the…

  5. Primary Principals' Leadership Styles, School Organizational Health and Workplace Bullying

    Science.gov (United States)

    Cemaloglu, Necati

    2011-01-01

    Purpose: The purpose of this paper is to determine the relationships between leadership styles of primary school principals and organizational health and bullying. Design/methodology/approach: Two hypotheses were formulated in relation to the research. Three instruments were used--a multi-level questionnaire for measuring leadership, an…

  6. Integrating mental health into primary care in Sverdlovsk.

    Science.gov (United States)

    Jenkins, Rachel; Bobyleva, Zinaida; Goldberg, David; Gask, Linda; Zacroeva, Alla G; Potasheva, Angelina; Krasnov, Valery; McDaid, David

    2009-03-01

    Introduction Mental disorders occur as frequently in Russia as elsewhere, but the common mental disorders, especially depression, have gone largely unrecognised and undiagnosed by policlinic staff and area doctors.Methods This paper describes the impact and sustainability of a multi-component programme to facilitate the integration of mental health into primary care, by situation appraisal, policy dialogue, development of educational materials, provision of a training programme and the publication of standards and good practice guidelines to improve the primary care of mental disorders in the Sverdlovsk region of the Russian Federation.Results The multi-component programme has resulted in sustainable training about common mental disorders, not only of family doctors but also of other cadres and levels of professionals, and it has been well integrated with Sverdlovsk's overall programme of health sector reforms.Conclusion It is possible to facilitate the sustainable integration of mental health into primary care within the Russian context. While careful adaptation will be needed, the approach adopted here may also hold useful lessons for policy makers seeking to integrate mental health within primary care in other contexts and settings.

  7. Medical students' attitudes towards the primary health care approach

    African Journals Online (AJOL)

    Medical students' attitudes towards the primary health care approach: what are they, how do they change and ... Journal Home > Vol 49, No 2 (2007) > ... The context of the research presented in this article is the new MBChB curriculum at the ...

  8. Barriers and facilitators of adolescent behavioral health in primary care: Perceptions of primary care providers.

    Science.gov (United States)

    Bitar, George W; Springer, Paul; Gee, Robert; Graff, Chad; Schydlower, Manuel

    2009-12-01

    Several major policy reports describe the central role of primary care in improving the delivery of behavioral health care services to children and adolescents. Although primary care providers are uniquely positioned to provide these services, numerous obstacles hinder the integration of these services, including time, clinic management and organization issues, training, and resources. Although many of these obstacles have been described in the literature, few studies have investigated these issues from the first-person perspective of front-line providers. The purpose of this study, therefore, is to provide an in-depth description of primary care providers' attitudes and perceptions of adolescent behavioral health care across a diversity of primary care settings (i.e., Federally Qualified Health Center [FQHC], FQHC-Look Alike, school-based, military). Sixteen focus groups were conducted at 5 primary care clinics. Thematic analysis was used to analyze the focus group data. Obstacles to integration are presented as well as strategies to overcome these challenges, using training and education, working groups, and community collaboratives.

  9. Strengthening of primary health care: Key to deliver inclusive health care

    Directory of Open Access Journals (Sweden)

    Rajiv Yeravdekar

    2013-01-01

    Full Text Available Inequity and poverty are the root causes of ill health. Access to quality health services on an affordable and equitable basis in many parts of the country remains an unfulfilled aspiration. Disparity in health care is interpreted as compromise in ′Right to Life.′ It is imperative to define ′essential health care,′ which should be made available to all citizens to facilitate inclusivity in health care. The suggested methods for this include optimal utilization of public resources and increasing public spending on health care. Capacity building through training, especially training of paramedical personnel, is proposed as an essential ingredient, to reduce cost, especially in tertiary care. Another aspect which is considered very important is improvement in delivery system of health care. Increasing the role of ′family physician′ in health care delivery system will improve preventive care and reduce cost of tertiary care. These observations underlie the relevance and role of Primary health care as a key to deliver inclusive health care. The advantages of a primary health care model for health service delivery are greater access to needed services; better quality of care; a greater focus on prevention; early management of health problems; and cumulative improvements in health and lower morbidity as a result of primary health care delivery.

  10. Mobile health data collection at primary health care in Ethiopia: a feasible challenge.

    Science.gov (United States)

    Medhanyie, Araya Abrha; Moser, Albine; Spigt, Mark; Yebyo, Henock; Little, Alex; Dinant, GeertJan; Blanco, Roman

    2015-01-01

    Feasibility assessment of mobile health (mHealth) data collection at primary health care in Ethiopia. A total of 14 health workers were recruited from 12 primary health care facilities to use smartphones, installed with customized data collection application and electronic maternal health care forms for assessing pregnant women's health for 6 months. Qualitative approaches comprising in-depth interviews and field notes were used to document the users' perception and experience in using the application and forms. All health workers had never had previous exposure to smartphones and electronic forms, but they got used to them easily. Over 6 months, all health workers completed a total of 952 patient records using the forms on smartphones. Health workers' acceptability and demand for the application and forms were high. In introducing the application, nontechnical challenges were more difficult to solve than technical challenges. Introducing an mHealth application at primary health care for routine collection of health data relevant to maternal health at a small scale was feasible. Nonetheless, implementing a system of assigning unique and consistent patient identifier, standardization of health services, and improving mobile network coverage would be prerequisites for scaled-up usage of such an application. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Primary health care in a paediatric setting — the background

    Directory of Open Access Journals (Sweden)

    D.J. Power

    1979-09-01

    Full Text Available At a recent conference, a definition was drawn up that is most appropriate to the South African situation: “ Primary health care is essential health care made universally accessible to individuals and families in the community by means acceptable to them, through their full participation, and at a cost that the community and country can afford. It forms an integral part both of the country’s health system of which it is the nucleus, and of the overall social and economic development of the community.”

  12. Men's health in question: seeking assistance in primary health care

    Directory of Open Access Journals (Sweden)

    Max Moura de Oliveira

    2015-01-01

    Full Text Available The scope of this study was to analyze the socio-demographic profile, morbidity and frequency of seeking of adult men enrolled in a Family Doctor Program for health care in Niterói in the State of Rio de Janeiro. It is a cross-sectional study using secondary data, files and records of the first care visit in November 2003 through August 2009. The frequencies of the variables studied and the prevalence rates among those who sought and those who did not seek attention were calculated. Among the 323 men registered, 56% sought attendance. The main reason given for the first visit was a routine appointment. It was observed that 43 men were overweight, 26 were obese and 44 had abnormal blood pressure. The profile of the men who sought and those who did not seek care presented statistically significant differences (p

  13. Service quality perceptions in primary health care centres in Greece.

    Science.gov (United States)

    Papanikolaou, Vicky; Zygiaris, Sotiris

    2014-04-01

    The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. © 2012 John Wiley & Sons Ltd.

  14. Service quality perceptions in primary health care centres in Greece

    Science.gov (United States)

    Papanikolaou, Vicky; Zygiaris, Sotiris

    2012-01-01

    Abstract Context  The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective  To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy  SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results  The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions  This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. PMID:22296402

  15. A renewed focus on primary health care: revitalize or reframe?

    Directory of Open Access Journals (Sweden)

    Rifkin Susan

    2010-07-01

    Full Text Available Abstract The year 2008 celebrated 30 years of Primary Health Care (PHC policy emerging from the Alma Ata Declaration with publication of two key reports, the World Health Report 2008 and the Report of the Commission on the Social Determinants of Health. Both reports reaffirmed the relevance of PHC in terms of its vision and values in today's world. However, important challenges in terms of defining PHC, equity and empowerment need to be addressed. This article takes the form of a commentary reviewing developments in the last 30 years and discusses the future of this policy. Three challenges are put forward for discussion (i the challenge of moving away from a narrow technical bio-medical paradigm of health to a broader social determinants approach and the need to differentiate primary care from primary health care; (ii The challenge of tackling the equity implications of the market oriented reforms and ensuring that the role of the State in the provision of welfare services is not further weakened; and (iii the challenge of finding ways to develop local community commitments especially in terms of empowerment. These challenges need to be addressed if PHC is to remain relevant in today's context. The paper concludes that it is not sufficient to revitalize PHC of the Alma Ata Declaration but it must be reframed in light of the above discussion.

  16. Primary oral health care: a missing link in public health in Pakistan.

    Science.gov (United States)

    Basharat, S; Shaikh, B T

    2016-12-12

    In Pakistan, the limited availability of oral health care and the high level of unmet oral health care needs are well documented. The recorded prevalence of dental caries is 50-70% and that of oral cancer is among the highest in the world. Although oral health care has been declared to be part of the primary health care system, oral health disparities between rich and poor, and emerging problems of access to and use of appropriate care have never been addressed, reflecting a lack of awareness among both patients and health system decisionmakers. Oral cancer screening and atraumatic restorative treatment for tooth decay could be included in a basic package of oral care that does not require qualified dental surgeons. This article develops an argument, based on literature review and an analysis of the health system in Pakistan, for how a basic oral health programme could be an accessible, affordable and acceptable component of the primary health care system.

  17. Sri Lanka's Health Unit Program: A Model of "Selective" Primary Health Care

    Directory of Open Access Journals (Sweden)

    Soma Hewa

    2011-12-01

    Full Text Available This paper argues that the health unit program developed in Sri Lanka in the early twentieth century was an earlier model of selective primary health care promoted by the Rockefeller Foundation in the 1980s in opposition to comprehensive primary health care advocated by the Alma-Ata Declaration of the World Health Organization. A key strategy of the health unit program was to identify the most common and serious infectious diseases in each health unit area and control them through improved sanitation, health education, immunization and treatment with the help of local communities. The health unit program was later introduced to other countries in South and Southeast Asia as part of the Rockefeller Foundation's global campaign to promote public health.

  18. Danish soldiers in Iraq

    DEFF Research Database (Denmark)

    Nissen, Lars Ravnborg; Marott, Jacob Louis; Gyntelberg, Finn

    2011-01-01

    Using data from an occupational medical health surveillance program, we studied the associations between mental stressors and social support and the two outcome measures postdeployment psychological distress and multiple physical symptoms among Danish soldiers deployed to Iraq. The study was cross...... the assumption that other factors than combat exposure-psychosocial and cultural-are of importance in increasing psychological distress among soldiers deployed to Iraq. Additionally, we have shown that the reporting of multiple physical symptoms among the deployed soldiers is closely related to increased...... psychological discomfort and certain mental stressors....

  19. Connecting Health and Labour: Bringing together occupational health and primary care to improve the health of working people

    NARCIS (Netherlands)

    Ivanov, I.D.; Buijs, P.

    2012-01-01

    The global conference "Connecting Health and Labour: What Role for Occupational health in Primary Health Care?" took place in The Hague from 29 November to 1 December 2011. The conference was organized by WHO in collaboration with TNO Work and Health and the Dutch government and with support from

  20. Connecting Health and Labour: Bringing together occupational health and primary care to improve the health of working people. Executive summary

    NARCIS (Netherlands)

    Anonymous

    2012-01-01

    The global conference "Connecting Health and Labour: What Role for Occupational health in Primary Health Care?" took place in The Hague from 29 November to 1 December 2011. The conference was organized by WHO in collaboration with TNO Work and Health and the Dutch government and with support from

  1. Nurse practitioner caseload in primary health care: Scoping review.

    Science.gov (United States)

    Martin-Misener, Ruth; Kilpatrick, Kelley; Donald, Faith; Bryant-Lukosius, Denise; Rayner, Jennifer; Valaitis, Ruta; Carter, Nancy; Miller, Patricia A; Landry, Véronique; Harbman, Patricia; Charbonneau-Smith, Renee; McKinlay, R James; Ziegler, Erin; Boesveld, Sarah; Lamb, Alyson

    2016-10-01

    To identify recommendations for determining patient panel/caseload size for nurse practitioners in community-based primary health care settings. Scoping review of the international published and grey literature. The search included electronic databases, international professional and governmental websites, contact with experts, and hand searches of reference lists. Eligible papers had to (a) address caseload or patient panels for nurse practitioners in community-based primary health care settings serving an all-ages population; and (b) be published in English or French between January 2000 and July 2014. Level one testing included title and abstract screening by two team members. Relevant papers were retained for full text review in level two testing, and reviewed by two team members. A third reviewer acted as a tiebreaker. Data were extracted using a structured extraction form by one team member and verified by a second member. Descriptive statistics were estimated. Content analysis was used for qualitative data. We identified 111 peer-reviewed articles and grey literature documents. Most of the papers were published in Canada and the United States after 2010. Current methods to determine panel/caseload size use large administrative databases, provider work hours and the average number of patient visits. Most of the papers addressing the topic of patient panel/caseload size in community-based primary health care were descriptive. The average number of patients seen by nurse practitioners per day varied considerably within and between countries; an average of 9-15 patients per day was common. Patient characteristics (e.g., age, gender) and health conditions (e.g., multiple chronic conditions) appear to influence patient panel/caseload size. Very few studies used validated tools to classify patient acuity levels or disease burden scores. The measurement of productivity and the determination of panel/caseload size is complex. Current metrics may not capture

  2. [Primary health care and the millennium development goals].

    Science.gov (United States)

    Faye, A; Bob, M; Fall, A; Fall, C

    2012-01-01

    Member countries of the World Health Organization (WHO) met in Alma Ata (8-12 September 1978) to define and advocate the implementation of primary health care (PHC) worldwide, above all, in developing countries, which had a real need to review their strategies for meeting the health needs of their populations. They did not suspect that 20 years later the vision they displayed would remain undeniably relevant. Here we examine the similarities and points of convergence of their declaration about PHC with the Millennium Development Goals that seek today to reduce poverty across the world. An exhaustive and analytic literature review was conducted to collect those similarities. Further analysis of the definitions, objectives, principles and recommendations of the Alma Ata Declaration and the Millennium Declaration reveals multiple dependencies and fundamental points of similarity between these two representations. Almost all states have pledged to achieve the eight MDG by 2015: to eradicate extreme poverty and hunger, achieve universal primary education, promote gender equality and empower women, reduce child mortality, improve maternal health, combat HIV/AIDS, malaria and other diseases, ensure environmental sustainability, and develop a global partnership for development. The Alma Ata conference defined primary health care as essential health care, based on practical methods and techniques that are both scientifically sound and socially acceptable, universally accessible to all individuals and all families of the community, through their full participation and at a cost that the community and countries can afford at all stages of their development in the spirit of self-reliance and self-determination. It is an integral part of economic and social development. The following principles are involved in the achievement of both primary health care and the MDG: social equity, community participation, and intersectorality. Public health is an essential condition of poverty

  3. A novel index for preoperative, non-invasive prediction of macro-radical primary surgery in patients with stage IIIC-IV ovarian cancer-a part of the Danish prospective pelvic mass study.

    Science.gov (United States)

    Karlsen, Mona Aarenstrup; Fagö-Olsen, Carsten; Høgdall, Estrid; Schnack, Tine Henrichsen; Christensen, Ib Jarle; Nedergaard, Lotte; Lundvall, Lene; Lydolph, Magnus Christian; Engelholm, Svend Aage; Høgdall, Claus

    2016-09-01

    The purpose of this study was to develop a novel index for preoperative, non-invasive prediction of complete primary cytoreduction in patients with FIGO stage IIIC-IV epithelial ovarian cancer. Prospectively collected clinical data was registered in the Danish Gynecologic Cancer Database. Blood samples were collected within 14 days of surgery and stored by the Danish CancerBiobank. Serum human epididymis protein 4 (HE4), serum cancer antigen 125 (CA125), age, performance status, and presence/absence of ascites at ultrasonography were evaluated individually and combined to predict complete tumor removal. One hundred fifty patients with advanced epithelial ovarian cancer were treated with primary debulking surgery (PDS). Complete PDS was achieved in 41 cases (27 %). The receiver operating characteristic curves demonstrated an area under the curve of 0.785 for HE4, 0.678 for CA125, and 0.688 for age. The multivariate model (Cancer Ovarii Non-invasive Assessment of Treatment Strategy (CONATS) index), consisting of HE4, age, and performance status, demonstrated an AUC of 0.853. According to the Danish indicator level, macro-radical PDS should be achieved in 60 % of patients admitted to primary surgery (positive predictive value of 60 %), resulting in a negative predictive value of 87.5 %, sensitivity of 68.3 %, specificity of 83.5 %, and cutoff of 0.63 for the CONATS index. Non-invasive prediction of complete PDS is possible with the CONATS index. The CONATS index is meant as a supplement to the standard preoperative evaluation of each patient. Evaluation of the CONATS index combined with radiological and/or laparoscopic findings may improve the assessment of the optimal treatment strategy in patients with advanced epithelial ovarian cancer.

  4. Mental health care: how can Family Health teams integrate it into Primary Healthcare?

    Science.gov (United States)

    Gryschek, Guilherme; Pinto, Adriana Avanzi Marques

    2015-10-01

    Mental health is one of the responsibilities of Brazil's Family Health system. This review of literature sought to understand what position Mental Health occupies in the practice of the Family Health Strategy. A search was made of the scientific literature in the database of the Virtual Health Library (Biblioteca Virtual de Saúde), for the keywords: 'Mental Health'; 'Family Health'; 'Primary Healthcare'. The criteria for inclusion were: Brazilian studies from 2009 through 2012 that contributed to understanding of the following question: "How to insert Mental health care into the routine of the Family Health Strategy?" A total of 11 articles were found, which identified difficulties and strategies of the professionals in Primary Healthcare in relation to mental health. Referral, and medicalization, were common practices. Matrix Support is the strategy of training and skill acquisition for teams that enables new approaches in mental health in the context of Primary healthcare. It is necessary for Management of the Health System to take an active role in the construction of healthcare networks in mental health.

  5. Reliability of patient-reported functional outcome in a joint replacement registry. A comparison of primary responders and non-responders in the Danish Shoulder Arthroplasty Registry

    DEFF Research Database (Denmark)

    Polk, Anne; Rasmussen, Jeppe V; Brorson, Stig;

    2013-01-01

    Patient-reported outcome measures (PROMs) are used by some arthroplasty registries to evaluate results after surgery, but non-response may bias the results. The aim was to identify a potential bias in the outcome scores of subgroups in a cohort of patients from the Danish Shoulder Arthroplasty...... Registry (DSR) and to characterize non-responders....

  6. Primary Health Care and Cervical Cancer Mortality Rates in Brazil

    Science.gov (United States)

    Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Thomaz, Erika Bárbara Abreu Fonseca; Queiroz, Rejane Christine de Sousa; de Souza, Marta Rovery; Lein, Adriana; Alvares, Viviane; de Almeida, Dante Grapiuna; Barbosa, Allan Claudius Queiroz; Thumé, Elaine; Staton, Catherine; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto

    2017-01-01

    Cervical cancer is a common neoplasm that is responsible for nearly 230 000 deaths annually in Brazil. Despite this burden, cervical cancer is considered preventable with appropriate care. We conducted a longitudinal ecological study from 2002 to 2012 to examine the relationship between the delivery of preventive primary care and cervical cancer mortality rates in Brazil. Brazilian states and the federal district were the unit of analysis (N = 27). Results suggest that primary health care has contributed to reducing cervical cancer mortality rates in Brazil; however, the full potential of preventive care has yet to be realized. PMID:28252500

  7. Telemental health: responding to mandates for reform in primary healthcare.

    Science.gov (United States)

    Myers, Kathleen M; Lieberman, Daniel

    2013-06-01

    Telemental health (TMH) has established a niche as a feasible, acceptable, and effective service model to improve the mental healthcare and outcomes for individuals who cannot access traditional mental health services. The Accountability Care Act has mandated reforms in the structure, functioning, and financing of primary care that provide an opportunity for TMH to move into the mainstream healthcare system. By partnering with the Integrated Behavioral Healthcare Model, TMH offers a spectrum of tools to unite primary care physicians and mental health specialist in a mind-body view of patients' healthcare needs and to activate patients in their own care. TMH tools include video-teleconferencing to telecommute mental health specialists to the primary care setting to collaborate with a team in caring for patients' mental healthcare needs and to provide direct services to patients who are not progressing optimally with this collaborative model. Asynchronous tools include online therapies that offer an efficient first step to treatment for selected disorders such as depression and anxiety. Patients activate themselves in their care through portals that provide access to their healthcare information and Web sites that offer on-demand information and communication with a healthcare team. These synchronous and asynchronous TMH tools may move the site of mental healthcare from the clinic to the home. The evolving role of social media in facilitating communication among patients or with their healthcare team deserves further consideration as a tool to activate patients and provide more personalized care.

  8. Can health care teams improve primary care practice?

    Science.gov (United States)

    Grumbach, Kevin; Bodenheimer, Thomas

    2004-03-10

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

  9. Comprehensive primary health care under neo-liberalism in Australia.

    Science.gov (United States)

    Baum, Fran; Freeman, Toby; Sanders, David; Labonté, Ronald; Lawless, Angela; Javanparast, Sara

    2016-11-01

    This paper applies a critical analysis of the impact of neo-liberal driven management reform to examine changes in Australian primary health care (PHC) services over five years. The implementation of comprehensive approaches to primary health care (PHC) in seven services: five state-managed and two non-government organisations (NGOs) was tracked from 2009 to 2014. Two questions are addressed: 1) How did the ability of Australian PHC services to implement comprehensive PHC change over the period 2009-2014? 2) To what extent is the ability of the PHC services to implement comprehensive PHC shaped by neo-liberal health sector reform processes? The study reports on detailed tracking and observations of the changes and in-depth interviews with 63 health service managers and practitioners, and regional and central health executives. The documented changes were: in the state-managed services (although not the NGOs) less comprehensive service coverage and more focus on clinical services and integration with hospitals and much less development activity including community development, advocacy, intersectoral collaboration and attention to the social determinants. These changes were found to be associated with practices typical of neo-liberal health sector reform: considerable uncertainty, more directive managerial control, budget reductions and competitive tendering and an emphasis on outputs rather than health outcomes. We conclude that a focus on clinical service provision, while highly compatible with neo-liberal reforms, will not on its own produce the shifts in population disease patterns that would be required to reduce demand for health services and promote health. Comprehensive PHC is much better suited to that task.

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

    Directory of Open Access Journals (Sweden)

    Nikki ePercival

    2016-03-01

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

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    In Tanzania access to urban and rural primary health care is relatively widespread, yet there is evidence of considerable bypassing of services; questions have been raised about how to improve functionality.The aim of this study was to explore the experiences of health workers working in the prim......In Tanzania access to urban and rural primary health care is relatively widespread, yet there is evidence of considerable bypassing of services; questions have been raised about how to improve functionality.The aim of this study was to explore the experiences of health workers working...

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

    Science.gov (United States)

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

    2017-01-20

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

  13. Prevalence of health promotion programs in primary health care units in Brazil

    Science.gov (United States)

    Ramos, Luiz Roberto; Malta, Deborah Carvalho; Gomes, Grace Angélica de Oliveira; Bracco, Mário M; Florindo, Alex Antonio; Mielke, Gregore Iven; Parra, Diana C; Lobelo, Felipe; Simoes, Eduardo J; Hallal, Pedro Curi

    2014-01-01

    OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil. PMID:25372175

  14. The Danish East India Company

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    2005-01-01

    The article analysis the first Danish East India Company incorporated in 1616, which was the first Danish Stock Company and which has impacts even on modern Danish company la......The article analysis the first Danish East India Company incorporated in 1616, which was the first Danish Stock Company and which has impacts even on modern Danish company la...

  15. The Danish Neuro-Oncology Registry

    DEFF Research Database (Denmark)

    Hansen, Steinbjørn

    2016-01-01

    AIM OF DATABASE: The Danish Neuro-Oncology Registry (DNOR) was established by the Danish Neuro-Oncology Group as a national clinical database. It was established for the purpose of supporting research and development in adult patients with primary brain tumors in Denmark. STUDY POPULATION: DNOR has...... advantage of reporting indicators is the related multidisciplinary discussions giving a better understanding of what actually is going on, thereby facilitating the work on adjusting the national guidelines in the Danish Neuro-Oncology Group. CONCLUSION: The establishment of DNOR has optimized the quality...

  16. Strengthening integrated primary health care in Sofala, Mozambique.

    Science.gov (United States)

    Sherr, Kenneth; Cuembelo, Fatima; Michel, Cathy; Gimbel, Sarah; Micek, Mark; Kariaganis, Marina; Pio, Alusio; Manuel, João Luis; Pfeiffer, James; Gloyd, Stephen

    2013-01-01

    health impact. The Mozambique PHIT Partnership expects to provide evidence on the effect of efforts to improve data quality coupled with the introduction of tools, training, and supervision to improve evidence-based decision making. This contribution to the knowledge base on what works to enhance health systems is highly replicable for rapid scale-up to other provinces in Mozambique, as well as other sub-Saharan African countries with limited resources and a commitment to comprehensive primary health care.

  17. Connecting Primary Health Care: A Comprehensive Pilot Study

    Directory of Open Access Journals (Sweden)

    Mehran Maghsoudloo

    2016-07-01

    Full Text Available The collection of data within the primary health care facilities in Iran is essentially paper-based. It is focused on family’s health, monitoring of non-infectious and infectious diseases. Clearly due to the paper-based nature of the tasks, timely decision making at most can be difficult if not impossible. As part of an on-going electronic health record implementation project at Tehran University of Medical Sciences, for the first time in the region, based on a comprehensive pilot project, four urban healthcare facilities are connected to their headquarters and beyond, covering all aspects of primary health care, for the last four years. Without delving into the technical aspects of its software engineering processes, the progress of the implementation is reported, selection of summarized data is presented, and experience gained thus far are discussed. Four years passed and if time is any important reason to go by, then it is safe to accept that the software architecture and electronic health record structural model implemented are robust and yet extensible. Aims and duration of a pilot study should be clearly defined prior to start and managed till its completion. Resistance to change and particularly to information technology, apart from its technical aspects, is also based on human factors.

  18. Bullying involvement in primary school and common health problems

    OpenAIRE

    Wolke, D; Woods, S; Bloomfield, L; Karstadt, L

    2001-01-01

    AIMS—To examine the association of direct (e.g. hitting) and relational (e.g. hurtful manipulation of peer relationships) bullying experience with common health problems.
METHODS—A total of 1639 children (aged 6-9 years) in 31 primary schools were studied in a cross sectional study that assessed bullying with a structured child interview and common health problems using parent reports. Main outcome measures were common physical (e.g. colds/coughs) and psychosomatic (e.g. ...

  19. Knowledge and attitudes of primary health care personnel concerning mental health problems in developing countries.

    Science.gov (United States)

    Ignacio, L L; de Arango, M V; Baltazar, J; Busnello, E D; Climent, C E; Elhakim, A; Farb, M; Guèye, M; Harding, T W; Ibrahim, H H; Murthy, R S; Wig, N N

    1983-01-01

    A semi-structured interview for assessing the knowledge and attitude of health workers concerning mental health problems was applied in seven developing country areas within the context of a World Health Organization coordinated collaborative study. The results indicate a lack of basic mental health training associated with a failure to recognize mental health problems, restricted knowledge concerning psychotropic drug therapy, and an inability to visualize practical forms of mental health care which could be introduced at primary care level. The results were used to design appropriate training programs, and the observations will be repeated to assess the effectiveness of training. PMID:6881406

  20. Nurses’ perceptions on nursing supervision in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Beatriz Francisco Farah

    2016-01-01

    Full Text Available Objective: to understand the perceptions of nurses on nursing supervision in the work process. Methods: this is a qualitative research, with a semi-structured interview, performed with 16 nurses. Data analysis was performed through content analysis. Results: two meanings topics emerged from the speeches of the participants: Nurses´ activities in Primary Health Care Units and Nurses´ perceptions about nursing supervision. In the first category, the actions listed were filling out forms and reports under the supervision of the nursing service. In the second category, supervision was perceived as a function of management and follow-up of the activities planned by the team, in opposition to the classical supervision concept, which is inspecting. Conclusion: nursing supervision has been configured for primary care nurses as an administrative function that involves planning, organization, coordination, evaluation, follow-up and support for the health team.

  1. [Social representations on aging by primary care health workers].

    Science.gov (United States)

    Mendes, Cristina Katya Torres Teixeira; Alves, Maria do Socorro Costa Feitosa; Silva, Antonia Oliveira; Paredes, Maria Adelaide Silva; Rodrigues, Tatyanni Peixoto

    2012-09-01

    The objective of this study was to get to know the social representations on aging developed by primary care health workers. This is an exploratory study involving 204 primary health care workers, in the city of João Pessoa, in the state of Paraíba. For data collection we used a semi-structured interview. The data obtained from 204 interviews was analyzed with the help of the Alceste software version 2010. The results indicated five classes or categories: vision of aging,psychosocial dimensions, a time of doubts, aging as a process, and aging versus disease, with positive content: joy, care, children, retirement, caregiver rights, maturity and wisdom, as well as negative factors: impairments, decadence, neglect, fragility, limitation, wrinkles, dependency and disease. It was observed that these meanings associated with aging express the need for total and humanized elderly care.

  2. Digital Media for Primary Health Care in Austria.

    Science.gov (United States)

    Kriegel, Johannes; Tuttle-Weidinger, Linda; Reckwitz, Luise

    2017-01-01

    Primary health care (PHC) is currently being improved in all developed industries. The aim is to make healthcare more patient-centered and close to the patient's place of residence. In addition to the organizational and interdisciplinary reorientation, the use of digital media is increasingly being emphasized. Through literature research and an online survey among Austrian doctors and general practitioners, the current and future challenges for the use of digital media in networked and regional primary health care were identified and prioritized. It becomes clear that basic functions like documentation, communication and coordination in the individual medical practice are at the forefront. In the future it will be necessary to support regional and interprofessional networking through digital media.

  3. Cervical cancer screening in primary health care setting in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Aro, Arja R.; Rasch, Vibeke;

    2012-01-01

    OBJECTIVE: To determine the feasibility of visual inspection with the use of acetic acid (VIA) as a screening method for cervical cancer, an alternative to the Pap smear used in primary health care setting in Sudan, and to compare sensitivity, specificity, positive and negative predictive values....../119 (73.9%) were positive for cervical intraepithelial neoplasia. VIA had higher sensitivity than Pap smear (74.2% versus 72.9%; P = 0.05) respectively. Out of 88 confirmed positive cases, 22 (25.0%) cases were invasive cervical cancer in stage 1, of which 19 versus three were detected by VIA and Pap...... of this study showed that VIA has higher sensitivity and lower specificity compared to Pap smear, but a combination of both tests has greater sensitivity and specificity than each test independently. It indicates that VIA is useful for screening of cervical cancer in the primary health care setting in Sudan...

  4. The Army Primary Health Care Service: from foundation to future.

    Science.gov (United States)

    Burgess, J

    2010-09-01

    Following the British Government's implementation of policies to improve quality and introduce clinical governance into healthcare delivery in the late 1990s, the British Army commissioned a study into how primary healthcare for the Regular Army should best be delivered in UK. The study recommended a unitary command structure, with more central control based upon a model of a main headquarters and seven regions. The change has been largely successful and has been subject to external scrutiny. Areas still to be developed include improving information management and benchmarking standards against the NHS, improvements in practice management, plus developments in occupational health and the nursing cadres. The forthcoming Strategic Defence and Security Review and other ongoing studies are likely to have a profound influence on how the current Army Primary Health Care Service develops.

  5. A A common symptom in primary health care: The cough

    Directory of Open Access Journals (Sweden)

    Halil Akbulut

    2015-08-01

    Full Text Available Cough is the common symptom consulted by primary health care providers. Although treatment of cough is usually simple, healing period could be longer if it diagnosed wrong. Basicly cough divide into two groups; acute and chronic. While the most common cause of acute cough is upper respiratory tract infections, causes of chronic cough are allergic rihinitis, chronic sinusitis, asthma and gastroeosefageal reflux diseases. Nonetheless cough could be the clinical evidence of highly mortal diseases like pulmonary embolism, tuberculosis and lung cancer. Consequently patients with cough symptom must be evaluated delicately and essential follow up protocol must be planned by primary health care providers. [TAF Prev Med Bull 2015; 14(4.000: 333-337

  6. Danish National Lymphoma Registry

    Directory of Open Access Journals (Sweden)

    Arboe B

    2016-10-01

    Full Text Available Bente Arboe,1 Pär Josefsson,2 Judit Jørgensen,3 Jacob Haaber,4 Paw Jensen,5 Christian Poulsen,6 Dorthe Rønnov-Jessen,7 Robert S Pedersen,8 Per Pedersen,9 Mikael Frederiksen,10 Michael Pedersen,1 Peter de Nully Brown1 1Department of Hematology, Copenhagen University Hospital, Rigshospitalet, 2Department of Hematology, Copenhagen University Hospital, Herlev Hospital, Copenhagen, 3Department of Hematology, Aarhus University Hospital, Aarhus, 4Department of Hematology, Odense University Hospital, Odense, 5Department of Hematology, Aalborg University Hospital, Aalborg, 6Department of Hematology, Roskilde Hospital, Roskilde, 7Department of Hematology, Vejle Hospital, Vejle, 8Department of Hematology, Holstebro Hospital, Holstebro, 9Department of Hematology, Esbjerg Hospital, Esbjerg, 10Department of Hematology, Haderslev Hospital, Haderslev, Denmark Aim of database: The Danish National Lymphoma Registry (LYFO was established in order to monitor and improve the diagnostic evaluation and the quality of treatment of all lymphoma patients in Denmark. Study population: The LYFO database was established in 1982 as a seminational database including all lymphoma patients referred to the departments of hematology. The database became nationwide on January 1, 2000. Main variables: The main variables include both clinical and paraclinical variables as well as details of treatment and treatment evaluation. Up to four forms are completed for each patient: a primary registration form, a treatment form, a relapse form, and a follow-up form. Variables are used to calculate six result quality indicators (mortality 30 and 180 days after diagnosis, response to first-line treatment, and survival estimates 1, 3, and 5 years after the time of diagnosis, and three process quality indicators (time from diagnosis until the start of treatment, the presence of relevant diagnostic markers, and inclusion rate in clinical protocols. Descriptive data: Approximately 23

  7. Oral health technicians in Brazilian primary health care: potentials and constraints.

    Science.gov (United States)

    Aguiar, Dulce Maria Lucena de; Tomita, Nilce Emy; Machado, Maria de Fátima Antero Sousa; Martins, Cleide Lavieri; Frazão, Paulo

    2014-07-01

    Different perspectives on the role of mid-level workers in health care might represent a constraint to health policies. This study aimed to investigate how different agents view the participation of oral health technicians in direct activities of oral healthcare with the goal of understanding the related symbolic dispositions. Theoretical assumptions related to inter-professional collaboration and conflicts in the field of healthcare were used for this analysis. A researcher conducted 24 in-depth interviews with general dental practitioners, oral health technicians and local managers. The concepts of Pierre Bourdieu supported the data interpretation. The results indicated inter-professional relations marked by collaboration and conflict that reflect an action space related to different perspectives of primary care delivery. They also unveiled the symbolic devices related to the participation of oral health technicians that represent a constraint to the implementation of oral health policy, thus reducing the potential of primary health care in Brazil.

  8. [Primary Health Care in the coordination of health care networks: an integrative review].

    Science.gov (United States)

    Rodrigues, Ludmila Barbosa Bandeira; Silva, Patricia Costa Dos Santos; Peruhype, Rarianne Carvalho; Palha, Pedro Fredemir; Popolin, Marcela Paschoal; Crispim, Juliane de Almeida; Pinto, Ione Carvalho; Monroe, Aline Aparecida; Arcêncio, Ricardo Alexandre

    2014-02-01

    Health systems organized in health care networks and coordinated by Primary Health Care can contribute to an improvement in clinical quality with a positive impact on health outcomes and user satisfaction (by improving access and resolubility) and a reduction in the costs of local health systems. Thus, the scope of this paper is to analyze the scientific output about the evidence, potential, challenges and prospects of Primary Health Care in the coordination of Health Care Networks. To achieve this, the integrative review method was selected covering the period between 2000 and 2011. The databases selected were Medline (Medical Literature Analysis and Retrieval System online), Lilacs (Latin American Literature in Health Sciences) and SciELO (Scientific Electronic Library Online). Eighteen articles fulfilled the selection criteria. It was seen that the potential impacts of primary care services supersede the inherent weaknesses. However, the results revealed the need for research with a higher level of classification of the scientific evidence about the role of Primary Healh Care in the coordination of Health Care Networks.

  9. Evaluation of the OSCE in the primary health care situation

    Directory of Open Access Journals (Sweden)

    P.M. Garde

    1984-09-01

    Full Text Available The traditional methods of examination by long written questions, case presentations and orals have given rise to difficulties with both candidates and examiners, especially when they have been inexperienced and untrained. The new method of examination as described by the Medical School of the University of Cape Town, the Objective Structured Clinical Examination (OSCE, was therefore evaluated in the KwaZulu Primary Health Care (PHC nursing examinations in February, 1984.

  10. BREASTFEEDING PRACTICE AMONG WOMEN ATTENDING PRIMARY HEALTH CENTERS IN RIYADH

    OpenAIRE

    Al-Amoud, Maysoon M.

    2003-01-01

    Objectives: (1) To study the patterns of breastfeeding of last children, duration, factors and reasons for it. (2) To study the factors affecting breastfeeding among mothers who are breastfeeding and the reasons for continuing or failure to continue, at the primary health care centers (PHC) in Riyadh. Method: A cross-sectional study was conducted by distributing 1000 questionnaires in 10 PHC centers. The breastfeeding practices were categorized on WHO terms. Results: Most of the studied last ...

  11. Self-rated health in patients with mild Alzheimer's disease: baseline data from the Danish Alzheimer Intervention Study

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Nielsen, Anni B S; Waldemar, Gunhild

    2010-01-01

    , but the validity and the influence on other factors on SRH among cognitively impaired persons remain unknown. This study reports how patients with mild Alzheimer's disease (AD) report SRH and which factors influence SRH. The study was based on baseline data from 321 home living patients with mild AD who...... participated in the Danish Alzheimer Intervention Study (DAISY). Analysis using the generalized estimating equation (GEE) models revealed that good/excellent SRH among patients with mild AD were associated with longer education, lack of other chronic conditions, higher scores of quality of life (QOL), lower...

  12. Recruited into Danishness?

    DEFF Research Database (Denmark)

    Lapina, Linda

    2017-01-01

    This article critically examines emergence of Danishness via an autoethnography of passing as Danish. Drawing on feminist scholarship, the author conceptualizes passing as an embodied, affective and discursive relation; simultaneously spontaneous and laboured, fleeting and solid, emergent and con...

  13. Diagnosis of Asthma in Primary Health Care: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Karin C. Ringsberg

    2014-01-01

    Full Text Available Some patients with an asthma diagnosis have a poor controlled asthma. One explanation may be an incorrect diagnosis. Aim. The aim of the study was to diagnose and classify patients with non-infectious lower respiratory tract problems in primary health care using internationally applied diagnostic criteria and diagnostic tests. Patients and Methods. New adult patients visiting a primary health care centre due to lower airway problems were included. The diagnostic tests included FEV1, FVC, PEF, two questionnaires, methacholine test, and skin prick test. Results. The patients (n=43 could be divided into four groups: asthma (28%, asthma-like disorder (44%, idiopathic cough (12%, and a nonreversible bronchial obstructive group (16%. The asthma and asthma-like groups showed similar patterns of airway symptoms and trigger factors, not significantly separated by a special questionnaire. Phlegm, heavy breathing, chest pressure/pain, cough, and wheezing were the most common symptoms. Physical exercise and scents were the dominating trigger factors. Conclusions. Nonobstructive asthma-like symptoms seem to be as common as bronchial asthma in primary health care. Due to the similarities in symptoms and trigger factors the study supports the hypothesis that asthma and nonobstructive asthma-like disorders are integrated in the same “asthma syndrome,” including different mechanisms, not only bronchial obstruction.

  14. Danish translation and validation of the Oslo Sports Trauma Research Centre questionnaires on overuse injuries and health problems

    DEFF Research Database (Denmark)

    Jorgensen, J. E.; Rathleff, C. R.; Rathleff, Michael Skovdal;

    2016-01-01

    The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O) and the Oslo Sports Trauma Research Centre questionnaire on Health Problems (The OSTRC-H) make it possible to monitor illness and injury at regular intervals capturing prevalence and incidence of acute injury, overuse...... respondents; response rate was 89%. The OSTRC-H was distributed to 58 heterogenous respondents; response rate was 86%. No major disagreements were observed between the original and translated versions of the questionnaires. The OSTRC-O had high internal consistency (Cronbach's alpha 0.80-0.93). The primary...... reliability analyses including all participants, showed reliability ICC: 0.62 (95% CI: 0.42-0.77. The secondary reliability analyses that only included subjects who did not change injury region from the test to the retest showed an ICC of 0.86 (95% CI: 0.77-0.92).The questionnaires were found to be valid...

  15. Feeding, feedback and sustenance of primary health care.

    Science.gov (United States)

    Rohde, J E; Northrup, R S

    1988-01-01

    The neglect of nutrition in primary health care is widespread despite the severity of malnutrition in the world today. Some of the reasons for this situation include a lack of definition, i.e. nutrition is considered a continuous daily need, not a health intervention; it is often a difficult task to solicit participation from the mothers; nutrition is often not an acutely felt need, thus there is no demand; nutrition requires continuous action on a daily basis, but produces no visible results; and finally actions aimed at malnutrition or even its prevention often do not seem to work. Nutrition interventions often do not work because the interventions come too late, often when permanent stunting of the child's growth has already occurred. Since inadequate nutrition can not be seen in the early stages, growth monitoring can be used as a feedback mechanism to stimulate appropriate feeding responses. For a mother to become involved in growth monitoring 4 elements are necessary: 1) she must be aware of the problem or situation, 2) she must be motivated to respond, 3) she must have the knowledge and skills of how to feed, what to feed, and when to feed, and 4) She must have the means to act, i.e. food must be available to give the child. Many growth monitoring programs have failed because the mother was not involved, and never perceives the problem, therefore she never acts. If growth monitoring is integrated into the primary health care system, it also becomes a regular time for health education in other topics. Disease and death are more often found in children who are malnourished, thus primary health care interventions are likely to be more effective in the presence of effective nutrition interventions.

  16. Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel – a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Hansen Claus D

    2012-07-01

    Full Text Available Abstract Background Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel. Methods Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691 and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. Results Ambulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%. Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%. The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality. Conclusions Ambulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal

  17. Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel – a cross-sectional study

    Science.gov (United States)

    2012-01-01

    Background Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel. Methods Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. Results Ambulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality. Conclusions Ambulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence

  18. Danish dental education:

    DEFF Research Database (Denmark)

    Moore, Rod

    1985-01-01

    The effects of Danish cultural traditions on dental education in Denmark are described, as well as the system's current structure and developing issues. Some Danish ideas for future exports of dental education programs and dental personnel are also discussed.......The effects of Danish cultural traditions on dental education in Denmark are described, as well as the system's current structure and developing issues. Some Danish ideas for future exports of dental education programs and dental personnel are also discussed....

  19. Danish dental education:

    DEFF Research Database (Denmark)

    Moore, Rod

    1985-01-01

    The effects of Danish cultural traditions on dental education in Denmark are described, as well as the system's current structure and developing issues. Some Danish ideas for future exports of dental education programs and dental personnel are also discussed.......The effects of Danish cultural traditions on dental education in Denmark are described, as well as the system's current structure and developing issues. Some Danish ideas for future exports of dental education programs and dental personnel are also discussed....

  20. The ethics of complex relationships in primary care behavioral health.

    Science.gov (United States)

    Reiter, Jeff; Runyan, Christine

    2013-03-01

    Primary care settings are particularly prone to complex relationships that can be ethically challenging. This is due in part to three of the distinctive attributes of primary care: a whole family orientation; team-based care; and a longitudinal care delivery model. In addition, the high patient volume of primary care means that the likelihood of encountering ethically challenging relationships is probably greater than in a specialty setting. This article argues that one ethical standard of the American Psychological Association (APA, 2010, Ethical principles of psychologists and code of conduct, www.apa.org/ethics/code) (10.02, Therapy Involving Couples or Families) should be revised to better accommodate the work of psychologists in primary care. The corresponding Principles of Medical Ethics from the American Medical Association (AMA, 2012, Code of medical ethics: Current opinions with annotations, 2012-2013, Washington, DC: Author), most notably the principle regarding a physician's duty to "respect the rights of patients, colleagues, and other health professionals as well as safeguard privacy" are also noted. In addition, the article details how the three attributes of primary care often result in complex relationships, and provides suggestions for handling such relationships ethically.

  1. The Danish Centre for Strategic Research in Type 2 Diabetes (DD2)

    DEFF Research Database (Denmark)

    Thomsen, Reimar Wernich; Friborg, Søren; Nielsen, Jens Steen

    2012-01-01

    This paper provides a short overview of the Danish health care system and the organization of care for type 2 diabetes patients in Denmark. It also describes the supplementary data sources that are used for collection of baseline data in the nationwide Danish Centre for Strategic Research in Type 2...... form the basis for recruiting diabetes patients in the DD2 project, and the data sources that these providers use in clinical practice give access to important supplementary patient data. The DD2's patient-enrollment system is designed to be fast and simple, and thus only collects primary interview...... data that cannot be extracted from already existing data sources. Thus, in addition to an online DD2 questionnaire filled out by general practitioners and hospital physicians at the time of patient enrollment, supplementary data are obtained from the Danish Diabetes Database for Adults, a nationwide...

  2. Treatment for hepatitis B virus (HBV) and hepatitis C virus (HCV) infection - Danish national guidelines 2011

    DEFF Research Database (Denmark)

    Christensen, Peer Brehm; Clausen, Mette Rye; Krarup, Henrik Bygum;

    2012-01-01

    The Danish Society of Infectious Diseases and Danish Society of Gastroenterology and Hepatology set up a committee in 2007 to produce national guidelines for treatment of viral hepatitis B and C. The 2011 version of the guidelines have been endorsed by the scientific societies and are presented...... is not common in Denmark. The prevalence has not been determined by national surveys, but it is estimated that 10,000-15,000 patients are chronically infected with hepatitis B and 15,000-20,000 with chronic hepatitis C. The majority of patients with HBV infection in Denmark are emigrants from high endemic...... for their chronic viral hepatitis. Clinical care: According to the Danish National Board of Health, patients with chronic viral hepatitis should be followed with regular intervals, at clinics specialized in either infectious diseases or gastroenterology/hepatology. The primary aim is to identify patients...

  3. The Danish Welfare Commission

    DEFF Research Database (Denmark)

    Gjerding, Allan Næs

    2006-01-01

    The paper deals with the main report of the Danish Welfare Commission and the one-hundred-and-nine proposals on the structure of the future Danish welfare state that the com-mission has put forward. Following upon a brief review of the discussion on the work of the Danish Welfare Commission...

  4. Health promotion in pediatric primary care: importance of health literacy and communication practices.

    Science.gov (United States)

    Davis, Deborah Winders; Jones, V Faye; Logsdon, M Cynthia; Ryan, Lesa; Wilkerson-McMahon, Mandie

    2013-12-01

    Health literacy has been shown to predict health behaviors and outcomes above the effects of education or socioeconomic status. Much remains unknown about the health literacy of parents and the role it plays in children's health outcomes or in health disparities. The current study explored the health communication needs and health literacy indicators in a diverse sample of parents (n = 75) to identify potential areas for future interventions. The sample consisted of parents of children 18 to 36 months old who were visiting 3 different pediatric medical offices, 2 of which served low-income families and 1 located in an affluent suburb. When comparisons were made between 2 educational attainment groups, there were variations in indicators of health literacy and health communication needs. These data can be used to guide the development of interventions by primary care providers to improve parent education.

  5. Indoor environment and pupils' health in primary schools

    DEFF Research Database (Denmark)

    van Dijken, F.; van Bronswijk, J.E.M.H.; Sundell, Jan

    2006-01-01

    the associations between indoor environmental quality in Dutch schools and pupils' health, also taking into account the children's home environment and personal factors. A cross-sectional study was performed in 11 classrooms in 11 different schools in the Netherlands. The study included exposure measurements......Dutch children are legally bound to spend 15% of their time in a school setting. The indoor environment in Dutch primary schools is known to be substandard. However, it is unclear to what extent the health of pupils is affected by the indoor school environment. The paper aims to assess......, building inspections, and a questionnaire survey on pupils' health and domestic exposure. Principal Component Analysis (PCA) and non-parametric tests were performed to assess relationships. None of the schools complied with all indoor environmental quality standards. The importance of both the school...

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

    Science.gov (United States)

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

    1994-01-01

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

  7. [The Danish Debate on Priority Setting in Medicine--An Update].

    Science.gov (United States)

    Pornak, S C; Raspe, H

    2015-09-01

    In the last years, the Danish debate about priority setting in medicine has gained new strength. This paper shows the main focuses of the current discussion based on a research of Danish primary literature. For the first time since the 1990s the Danish Council of Ethics has been involved with priority setting in medicine in a project running from 2011 to 2013. The Council emphasises the importance of legitimate processes and calls for visible values and criteria. A focus of the debate is how to deal with new expensive drugs. Politicians, physicians, health economists and the Council of Ethics have called for a national institution for priority setting in medicine. They have mainly looked to the Norwegian National Council for Priority Setting in Health Care and the British National Institute for Health and Care Excellence for inspiration. The Danish Government considered establishing a national institute for priority setting, but the plans were not put into practice. In the year 2012 a new national project was launched to create clinical guidelines. Danish doctors welcome the guidelines as a good basis for priority setting. Just like in earlier Danish priority setting debates, a coordinating institution is lacking to bundle the discussion and keep it going. The debate seems to have come to an end once again. The fact that it was seriously considered to establish an institute for priority setting is a new development. It can be expected that the discussion will be resumed in the near future, possibly the idea of an institute for priority setting will be readopted. The general conditions for priority setting in health care have improved.

  8. Multidisciplinary Practice Experience of Nursing Faculty and Their Collaborators for Primary Health Care in Korea

    Directory of Open Access Journals (Sweden)

    Mi Ja Kim, PhD, RN, FAAN

    2008-03-01

    Conclusion: Teamwork should be included in all health professions' curricula, and nursing clinical practicums should include primary health care in all specialty areas. More faculties should engage in multidisciplinary primary health care. The benefits of a multidisciplinary approach to primary health care outweigh the difficulties experienced by multidisciplinary team members. The findings of this study may be useful for future multidisciplinary primary health care work worldwide.

  9. Primary health care research in Bolivia: systematic review and analysis.

    Science.gov (United States)

    Alvarez, Francisco N; Leys, Mart; Mérida, Hugo E Rivera; Guzmán, Giovanni Escalante

    2016-02-01

    Bolivia is currently undergoing a series of healthcare reforms centred around the Unified Family, Community and Intercultural Health System (SAFCI), established in 2008 and Law 475 for Provision of Comprehensive Health Services enacted in 2014 as a first step towards universal health coverage. The SAFCI model aims to establish an intercultural, intersectoral and integrated primary health care (PHC) system, but there has not been a comprehensive analysis of effective strategies towards such an end. In this systematic review, we analyse research into developing PHC in Bolivia utilizing MEDLINE, the Virtual Health Library and grey literature from Pan American Health Organization/World Health Organization's internal database. We find that although progress has been made towards implementation of a healthcare system incorporating principles of PHC, further refining the system and targeting improvements effectively will require increased research and evaluation. Particularly in the 7 years since establishment of SAFCI, there has been a dearth of PHC research that makes evaluation of such key national policies impossible. The quantity and quality of PHC research must be improved, especially quasi-experimental studies with adequate control groups. The infrastructure for such studies must be strengthened through improved financing mechanisms, expanded institutional capacity and setting national research priorities. Important for future progress are improved tracking of health indicators, which in Bolivia are often out-of-date or incomplete, and prioritization of focused national research priorities on relevant policy issues. This study aims to serve as an aid towards PHC development efforts at the national level, as well as provide lessons for countries globally attempting to build effective health systems accommodating of a multi-national population in the midst of development.

  10. Primary Health Care Reform in Portugal: Portuguese, modern and innovative.

    Science.gov (United States)

    Biscaia, André Rosa; Heleno, Liliana Correia Valente

    2017-03-01

    The 2005 Portuguese primary health care (CSP) reform was one of the most successful reforms of the country's public services. The most relevant event was the establishment of Family Health Units (USF): voluntary and self-organized multidisciplinary teams that provide customized medical and nursing care to a group of people. Then, the remaining realms of CSP were reorganized with the establishment of Health Center Clusters (ACeS). Clinical governance was implemented aiming at achieving health gains by improving quality and participation and accountability of all. This paper aims to characterize the 2005 reform of Portuguese CSP with an analysis of its systemic and local realms. This is a case study of a CSP reform of a health system with documentary analysis and description of one of its facilities. This reform was Portuguese, modern and innovative. Portuguese by not breaking completely with the past, modern because it has adhered to technology and networking, and innovative because it broke with the traditional hierarchized model. It fulfilled the goal of a reform: it achieved improvements with greater satisfaction of all and health gains.

  11. Maternal protein intake in pregnancy and offspring metabolic health at age 9-16 y: results from a Danish cohort of gestational diabetes mellitus pregnancies and controls

    DEFF Research Database (Denmark)

    Maslova, Ekaterina; Hansen, Susanne; Grunnet, Louise Groth

    2017-01-01

    in free-living populations remains limited.Objective: We examined the association of protein intake in pregnancy with offspring metabolic health at age 9-16 y in a longitudinal cohort that oversampled pregnancies with gestational diabetes mellitus (GDM).Design: Six hundred eight women with an index...... pregnancy affected by gestational diabetes mellitus and 626 controls enrolled in the Danish National Birth Cohort were used for the analysis. Protein (total, animal, vegetable) intake was assessed by using a food frequency questionnaire in gestational week 25. The offspring underwent a clinical examination...... including fasting blood samples and a dual-energy X-ray absorptiometry scan (subset of 650) from which metabolic outcomes were derived. Multivariable analyses were conducted applying a 1: 1 substitution of carbohydrates for protein.Results: The mean +/- SD protein intake in pregnancy was 93 +/- 15 g/d (16...

  12. Comparison of psychiatric disability on the health of nation outcome scales (HoNOS) in resettled traumatized refugee outpatients and Danish inpatients

    DEFF Research Database (Denmark)

    Palic, Sabina; Kappel, Michelle; Nielsen, Monica

    2014-01-01

    BACKGROUND: Currently, the mental health issues of traumatized refugees are mainly documented in terms of posttraumatic stress disorder, depression, and anxiety. Importantly, there are no reports of the level of psychiatric disability in treatment seeking traumatized refugees resettled in the West...... and social domains. The rate of pre- to post-treatment improvement on the HoNOS was smaller for the traumatized refugees than it was for the psychiatric inpatients. CONCLUSIONS: The level, and the versatile profile, of psychiatric disability on the HoNOS point to complex bio-psycho-social problems....... Insufficient acknowledgment of the collective load of bio-psycho-social problems in this patient group hinders effective psychiatric and social service utilization outside the specialized clinics for traumatized refugees. METHODS: The level of psychiatric disability in traumatized refugees from Danish...

  13. Primary Health Care: care coordinator in regionalized networks?

    Science.gov (United States)

    Almeida, Patty Fidelis de; Santos, Adriano Maia Dos

    2016-12-22

    To analyze the breadth of care coordination by Primary Health Care in three health regions. This is a quantitative and qualitative case study. Thirty-one semi-structured interviews with municipal, regional and state managers were carried out, besides a cross-sectional survey with the administration of questionnaires to physicians (74), nurses (127), and a representative sample of users (1,590) of Estratégia Saúde da Família (Family Health Strategy) in three municipal centers of health regions in the state of Bahia. Primary Health Care as first contact of preference faced strong competition from hospital outpatient and emergency services outside the network. Issues related to access to and provision of specialized care were aggravated by dependence on the private sector in the regions, despite progress observed in institutionalizing flows starting out from Primary Health Care. The counter-referral system was deficient and interprofessional communication was scarce, especially concerning services provided by the contracted network. Coordination capacity is affected both by the fragmentation of the regional network and intrinsic problems in Primary Health Care, which poorly supported in its essential attributes. Although the health regions have common problems, Primary Health Care remains a subject confined to municipal boundaries. Analisar o alcance da coordenação do cuidado pela Atenção Primária à Saúde em três regiões de saúde. Trata-se de estudo de caso, com abordagem quantitativa e qualitativa. Foram realizadas 31 entrevistas semiestruturadas com gestores municipais, regionais e estaduais e estudo transversal com aplicação de questionários para médicos (74), enfermeiros (127) e amostra representativa de usuários (1.590) da Estratégia Saúde da Família em três municípios-sede de regiões de saúde do estado da Bahia. A função de porta de entrada preferencial pela Atenção Primária à Saúde deparava-se com forte concorrência de servi

  14. Eliciting meta consent for future secondary research use of health data using a smartphone application - a proof of concept study in the Danish population.

    Science.gov (United States)

    Ploug, Thomas; Holm, Søren

    2017-08-15

    The increased use of information technology in every day health care creates vast amounts of stored health data that can be used for research. The secondary research use of routinely collected data raises questions about appropriate consent mechanisms for such use. One option is meta consent where individuals state their own consent preferences in relation to future use of their data, e.g. whether they want the data to be accessible to researchers under conditions of specific consent, broad consent, blanket consent or not at all. This study investigates whether meta consent preferences can be successfully elicited by a smartphone application in the adult Danish population. A smartphone app was developed for the elicitation of meta consent preferences. An invitation to use the app was distributed to a stratified, representative sample of the Danish adult population. The meta consent choices, the use of the app, user experience data, and demographic data were logged and analysed statistically using IBM SPSS version 20. Of 1000 potential respondents 221 used the app. One hundred eighty-eight of the respondents were female and 103 male. The age range was 19 to 79 years with an average of 51 years (SD 16). Most users indicate 1) that they find the choices they are asked to make easy to understand (>75% find it 'Easy' or 'Very easy'), 2) that the application is easy to use (>75% find it 'Easy' or 'Very easy'), and 3) that this kind of choice should be offered to people (89% find it 'Absolutely' or 'Somewhat' important). It is possible to collect meta consent preferences in the general, adult population using a smartphone app.

  15. [An experience of collaboration between primary health care and mental health care in La Ribera Department of Health (Valencia, Spain)].

    Science.gov (United States)

    Morera-Llorca, Miquel; Romeu-Climent, José Enrique; Lera-Calatayud, Guillem; Folch-Marín, Blanca; Palop-Larrea, Vicente; Vidal-Rubio, Sonia

    2014-01-01

    Despite the high prevalence of mental health problems among patients attending primary care, diagnosis and treatment of these disorders remain inadequate. Sound training of primary care physicians in how to manage mental health problems is needed to reduce the health, economic and social impact associated with these disorders. Among other elements, there is a need for cooperation between primary care physicians and mental health services. Distinct models are available for such collaboration. In 2006, our health department started a collaboration between these two levels of heath care, using a liaison model. Delays until the first specialist visit were reduced and satisfaction among health professionals increased, although these results should be interpreted with caution. Evidence has recently accumulated on the usefulness of the collaborative model, but evaluation of this model and extrapolation of its results are complex. We intend to evaluate our model more thoroughly, similar to other projects in our environment. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  16. Essential interventions on workers' health by primary health care : a scoping review of the literature: a technical report

    NARCIS (Netherlands)

    Buijs, P.; Dijk, F. van

    2014-01-01

    The TNO review Essential interventions on Workers’ Health by Primary Health Care shows those interventions in primary, secondary and tertiary prevention are necessary and feasible but not yet satisfactorily evidence-based. Necessary, because primary or community health care covers about 80% of the w

  17. HIV testing in the Danish population

    DEFF Research Database (Denmark)

    Lemcke, Asja; Kjøller, Mette; Ekholm, Ola

    2007-01-01

    AIMS: To describe the accumulated prevalence of HIV testing in the Danish population until and including the year 2000. METHODS: The study was based on nationally representative data from the Danish Health Interview Survey 2000. Multiple logistic regression analysis investigated the association...... between HIV testing and background variables, such as gender, age, marital status, educational level, and sexual orientation. RESULTS: Overall 28.5% of the Danish population aged over 16 years have "ever been tested for HIV". More females (29.4%) than males (27.6%) were tested; 12.6% might not be aware...

  18. Antibiotic Prescription in Danish General Practice

    DEFF Research Database (Denmark)

    Sydenham, Rikke Vognbjerg; Plejdrup Hansen, Malene; Pedersen, Line Bjørnskov

    2016-01-01

    will explore how the GPs prescription behaviour is influenced by selected factors. Antibiotics are essential when treating potentially lethal infections. An increasing development of resistant bacteria is considered one of the primary threats to public health. The majority of antibiotics (90%) are prescribed...... from general practice. The prescription of broad-spectrum antibiotics can cause unnecessary side effects for the individual and increases the risk of development of bacteria resistant to antibiotic treatment. Both the prescription of broad-spectrum antibiotics and the level of resistant bacteria......1. Background & Aim The overall aim of the project is to describe antibiotic consumption in Danish general practice with emphasis on specific types of antibiotics. The project will shed light on the impact of microbiological diagnostic methods (MDM) on the choice of antibiotic and the project...

  19. The long term importance of English primary care groups for integration in primary health care and deinstitutionalisation of hospital care

    Directory of Open Access Journals (Sweden)

    Nick Goodwin

    2001-03-01

    Full Text Available Purpose: This article reviews the impact of successive experiments in the development of primary care organisations in England and assesses the long-term importance of English primary care groups for the integration of health and community and health and social care and the deinstitutionalisation of hospital care. Theory: Governments in a number of Western countries are attempting to improve the efficiency, appropriateness and equity of their health systems. One of the main ways of doing this is to devolve provision and commissioning responsibility from national and regional organisations to more local agencies based in primary care. Such primary care organisations are allocated budgets that span both primary and secondary (hospital services and also, potentially, social care. Method: This article is based on a systematic review of the literature forthcoming from the UK Government's Department of Health-funded evaluations of successive primary care organisational developments. These include total purchasing pilots, GP commissioning group pilots, personal medical services pilots and primary care groups and trusts. Results: Primary care organisations in England have proved to be a catalyst in facilitating the development of integrated care working between primary and community health services. Conversely, primary care organisations have proved less effective in promoting integration between health and social care agencies where most progress has been made at the strategic commissioning level. The development of primary care trusts in England is heralding an end to traditional community hospitals. Conclusions: The development of primary care groups in England are but an intermediate step of a policy progression towards future primary care-based organisations that will functionally integrate primary and community health services with local authority services under a single management umbrella.

  20. Telemedicine in Primary Health: The Virtual Doctor Project Zambia

    Directory of Open Access Journals (Sweden)

    Mustarde Paul

    2011-05-01

    Full Text Available Abstract This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach due to rugged natural terrain and have very limited telecommunications infrastructure. The lack of these and other basic services makes it difficult for medical personnel to settle in these areas, which leads to an acute shortage of medical personnel. We comment on this problem and how it is addressed by 'The Virtual Doctor Project', emphasizing that while the telemedicine concept is not new in sub-Saharan Africa, the combination of mobility and connectivity to service a number of villages 'on the go' is an important variation in the shift back to the 1978 Alma Ata principles of the United Nations World Health Organization [WHO]. This overview of the Virtual Doctor Project in Zambia provides insight into both the potential for ICT, and the problems and limitations that any "real-world" articulation of this technology must confront.

  1. The Burnout Condition of Primary Health Care Personnel

    Directory of Open Access Journals (Sweden)

    Mehmet Kaya

    2007-10-01

    Full Text Available The concept of burnout was first introduced by Fredeunberger in 1974. Fredeunberger had stated that burnout occurred more commonly in occupations whose members directly work with people. The aim of the study is to examine the burnout status of primary health care staff. The universe of this descriptive study is 466 health staff who work in primary health care units in Kecioren. The participation of the study was 54%. A Questionnaire including Maslach Burnout Inventory (MBI and some characteristics of the participants were used for data collection. Mann-whitney U and Kruskal Wallis tests have been used for analizing the survey data. Seventyseven percent of the participants were female and the emotional exhaustion score of female was higher than male (p<0.01. The age of the participants effect the individual achievement scores (p<0.01. The profession or marital status of the participants didn’t affect the MBI scores. Some socio-demografic characteristics of the participants such as gender and age, affect the scores of MBI. Comprehensive studies which display the causes of problems, needed in this issue. [TAF Prev Med Bull. 2007; 6(5: 357-363

  2. Danish National Lymphoma Registry

    DEFF Research Database (Denmark)

    Arboe, Bente; Josefsson, Pär; Jørgensen, Judit;

    2016-01-01

    AIM OF DATABASE: The Danish National Lymphoma Registry (LYFO) was established in order to monitor and improve the diagnostic evaluation and the quality of treatment of all lymphoma patients in Denmark. STUDY POPULATION: The LYFO database was established in 1982 as a seminational database including...... all lymphoma patients referred to the departments of hematology. The database became nationwide on January 1, 2000. MAIN VARIABLES: The main variables include both clinical and paraclinical variables as well as details of treatment and treatment evaluation. Up to four forms are completed for each...... patient: a primary registration form, a treatment form, a relapse form, and a follow-up form. Variables are used to calculate six result quality indicators (mortality 30 and 180 days after diagnosis, response to first-line treatment, and survival estimates 1, 3, and 5 years after the time of diagnosis...

  3. [Levers in Primary Health Care - Identifying Strategic Success Factors for Improved Primary Care in Upper Austria].

    Science.gov (United States)

    Kriegel, J; Rebhandl, E; Reckwitz, N; Hockl, W

    2016-12-01

    Current and projected general practitioner (GP) and primary care in Austria shows structural and process inadequacies in the quality as well as assurance of healthcare supply. The aim is therefore to develop solution- and patient-oriented measures that take patient-related requirements and medical perspectives into account. Using an effect matrix, subjective expert and user priorities were ascertained, cause and effect relationships were examined, and an expanded circle of success for the optimization of GP and primary care in Upper Austria was developed. Through this, the relevant levers for target-oriented development and optimization of the complex system of GP and primary care in Upper Austria were identified; these are training to become general practitioners, entrepreneurs as well as management and coordination. It is necessary to further adapt the identified levers conceptually and operationally in a targeted approach. This is to be achieved by means of the primary health care (PHC) concept as well as management tools and information and communication technologies (ICT) associated with it. © Georg Thieme Verlag KG Stuttgart · New York.

  4. 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.

  5. [Health, power, and democracy. Notes for a primary care theory].

    Science.gov (United States)

    Gyarmati, G

    1993-03-01

    Health services are relentlessly deteriorating due to the persistent increase in their costs. This deterioration not only affects people's health. This service is directly linked to personal and family security and populations social equity expectatives. Thus, its failure inevitably leads to a gradual loss of State and public authorities legitimacy, threatening the stability of the democratic system. In the long run, it also affects the legitimacy of medical profession. To overcome this problem, considering the limited possibilities of a relatively poor country, a new health services model is proposed, based on a massive strengthening of primary care, organized in a way in which the community assumes an important part of the responsibility for the health of its members. To achieve this purpose the use of the concept of "empowerment" is proposed, practically applied through the "pedagogic investigation-action". As a result a noticeable increase in the general health level of the population is expected. At the same time, one of the serious threatens to the legitimacy of the Democratic State will be eliminated.

  6. [Primary health care reform and implications for the organizational culture of Health Center Groups in Portugal].

    Science.gov (United States)

    Leone, Claudia; Dussault, Gilles; Lapão, Luís Velez

    2014-01-01

    The health sector's increasing complexity poses major challenges for administrators. There is considerable consensus on workforce quality as a key determinant of success for any health reform. This study aimed to explore the changes introduced by an action-training intervention in the organizational culture of the 73 executive directors of Health Center Groups (ACES) in Portugal during the primary health care reform. The study covers two periods, before and after the one-year ACES training, during which the data were collected and analyzed. The Competing Values Framework allowed observing that after the ACES action-training intervention, the perceptions of the executive directors regarding their organizational culture were more aligned with the practices and values defended by the primary health care reform. The study highlights the need to continue monitoring results over different time periods to elaborate further conclusions.

  7. Reliability of the Danish version of the short questionnaire to assess health-enhancing physical activity (SQUASH)

    DEFF Research Database (Denmark)

    Jacobsen, Julie Sandell; Sørensen, Lotte; Mikkelsen, Lone Ramer

    2015-01-01

    was evaluated in 22 patients with hip dysplasia, mean age 34.8 � 7.9 years, who were compared with 26 healthy individuals matched on age. Findings / Results: For the total activity score ICC was 0.71 (95% CI: 0.54; 0.82), SEM was 2351 MET x min/week (25% of the grand mean) and the SDC was 6517 MET x min....../week (70% of the grand mean). There was no significant difference between healthy adults and patients with hip dysplasia in total activity score but a significant difference in time spent on activities of high intensity. Conclusions: Relative raliability was acceptable and indicates that the Danish...... reliability was poor and SQUASH is not considered suitable for measuring physical activity on an individual level. SQUASH was unable to discriminate between healthy individuals and patients with hip dysplasia with respect to total activity score, but was able to discriminate on time spent on activities...

  8. Preparing the Workforce for Behavioral Health and Primary Care Integration.

    Science.gov (United States)

    Hall, Jennifer; Cohen, Deborah J; Davis, Melinda; Gunn, Rose; Blount, Alexander; Pollack, David A; Miller, William L; Smith, Corey; Valentine, Nancy; Miller, Benjamin F

    2015-01-01

    To identify how organizations prepare clinicians to work together to integrate behavioral health and primary care. Observational cross-case comparison study of 19 U.S. practices, 11 participating in Advancing Care Together, and 8 from the Integration Workforce Study. Practices varied in size, ownership, geographic location, and experience delivering integrated care. Multidisciplinary teams collected data (field notes from direct practice observations, semistructured interviews, and online diaries as reported by practice leaders) and then analyzed the data using a grounded theory approach. Organizations had difficulty finding clinicians possessing the skills and experience necessary for working in an integrated practice. Practices newer to integration underestimated the time and resources needed to train and organizationally socialize (onboard) new clinicians. Through trial and error, practices learned that clinicians needed relevant training to work effectively as integrated care teams. Training efforts exclusively targeting behavioral health clinicians (BHCs) and new employees were incomplete if primary care clinicians (PCCs) and others in the practice also lacked experience working with BHCs and delivering integrated care. Organizations' methods for addressing employees' need for additional preparation included hiring a consultant to provide training, sending employees to external training programs, hosting residency or practicum training programs, or creating their own internal training program. Onboarding new employees through the development of training manuals; extensive shadowing processes; and protecting time for ongoing education, mentoring, and support opportunities for new and established clinicians and staff were featured in these internal training programs. Insufficient training capacity and practical experience opportunities continue to be major barriers to supplying the workforce needed for effective behavioral health and primary care integration

  9. Evaluation of Enviromental Health in Primary Schools, Kemalpasa-Izmir

    Directory of Open Access Journals (Sweden)

    Ahmet Soysal

    2008-10-01

    Full Text Available AIM: The aim of this study was to evaluate the situation of environmental health and the differences in environmental health among primary schools of county seat and rural area in Kemalpasa county, Izmir. METHODS: Fourty six primary schools in Kemalpasa county constituted the research universe this cross-sectionel study. We intended to reach all of these schools. Surrounding conditions, toilet hygene, waste materials, food and water safety of the schools were evaluated. Data were collected from school administrators by questionnaire and by measuring and observing some of the variables. RESULTS: Of the 46 primary schools found in Kemalpasa county 9 are located in the county seat and 37 are located rural area. The mean number of classrooms was 10.8±1.4 (1-38 and students was 320.1±55.9 (7-1323 in these schools. Twenty (43.5% of these schools were located on the main roads with heavy traffic, 8 (17.4% had playground features appropriate for accidents, 31 (67.4% had enviromentproffesionals, 33 (71.7% had preventive walls around them, 28 (60.9% had connection to the canalization system, 31 (67.4% had the necessary measures taken for fire. Of the 16 (34.8% schools those had canteens, 12 (75.0% of them were not licenced for sanitation, 11 (68,8% of them could not get systematic porter inspection. Among these primary schools 37 (80.4% had sufficient amount of soap and 5 (10.9% had paper towels. Fourty four (95.7% of the schools had their water analyzed at various intervals, 17 (37.0% had water tanks in case of inadequate water supply. There was a significant difference among schools in the county seat of Kemalpasa compared to schools in the countryside on being connected to canalization network (p=0.007, on having necessary fire precautions (p=0.021, on providing waste baskets in the school coridors (p=0.001 and on making porter examinations in the canteen personels (p=0.035. CONCLUSION: This study shows that the primary schools in the county of

  10. Primary health care in the Philippines: banking on the barangays?

    Science.gov (United States)

    Phillips, D R

    1986-01-01

    Primary health care has been hailed by some countries as the only practical means of providing any form of health care for expanding populations in poor economies. This is particularly true in Third World countries where the cost explosion of technology-oriented health care has been a major problem in extending services. Therefore, the PHC package of education, nutrition, preventive medicine and treatment of the most common diseases and injuries is sometimes regarded as the most beneficial application of scarce resources. The Philippines claims to be one of the first (perhaps the first) countries to have adopted PHC as a national strategy for health care and, since 1981, impressive achievements have been attained in this sector by contrast with reversals in many other sectors of the economy. PHC has not challenged the pre-eminence of Metro-Manila in the provision of hospital and specialist facilities but it has extended some basic care particularly to rural regions of the country. This paper reviews the background to health care in the Philippines and it then examines the implementation of PHC in Negros Oriental, where PHC has taken on the additional feature of special use of indigenous materials and resources. The administrative, financial and legal bases and some geographical facets of PHC are highlighted in this province. The campaign relies heavily on local (barangay) initiatives and community participation, in part to minimise resources which have to be devoted to health in a very troubled national economy. In spite of local skills and enthusiasm, this arguably still involves the abrogation of a degree of government responsibility for health care. As a result, the Philippines strategy may be said to be "banking on the barangays."

  11. Intertester reliability of shoulder complaints diagnoses in primary health care

    Science.gov (United States)

    Storheil, Benny; Klouman, Elise; Holmvik, Stian; Emaus, Nina; Fleten, Nils

    2016-01-01

    Objective Shoulder complaints are frequently encountered in general practice, but precise diagnosing is challenging. This study investigated agreement of shoulder complaints diagnoses between clinicians in a primary health care setting. Design Cross-sectional study. Setting Four primary health care clinicians used patients’ history and functional examination of the shoulder by selective tissue tension techniques (STTs), to diagnose shoulder complaints. Subjects 62 patients, aged 18–75 years. Main outcome measure Reliability of diagnoses was assessed by observed intertester agreement and Cohen’s kappa. A total of 372 diagnostic pairs were available for intertester comparisons. Results Six diagnoses were assigned by all clinicians; supraspinatus-, infraspinatus-, subscapularis-tendinopathies; chronic subacromial bursitis; glenohumeral capsulitis, and acromioclavicular joint lesion. The observed agreement on these diagnoses ranged from 0.84 for glenohumeral capsulitis to 0.97 for acromioclavicular joint lesion. Kappa scores were 0.46 (95% CI 0.33, 0.58) for chronic subacromial bursitis; 0.53 (95% CI 0.34, 0.68), 0.59 (95% CI 0.47, 0.70), and 0.68 (95% CI 0.53, 0.82) for infraspinatus -, supraspinatus -, and subscapularis-tendinopathy, respectively. For glenohumeral capsulitis and acromioclavicular lesion kappa scores were 0.66 (95% CI 0.57, 0.73) and 0.78 (95% CI 0.61, 0.90). Kappa scores were higher for individual diagnoses than for individual tests, except for limitation in passive abduction (0.70, 95% CI 0.62, 0.78) and passive lateral rotation (0.66, 95% CI 0.57, 0.73). Conclusions Although experienced clinicians showed substantial intertester agreement, precise diagnoses of shoulder complaints in primary health care remain a challenge. The present results call for further research on refined diagnoses of shoulder complaints. Key Points Based on medical history and a systematic functional examination by selective tissue tension techniques (STTs), we

  12. Functional health literacy among primary health care users in transitional Kosovo.

    Science.gov (United States)

    Kamberi, Haxhi; Hysa, Bajram; Toçi, Ervin; Jerliu, Naim; Qirjako, Gentiana; Burazeri, Genc

    2013-01-01

    Adequate functional health literacy is considered as a basic prerequisite for a proper health-seeking behavior of adult individuals. Our aim was to assess the levels and socioeconomic correlates of functional health literacy among adult primary care users in transitional Kosovo. A cross-sectional study was conducted in Kosovo in November 2012-February 2013 including a representative sample of 1035 primary health care users aged > or = 18 years (60% females; overall mean age: 44.3 +/- 16.9 years; overall response rate: 86%). The cross-culturally adapted long version of TOFHLA test (an instrument assessing reading comprehension and numerical abilities) was used to assess functional health literacy among study participants. TOFHLA scores range between 0-100 with higher scores implying better functional health literacy. The analysis of variance (ANOVA) was used to assess the association of functional health literacy with demographic and socioeconomic characteristics. Mean score of the functional health literacy was significantly higher among younger participants, in men, in highly educated individuals and participants with better self-reported income level. Our findings indicate that vulnerable socioeconomic individuals exhibit lower functional health literacy levels in post-war Kosovo. Health care professionals and particularly policy makers in Kosovo must be aware of the excess risk among the low socioeconomic groups and should tailor intervention programs accordingly.

  13. Electronic health records and support for primary care teamwork

    Science.gov (United States)

    Draper, Kevin; Gourevitch, Rebecca; Cross, Dori A.; Scholle, Sarah Hudson

    2015-01-01

    Objective Consensus that enhanced teamwork is necessary for efficient and effective primary care delivery is growing. We sought to identify how electronic health records (EHRs) facilitate and pose challenges to primary care teams as well as how practices are overcoming these challenges. Methods Practices in this qualitative study were selected from those recognized as patient-centered medical homes via the National Committee for Quality Assurance 2011 tool, which included a section on practice teamwork. We interviewed 63 respondents, ranging from physicians to front-desk staff, from 27 primary care practices ranging in size, type, geography, and population size. Results EHRs were found to facilitate communication and task delegation in primary care teams through instant messaging, task management software, and the ability to create evidence-based templates for symptom-specific data collection from patients by medical assistants and nurses (which can offload work from physicians). Areas where respondents felt that electronic medical record EHR functionalities were weakest and posed challenges to teamwork included the lack of integrated care manager software and care plans in EHRs, poor practice registry functionality and interoperability, and inadequate ease of tracking patient data in the EHR over time. Discussion Practices developed solutions for some of the challenges they faced when attempting to use EHRs to support teamwork but wanted more permanent vendor and policy solutions for other challenges. Conclusions EHR vendors in the United States need to work alongside practicing primary care teams to create more clinically useful EHRs that support dynamic care plans, integrated care management software, more functional and interoperable practice registries, and greater ease of data tracking over time. PMID:25627278

  14. Electronic health records and support for primary care teamwork.

    Science.gov (United States)

    O'Malley, Ann S; Draper, Kevin; Gourevitch, Rebecca; Cross, Dori A; Scholle, Sarah Hudson

    2015-03-01

    Consensus that enhanced teamwork is necessary for efficient and effective primary care delivery is growing. We sought to identify how electronic health records (EHRs) facilitate and pose challenges to primary care teams as well as how practices are overcoming these challenges. Practices in this qualitative study were selected from those recognized as patient-centered medical homes via the National Committee for Quality Assurance 2011 tool, which included a section on practice teamwork. We interviewed 63 respondents, ranging from physicians to front-desk staff, from 27 primary care practices ranging in size, type, geography, and population size. EHRs were found to facilitate communication and task delegation in primary care teams through instant messaging, task management software, and the ability to create evidence-based templates for symptom-specific data collection from patients by medical assistants and nurses (which can offload work from physicians). Areas where respondents felt that electronic medical record EHR functionalities were weakest and posed challenges to teamwork included the lack of integrated care manager software and care plans in EHRs, poor practice registry functionality and interoperability, and inadequate ease of tracking patient data in the EHR over time. Practices developed solutions for some of the challenges they faced when attempting to use EHRs to support teamwork but wanted more permanent vendor and policy solutions for other challenges. EHR vendors in the United States need to work alongside practicing primary care teams to create more clinically useful EHRs that support dynamic care plans, integrated care management software, more functional and interoperable practice registries, and greater ease of data tracking over time. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  15. Vector surveillance and eradication in primary health care

    Directory of Open Access Journals (Sweden)

    Ada Crespo Guzmán

    2011-08-01

    Full Text Available A bibliographical revision was done about in Dengue fever and the control that is carrier on against the Aedes aegypti “mosquito”, the principal agent that treatments this illness, with the objective of describing the functioning of the Control and Elimination Program of the Mosquito in the Cuban Primary Health Care System. The main objective of this program is to avoid the Dengue epidemics and the loss of human life and the negative impact that will cost to, the socioeconomic development of over country. Accomplishing the promotion, prevention and controlling actions by the basic health care team the mosquito campaign workers and our population, the vector infestation index has been diminished below 0.5 in the last five years. It is important to point out that the rapid decisions taken by our government and its consequent efforts and political willingness has made this program sustained.

  16. Evaluation of Mental Health Integration in Primary Health Care in View of Participants and Rural Health Workers of Dezful, Khuzestan

    Directory of Open Access Journals (Sweden)

    Khosrotaj

    2015-04-01

    Full Text Available Background Evaluation and determination of different achievements of interventions in health care is one of the important responsibilities of the health system. Objectives The aim of present study was to evaluate the integration of mental health program in the primary health care (PHC system in rural areas of Dezful district in view of participants and health workers. Patients and Methods In this descriptive-cross sectional research, which was done in rural areas of Dezful during year 2014, the main indexes of mentioned integration such as knowledge, attitude and performance of physicians, health workers and participants were measured. The data collection instrument was valid and reliable questionnaires, which are often used by the mental health department of the health ministry. Validity and reliability of questionnaires have frequently been confirmed by researchers in different studies. The study population included all 19 rural physicians, 89 health workers and a random sample of 15 - 60 year-old participants in the health network of Dezful. Frequency of distribution and computation of central and distribution indexes were used for data analysis. Results The amount of physicians’ knowledge was about 50%, while the rate of health workers’ knowledge was 62%. The rate of health workers’ attitude was 92%, while the rate of participants’ knowledge was 50% and the rate of participants’ attitude was 19%. Consequently, the integration of mental health in primary health care system of rural areas of Dezful district has been relatively successful. Conclusions The integration of mental health into primary health care is an important priority in the Iranian health system. Monitoring and evaluation of this strategic project to remove its weaknesses is essential.

  17. The process of formation of mental health for nurses in primary health care

    Directory of Open Access Journals (Sweden)

    Hilton Giovani Neves

    2012-04-01

    Full Text Available This study was based on descriptive, exploratory and qualitative approach and aimed at analyzing scientific knowledge that was developed in the formation of Family Health (FH nurses to address Mental Health in Primary Care regarding psychosocial aspects. Research conducted in 2008 with three teams of FH nurses a municipality in the countryside of Mato Grosso, whose data were submitted to content analysis. The results were organized according to two themes "The limitations of official spaces for the training of nurses" and "The Family Health as well as the transformation praxis in Mental Health ". It was concluded that the official spaces mentioned above do not give too much importance to education on mental health, the same occurs in the context of lifelong learning. Despite the limited provision of skills for Mental Health care, we have found significant changes such as the sensitization to emotional and psychological manifestations of the population with higher awareness of health.

  18. The Danish National Multiple Myeloma Registry

    DEFF Research Database (Denmark)

    Gimsing, Peter; Holmström, Morten O; Klausen, Tobias Wirenfelt

    2016-01-01

    is to support research. Patients are registered with their unique Danish personal identification number, and the combined use of DMMR, other Danish National registries, and the Danish National Cancer Biobank offers a unique platform for population-based translational research. STUDY POPULATION: All newly......, clinical complications, prognostics, first- and second-line treatments, treatment responses, progression free, and overall survival. DESCRIPTIVE DATA: Up to June 2015, 2,907 newly diagnosed patients with MM, 485 patients with smoldering MM, 64 patients with plasma cell leukemia, and 191 patients......AIM: The Danish National Multiple Myeloma Registry (DMMR) is a population-based clinical quality database established in January 2005. The primary aim of the database is to ensure that diagnosis and treatment of plasma cell dyscrasia are of uniform quality throughout the country. Another aim...

  19. Did Massachusetts Health Reform Affect Veterans Affairs Primary Care Use?

    Science.gov (United States)

    Wong, Edwin S; Maciejewski, Matthew L; Hebert, Paul L; Batten, Adam; Nelson, Karin M; Fihn, Stephan D; Liu, Chuan-Fen

    2016-09-20

    Massachusetts Health Reform (MHR), implemented in 2006, introduced new health insurance options that may have prompted some veterans already enrolled in the Veterans Affairs Healthcare System (VA) to reduce their reliance on VA health services. This study examined whether MHR was associated with changes in VA primary care (PC) use. Using VA administrative data, we identified 147,836 veterans residing in Massachusetts and neighboring New England (NE) states from October 2004 to September 2008. We applied difference-in-difference methods to compare pre-post changes in PC use among Massachusetts and other NE veterans. Among veterans not enrolled in Medicare, VA PC use was not significantly different following MHR for Massachusetts veterans relative to other NE veterans. Among VA-Medicare dual enrollees, MHR was associated with an increase of 24.5 PC visits per 1,000 veterans per quarter (p = .048). Despite new non-VA health options through MHR, VA enrollees continued to rely on VA PC. © The Author(s) 2016.

  20. Perceived risk of mental health problems in primary care.

    LENUS (Irish Health Repository)

    2015-01-01

    In the face of limited resources and an aging population with increasingly care needs, healthcare systems must identify community-dwelling older adults with mental health problems at higher risk of adverse outcomes such as institutionalization, hospitalization and death, in order to deliver timely and efficient care. The objectives of this study were to assess the prevalence of mental health concerns and the associated perceived risk of adverse outcomes in a large sample of older patients in primary care (PC). We trained general practitioners and nurses to use the Risk Instrument for Screening in the Community to rank perceived risk of mental health concerns (including neurocognitive and mood disorders) from 1 (mild) to 3 (severe). The mean age of the 4499 people assessed was 76.3 years (SD = 7.3) and 2645 (58.8%) were female. According to the PC team 1616 (35.9%) were perceived to have mental health concerns of whom 847 (52.4%) were mild, 559 (34.6%) were moderate and 210 (13%) were severe. Patients with mental health concerns had higher odds of perceived risk of adverse outcomes (OR = 2.22, 95% CI 1.83-2.69 for institutionalization; OR = 1.66, 95% CI 1.41-1.94 for hospitalization; OR = 1.69, 95% CI 1.42-2.01 for death). These results suggest a high prevalence of mental health concerns among older adults and supports the need for early identification of patients at high-risk of adverse healthcare outcomes.

  1. From pedagogy to timeagogy? Leisure-time pedagogues handling time in the reformed Danish Primary School and Leisure-time Center

    DEFF Research Database (Denmark)

    Gravesen, David Thore; Ringskou, Lea Thomsen

    2016-01-01

    is based on concepts from Foucault and Bourdieu and theories from the fields of sociology of time and sociology of emotions. Conclusions/findings: The meeting between time and pedagogy seems to create a field of tension in the daily routines and tasks of the leisure-time pedagogues. Traditional keywords...... and uncertainty. Relevance to Nordic educational research: Our research offers in-depth insights concerning national restructuring within the Danish school system. Insights that can cultivate important discussions on how timeagogy and demands of effectiveness challenge traditional values of equality...

  2. The Danish National Cohort Study (DANCOS)

    DEFF Research Database (Denmark)

    Helweg-Larsen, Karin; Kjøller, Mette; Davidsen, Michael

    2003-01-01

    This article gives an overview of a nationally representive public health research database in Denmark, the Danish National Cohort Study (DANCOS). DANCOS combines baseline data from health interview surveys with both pre- and post-baseline data from national health registries with date from a re...

  3. Trends in socioeconomic inequalities in oral health among 15-year-old Danish adolescents during 1995-2013: A nationwide, register-based, repeated cross-sectional study.

    Science.gov (United States)

    Sengupta, Kaushik; Christensen, Lisa Bøge; Mortensen, Laust Hvas; Skovgaard, Lene Theil; Andersen, Ingelise

    2017-10-01

    Scandinavian welfare states, despite having better population oral health than less egalitarian societies, are characterized by ubiquitous social gradients and large relative socioeconomic inequalities in oral health. However, trends in these inequalities among Scandinavian children and adolescents have not been studied in detail. To describe the associations between socioeconomic position (SEP) and oral health in adolescents and to investigate the trends in these associations between 1995 and 2013. Nationwide repeated cross-sectional studies (using individual-level data) were conducted on 15-year-olds in Denmark from 1995, 2003, and 2013 (N=154,750). Dental data were obtained from the national dental register of the Danish Health Authority (Sundhedsstyrelsens Centrale Odontologiske Register [SCOR]) and data on social variables from administrative registers at Statistics Denmark. SEP measures included previous year's parental education (highest attained educational level by either of the parents), income (equivalized household disposable income), and occupational social class (highest recorded occupational class between the parents). Covariates were immigration status, country of origin, number of children and persons in the family, and household type. The outcome was dental caries experience, represented by the decayed, missing, and filled surfaces (DMFS) index. Negative binomial regression models were used to examine the association between DMFS count and each of the explanatory variables separately while accounting for cluster-correlated family data. Furthermore, hierarchical multiple regressions of DMFS on SEP indicators-using the zero-inflated negative binomial (ZINB) distribution as the outcome distribution-were estimated while successively adjusting for the potential effects of the included covariates. Caries prevalence declined from 71% in 1995 to 63% in 2003 and 45% in 2013. Separate assessment of each covariate showed statistically significant graded

  4. The effects of the Danish saturated fat tax on food and nutrient intake and modelled health outcomes: an econometric and comparative risk assessment evaluation.

    Science.gov (United States)

    Smed, S; Scarborough, P; Rayner, M; Jensen, J D

    2016-06-01

    The World Health Organisation recommends governments to consider the use of fiscal policies to promote healthy eating. However, there is very limited evidence of the effect of food taxation in a real-life setting, as most evidence is based on simulation studies. The objective of this study is to evaluate the effect of the Danish tax on saturated fat in terms of changes in nutritional quality of the diet, that is, changes in saturated fat consumption, as well as other non-targeted dietary measures, and to model the associated changes in mortality for different age groups and genders. On the basis of household scanner data, we estimate the impact of the tax on consumption of saturated fat, unsaturated fat, salt, fruit, vegetables and fibre. The resultant changes in dietary quality are then used as inputs into a comparative risk assessment model (PRIME (Preventable Risk Integrated ModEl)) to estimate the effect of these changes on non-communicable diseases (NCDs) and mortality. The tax resulted in a 4.0% reduction in saturated fat intake. Vegetable consumption increased, and salt consumption increased for most individuals, except younger females. We find a modelled reduction in mortality with 123 lives saved annually, 76 of them below 75 years equal to 0.4% of all deaths from NCDs. Modelling the effect of the changes in diet on health outcomes suggests that the saturated fat tax made a positive, but minor, contribution to public health in Denmark.

  5. Health care reform and care at the behavioral health--primary care interface.

    Science.gov (United States)

    Druss, Benjamin G; Mauer, Barbara J

    2010-11-01

    The historic passage of the Patient Protection and Affordable Care Act in March 2010 offers the potential to address long-standing deficits in quality and integration of services at the interface between behavioral health and primary care. Many of the efforts to reform the care delivery system will come in the form of demonstration projects, which, if successful, will become models for the broader health system. This article reviews two of the programs that might have a particular impact on care on the two sides of that interface: Medicaid and Medicare patient-centered medical home demonstration projects and expansion of a Substance Abuse and Mental Health Services Administration program that colocates primary care services in community mental health settings. The authors provide an overview of key supporting factors, including new financing mechanisms, quality assessment metrics, information technology infrastructure, and technical support, that will be important for ensuring that initiatives achieve their potential for improving care.

  6. Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

    Directory of Open Access Journals (Sweden)

    Buykx Penny

    2011-03-01

    Full Text Available Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a Structural domains (health service performance; sustainability; and quality of care; (b Process domains (health service utilisation and satisfaction; and (c Outcome domains (health behaviours, health outcomes and community viability. Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how

  7. The Danish Prostate Cancer Database

    DEFF Research Database (Denmark)

    Nguyen-Nielsen, Mary; Høyer, Søren; Friis, Søren

    2016-01-01

    AIM OF DATABASE: The Danish Prostate Cancer Database (DAPROCAdata) is a nationwide clinical cancer database that has prospectively collected data on patients with incident prostate cancer in Denmark since February 2010. The overall aim of the DAPROCAdata is to improve the quality of prostate cancer...... care in Denmark by systematically collecting key clinical variables for the purposes of health care monitoring, quality improvement, and research. STUDY POPULATION: All Danish patients with histologically verified prostate cancer are included in the DAPROCAdata. MAIN VARIABLES: The DAPROCAdata...... registers clinical data and selected characteristics for patients with prostate cancer at diagnosis. Data are collected from the linkage of nationwide health registries and supplemented with online registration of key clinical variables by treating physicians at urological and oncological departments. Main...

  8. Danish Chiropractic Practice

    DEFF Research Database (Denmark)

    Myburgh, Cornelius; Boyle, Eleanor; Christensen, Henrik Wulff

    Objectives: To develop a contemporary, patient-oriented perspective of chiropractic private practice, as reflected by the setting, practice models and clinical interactions observable in Denmark. Methods: A qualitative point-of-view investigation was conducted making use of participant observation......, face-to-face interviews and video analysis. Data was analysed for content and thematic emergence. Results: A purposive sampling framework yielded 11 clinic sites, representative of prevalent practice models. Data collected over a 6-month period included interviews with 60 patients, 22 health care...... value competence and professionalism in their clinical encounter with their chiropractor. Conclusion: Danish chiropractic practice is strongly influenced by modern consumer behaviour and team-oriented practice trends. Furthermore, the administrative hub plays an important role in operationalizing...

  9. Danish Palliative Care Database

    DEFF Research Database (Denmark)

    Grønvold, Mogens; Adsersen, Mathilde; Hansen, Maiken Bang

    2016-01-01

    Aims: The aim of the Danish Palliative Care Database (DPD) is to monitor, evaluate, and improve the clinical quality of specialized palliative care (SPC) (ie, the activity of hospital-based palliative care teams/departments and hospices) in Denmark. Study population: The study population is all......, and the patient-reported European Organisation for Research and Treatment of Cancer Quality of Life Questionaire-Core-15-Palliative Care questionnaire, assessing health-related quality of life. The data support the estimation of currently five quality of care indicators, ie, the proportions of 1) referred......-Core-15-Palliative Care at admission to SPC, and 5) patients who were discussed at a multidisciplinary conference. Descriptive data: In 2014, all 43 SPC units in Denmark reported their data to DPD, and all 9,434 cancer patients (100%) referred to SPC were registered in DPD. In total, 41,104 unique cancer...

  10. The Danish Twin Registry

    DEFF Research Database (Denmark)

    Skytthe, Axel; Christiansen, Lene; Kyvik, Kirsten Ohm;

    2013-01-01

    decade of combining questionnaire and survey data with national demographic, social, and health registers in Statistics Denmark. Second, we describe our most recent data collection effort, which was conducted during the period 2008-2011 and included both in-person assessments of 14,000+ twins born 1931......Over the last 60 years, the resources and the research in the Danish Twin Registry (DTR) have periodically been summarized. Here, we give a short overview of the DTR and a more comprehensive description of new developments in the twenty-first century. First, we outline our experience over the last......-1969 and sampling of biological material, hereby expanding and consolidating the DTR biobank. Third, two examples of intensively studied twin cohorts are given. The new developments in the DTR in the last decade have facilitated the ongoing research and laid the groundwork for new research directions....

  11. Health workers’ attitudes toward immigrant patients: a cross-sectional survey in primary health care services

    Directory of Open Access Journals (Sweden)

    Dias Sónia

    2012-07-01

    Full Text Available Abstract Background Health workers’ attitudes toward immigrant patients influence behaviour, medical decisions, quality of care and health outcomes. Despite the increasing number of immigrant patients in health services and the potential influence of health workers’ attitudes, there is little research in this area. This study aimed to examine attitudes of different health workers’ groups toward immigrant patients and to identify the associated factors. Methods This cross-sectional study was conducted with a random sample of 400 health workers from primary health care services in the Lisbon region, Portugal. Among those, 320 completed a structured questionnaire. Descriptive analysis and multiple linear regression analysis were used for the evaluation of data. Results Most participants did not agree that immigrant patients tend to behave like victims, but about half considered that some are aggressive and dangerous. Doctors and nurses showed more positive attitudes than office workers. Among doctors, the older ones reported less positive attitudes compared to the younger ones. Health workers who have less daily contact with immigrants revealed more positive attitudes. Most participants evaluated their knowledge and competencies to work with immigrants as moderate or low. Conclusions Although health workers reveal positive attitudes, this study reinforces the need to develop strategies that prevent negative attitudes and stereotyping in health services. Efforts should be made to improve workers’ competencies to deal with culturally diverse populations, in order to promote quality of health care and obtain positive health outcomes among immigrant populations.

  12. The Danish Schizophrenia Registry

    Directory of Open Access Journals (Sweden)

    Baandrup L

    2016-10-01

    Full Text Available Lone Baandrup,1 Charlotte Cerqueira,2 Lea Haller,3 Lene Korshøj,3 Inge Voldsgaard,4 Merete Nordentoft5 1Centre for Neuropsychiatric Schizophrenia Research (CNSR and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS, Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, 2Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, Capital Region of Denmark, Copenhagen, 3The Danish Clinical Registries, Registry Support Centre for Health Quality and Informatics (KCKS-West, Aarhus, 4Psychosis Ward, Section P, Aarhus University Hospital, Risskov, 5Mental Health Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, University of Copenhagen, Copenhagen, DenmarkAim of database: To systematically monitor and improve the quality of treatment and care of patients with schizophrenia in Denmark. In addition, the database is accessible as a resource for research.Study population: Patients diagnosed with schizophrenia and receiving mental health care in psychiatric hospitals or outpatient clinics. During the first year after the diagnosis, patients are classified as incident patients, and after this period as prevalent patients.Main variables: The registry currently contains 21 clinical quality measures in relation to the following domains: diagnostic evaluation, antipsychotic treatment including adverse reactions, cardiovascular risk factors including laboratory values, family intervention, psychoeducation, postdischarge mental health care, assessment of suicide risk in relation to discharge, and assessment of global functioning.Descriptive data: The recorded data are available electronically for the reporting clinicians and responsible administrative personnel, and they are updated monthly. The registry publishes the national and regional results of all included quality measures in the annual audit reports. External researchers may

  13. [Workers in primary health care and partner violence against women].

    Science.gov (United States)

    Arredondo-Provecho, Ana Belén; Broco-Barredo, Manuel; Alcalá-Ponce de León, Teresa; Rivera-Álvarez, Araceli; Jiménez Trujillo, Isabel; Gallardo-Pino, Carmen

    2012-01-01

    Morbidity associated to partner violence against women (PVAW) justify these patients repeated visits to Health Services. Primary Care is the ideal place for detectión and first aid, due to its easy accesibility and continuated assistance. Nevertheless, numbers show important difficulties to achieve this goal. Our aim is to find out the level of knowledge, opinions, awareness about organizacional barriers and improvement proposals suggested by the workers of primary care. Cross-sectional descriptive study using an anonymous and voluntary survey during the months of August and September 2010, targeted to all professionals who perform their work in a Primary Care Area of Madrid. We made a descriptive analysis of variables and used chi(2) to compare the answers. Answer rate is 170 (21.4%). There are stereotypes regarding battered woman and perpetrador. 118 (70.7%) professionals believe that this is a major problem and 154 (91.7%) that usually goes unnoticed. 91 (55.2%) know their legal commitments. 73 (51.8%) think that there are organizational barriers, among them: the burden of care 50(29%), lack of specific training 40(23.5), lack of knowledge about the procedure to be followed 20(11.8%) and about the professional responsabilities 12 (7%). All profesional categoríes showed an average level of knowledge, except for social workers that was high. Primary Care workers think that PVAW is an important issue that usually goes unnoticed. Half of them know the legal commitments o detección. There are organizacional barriers and stereotypes.

  14. Promoting Health Literacy in the Classroom

    Science.gov (United States)

    Bruselius-Jensen, Maria; Bonde, Ane Høstgaard; Christensen, Julie Hellesøe

    2017-01-01

    Objective: Research has shown that developing health literacy in early life is critical to reducing lifestyle-related diseases, with schools being identified as central settings for this purpose. This paper examines how one classroom-based health educational programme, "IMOVE," helped Danish primary school pupils develop health literacy…

  15. Promoting Health Literacy in the Classroom

    Science.gov (United States)

    Bruselius-Jensen, Maria; Bonde, Ane Høstgaard; Christensen, Julie Hellesøe

    2017-01-01

    Objective: Research has shown that developing health literacy in early life is critical to reducing lifestyle-related diseases, with schools being identified as central settings for this purpose. This paper examines how one classroom-based health educational programme, "IMOVE," helped Danish primary school pupils develop health literacy…

  16. Diagnosis of compliance of health care product processing in Primary Health Care 1

    Science.gov (United States)

    Roseira, Camila Eugenia; da Silva, Darlyani Mariano; Passos, Isis Pienta Batista Dias; Orlandi, Fabiana Souza; Padoveze, Maria Clara; de Figueiredo, Rosely Moralez

    2016-01-01

    ABSTRACT Objective: identify the compliance of health care product processing in Primary Health Care and assess possible differences in the compliance among the services characterized as Primary Health Care Service and Family Health Service. Method: quantitative, observational, descriptive and inferential study with the application of structure, process and outcome indicators of the health care product processing at ten services in an interior city of the State of São Paulo - Brazil. Results: for all indicators, the compliance indices were inferior to the ideal levels. No statistically significant difference was found in the indicators between the two types of services investigated. The health care product cleaning indicators obtained the lowest compliance index, while the indicator technical-operational resources for the preparation, conditioning, disinfection/sterilization, storage and distribution of health care products obtained the best index. Conclusion: the diagnosis of compliance of health care product processing at the services assessed indicates that the quality of the process is jeopardized, as no results close to ideal levels were obtained at any service. In addition, no statistically significant difference in these indicators was found between the two types of services studied. PMID:27878220

  17. Diagnosis of compliance of health care product processing in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Camila Eugenia Roseira

    Full Text Available ABSTRACT Objective: identify the compliance of health care product processing in Primary Health Care and assess possible differences in the compliance among the services characterized as Primary Health Care Service and Family Health Service. Method: quantitative, observational, descriptive and inferential study with the application of structure, process and outcome indicators of the health care product processing at ten services in an interior city of the State of São Paulo - Brazil. Results: for all indicators, the compliance indices were inferior to the ideal levels. No statistically significant difference was found in the indicators between the two types of services investigated. The health care product cleaning indicators obtained the lowest compliance index, while the indicator technical-operational resources for the preparation, conditioning, disinfection/sterilization, storage and distribution of health care products obtained the best index. Conclusion: the diagnosis of compliance of health care product processing at the services assessed indicates that the quality of the process is jeopardized, as no results close to ideal levels were obtained at any service. In addition, no statistically significant difference in these indicators was found between the two types of services studied.

  18. Health communication in primary health care -A case study of ICT development for health promotion

    Directory of Open Access Journals (Sweden)

    Mahmud Amina

    2013-01-01

    Full Text Available Abstract Background Developing Information and Communication Technology (ICT supported health communication in PHC could contribute to increased health literacy and empowerment, which are foundations for enabling people to increase control over their health, as a way to reduce increasing lifestyle related ill health. However, to increase the likelihood of success of implementing ICT supported health communication, it is essential to conduct a detailed analysis of the setting and context prior to the intervention. The aim of this study was to gain a better understanding of health communication for health promotion in PHC with emphasis on the implications for a planned ICT supported interactive health channel. Methods A qualitative case study, with a multi-methods approach was applied. Field notes, document study and focus groups were used for data collection. Data was then analyzed using qualitative content analysis. Results Health communication is an integral part of health promotion practice in PHC in this case study. However, there was a lack of consensus among health professionals on what a health promotion approach was, causing discrepancy in approaches and practices of health communication. Two themes emerged from the data analysis: Communicating health and environment for health communication. The themes represented individual and organizational factors that affected health communication practice in PHC and thus need to be taken into consideration in the development of the planned health channel. Conclusions Health communication practiced in PHC is individual based, preventive and reactive in nature, as opposed to population based, promotive and proactive in line with a health promotion approach. The most significant challenge in developing an ICT supported health communication channel for health promotion identified in this study, is profiling a health promotion approach in PHC. Addressing health promotion values and principles in the

  19. Development of disease-specific quality indicators for danish chiropractic patients with low back pain

    DEFF Research Database (Denmark)

    Sorensen, Line P; Krog, Birgitte R; Kongsted, Alice;

    2011-01-01

    The purpose of this study is to develop disease-specific quality indicators for Danish chiropractic patients with low back pain (LBP) as an initial effort to include chiropractors in the Danish Health Care Quality Programme.......The purpose of this study is to develop disease-specific quality indicators for Danish chiropractic patients with low back pain (LBP) as an initial effort to include chiropractors in the Danish Health Care Quality Programme....

  20. A Study of the Combined Effects of Physical Activity and Air Pollution on Mortality in Elderly Urban Residents: The Danish Diet, Cancer, and Health Cohort

    Science.gov (United States)

    de Nazelle, Audrey; Mendez, Michelle Ann; Garcia-Aymerich, Judith; Hertel, Ole; Tjønneland, Anne; Overvad, Kim; Raaschou-Nielsen, Ole; Nieuwenhuijsen, Mark J.

    2015-01-01

    Background Physical activity reduces, whereas exposure to air pollution increases, the risk of premature mortality. Physical activity amplifies respiratory uptake and deposition of air pollutants in the lung, which may augment acute harmful effects of air pollution during exercise. Objectives We aimed to examine whether benefits of physical activity on mortality are moderated by long-term exposure to high air pollution levels in an urban setting. Methods A total of 52,061 subjects (50–65 years of age) from the Danish Diet, Cancer, and Health cohort, living in Aarhus and Copenhagen, reported data on physical activity in 1993–1997 and were followed until 2010. High exposure to air pollution was defined as the upper 25th percentile of modeled nitrogen dioxide (NO2) levels at residential addresses. We associated participation in sports, cycling, gardening, and walking with total and cause-specific mortality by Cox regression, and introduced NO2 as an interaction term. Results In total, 5,534 subjects died: 2,864 from cancer, 1,285 from cardiovascular disease, 354 from respiratory disease, and 122 from diabetes. Significant inverse associations of participation in sports, cycling, and gardening with total, cardiovascular, and diabetes mortality were not modified by NO2. Reductions in respiratory mortality associated with cycling and gardening were more pronounced among participants with moderate/low NO2 [hazard ratio (HR) = 0.55; 95% CI: 0.42, 0.72 and 0.55; 95% CI: 0.41, 0.73, respectively] than with high NO2 exposure (HR = 0.77; 95% CI: 0.54, 1.11 and HR = 0.81; 95% CI: 0.55, 1.18, p-interaction = 0.09 and 0.02, respectively). Conclusions In general, exposure to high levels of traffic-related air pollution did not modify associations, indicating beneficial effects of physical activity on mortality. These novel findings require replication in other study populations. Citation Andersen ZJ, de Nazelle A, Mendez MA, Garcia-Aymerich J, Hertel O, Tjønneland A, Overvad

  1. Primary health care to elderly people: Occupational Therapy actions perspectives

    Directory of Open Access Journals (Sweden)

    Cassio Batista Alves

    2015-09-01

    Full Text Available In Brazil, Occupational Therapy (OT was legislated in 1969, and was introduced into the Primary Health Care (PHC in the 90s. At this level of care, the OT serves various stages of human development, including aging, in a perspective of care and active aging line, seeks to optimize opportunities for health, participation and safety, using clinical reasoning in order to plan, guide, conduct and reflect their actions in producing the line of care. This career considers human activities as part of the construction of the man himself as an expertise area and seeks to understand the relationships that the active human establishes in its life and health. This study aimed to verify the actions and identify the occupational therapy line of care with the elderly in APS. This is a qualitative study that used a semi-structured interview applied during April to May 2013 with six occupational therapists that cared for older people in the APS at Uberaba-MG. The data was analyzed using the Collective Subject Discourse (CSD technique. We observed that the OT actions to produce line of care for the elderly happen according to the general public care, whether individual or group, with the team during case discussions, referrals or work management and the territory during the territorial diagnosis and networks formation, all permeated by the principles of fairness, integrity, intersectoriality and clinical reasoning in OT.

  2. The Discursive Formation of Health. A Study of Printed Health Education Material Used in Primary Care.

    Science.gov (United States)

    Selander, Staffan; Troein, Margareta; Finnegan, John, Jr.; Rastam, Lennart

    1997-01-01

    Printed educational material on cholesterol, food, and health-related lifestyle changes used in primary care in Sweden are evaluated. Materials (211 different products) are analyzed from two theoretically grounded perspectives: orientation of knowledge and rhetoric. Findings are related to patients' ability to make use of the material. (Author/EMK)

  3. Europe's strong primary care systems are linked to better population health but also to higher health spending.

    NARCIS (Netherlands)

    Kringos, D.S.; Boerma, W.; Zee, J. van der; Groenewegen, P.

    2013-01-01

    Strong primary care systems are often viewed as the bedrock of health care systems that provide high-quality care, but the evidence supporting this view is somewhat limited. We analyzed comparative primary care data collected in 2009-10 as part of a European Union-funded project, the Primary Health

  4. Essential attributes and qualifiers of primary health care

    Directory of Open Access Journals (Sweden)

    Andréa Silvia Walter de Aguiar

    2012-06-01

    Full Text Available Historically, the primary health care (PHC has been associated with the first level of care from a health system and characterized by the kind of professional that in it operates, where is expected a predominance of specialists in this area. However, the major limitation for this type of characterization is that the profile of professionals engaged in this service may vary from country to country.Several theoretical and conceptual landmarks proposed approaches and indicators to assess and characterize the APS. In 1978, the American Institute of Medicine suggested an approach in which listed its attributes such as accessibility, integrality, coordination, continuity and responsibility. This was an important landmark in an attempt to outline a normative approach to measure it. However, most indicators and specific definition was not suggested. The selected indicators required a high level of performance, were difficult to be achieved, and focused on the capacity of services and not in its concrete realization(1.A 1996 report, from the same institution, defined PHC as the provision of integrated services and accessible by clinicians who are responsible for attending a large majority of personal care needs, developing a continued partnership with patients and working within family and community. This definition does not include the first contact and focuses on individual attention.The Canadian Medical Association, in 1996, considered the APS as a front door of the health system and community interventions included in the definition of the functions of APS. In the same year was published a Charter for General Practice / Family Medicine in Europe (Letter to General Practice / Family Medicine in Europe, which describes 12 characteristics: general, accessible, integrated, continuous, as a team, holistic, personalized, targeted for the family and the community, coordinated, confidential and protectress(2.Donabedian(3 systematized a group of important

  5. Pediatric Primary Care Providers' Relationships with Mental Health Care Providers: Survey Results

    Science.gov (United States)

    Pidano, Anne E.; Honigfeld, Lisa; Bar-Halpern, Miri; Vivian, James E.

    2014-01-01

    Background: As many as 20 % of children have diagnosable mental health conditions and nearly all of them receive pediatric primary health care. However, most children with serious mental health concerns do not receive mental health services. This study tested hypotheses that pediatric primary care providers (PPCPs) in relationships with mental…

  6. Preliminary Exploration of the Mental Health Education Competency Survey of Primary and Middle School Head Teachers

    Science.gov (United States)

    Liu, Chunyu; Liu, Yanling; Guo, Cheng; Lan, Haiying

    2014-01-01

    Despite a recent focus on the mental health of students, primary and middle school mental health education in China has been hampered by a lack of resources and inadequate professional training. This study assessed the mental health education competency of primary and middle school head teachers using the Mental Health Education Competency…

  7. The Danish letters

    DEFF Research Database (Denmark)

    Beier, Sofie; Ejlers, Steen

    2011-01-01

    The talk will focus on Danish type designers and their work on Æ (AE), Ø (Oslash) and Å (Aring). These 'anomalies' found in the Danish written language, often causes difficulties for type designers. The counters of Ø/ø sometimes appear overcrowded, the uppercase Æ can result in an uncomfortably o......' attempt to create the optimal variation of these letters, we will give a brief introduction to the Danish typography tradition ranging from the early 20th Century and up until today....

  8. The Danish letters

    DEFF Research Database (Denmark)

    Beier, Sofie; Ejlers, Steen

    2011-01-01

    The talk will focus on Danish type designers and their work on Æ (AE), Ø (Oslash) and Å (Aring). These 'anomalies' found in the Danish written language, often causes difficulties for type designers. The counters of Ø/ø sometimes appear overcrowded, the uppercase Æ can result in an uncomfortably o......' attempt to create the optimal variation of these letters, we will give a brief introduction to the Danish typography tradition ranging from the early 20th Century and up until today....

  9. Mental health, pregnancy and self-rated health in antenatal women attending primary health clinics.

    Science.gov (United States)

    Sonkusare, S; Adinegara; Hebbar, S

    2007-12-01

    The purpose of this study was to study the determinants of self rated health in the low-risk pregnant women of Melaka Tengah in Malaysia. A total of 387 subjects were analysed. The role of mental health, psychosocial stressors, support from husband, coping skills, socio-economic status and pregnancy characteristics in determining self- rated health were studied. Health items were taken from the Duke Health Profile. Bad obstetric history, poor mental health, stress from the family were found to be significantly associated with poor self - rated health whereas good support from the husband was related to good self - rated health.

  10. Providing primary health care through integrated microfinance and health services in Latin America.

    Science.gov (United States)

    Geissler, Kimberley H; Leatherman, Sheila

    2015-05-01

    The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic

  11. Quality of Primary Health Services in the Clinics of Shomal Health Center of Tehran

    Directory of Open Access Journals (Sweden)

    Mohammad-Hossein Safi

    2015-02-01

    Full Text Available Background and Objective: Quality is a major concern in the services offered by the health sector.  The first basic step, in formulating any quality-improvement program, is recognizing consumers’ perceptions and expectations of the services' quality. The aim of this study is to determine the gaps in the health services and provide solutions to increase clients' satisfaction in the clinics of Shomal Health Center of Tehran.Material and Methods: This cross-sectional and descriptive study was done in 2013. The sample size was 325, proportionately selected from the recipients of primary health care in each clinic. Data was collected by a questionnaire, based on the five dimensions of service quality gap SERVQUAL instrument; which includes 22 questions. The collected data was statistically analyzed using SPSS software.  Results: There was a significant difference between the client's perception and expectation in each of the five dimensions of service quality. The smallest gap was in the communion (0.68 and the largest gap in the concrete (0/88 service. The client's education was significantly associated with the quality gap.Conclusion: None of the service dimensions were beyond the expectations of the respondents. Therefore, there is an ample room for improving the service processes.Keywords: Health center, Quality of service, SERVQUAL, Shomal Health Center, Primary Health

  12. Choosing a Primary Health Care Provider (PCP): A Guide for Young Men

    Science.gov (United States)

    ... Health Medical Conditions Nutrition & Fitness Emotional Health Choosing a Primary Health Care Provider (PCP): General Information Posted ... help address your problems. Why do I need a PCP? You need a PCP so that your ...

  13. Health care, quality certification and institutional support: a focus on primary health care in Brazil

    Directory of Open Access Journals (Sweden)

    Antônio Thomaz Gonzaga da Matta-Machado

    2016-05-01

    Full Text Available Objective. To provide an overview of the distribution of institutional support in primary care in Brazil and to identify associations between the activities of institutional support and the outcome of the certification of the National Programme for Improving Access and Quality in Primary Health Care (PMAQ. Materials and methods. A cross-sectional study was conducted through interviews with 16 960 profes- sionals in Brazil in 2012. To examine the relationship between the received support and the quality of health care it was made a multiple binary logistic regression. Results. A positive relationship between high-level support and certification in the sub-dimensions analyzed was observed: women and child care, diabetes mellitus/ hypertension and mental health. The support activities which contributed most were: self-assessment, shared assessment, targeted workshops and training. Conclusion. Institutional support activities have helped to improve the quality and access of the population to healthcare in the country.

  14. The Danish National Cohort Study (DANCOS)

    DEFF Research Database (Denmark)

    Helweg-Larsen, Karin; Kjøller, Mette; Davidsen, Michael;

    2003-01-01

    This article gives an overview of a nationally representive public health research database in Denmark, the Danish National Cohort Study (DANCOS). DANCOS combines baseline data from health interview surveys with both pre- and post-baseline data from national health registries with date from a re...... Service Register recorded 980,043 contacts with general practitioners and specialist physicians. For 1943-1996, the Danish cancer Registry contained information about one or more cancer diseases among 1,432 people. A total of 4,334 people in the 1994 cohort were re-interview in 2000. DANCOS allows...

  15. Socio-economic correlates of functional health literacy among patients of primary health care in Kosovo.

    Science.gov (United States)

    Toçi, E; Burazeri, G; Kamberi, H; Jerliu, N; Sørensen, K; Brand, H

    2014-09-01

    Functional health literacy (FHL) has been related to individual characteristics, ill-health and disease knowledge. However, the information about FHL in Kosovo is very limited and thus the aim of this study was to assess the demographic and socio-economic correlates of FHL among users of primary health care in Kosovo, a postconflict country in the Western Balkans. Cross-sectional study. A cross-sectional study was conducted in Kosovo between November 2012-February 2013, including a representative sample of 1035 consecutive primary care users aged ≥18 years (60% females; overall mean age: 44.3 ± 16.9 years; overall response rate: 86%). Test of Functional Health Literacy in Adults (TOFHLA) was used to assess FHL. General linear model and logistic regression were used to assess the association of TOFHLA score with demographic and socio-economic characteristics. Overall, four out of five participants exhibited inadequate or marginal FHL in this Kosovo sample. FHL score was independently and inversely related to age, but positively associated with educational attainment and being in a situation other than unemployed. Limited or marginal FHL was very common among primary care users in Kosovo and considerably higher than in the neighbouring Serbia. The low health literacy levels in Kosovo may provide an additional barrier towards achievement of health care goals. There is a need to design and implement suitable and effective educational and health system interventions in the Kosovo context. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  16. Guidelines for Primary Health Care teaching in undergraduate medical education

    Directory of Open Access Journals (Sweden)

    Marcelo Marcos Piva Demarzo

    2011-05-01

    Full Text Available These are a set of guidelines built by the Brazilian Association of Medical Education (ABEM and the Brazilian Society of Family and Community Medicine (SBMFC with the aim of supporting medical schools in a practical and objective manner, when elaborating pedagogical-political projects on Primary Health Care (PHC. The advent of the Brazilian National Curricular Guidelines for Medical Education, which are approved by the Ministry of Education in 2001 have since improved the teaching of undergraduate medical students on PHC, but there are still wide variations in implementation and quality of it in medical curricula. These guidelines by ABEM/SBMFC partnership can exert considerable influence on medical curricula by establishing minimum requirements and core competencies for PHC in Brazil.

  17. Work context, job satisfaction and suffering in primary health care

    Directory of Open Access Journals (Sweden)

    Greisse da Silveira Maissiat

    Full Text Available OBJECTIVE: To evaluate the work context, job satisfaction and suffering from the perspective of workers in primary health care. METHOD: This cross-sectional study was conducted with 242 employees of a municipality of Rio Grande do Sul, Brazil, from May to July 2012. The adopted instruments were the Work Context Assessment Scale (EACT and the Job Satisfaction and Suffering Indicators Scale (EIPST. Research also included descriptive and inferential statistical analysis. RESULTS: Organization (91.3% and work conditions (64% received the worst scores in terms of context. The indicators of job satisfaction were related to professional achievement (55.8%, freedom of expression (62.4% and recognition (59.9%. However, 64.5% presented professional exhaustion, which had an inverse association with age and years in the institution (p<0.05. CONCLUSION: The workers evaluated their work context as inappropriate and complained of exhaustion, although they claimed their work affords some satisfaction.

  18. [Management of adult secondary insomnia in primary health care].

    Science.gov (United States)

    Cavadas, Luís Filipe; Ribeiro, Lúcia

    2011-01-01

    Insomnia is the most common sleep disorder in adults, with secondary insomnia being the most prevalent. This sleep disorder is associated with important medical and social consequences. The General Practitioner (GP) plays a key role in the diagnosis of insomnia, which may affect about 69% of their patients in the PHC (Primary Health Care). Recognize the differential diagnosis of secondary insomnia in adults, evaluate and manage these patients in the PHC, appropriately use the treatments available and meet the criteria for referral. Bibliographic search in MEDLINE databases, and evidence based review databases, using the MeSH terms: Primary Health Care, Sleep Disorders, Insomnia, for articles published since January 2000 until July 2009, in English, Portuguese, French and Spanish. Index de Revistas Médicas Portuguesas and scientific societies dedicated to sleep disorders were searched. Mood and anxiety disorders are the main co-morbidities associated with secondary insomnia, being present in 30% to 50% of patients with insomnia. The medical pathology and substance abuse are present respectively in 10% of patients. It is essential a proper clinical history, with a history of sleep, sleep diary and the partner information. There is evidence that the combination of specific pharmacological treatments (benzodiazepines and the benzodiazepine receptor agonists) with the nonpharmacological (cognitive-behavioral therapy) may be useful in secondary insomnia, as co-adjuvant treatment of the underlying disease. There are several treatment options with their indications and adverse effects. The criteria for referral should be defined according to the availability of human resources. Due to the high prevalence and the serious consequences of secondary insomnia in adults, it must be systematically managed by the GP. It is important to know and to use non-pharmacological therapy in GP consultation, because this therapy was shown to be important in treating this type of insomnia

  19. Knowledge about COPD among users of primary health care services

    Science.gov (United States)

    de Queiroz, Maria Conceição de Castro Antonelli Monteiro; Moreira, Maria Auxiliadora Carmo; Jardim, Jose R; Barbosa, Maria Alves; Minamisava, Ruth; Gondim, Heicilainy Del Carlos; Velasco, Flávia Castro; Penhavel, Maria Vitoria Carmo

    2015-01-01

    Background Chronic obstructive pulmonary disease (COPD) is often underdiagnosed, which might be attributable to a lack of knowledge about the disease among the general population. The objective of this study was to evaluate COPD-related knowledge among primary care users in an urban area in Brazil. Methods This study was carried out at primary care clinics (PCCs), including 12 general PCCs and 26 family health PCCs, in the city of Goiânia, Brazil. Between May 2013 and February 2014, we interviewed 674 PCC users, applying a questionnaire designed to assess COPD-related knowledge. Satisfactory knowledge of COPD was defined as knowing at least two of its symptoms and that smoking is a risk factor for the disease. Results Of the 674 users interviewed, only 9.2% recognized the term “COPD”, 75.1% recognized the term “emphysema”, and 15.7% did not recognize either term. We found that recognizing either term was associated with a higher level of education (P<0.001). The prevalence of satisfactory knowledge of COPD was 16.2%, and having such knowledge was associated with being over 60 years of age. The COPD symptom known by the greatest proportion of users (70.6%) was dyspnea, and most (87.5%) knew that smoking is a risk factor, whereas only a few (4.9%) knew that exposure to wood smoke is also a risk factor. The most frequently cited sources of knowledge were the media (43.1%) and a relative with COPD (36.4%). Conclusion Most of the PCC users evaluated did not know the term “COPD” but were familiar with the term “emphysema”. The level of basic knowledge about the disease was low in this population. These results should alert health care administrators to the need for interventions aimed at increasing the diagnosis rate and thus promoting the early treatment of COPD. PMID:25565794

  20. Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra

    2014-01-01

    To examine the costs to the public health care system of couples in medically assisted reproduction.......To examine the costs to the public health care system of couples in medically assisted reproduction....

  1. 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.

  2. 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

  3. Exploring barriers for health visitors’ adaption of the Danish Children’s Database through an empirical study

    DEFF Research Database (Denmark)

    Pape-Haugaard, Louise; Haugaard, Karin; Carøe, Per

    2013-01-01

    families and from health visitors at central health offices. Results are discussed from a socio-technical perspective using Schein’s cultural theory to understand the interaction between the health visitors and the information technology used for collecting data. Cultural theory is used to explain...... the underlying socially constructed mechanisms that cause errors when using the information technology....

  4. Disability inclusion in primary health care in Nepal: an explorative study of perceived barriers to access governmental health services.

    NARCIS (Netherlands)

    Hees, S. van; Cornielje, H.; Wagle, P.; Veldman, E.

    2014-01-01

    Purpose: Persons with disabilities face additional barriers in accessing primary healthcare services, especially in developing countries. Consequently the prevalence of secondary health conditions is higher among this population. This study aims to explore the perceived barriers to access primary

  5. The Danish Sarcoma Database

    Directory of Open Access Journals (Sweden)

    Jorgensen PH

    2016-10-01

    Full Text Available Peter Holmberg Jørgensen,1 Gunnar Schwarz Lausten,2 Alma B Pedersen3 1Tumor Section, Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, 2Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen, 3Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark Aim: The aim of the database is to gather information about sarcomas treated in Denmark in order to continuously monitor and improve the quality of sarcoma treatment in a local, a national, and an international perspective. Study population: Patients in Denmark diagnosed with a sarcoma, both skeletal and ekstraskeletal, are to be registered since 2009. Main variables: The database contains information about appearance of symptoms; date of receiving referral to a sarcoma center; date of first visit; whether surgery has been performed elsewhere before referral, diagnosis, and treatment; tumor characteristics such as location, size, malignancy grade, and growth pattern; details on treatment (kind of surgery, amount of radiation therapy, type and duration of chemotherapy; complications of treatment; local recurrence and metastases; and comorbidity. In addition, several quality indicators are registered in order to measure the quality of care provided by the hospitals and make comparisons between hospitals and with international standards. Descriptive data: Demographic patient-specific data such as age, sex, region of living, comorbidity, World Health Organization's International Classification of Diseases – tenth edition codes and TNM Classification of Malignant Tumours, and date of death (after yearly coupling to the Danish Civil Registration System. Data quality and completeness are currently secured. Conclusion: The Danish Sarcoma Database is population based and includes sarcomas occurring in Denmark since 2009. It is a valuable tool for monitoring sarcoma incidence and quality of treatment and its improvement, postoperative

  6. Exploring barriers for health visitors’ adaption of the Danish Children’s Database through an empirical study

    DEFF Research Database (Denmark)

    Pape-Haugaard, Louise; Haugaard, Karin; Carøe, Per

    2013-01-01

    families and from health visitors at central health offices. Results are discussed from a socio-technical perspective using Schein’s cultural theory to understand the interaction between the health visitors and the information technology used for collecting data. Cultural theory is used to explain...... analysis. The data show redundant records. This redundancy can be explained by multiple transmissions conducted by end users or systems, or a lack of validation methods in the National CDB. In our results three types of cases are presented: from health visitors at school, from health visitors visiting...

  7. An analysis of the meaning of integrated Primary Health Care from the KwaZulu- Natal Primary Health Care context

    Directory of Open Access Journals (Sweden)

    M.N. Sibiya

    2009-09-01

    Full Text Available In South Africa, integration o f services policy was enacted in 1996 with the aim of increasing health service utilization by increasing accessibility and availability of all health care services at Primary Health Care (PHC level. Integration of PHC services continues to be seen as a pivotal strategy towards the achievement of the national goals of transformation of health services, and the attainment of a comprehensive and seamless public health system. Although the drive behind the integration of PHC services was to improve accessibility of services to the community, the problem however, arises in the implementation of integrated PHC (IPHC as there is no agreed upon understanding of what this phenomenon means in the South African context. To date no research studies have been reported on the meaning of the integration of PHC services. Hence, there is a need for shared views on this phenomenon in order to facilitate an effective implementation of this approach. A cross-sectional study, using a qualitative approach was employed in this study in order to analyze the phenomenon, IPHC in KwaZulu-Natal and the meaning attached to it in different levels of the health system. A grounded theory was selected as it is a method known for its ability to make greatest contribution in areas where little research has been done and when new viewpoints are needed to describe the familiar phenomenon that is not clearly understood. Policy makers and co-ordinators of PHC at national, provincial and district levels as well as PHC nurses at functional level participated in the study. The data was collected by means of observations, interviews and document analysis. The sample size for interviews was comprised of 38 participants. Strauss and Corbin’s process of data analysis was used. It emerged that there were three core categories that were used by the participants as discriminatory dimensions of IPHC in South Africa. These core categories were (a comprehensive

  8. [Psychosocial stress environment and health workers in public health: Differences between primary and hospital care].

    Science.gov (United States)

    García-Rodríguez, Antonio; Gutiérrez-Bedmar, Mario; Bellón-Saameño, Juan Ángel; Muñoz-Bravo, Carlos; Fernández-Crehuet Navajas, Joaquín

    2015-01-01

    To describe the psychosocial environment of health professionals in public health in primary and hospital care, and compare it with that of the general Spanish working population, as well as to evaluate the effect of psychosocial risk factors on symptoms related to perceived stress. Cross-sectional study with stratified random sampling. Health care workers in the province of Granada, distributed in 5 hospitals and 4 health districts. A total of 738 employees (medical and nursing staff) of the Andalusian Health Service (SAS) were invited to take part. CopSoQ/Istas21 questionnaire developed for the multidimensional analysis of the psychosocial work environment. Stress symptoms were measured with the Stress Profile questionnaire. The response rate was 67.5%. Compared with the Spanish workforce, our sample showed high cognitive, emotional, and sensory psychological demands, possibilities for development and sense of direction in their work. Primary care physicians were the group with a worse psychosocial work environment. All the groups studied showed high levels of stress symptoms. Multivariate analysis showed that variables associated with high levels of stress symptom were younger and with possibilities for social relations, role conflict, and higher emotional demands, and insecurity at work. Our findings support that the psychosocial work environment of health workers differs from that of the Spanish working population, being more unfavorable in general practitioners. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  9. Mental health and primary care: an experience with community health agents in Salvador-BA

    Directory of Open Access Journals (Sweden)

    Noêmia Aragão Casais

    2009-12-01

    Full Text Available Objective: To share an experience of a link between primary care and mental health by means of matrix support. Method: A survey conducted from March to December 2007, in Pernambués neighborhood, District of Cabula-beiru, in Salvador - Bahia. The shared knowledge construction was carried out by residents of the Multidisciplinary Residency Program in Health from the Nucleus of Mental Health, State University of Bahia, with Community Health Agents (ACS. Meetings, discussions and domiciliary visits were applyed as sharing technics and tools with phonographic recording, photographic register and report. The obtained information were evaluated regarding their content and were divided into stages and categories. Results: We determined the following stages by means of the technique: approach, ties’ strengthening, teamwork and conclusion. The results were analyzed based on the ACS’ everyday interactivity for cooperation, thus obtaining the development of a critical spirit in the assesment of the relationship between primary care and mental health. Final Considerations: The exchange of experiences produced significant learning, besides health promotion for all those involved in the process: ACS, families cared for and residents.

  10. Primary health care models: medical students’ knowledge and perceptions.

    Science.gov (United States)

    Brown, Judith Belle; French, Reta; McCulloch, Amy; Clendinning, Eric

    2012-03-01

    To explore the knowledge and perceptions of fourth-year medical students regarding the new models of primary health care (PHC) and to ascertain whether that knowledge influenced their decisions to pursue careers in family medicine. Qualitative study using semistructured interviews. The Schulich School of Medicine and Dentistry at The University of Western Ontario in London. Participants Fourth-year medical students graduating in 2009 who indicated family medicine as a possible career choice on their Canadian Residency Matching Service applications. Eleven semistructured interviews were conducted between January and April of 2009. Data were analyzed using an iterative and interpretive approach. The analysis strategy of immersion and crystallization assisted in synthesizing the data to provide a comprehensive view of key themes and overarching concepts. Four key themes were identified: the level of students’ knowledge regarding PHC models varied; the knowledge was generally obtained from practical experiences rather than classroom learning; students could identify both advantages and disadvantages of working within the new PHC models; and although students regarded the new PHC models positively, these models did not influence their decisions to pursue careers in family medicine. Knowledge of the new PHC models varies among fourth-year students, indicating a need for improved education strategies in the years before clinical training. Being able to identify advantages and disadvantages of the PHC models was not enough to influence participants’ choice of specialty. Educators and health care policy makers need to determine the best methods to promote and facilitate knowledge transfer about these PHC models.

  11. New demands for primary health care in Brazil: palliative care

    Directory of Open Access Journals (Sweden)

    Cássia Regina de Paula Paz

    Full Text Available Objective.Assess the need for incorporation of palliative care in primary health care (PHC through the characterization of users eligible for this type of care, enrolled in a program for devices dispensing. Methods. Descriptive study of case series conducted in 14 health units in São Paulo (Brazil in 2012. It was included medical records of those enrolled in a program for users with urinary and fecal incontinence, and it was applied Karnofsky Performance Scale Index (KPS to identify the indication of palliative care. Results. 141 of the 160 selected medical records had KPS information. Most cases (98.3%, 138/141 had performance below 70% and, therefore, patients were eligible for palliative care. The most frequent pathologies was related to chronic degenerative diseases (46.3%, followed by disorders related to quality of care during pregnancy and childbirth (24.38%. Conclusion. It is necessary to include palliative care in PHC in order to provide comprehensive, shared and humanized care to patients who need this.

  12. New demands for primary health care in Brazil: palliative care.

    Science.gov (United States)

    de Paula Paz, Cássia Regina; Reis Pessalacia, Juliana Dias; Campos Pavone Zoboli, Elma Lourdes; Ludugério de Souza, Hieda; Ferreira Granja, Gabriela; Cabral Schveitzer, Mariana

    2016-04-01

    Assess the need for incorporation of palliative care in primary health care (PHC) through the characterization of users eligible for this type of care, enrolled in a program for devices dispensing. Descriptive study of case series conducted in 14 health units in São Paulo (Brazil) in 2012. It was included medical records of those enrolled in a program for users with urinary and fecal incontinence, and it was applied Karnofsky Performance Scale Index (KPS) to identify the indication of palliative care. 141 of the 160 selected medical records had KPS information. Most cases (98.3%, 138/141) had performance below 70% and, therefore, patients were eligible for palliative care. The most frequent pathologies was related to chronic degenerative diseases (46.3%), followed by disorders related to quality of care during pregnancy and childbirth (24.38%). It is necessary to include palliative care in PHC in order to provide comprehensive, shared and humanized care to patients who need this.

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

    Directory of Open Access Journals (Sweden)

    Bygbjerg Ib Christian

    2006-03-01

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

  14. Understanding persons with psychological distress in primary health care.

    Science.gov (United States)

    Arvidsdotter, Tina; Marklund, Bertil; Kylén, Sven; Taft, Charles; Ekman, Inger

    2016-12-01

    The purpose of this study was to gain more knowledge and a deeper understanding of experiences of persons living with psychological distress who seek help in primary care. Psychological distress is a state of emotional suffering associated with stressors and demands that are difficult to cope with in daily life. The lack of effective care for and difficulty in identifying psychological distress is frustrating for patients and health professionals alike. The aim was therefore to gain more knowledge about the experience of living with psychological distress. Twelve persons (nine women and three men) aged 23-51 years were interviewed. Analyses were based on a phenomenological hermeneutic method and indicated that psychological distress may be seen as an imbalance (incongruence) between the self and the ideal self, which slowly breaks down a person's self-esteem. This imbalance was described in three dimensions: Struggling to cope with everyday life, Feeling inferior to others and Losing one's grip on life. It seems to be associated with a gradual depletion of existential capacities and lead to dissatisfaction, suffering, poor self-esteem and lack of control. As psychological distress may be a forerunner to mental, physical and emotional exhaustion, there is a need to initiate preventive or early interventions to avoid mental, physical and emotional chaos in such patients. Patients' with psychological distress need to be involved in a person-centred salutogenic dialogue with health professionals to become aware of and strengthen their own capacities to regain health and well-being. © 2015 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

  15. The Danish National Database for Asthma

    DEFF Research Database (Denmark)

    Backer, Vibeke; Lykkegaard, Jesper; Bodtger, Uffe

    2016-01-01

    of 6 years, with a specific focus on 6-44 years, are included. The DNDA links three existing nationwide registries of administrative records in the Danish health care system: the National Patient Register, the National Health Insurance Services Register, and the National Prescription Registry. For each...

  16. The Danish Hip Arthroplasty Register

    DEFF Research Database (Denmark)

    Gundtoft, Per Hviid; Varnum, Claus; Pedersen, Alma Becic

    2016-01-01

    through the DHR. Approximately 9,000 primary THAs and 1,500 revisions are reported to the register annually. CONCLUSION: The DHR is important for monitoring and improvement of treatment with THA and is a valuable tool for research in THA surgery due to the high quality of prospective collected data....... All Danish orthopedic departments - both public and private - report to the register, and registration is compulsory. MAIN VARIABLES: The main variables in the register include civil registration number, indication for primary and revision surgery, operation date and side, and postoperative...... complications. Completeness of primary and revision surgery is evaluated annually and validation of a number of variables has been carried out. DESCRIPTIVE DATA: A total of 139,525 primary THAs and 22,118 revisions have been registered in the DHR between January 1, 1995 and December 31, 2014. Since 1995...

  17. Health systems context(s) for integrating mental health into primary health care in six Emerald countries: a situation analysis.

    Science.gov (United States)

    Mugisha, James; Abdulmalik, Jibril; Hanlon, Charlotte; Petersen, Inge; Lund, Crick; Upadhaya, Nawaraj; Ahuja, Shalini; Shidhaye, Rahul; Mntambo, Ntokozo; Alem, Atalay; Gureje, Oye; Kigozi, Fred

    2017-01-01

    Mental, neurological and substance use disorders contribute to a significant proportion of the world's disease burden, including in low and middle income countries (LMICs). In this study, we focused on the health systems required to support integration of mental health into primary health care (PHC) in Ethiopia, India, Nepal, Nigeria, South Africa and Uganda. A checklist guided by the World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) was developed and was used for data collection in each of the six countries participating in the Emerging mental health systems in low and middle-income countries (Emerald) research consortium. The documents reviewed were from the following domains: mental health legislation, health policies/plans and relevant country health programs. Data were analyzed using thematic content analysis. Three of the study countries (Ethiopia, Nepal, Nigeria, and Uganda) were working towards developing mental health legislation. South Africa and India were ahead of other countries, having enacted recent Mental Health Care Act in 2004 and 2016, respectively. Among all the 6 study countries, only Nepal, Nigeria and South Africa had a standalone mental health policy. However, other countries had related health policies where mental health was mentioned. The lack of fully fledged policies is likely to limit opportunities for resource mobilization for the mental health sector and efforts to integrate mental health into PHC. Most countries were found to be allocating inadequate budgets from the health budget for mental health, with South Africa (5%) and Nepal (0.17%) were the countries with the highest and lowest proportions of health budgets spent on mental health, respectively. Other vital resources that support integration such as human resources and health facilities for mental health services were found to be in adequate in all the study countries. Monitoring and evaluation systems to support the integration of mental

  18. Danish SDHW Technology

    DEFF Research Database (Denmark)

    Furbo, Simon

    1996-01-01

    The status of Danish technology for solar heating systems for hot water supply as well as R&D work in the field is presented.......The status of Danish technology for solar heating systems for hot water supply as well as R&D work in the field is presented....

  19. Danish Technology Framework

    DEFF Research Database (Denmark)

    Bonke, Sten; Jørgensen, Tom Rydahl

    This report investigates the occurrence of foundation failures within the context of the Danish construction technology framework. The report comprises a definition/typology section on the basis of which Danish regulatory and administrative procedures in relation to foundation failures are reviewed....

  20. The Danish Adoption Register

    DEFF Research Database (Denmark)

    Petersen, Liselotte; Sørensen, Thorkild I A

    2011-01-01

    The Danish Adoption Register was established in 1963-1964 to explore the genetic and environmental contribution to familial aggregation of schizophrenia.......The Danish Adoption Register was established in 1963-1964 to explore the genetic and environmental contribution to familial aggregation of schizophrenia....

  1. Greening of Danish Industry

    DEFF Research Database (Denmark)

    Remmen, Arne

    2002-01-01

    The article outlines the major changes in the discourse on cleaner technology and on pollution prevention, together with policy instuments applied in the Danish industry.......The article outlines the major changes in the discourse on cleaner technology and on pollution prevention, together with policy instuments applied in the Danish industry....

  2. Does employee participation in workplace health promotion depend on the working environment? A cross-sectional study of Danish workers

    OpenAIRE

    Jørgensen, Marie Birk; Villadsen, Ebbe; Burr, Hermann; Punnett, Laura; Holtermann, Andreas

    2016-01-01

    Objectives To investigate if participation in workplace health promotion (WHP) depends on the work environment. Methods Questionnaire data on participation in WHP activities (smoking cessation, healthy diet, exercise facilities, weekly exercise classes, contact with health professionals, health screenings) and the work environment (social support, fatiguing work, physical, quantitative and emotional demands, job control and WHP availability setting) were collected cross-sectionally in 2010 in...

  3. Asthma control limitations in selected primary health care clinics

    Directory of Open Access Journals (Sweden)

    Jan J. Gerber

    2009-04-01

    Full Text Available Primary health care services worldwide are currently experiencing many quality-related problems. Efforts to improve these services appear to be sporadic and unsatisfactory. Investigations have revealed (Sharma & Sharma 2007 that one of the main causes for this state of affairs can be identif ed as neglected or inadequate documentation of patient/case history. The health care provider (HCP should be equipped to improve the quality of health care and to take the lead in assuaging the predicament.

    The present study was undertaken to assess the correlation between asthma control and patient-related case history notes as recorded via the HCP. The data were obtained retrospectively from the patient notes of all asthmatic patients (including children and pregnant women who attended six selected clinics in the North West Province of South Africa (Dr Kenneth Kaunda Municipal District.

    The analysis of the data collected from the patient clinic books confirmed the suspicion of poor quality of documentation, although the documentation in certain categories rendered some positive results. When compared to the GINA® guidelines, none of the patients had been controlled properly and only a small number (18.4% had been controlled partly (GINA 2008. Asthma control may be enhanced when a standard template is developed for completion by the HCP. It is envisaged that this will ensure that vital information regarding asthma control is documented in order to contribute to satisfactory chronic disease control.

    Opsomming

    Primêre gesondheidsorgdienste wêreldwyd ondervind tans menige gehaltediens-verwante probleme, terwyl pogings om dit te verbeter sporadies en onbevredigend voorkom. Navorsing toon (Sharma & Sharma, 2007 dat een van die hoofoorsake hiervan die onvoldoende dokumentasie van die pasiënt of die geval se geskiedenis of nalating om te dokumenteer, is. Die gesondheidsorgverskaffer (GSV moet toegerus word om die gehalte

  4. Danish Exports and Danish Bilateral Aid

    DEFF Research Database (Denmark)

    Hansen, Henrik; Rand, John

    countries. This Evaluation Study presents an econometric analysis of Danish exports to 144 countries over the period from 1981 to 2010. The analysis is based on the gravity model of bilateral trade; a structural model developed over decades and now the central model in analyses of bilateral trade flows...... and trade policies. The main result of the study is that Danish bilateral aid has a positive and statistically significant impact on Danish exports to the recipient countries. Bilateral development assistance may affect exports through several channels. Three of the main channels are direct aid tying......; increasing recipient income where higher income leads to higher imports, and decreased trade costs, say due to improved information about cultural and administrative customs and practices. Thus, as for preferential trade arrangements, bilateral aid has two potential economic effects; trade creation working...

  5. More Danish, More English

    DEFF Research Database (Denmark)

    Chopin, Kimberly Renée

    Universities in Denmark are becoming increasingly internationalized, and areincreasingly using English as a language of research, teaching, and administration. At the same time, the Danish language is seen by some as being under threat, and Danish public discourse has focused on what role...... the Danish language may play in higher education in Denmark. This study investigates both trends through a focus on recently implemented language policies at one Danish university faculty which mandate that graduate instruction becarried out only in English, and undergraduate instruction only in Danish.......This study investigated the decision making process over time in order to reveal how such language policies would be received in one affected department. Interviews with department teaching staff were carried out both before and after the implementation of the decisions, along with interviews of department...

  6. The Danish Melanoma Database

    DEFF Research Database (Denmark)

    Hölmich, Lisbet Rosenkrantz; Klausen, Siri; Spaun, Eva;

    2016-01-01

    AIM OF DATABASE: The aim of the database is to monitor and improve the treatment and survival of melanoma patients. STUDY POPULATION: All Danish patients with cutaneous melanoma and in situ melanomas must be registered in the Danish Melanoma Database (DMD). In 2014, 2,525 patients with invasive...... melanoma and 780 with in situ tumors were registered. The coverage is currently 93% compared with the Danish Pathology Register. MAIN VARIABLES: The main variables include demographic, clinical, and pathological characteristics, including Breslow's tumor thickness, ± ulceration, mitoses, and tumor...... quality register. The coverage is high, and the performance in the five Danish regions is quite similar due to strong adherence to guidelines provided by the Danish Melanoma Group. The list of monitored indicators is constantly expanding, and annual quality reports are issued. Several important scientific...

  7. Danish Wind Power

    DEFF Research Database (Denmark)

    Lund, Henrik; Hvelplund, Frede; Østergaard, Poul Alberg

    In a normal wind year, Danish wind turbines generate the equivalent of approx. 20 percent of the Danish electricity demand. This paper argues that only approx. 1 percent of the wind power production is exported. The rest is used to meet domestic Danish electricity demands. The cost of wind power...... is paid solely by the electricity consumers and the net influence on consumer prices was as low as 1-3 percent on average in the period 2004-2008. In 2008, the net influence even decreased the average consumer price, although only slightly. In Denmark, 20 percent wind power is integrated by using both......, a study made by the Danish think tank CEPOS claimed the opposite, i.e. that most of the Danish wind power has been exported in recent years. However, this claim is based on an incorrect interpretation of statistics and a lack of understanding of how the international electricity markets operate...

  8. Assessment of human health risk associated with pyaemia in Danish finisher pigs when conducting visual-only inspection of the lungs.

    Science.gov (United States)

    Kruse, Amanda Brinch; Larsen, Marianne Halberg; Skou, Peter Bæk; Alban, Lis

    2015-03-02

    The most important lesion to be overlooked when performing visual-only inspection of the lungs is embolic pneumonia. The aim of the present study was to assess the additional human health risk represented by overlooking cases of pyaemia represented by embolic pneumonia in finisher pigs, when conducting visual-only compared to palpation of the lungs, as is the traditional meat inspection procedure. An examination of bacteria isolated from 19 finisher pigs identified with embolic pneumonia at traditional meat inspection was undertaken. From each pig samples were taken from various organs (lungs, spleen, heart, liver and kidney), from the carpal joints (A. carpi) and flexor muscle (M. flexor digitorum superficialis) on the right foreleg. These data were included in a risk assessment following OIE guidelines. Bacteria were isolated from 78 out of 127 tissue and swap samples taken (61% positive samples). Staphylococcus aureus (N=37) was the most frequently isolated bacterium. The predominant site of S. aureus was the lung. S. aureus was detected although less frequently in low numbers in some organs (risk of a food-borne intoxication from S. aureus in relation to pyaemia in pigs was considered very low due to the low quantitative numbers of S. aureus in muscle tissue samples. Implementing visual-only inspection will reduce the exposure of S. aureus due to less cross-contamination and handling of the plucks by the meat inspectors. The human health risk associated with S. warneri was considered very low, due to the limited zoonotic potential of this bacterium. In conclusion, the additional human health risk in relation to possibly overlooking pyaemia in Danish finisher pigs was considered negligible when conducting visual-only compared to traditional meat inspection.

  9. The Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Olsen, J; Melbye, M; Olsen, S F

    2001-01-01

    component causes that act early in life. Exposures in this period, which influence fetal growth, cell divisions, and organ functioning, may have long-lasting impact on health and disease susceptibility. METHODS: To investigate these issues the Danish National Birth Cohort (Better health for mother and child...... bank has been set up with blood taken from the mother twice during pregnancy and blood from the umbilical cord taken shortly after birth. Data collection started in 1996 and the project covered all regions in Denmark in 1999. By August 2000. a total of 60,000 pregnant women had been recruited...

  10. Cold chain management practices of health care workers in primary health care facilities in Southern Nigeria

    Science.gov (United States)

    Ogboghodo, Esohe Olivia; Omuemu, Vivian Ossaidiom; Odijie, Oisedebame; Odaman, Ofure Jennifer

    2017-01-01

    Introduction Vaccination has caused a dramatic reduction in the threat of diseases that were once widespread and often times fatal. The efficient practice of cold chain management is therefore key to ensuring that the benefits of vaccination are sustained. The objective of this study is to assess the practice of cold chain management among health workers in primary health care facilities in Benin City, Edo State. Methods A descriptive cross-sectional study design was employed in this study. The study population consisted of registered nurses, auxiliary nurses and community health extension workers in primary health care facilities in Benin City, Edo State. The tool for data collection was pre-tested, structured self-administered questionnaire. Bivariate analysis between socio-demographic variables and practice of cold chain management was done. Binary logistic regression was also done to determine significant predictors of practice of cold chain management. The level of significance was set at p cold chain management. Significant determinants of practice of cold chain management were cold chain management training (p = 0.004), presence of functional refrigerators (p = 0.016), NPI supervision (p cold chain management among respondents was fair. All stakeholders should ensure they work collectively towards ensuring that favorable environments which would improve the practice among health workers are put in place. PMID:28761610

  11. Psychosocial work environment among immigrant and Danish cleaners

    DEFF Research Database (Denmark)

    Olesen, Kasper; Carneiro, Isabella G; Jørgensen, Marie B;

    2012-01-01

    Non-Western cleaners have been shown to have poorer health than their Danish colleagues. One reason could be a poorer psychosocial work environment. However, it is unknown if differences in self-reported psychosocial work environment exist between non-Western and Danish workers within the same...

  12. Accessibility to primary health care services in the state of Goiás

    Directory of Open Access Journals (Sweden)

    Juliana Pires Ribeiro

    2015-09-01

    Full Text Available The objective of this study was to evaluate accessibility to primary health care services in the state of Goiás. A descriptive cross-sectional study was conducted based on secondary data from the National Program to Improve Access to and Quality of Primary Health Care. The study sample was composed of health professionals from 1,216 primary health care units. Results showed that 68.5% of the health units miss a screening room, thus considerably damaging prompt decision-making by professionals. The lack of medical offices in 2% of the sites hinders the primary health care services accessibility in Goiás. As regards opening hours and work shifts, 86% of the units are open five days a week in eight-hour shifts, which does not favor accessibility for users. This study confirms the lack of accessibility to health services and the need for additional investments to strengthen primary health care.

  13. Dental health behaviors and periodontal disease indicators in Danish youths. A 10-year epidemiological follow-up

    DEFF Research Database (Denmark)

    Lissau, I; Holst, D; Friis-Hasché, E

    1990-01-01

    ) was operationalized as level of plaque, gingivitis, and dmfs. The results showed that dental health behaviors in childhood and in adulthood were together responsible for 9.4-13.8% of the variance in level of periodontal disease indicators. Determinants of early dental health behaviors in terms of plaque and dmfs...

  14. Health-related quality of life among Danish patients 3 and 12 months after TIA or mild stroke

    DEFF Research Database (Denmark)

    Muus, Ingrid; Petzold, Max; Ringsberg, Karin C

    2010-01-01

    This paper aimed to describe health related quality of life three and 12 months after mild stroke or transient ischemic attack, TIA, to describe the perceived changes from pre to post stroke status and to examine sociodemographic determinants for health related quality of life....

  15. Appeals to autonomy and obedience: continuity and change in governing technologies in Danish and Swedish health promotion.

    Science.gov (United States)

    Vallgårda, Signild

    2011-01-01

    The increasingly used concept new public health indicates that a fundamental change has occurred in the goals and methods of disease prevention and health promotion. The change is often said to imply less expert-driven governing of citizens. In this article, governing technologies in the field of public health in Denmark and Sweden are analysed to investigate whether substantial changes have taken place in the governing efforts. In the endeavours unfolded in relation to health examinations for children and pregnant women during the last eighty years, no apparent evidence exists of a significant change in governing technologies. Regulatory, expert-driven and empowering technologies have been used during the whole period; additionally, appeals to autonomy, responsibility and obedience as well as to trust in authorities co-exist throughout the period. The fundamental change is the huge increase in the health authorities' governing ambitions.

  16. Intention and Usage of Computer Based Information Systems in Primary Health Centers

    Science.gov (United States)

    Hosizah; Kuntoro; Basuki N., Hari

    2016-01-01

    The computer-based information system (CBIS) is adopted by almost all of in health care setting, including the primary health center in East Java Province Indonesia. Some of softwares available were SIMPUS, SIMPUSTRONIK, SIKDA Generik, e-puskesmas. Unfortunately they were most of the primary health center did not successfully implemented. This…

  17. Pupils' Perceptions of Sex and Reproductive Health Education in Primary Schools in Tanzania: A Phenomenological Study

    Science.gov (United States)

    Kapinga, Orestes Silverius; Hyera, Daniel Frans

    2015-01-01

    This study explored pupils' perceptions of sex and reproductive health education in primary schools in Tanzania. Specifically, the study aimed at (i) exploring pupils' views on sex and reproductive health education in primary schools; (ii) determining opinions on the appropriateness of sex and reproductive health education for pupils in primary…

  18. HEALTH-CARE COSTS ASSOCIATED WITH DEPRESSIVE AND ANXIETY DISORDERS IN PRIMARY-CARE

    NARCIS (Netherlands)

    SIMON, G; ORMEL, J; VONKORFF, M; BARLOW, W

    Objective: The authors examined the overall health care costs associated with depression and anxiety among primary care patients. Method: Of 2,110 consecutive primary care patients in a health maintenance organization, 1,962 were screened with the 12-item General Health Questionnaire. A stratified

  19. ROLE OF MANAGEMENT IN ORGANIZATION OF PRIMARY HEALTH CARE IN UNITS OF REGIONAL GOVERNMENT

    OpenAIRE

    2014-01-01

    The role of primary care is of great importance for the proper functioning of the health system. Social transformation in the last twenty year resulted in a fall of the interest of health care professionals to work in this segment of health care. At the same time, as a result of improving communications and increasing the available information, interested of individuals for their own health is growing. The first contact with an individual health care is in primary care segment, which must be ...

  20. Translation of the Manchester Clinical Supervision Scale (MCSS) into Danish and a preliminary psychometric validation

    DEFF Research Database (Denmark)

    Buus, Niels; Gonge, Henrik

    2013-01-01

    for the translation of the MCSS from English into Danish and to present a preliminary psychometric validation of the Danish version of the scale. Methods included a formal translation/back-translation procedure and statistical analyses. The sample consisted of MCSS scores from 139 Danish mental health nursing staff...