New Opportunities for eBeam Technologies in One Health. Chapter 2

Energy Technology Data Exchange (ETDEWEB)

Pillai, S. D. [National Center for Electron Beam Research, Texas A& M University (United States)

2014-07-15

Globally, there is a growing recognition that, in order to address current and emerging risks and provide system-level solutions, one has to look at public health, animal health, and environmental health at a holistic level. Several international and federal agencies such as the United Nations, World Health Organization, the Centers for Disease Control and Prevention (CDC), and the United States Department of Agriculture (USDA) have come to embrace the One Health concept. The One Health concept is based on the premise that the health of humans, animals, and the environment are interconnected. Ionizing radiation technology, especially eBeam (electron beam) technology, can play a major role in providing solutions pertinent to the One Health concept. There can be no discussion of public health without confronting the issue of food safety and quality. There can be no discussion of animal health without tackling the pre-harvest pathogen protection strategies involving vaccination. And there can be no discussion of environmental health without discussing the proper management of the burgeoning levels of animal and human wastes. The salient features of eBeam technology such as high dose rate, economic feasibility, and that it is the ultimate “green technology”, can be exploited commercially to develop materials from natural and man-made sources that can be used for high value agricultural, industrial and therapeutic applications. (author)

Opportunities in Reform: Bioethics and Mental Health Ethics.

Science.gov (United States)

Williams, Arthur Robin

2016-05-01

Last year marks the first year of implementation for both the Patient Protection and Affordable Care Act and the Mental Health Parity and Addiction Equity Act in the United States. As a result, healthcare reform is moving in the direction of integrating care for physical and mental illness, nudging clinicians to consider medical and psychiatric comorbidity as the expectation rather than the exception. Understanding the intersections of physical and mental illness with autonomy and self-determination in a system realigning its values so fundamentally therefore becomes a top priority for clinicians. Yet Bioethics has missed opportunities to help guide clinicians through one of medicine's most ethically rich and challenging fields. Bioethics' distancing from mental illness is perhaps best explained by two overarching themes: 1) An intrinsic opposition between approaches to personhood rooted in Bioethics' early efforts to protect the competent individual from abuses in the research setting; and 2) Structural forces, such as deinstitutionalization, the Patient Rights Movement, and managed care. These two themes help explain Bioethics' relationship to mental health ethics and may also guide opportunities for rapprochement. The potential role for Bioethics may have the greatest implications for international human rights if bioethicists can re-energize an understanding of autonomy as not only free from abusive intrusions but also with rights to treatment and other fundamental necessities for restoring freedom of choice and self-determination. Bioethics thus has a great opportunity amid healthcare reform to strengthen the important role of the virtuous and humanistic care provider. © 2015 John Wiley & Sons Ltd.

Integrating Social Determinants of Health into Dental Curricula: An Interprofessional Approach.

Science.gov (United States)

Sabato, Emily; Owens, Jessica; Mauro, Ann Marie; Findley, Patricia; Lamba, Sangeeta; Fenesy, Kim

2018-03-01

Approaching patient care from a holistic perspective, incorporating not only the patient's medical and dental history but also psychosocial history, improves patient outcomes. Practitioners should be trained to provide this style of care through inclusive education, including training working on interprofessional teams. A component of this education must incorporate social determinants of health into the treatment plan. Social determinants of health include income, race/ethnicity, education level, work opportunities, living conditions, and access to health care. Education regarding social determinants of health should be woven throughout dental curricula, including hands-on application opportunities. This education must extend to patient care situations rather than be limited to didactic settings. This article explains the need to incorporate social determinants of health into dental education and illustrates how social determinants education is being addressed in two U.S. dental schools' curricula, including how to weave social determinants of health into interprofessional education. These descriptions may serve as a model for curricular innovation and faculty development across the dental education community.

Participant Recruitment and Engagement in Automated eHealth Trial Registration: Challenges and Opportunities for Recruiting Women Who Experience Violence

Science.gov (United States)

McLean, Christine; Rohan, Maheswaran; Sisk, Rose; Dobbs, Terry; Nada-Raja, Shyamala; Wilson, Denise; Vandal, Alain C

2016-01-01

Background Automated eHealth Web-based research trials offer people an accessible, confidential opportunity to engage in research that matters to them. eHealth trials may be particularly useful for sensitive issues when seeking health care may be accompanied by shame and mistrust. Yet little is known about people’s early engagement with eHealth trials, from recruitment to preintervention autoregistration processes. A recent randomized controlled trial that tested the effectiveness of an eHealth safety decision aid for New Zealand women in the general population who experienced intimate partner violence (isafe) provided the opportunity to examine recruitment and preintervention participant engagement with a fully automated Web-based registration process. The trial aimed to recruit 340 women within 24 months. Objective The objective of our study was to examine participant preintervention engagement and recruitment efficiency for the isafe trial, and to analyze dropout through the registration pathway, from recruitment to eligibility screening and consent, to completion of baseline measures. Methods In this case study, data collection sources included the trial recruitment log, Google Analytics reports, registration and program metadata, and costs. Analysis included a qualitative narrative of the recruitment experience and descriptive statistics of preintervention participant engagement and dropout rates. A Koyck model investigated the relationship between Web-based online marketing website advertisements (ads) and participant accrual. Results The isafe trial was launched on September 17, 2012. Placement of ads in an online classified advertising platform increased the average number of recruited participants per month from 2 to 25. Over the 23-month recruitment period, the registration website recorded 4176 unique visitors. Among 1003 women meeting eligibility criteria, 51.55% (517) consented to participate; among the 501 women who enrolled (consented, validated

eHealth, care and quality of life

CERN Document Server

Capello, Fabio; Manca, Marco

2014-01-01

The debate over eHealth is alive as never before. Supporters suggest that it will result in dramatic innovations in healthcare, including a giant leap towards patient-centered care, new opportunities to improve effectiveness, and enhanced wellness and quality of life. In addition, the growing market value of investments in health IT suggests that eHealth can offer at least a partial cure for the current economic stagnation. Detractors counter these arguments by claiming that eHealth has already failed: the UK Department of Health has shut down the NHS National Program for IT, Google has discontinued its Health flagship, and doubts have arisen over privacy safeguards for both patients and medical professionals. This book briefly explains why caregivers, professionals, technicians, patients, politicians, and others should all consider themselves stakeholders in eHealth. It offers myth-busting responses to some ill-considered arguments from both sides of the trench, in the process allowing a fresh look at eHeal...

Immigration as a social determinant of health.

Science.gov (United States)

Castañeda, Heide; Holmes, Seth M; Madrigal, Daniel S; Young, Maria-Elena DeTrinidad; Beyeler, Naomi; Quesada, James

2015-03-18

Although immigration and immigrant populations have become increasingly important foci in public health research and practice, a social determinants of health approach has seldom been applied in this area. Global patterns of morbidity and mortality follow inequities rooted in societal, political, and economic conditions produced and reproduced by social structures, policies, and institutions. The lack of dialogue between these two profoundly related phenomena-social determinants of health and immigration-has resulted in missed opportunities for public health research, practice, and policy work. In this article, we discuss primary frameworks used in recent public health literature on the health of immigrant populations, note gaps in this literature, and argue for a broader examination of immigration as both socially determined and a social determinant of health. We discuss priorities for future research and policy to understand more fully and respond appropriately to the health of the populations affected by this global phenomenon.

Beyond the hype: a taxonomy of e-health business models.

Science.gov (United States)

Parente, S T

2000-01-01

This paper describes a business model of e-commerce, its application to health care, and the reasons why the health policy community should monitor its development. The business model identifies the market barriers health e-commerce firms must overcome and provides perspective on opportunities for building a health care data infrastructure that is capable of delivering both a private and a public good.

Quality improvement initiatives: the missed opportunity for health plans.

Science.gov (United States)

Fernandez-Lopez, Sara; Lennert, Barbara

2009-11-01

The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations.

Healthy e-health? Think 'environmental e-health'!

Science.gov (United States)

Scott, Richard E; Saunders, Chad; Palacios, Moné; Nguyen, Duyen Thi Kim; Ali, Sajid

2010-01-01

The Environmental e-Health Research and Training Program has completed its scoping study to understand the breadth of a new field of research: Environmental e-Health. Nearly every aspect of modern life is associated, directly or indirectly, with application of technology, from a cup of coffee, through transportation to and from work, to appliances in the home and industrial activities. In recent decades the rapidly increasing application of information and communications technologies (ICT) has added to the cacophony of technological 'noise' around us. Research has shown that technology use, including ICTs, has impact upon the environment. Studying environmental impact in such a complex global setting is daunting. e-Health is now being used as a convenient microcosm of ICT application within which to study these impacts, and is particularly poignant given that e-Health's environmental harms conflict with its noble goals of 'doing no harm'. The study has identified impacts, both benefits and harms in all three life-cycle phases for e-Health: up-stream (materials extraction, manufacturing, packaging, distribution), mid-stream (use period), and down-stream (end-of-life processes--disposal, recycling). In addition the literature shows that a holistic 'Life Cycle Assessment' approach is essential to understand the complexity of the setting, and determine the true balance between total harms and total benefits, and for whom.

eHealth in the future of medications management: personalisation, monitoring and adherence.

Science.gov (United States)

Car, Josip; Tan, Woan Shin; Huang, Zhilian; Sloot, Peter; Franklin, Bryony Dean

2017-04-05

Globally, healthcare systems face major challenges with medicines management and medication adherence. Medication adherence determines medication effectiveness and can be the single most effective intervention for improving health outcomes. In anticipation of growth in eHealth interventions worldwide, we explore the role of eHealth in the patients' medicines management journey in primary care, focusing on personalisation and intelligent monitoring for greater adherence. eHealth offers opportunities to transform every step of the patient's medicines management journey. From booking appointments, consultation with a healthcare professional, decision-making, medication dispensing, carer support, information acquisition and monitoring, to learning about medicines and their management in daily life. It has the potential to support personalisation and monitoring and thus lead to better adherence. For some of these dimensions, such as supporting decision-making and providing reminders and prompts, evidence is stronger, but for many others more rigorous research is urgently needed. Given the potential benefits and barriers to eHealth in medicines management, a fine balance needs to be established between evidence-based integration of technologies and constructive experimentation that could lead to a game-changing breakthrough. A concerted, transdisciplinary approach adapted to different contexts, including low- and middle-income contries is required to realise the benefits of eHealth at scale.

Efficacy of Environmental Health E-Training for Journalists

Science.gov (United States)

Parin, Megan L.; Yancey, Elissa; Beidler, Caroline; Haynes, Erin N.

2015-01-01

Communities report a low level of trust in environmental health media coverage. In order to support risk communication objectives, the goals of the research study were to identify whether or not there is a gap in environmental reporting training for journalists, to outline journalists’ methods for gathering environmental health news, to observe journalists’ attitudes toward environmental health training and communication, and to determine if electronic training (online/e-training) can effectively train journalists in environmental health topics. The results indicated that environmental journalists have very little to no formal environmental journalism training. In addition, a significant percentage of journalists do not have any formal journalism education. Respondents most preferred to receive continuing environmental journalism training online. Online instruction was also perceived as effective in increasing knowledge and providing necessary reporting tools, even among participants adverse to online instructional methods. Our findings highlight the changing media climate’s need for an increase in electronic journalism education opportunities to support environmental health journalism competencies among working professional journalists. PMID:26998499

Mobile Opportunities and Applications for E-service Innovations

DEFF Research Database (Denmark)

Scupola, Ada

Mobile technology continues to shape our society, delivering information and knowledge right to our finger tips. It is only fitting that these advancements and opportunities are applied to the area of electronic services. Mobile Opportunities and Applications for E-Service Innovations brings...

Social determinants of workers' health in Central America.

Science.gov (United States)

Aragón, Aurora; Partanen, Timo; Felknor, Sarah; Corriols, Marianela

2011-01-01

This communication summarizes the available data on work-related determinants of health in Central America. The Central American working population is young and moving from agriculture toward industry and services. Ethnicity, gender, migration, subemployment and precarious work, informality, rural conditions, low-level educational, poverty, ubiquitous worksite health hazards, insufficient occupational health services, low labor inspection density, and weak unions define the constellation of social determinants of workers' health in Central America. Data are, however, scanty both for hazards and work-related illnesses and injuries. Governments and industries have the responsibility of opening decent work opportunities, especially for those facing multiple inequalities in social determinants of health. A first step would be the ratification and implementation of the ILO Convention (187) on occupational safety and health by the seven national governments of the region.

A Service Design Thinking Approach for Stakeholder-Centred eHealth.

Science.gov (United States)

Lee, Eunji

2016-01-01

Studies have described the opportunities and challenges of applying service design techniques to health services, but empirical evidence on how such techniques can be implemented in the context of eHealth services is still lacking. This paper presents how a service design thinking approach can be applied for specification of an existing and new eHealth service by supporting evaluation of the current service and facilitating suggestions for the future service. We propose Service Journey Modelling Language and Service Journey Cards to engage stakeholders in the design of eHealth services.

Opportunities and Challenges of Cloud Computing to Improve Health Care Services

Science.gov (United States)

2011-01-01

Cloud computing is a new way of delivering computing resources and services. Many managers and experts believe that it can improve health care services, benefit health care research, and change the face of health information technology. However, as with any innovation, cloud computing should be rigorously evaluated before its widespread adoption. This paper discusses the concept and its current place in health care, and uses 4 aspects (management, technology, security, and legal) to evaluate the opportunities and challenges of this computing model. Strategic planning that could be used by a health organization to determine its direction, strategy, and resource allocation when it has decided to migrate from traditional to cloud-based health services is also discussed. PMID:21937354

Opportunities and challenges of cloud computing to improve health care services.

Science.gov (United States)

Kuo, Alex Mu-Hsing

2011-09-21

Cloud computing is a new way of delivering computing resources and services. Many managers and experts believe that it can improve health care services, benefit health care research, and change the face of health information technology. However, as with any innovation, cloud computing should be rigorously evaluated before its widespread adoption. This paper discusses the concept and its current place in health care, and uses 4 aspects (management, technology, security, and legal) to evaluate the opportunities and challenges of this computing model. Strategic planning that could be used by a health organization to determine its direction, strategy, and resource allocation when it has decided to migrate from traditional to cloud-based health services is also discussed.

Social media, knowledge translation, and action on the social determinants of health and health equity: A survey of public health practices.

Science.gov (United States)

Ndumbe-Eyoh, Sume; Mazzucco, Agnes

2016-11-01

The growth of social media presents opportunities for public health to increase its influence and impact on the social determinants of health and health equity. The National Collaborating Centre for Determinants of Health at St. Francis Xavier University conducted a survey during the first half of 2016 to assess how public health used social media for knowledge translation, relationship building, and specific public health roles to advance health equity. Respondents reported that social media had an important role in public health. Uptake of social media, while relatively high for personal use, was less present in professional settings and varied for different platforms. Over 20 per cent of those surveyed used Twitter or Facebook at least weekly for knowledge exchange. A lesser number used social media for specific health equity action. Opportunities to enhance the use of social media in public health persist. Capacity building and organizational policies that support social media use may help achieve this.

Job Satisfaction and Its Determinants among Health Workers in ...

African Journals Online (AJOL)

Job Satisfaction and Its Determinants among Health Workers in Jimma University ... insufficient training opportunities and inadequate number of human resources. ... salary increment, establishing good administration management system and ...

Determinants Of Missed Opportunities For Immunization Among ...

African Journals Online (AJOL)

Factors responsible for the missed opportunities included the attitude of the health worker, prolonged time of waiting to receive vaccine, immunization clashing with other schedules and transportation problem. Respondents' level ofknowledge on immunization and educational background were significantly associated with ...

Principles and framework for eHealth strategy development.

Science.gov (United States)

Scott, Richard E; Mars, Maurice

2013-07-30

Significant investment in eHealth solutions is being made in nearly every country of the world. How do we know that these investments and the foregone opportunity costs are the correct ones? Absent, poor, or vague eHealth strategy is a significant barrier to effective investment in, and implementation of, sustainable eHealth solutions and establishment of an eHealth favorable policy environment. Strategy is the driving force, the first essential ingredient, that can place countries in charge of their own eHealth destiny and inform them of the policy necessary to achieve it. In the last 2 years, there has been renewed interest in eHealth strategy from the World Health Organization (WHO), International Telecommunications Union (ITU), Pan American Health Organization (PAHO), the African Union, and the Commonwealth; yet overall, the literature lacks clear guidance to inform countries why and how to develop their own complementary but locally specific eHealth strategy. To address this gap, this paper further develops an eHealth Strategy Development Framework, basing it upon a conceptual framework and relevant theories of strategy and complex system analysis available from the literature. We present here the rationale, theories, and final eHealth strategy development framework by which a systematic and methodical approach can be applied by institutions, subnational regions, and countries to create holistic, needs- and evidence-based, and defensible eHealth strategy and to ensure wise investment in eHealth.

Equity, social determinants and public health programmes - the case of oral health

DEFF Research Database (Denmark)

Petersen, Poul Erik; Kwan, Stella

2011-01-01

is that means are available for breaking poverty and reduce if not eliminate social inequalities in oral health. Whether public health actions are initiated simply depends on the political will. The Ottawa Charter for Health Promotion (1986) and subsequent charters have emphasized the importance of policy......', with the aim of translating knowledge into concrete, workable actions. Poor oral health was flagged as a severe public health problem. Oral disease and illness remain global problems and widening inequities in oral health status exist among different social groupings between and within countries. The good news......The WHO Commission on Social Determinants of Health issued the 2008 report 'Closing the gap within a generation - health equity through action on the social determinants of health' in response to the widening gaps, within and between countries, in income levels, opportunities, life expectancy...

Pharmacy, social media, and health: Opportunity for impact.

Science.gov (United States)

Cain, Jeff; Romanelli, Frank; Fox, Brent

2010-01-01

To discuss opportunities and challenges for pharmacists' use of social media to affect health care. Not applicable. Evolutions in social media (e.g., Facebook, Twitter, YouTube) are beginning to alter the way society communicates. These new applications promote openness, user-generated content, social networking, and collaboration. The technologies, along with patient behaviors and desires, are stimulating a move toward more open and transparent access to health information. Although social media applications can reach large audiences, they offer message-tailoring capabilities that can effectively target specific populations. Another powerful aspect of social media is that they facilitate the organization of people and distribution of content-two necessary components of public health services. Although implementing health interventions via social media poses challenges, several examples exist that display the potential for pharmacists to use social media in health initiatives. Pharmacists have long played a role in educating patients on matters influencing health care. Social media offer several unique features that may be used to advance the role of pharmacy in health care initiatives. Public familiarity with social media, the economical nature of using social media, and the ability to disseminate information rapidly through social media make these new applications ideal for pharmacists wanting to provide innovative health care on both an individual and public level.

[E-health within the Dutch mental health services: what is the current situation?].

Science.gov (United States)

Smeets, Odile; Martin Abello, Katherina; Zijlstra-Vlasveld, Moniek; Boon, Brigitte

2014-01-01

The 'e-mental health' currently available, which also covers m-health and i-health, varies from psycho-education and self-tests to self-help, treatment and contact with fellow sufferers. Many programs are based on cognitive behavioural therapy, but other types of therapy are also used. Research shows that online programs for depression, alcohol problems and anxiety can reduce these symptoms and can be cost effective. This applies to both self-help and treatment programs. Many e-programs in the Netherlands have been developed for the Dutch Association of Mental Health and Addiction Care (GGZ) and for treatment of addiction problems. One problem with e-mental-health is that provision is fragmented, and there is no national overview, while insight into quality is important for patients and professionals. The quality hallmark 'Onlinehulpstempel.nl' ('Online help hallmark') provides this insight. The use of e-mental-health within Dutch healthcare services is still in its infancy. New financing methods are stimulating general practitioners to use it. The consolidation of online and face-to-face care ('blended e-health') provides an opportunity for patients and GGZ support personnel within general practice to start to use e-health.

Inclusion of the equity focus and social determinants of health in health care education programmes in Colombia: a qualitative approach.

Science.gov (United States)

Hernández-Rincón, Erwin H; Pimentel-González, Juan P; Orozco-Beltrán, Domingo; Carratalá-Munuera, Concepción

2016-06-01

The Pan American Health Organization (PAHO) and the Colombian Ministry of Health and Social Protection have determined a need for an approach to include Equity Focus (EF) and Social Determinants of Health (SDH) in health training programmes in Colombia. We studied the incorporation of EF and SDH in the curricula of several universities in Colombia to identify opportunities to strengthen their inclusion. Qualitative methodology was performed in two stages: (i) initial exploration (self-administered questionnaires and review of curricula) and (ii) validation of the information (semi-structured interviews). The inclusion of the EF and SDH in university curricula is regarded as an opportunity to address social problems. This approach addresses a broad cross-section of the curriculum, especially in the subjects of public health and Primary Health Care (PHC), where community outreach generates greater internalization by students. The dominance of the biomedical model of study plans and practice scenarios focusing on disease and little emphasis on community outreach are factors that limit the inclusion of the approach. The inclusion of EF and SDH in university curricula in Colombia has primarily focused on increasing the knowledge of various subjects oriented towards understanding the social dynamics or comprehensiveness of health and disease and, in some programmes, through practical courses in community health and PHC. Increased integration of EF and SDH in subjects or modules with clinical orientation is recommended. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Acceptance of Swedish e-health services

Science.gov (United States)

Jung, Mary-Louise; Loria, Karla

2010-01-01

Objective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide. PMID:21289860

Acceptance of Swedish e-health services

Directory of Open Access Journals (Sweden)

Mary-Louise Jung

2010-11-01

Full Text Available Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM, in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted.Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use.Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide.Keywords: health services, elderly, technology, Internet, TAM, patient acceptance, health-seeking behavior

Mobile eHealth Interventions for Obesity: A Timely Opportunity to Leverage Convergence Trends

OpenAIRE

Tufano, James T; Karras, Bryant T

2005-01-01

Obesity is often cited as the most prevalent chronic health condition and highest priority public health problem in the United States. There is a limited but growing body of evidence suggesting that mobile eHealth behavioral interventions, if properly designed, may be effective in promoting and sustaining successful weight loss and weight maintenance behavior changes. This paper reviews the current literature on the successes and failures of public health, provider-administered, and self-mana...

Employment-based health benefits and public-sector coverage: opportunity for leadership.

Science.gov (United States)

Darling, Helen

2006-01-01

In this commentary, Helen Darling, speaking from the large-employer perspective, responds to James Robinson's paper on the mature health insurance industry, which faces declining opportunities with employer-based health benefits and growing but less appealing public-sector opportunities for management and other services. The similar needs of public and private employers and payers provide an opportunity for leadership, accelerating innovation and using value-added services to improve safety, quality, and efficiency of health care for all.

Analysis of eHealth Search Perspectives Among Female College Students in the Health Professions Using Q Methodology

Science.gov (United States)

Hanik, Bruce; Chaney, J. Don; Tennant, Bethany

2012-01-01

Background The current “Millennial Generation” of college students majoring in the health professions has unprecedented access to the Internet. Although some research has been initiated among medical professionals to investigate the cognitive basis for health information searches on the Internet, little is known about Internet search practices among health and medical professional students. Objective To systematically identify health professional college student perspectives of personal eHealth search practices. Methods Q methodology was used to examine subjective perspectives regarding personal eHealth search practices among allied health students majoring in a health education degree program. Thirteen (n = 13) undergraduate students were interviewed about their attitudes and experiences conducting eHealth searches. From the interviews, 36 statements were used in a structured ranking task to identify clusters and determine which specific perceptions of eHealth search practices discriminated students into different groups. Scores on an objective measure of eHealth literacy were used to help categorize participant perspectives. Results Q-technique factor analysis of the rankings identified 3 clusters of respondents with differing views on eHealth searches that generally coincided with participants’ objective eHealth literacy scores. The proficient resourceful students (pattern/structure coefficient range 0.56-0.80) described themselves as using multiple resources to obtain eHealth information, as opposed to simply relying on Internet search engines. The intermediate reluctant students (pattern/structure coefficient range 0.75-0.90) reported engaging only Internet search engines to locate eHealth information, citing undeveloped evaluation skills when considering sources of information located on the Internet. Both groups of advanced students reported not knowing how to use Boolean operators to conduct Internet health searches. The basic hubristic students

Patient monitoring in mobile health: opportunities and challenges.

Science.gov (United States)

Mohammadzadeh, Niloofar; Safdari, Reza

2014-01-01

In most countries chronic diseases lead to high health care costs and reduced productivity of people in society. The best way to reduce costs of health sector and increase the empowerment of people is prevention of chronic diseases and appropriate health activities management through monitoring of patients. To enjoy the full benefits of E-health, making use of methods and modern technologies is very important. This literature review articles were searched with keywords like Patient monitoring, Mobile Health, and Chronic Disease in Science Direct, Google Scholar and Pub Med databases without regard to the year of publications. Applying remote medical diagnosis and monitoring system based on mobile health systems can help significantly to reduce health care costs, correct performance management particularly in chronic disease management. Also some challenges are in patient monitoring in general and specific aspects like threats to confidentiality and privacy, technology acceptance in general and lack of system interoperability with electronic health records and other IT tools, decrease in face to face communication between doctor and patient, sudden interruptions of telecommunication networks, and device and sensor type in specific aspect. It is obvious identifying the opportunities and challenges of mobile technology and reducing barriers, strengthening the positive points will have a significant role in the appropriate planning and promoting the achievements of the health care systems based on mobile and helps to design a roadmap for improvement of mobile health.

An eHealth Capabilities Framework for Graduates and Health Professionals: Mixed-Methods Study

Science.gov (United States)

McGregor, Deborah; Keep, Melanie; Janssen, Anna; Spallek, Heiko; Quinn, Deleana; Jones, Aaron; Tseris, Emma; Yeung, Wilson; Togher, Leanne; Solman, Annette; Shaw, Tim

2018-01-01

Background The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. Objective This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates. Methods A 3-phase, mixed-methods approach incorporated the results of a literature review, focus groups, and a Delphi process to develop a framework of eHealth capability statements. Results Participants (N=39) with expertise or experience in eHealth education, practice, or policy provided feedback on the proposed framework, and following the fourth iteration of this process, consensus was achieved. The final framework consisted of 4 higher-level capability statements that describe the learning outcomes expected of university graduates across the domains of (1) digital health technologies, systems, and policies; (2) clinical practice; (3) data analysis and knowledge creation; and (4) technology implementation and codesign. Across the capability statements are 40 performance cues that provide examples of how these capabilities might be demonstrated. Conclusions The results of this study inform a cross-faculty eHealth curriculum that aligns with workforce expectations. There is a need for educational curriculum to reinforce existing eHealth capabilities, adapt existing capabilities to make them transferable to novel eHealth contexts, and introduce new learning opportunities for interactions with technologies within education and practice encounters. As such, the capability framework developed may assist in the application of eHealth by emerging and existing health care professionals. Future research needs to explore the potential for integration of findings into workforce development

Ready for eHealth. Older Swedes’ Perceptions of eHealth Services: Using the PIADS Scale as a Predictor for Readiness

Directory of Open Access Journals (Sweden)

Sarianne Wiklund Axelsson

2016-09-01

Full Text Available Introduction: Relevant determinants of adoption of eHealth are needed in order to understand future usage. Aim: To investigate the anticipated psychosocial impact of present and future eHealth services and discuss how psychosocial factors can impact the readiness for eHealth services among older Swedes and reflect upon instruments for measuring eHealth acceptance. Method: The Psychosocial Impact of Assistive Device Scale (PIADS measured the psychosocial impact of eHealth services as illustrated in pictures of a set of events of eHealth services that may reasonably occur in the present and the future. The PIADS scale and the scenarios were administered via a randomly selected sample from the Swedish population aged 55–105. Results and Discussion: Older Swedes have, from a psychosocial perspective, positive expectations regarding eHealth services. The PIADS scale could be a useful supplement to acceptance measurements in the context of eHealth. Using animated illustrations to depict eHealth services, together with the PIADS scale, can generate findings that are generalizable across technologies. The dimensions adaptability, competence and self-esteem could be relevant determinants of adoption of eHealth.

A unique funding opportunity for public health in Texas.

Science.gov (United States)

Schlenker, Thomas; Huber, Carol A

2015-01-01

In addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the "Triple Aim" goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation.

Oral health: equity and social determinants

DEFF Research Database (Denmark)

Kwan, Stella; Petersen, Poul Erik

2010-01-01

This book chapter discusses the social determinants of oral health, and identifies interventions that have been, or can be, used in addressing oral health inequities (e.g. oral health promotion, education programmes, improving access to oral health care)....

Critical analysis of e-health readiness assessment frameworks: suitability for application in developing countries.

Science.gov (United States)

Mauco, Kabelo Leonard; Scott, Richard E; Mars, Maurice

2018-02-01

Introduction e-Health is an innovative way to make health services more effective and efficient and application is increasing worldwide. e-Health represents a substantial ICT investment and its failure usually results in substantial losses in time, money (including opportunity costs) and effort. Therefore it is important to assess e-health readiness prior to implementation. Several frameworks have been published on e-health readiness assessment, under various circumstances and geographical regions of the world. However, their utility for the developing world is unknown. Methods A literature review and analysis of published e-health readiness assessment frameworks or models was performed to determine if any are appropriate for broad assessment of e-health readiness in the developing world. A total of 13 papers described e-health readiness in different settings. Results and Discussion Eight types of e-health readiness were identified and no paper directly addressed all of these. The frameworks were based upon varying assumptions and perspectives. There was no underlying unifying theory underpinning the frameworks. Few assessed government and societal readiness, and none cultural readiness; all are important in the developing world. While the shortcomings of existing frameworks have been highlighted, most contain aspects that are relevant and can be drawn on when developing a framework and assessment tools for the developing world. What emerged is the need to develop different assessment tools for the various stakeholder sectors. This is an area that needs further research before attempting to develop a more generic framework for the developing world.

Implementation of eMental Health care: viewpoints from key informants from organizations and agencies with eHealth mandates.

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Wozney, Lori; Newton, Amanda S; Gehring, Nicole D; Bennett, Kathryn; Huguet, Anna; Hartling, Lisa; Dyson, Michele P; McGrath, Patrick

2017-06-02

The use of technology such as computers, tablets, and smartphones to improve access to and the delivery of mental health care (eMental Health care) is growing worldwide. However, despite the rapidly expanding evidence base demonstrating the efficacy of eMental Health care, its implementation in clinical practice and health care systems remains fragmented. To date, no peer-reviewed, key-informant studies have reported on the perspectives of decision-makers concerned with whether and how to implement eMental Health care. From September to November 2015, we conducted 31 interviews with key informants responsible for leadership, policy, research, and/ or information technology in organizations influential in the adoption of technology for eMental Health care. Deductive and inductive thematic analyses of transcripts were conducted using the Behavior Change Wheel as an organizing framework. Frequency and intensity effect sizes were calculated for emerging themes to further explore patterns within the data. Key informant responses (n = 31) representing 6 developed countries and multiple organizations showed consensus on common factors impacting implementation: individual and organizational capacities (e.g., computer literacy skills [patients and providers], knowledge gaps about cyber security, limited knowledge of available services); motivational drivers of technology-based care (e.g., extending care, data analytics); and opportunities for health systems to advance eMental Health care implementation (e.g., intersectoral research, rapid testing cycles, sustainable funding). Frequency effect sizes showed strong associations between implementation and credibility, knowledge, workflow, patient empowerment, electronic medical record (EMR) integration, sustained funding and intersectoral networks. Intensity effect sizes showed the highest concentration of statements (>10% of all comments) related to funding, credibility, knowledge gaps, and patient empowerment. This study

Exploring E-marketing Opportunities for Exporting Education Services : Case HAAGA-HELIA Global Education Services

OpenAIRE

Gómez , Julio

2013-01-01

This Bachelor’s thesis examines online marketing opportunities for exporting education programs and education consulting services from Finland and internationally. The objective of the study is to determine how is the current B2B environment in e-marketing communications. The purpose of this research is to provide useful information on e-marketing strategies that would benefit HAAGA-HELIA Global Education Services (HAAGA-HELIA GES). This study consists of a theoretical section tha...

The Mexican experience in monitoring and evaluation of public policies addressing social determinants of health

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Valle, Adolfo Martinez

2016-01-01

Monitoring and evaluation (M&E) have gradually become important and regular components of the policy-making process in Mexico since, and even before, the World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) called for interventions and policies aimed at tackling the social determinants of health (SDH). This paper presents two case studies to show how public policies addressing the SDH have been monitored and evaluated in Mexico using reliable, valid, and complete information, which is not regularly available. Prospera, for example, evaluated programs seeking to improve the living conditions of families in extreme poverty in terms of direct effects on health, nutrition, education and income. Monitoring of Prospera's implementation has also helped policy-makers identify windows of opportunity to improve the design and operation of the program. Seguro Popular has monitored the reduction of health inequalities and inequities evaluated the positive effects of providing financial protection to its target population. Useful and sound evidence of the impact of programs such as Progresa and Seguro Popular plus legal mandates, and a regulatory evaluation agency, the National Council for Social Development Policy Evaluation, have been fundamental to institutionalizing M&E in Mexico. The Mexican experience may provide useful lessons for other countries facing the challenge of institutionalizing the M&E of public policy processes to assess the effects of SDH as recommended by the WHO CSDH. PMID:26928215

The Mexican experience in monitoring and evaluation of public policies addressing social determinants of health.

Science.gov (United States)

Valle, Adolfo Martinez

2016-01-01

Monitoring and evaluation (M&E) have gradually become important and regular components of the policy-making process in Mexico since, and even before, the World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) called for interventions and policies aimed at tackling the social determinants of health (SDH). This paper presents two case studies to show how public policies addressing the SDH have been monitored and evaluated in Mexico using reliable, valid, and complete information, which is not regularly available. Prospera, for example, evaluated programs seeking to improve the living conditions of families in extreme poverty in terms of direct effects on health, nutrition, education and income. Monitoring of Prospera's implementation has also helped policy-makers identify windows of opportunity to improve the design and operation of the program. Seguro Popular has monitored the reduction of health inequalities and inequities evaluated the positive effects of providing financial protection to its target population. Useful and sound evidence of the impact of programs such as Progresa and Seguro Popular plus legal mandates, and a regulatory evaluation agency, the National Council for Social Development Policy Evaluation, have been fundamental to institutionalizing M&E in Mexico. The Mexican experience may provide useful lessons for other countries facing the challenge of institutionalizing the M&E of public policy processes to assess the effects of SDH as recommended by the WHO CSDH.

The Mexican experience in monitoring and evaluation of public policies addressing social determinants of health

Directory of Open Access Journals (Sweden)

Adolfo Martinez Valle

2016-02-01

Full Text Available Monitoring and evaluation (M&E have gradually become important and regular components of the policy-making process in Mexico since, and even before, the World Health Organization (WHO Commission on Social Determinants of Health (CSDH called for interventions and policies aimed at tackling the social determinants of health (SDH. This paper presents two case studies to show how public policies addressing the SDH have been monitored and evaluated in Mexico using reliable, valid, and complete information, which is not regularly available. Prospera, for example, evaluated programs seeking to improve the living conditions of families in extreme poverty in terms of direct effects on health, nutrition, education and income. Monitoring of Prospera's implementation has also helped policy-makers identify windows of opportunity to improve the design and operation of the program. Seguro Popular has monitored the reduction of health inequalities and inequities evaluated the positive effects of providing financial protection to its target population. Useful and sound evidence of the impact of programs such as Progresa and Seguro Popular plus legal mandates, and a regulatory evaluation agency, the National Council for Social Development Policy Evaluation, have been fundamental to institutionalizing M&E in Mexico. The Mexican experience may provide useful lessons for other countries facing the challenge of institutionalizing the M&E of public policy processes to assess the effects of SDH as recommended by the WHO CSDH.

Equity, social determinants and public health programmes--the case of oral health.

Science.gov (United States)

Petersen, Poul Erik; Kwan, Stella

2011-12-01

The WHO Commission on Social Determinants of Health issued the 2008 report 'Closing the gap within a generation - health equity through action on the social determinants of health' in response to the widening gaps, within and between countries, in income levels, opportunities, life expectancy, health status, and access to health care. Most individuals and societies, irrespective of their philosophical and ideological stance, have limits as to how much unfairness is acceptable. In 2010, WHO published another important report on 'Equity, Social Determinants and Public Health Programmes', with the aim of translating knowledge into concrete, workable actions. Poor oral health was flagged as a severe public health problem. Oral disease and illness remain global problems and widening inequities in oral health status exist among different social groupings between and within countries. The good news is that means are available for breaking poverty and reduce if not eliminate social inequalities in oral health. Whether public health actions are initiated simply depends on the political will. The Ottawa Charter for Health Promotion (1986) and subsequent charters have emphasized the importance of policy for health, healthy environments, healthy lifestyles, and the need for orientation of health services towards health promotion and disease prevention. This report advocates that oral health for all can be promoted effectively by applying this philosophy and some major public health actions are outlined. © 2011 John Wiley & Sons A/S.

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

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Valente, Thomas W; Pitts, Stephanie R

2017-03-20

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

Are Health Literacy and eHealth Literacy the Same or Different?

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Monkman, Helen; Kushniruk, Andre W; Barnett, Jeff; Borycki, Elizabeth M; Greiner, Leigh E; Sheets, Debra

2017-01-01

Many researchers assume that there is a relationship between health literacy and eHealth literacy, yet it is not clear whether the literature supports this assumption. The purpose of this study was to determine if there was a relationship between health and eHealth literacy. To this end, participants' (n = 36) scores on the Newest Vital Sign (NVS, a health literacy measure) were correlated with the eHealth Literacy Scale (eHEALS, an eHealth literacy measure). This analysis revealed no relationship (r = -.041, p = .81) between the two variables. This finding suggests that eHealth Literacy and health literacy are dissimilar. Several possible explanations of the pattern of results are proposed. Currently, it does not seem prudent to use the eHEALS as the sole measure of eHealth literacy, but rather researchers should continue to complement it with a validated health literacy screening tool.

Opportunity to Learn: The Health Connection.

Science.gov (United States)

Jackson, Shirley A.

1993-01-01

Reviews the following health issues related to the opportunity to learn for poor African-American and other minority children: (1) inadequate prenatal care; (2) malnutrition; (3) childhood diseases and illnesses; (4) unsafe environments and violence; (5) teenage sexual activity, pregnancy, and AIDS; (6) substance use and abuse; and (7) mental and…

Critical Incidents of Growth in Nordic eHealth Service Start-Ups

Directory of Open Access Journals (Sweden)

Martti Saarela

2017-06-01

Full Text Available Digitalisation can revolutionise healthcare delivery and provide new business opportunities for innovative start-ups. Start-up businesses in the healthcare service sector are a promising source of new employment and innovations. The start-up stage is the most critical period for the survival of a business, as decisions made during the early stages have a definitive influence on success. This study seeks to clarify the early development of eHealth service start-ups. To summarise the research problem, the authors ask the following question: What are the critical incidents related to the early development of eHealth service start-ups? The units of analysis in this study are 14 Nordic eHealth service start-ups located in Sweden and Finland. The Critical Incident Technique (CIT and semi-structured interviews were applied for data collection. The results are of interest to the public sector, which plays an essential role in healthcare as a service producer, but also as a creator of the business conditions of and opportunities for small businesses.

An eHealth Capabilities Framework for Graduates and Health Professionals: Mixed-Methods Study.

Science.gov (United States)

Brunner, Melissa; McGregor, Deborah; Keep, Melanie; Janssen, Anna; Spallek, Heiko; Quinn, Deleana; Jones, Aaron; Tseris, Emma; Yeung, Wilson; Togher, Leanne; Solman, Annette; Shaw, Tim

2018-05-15

The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates. A 3-phase, mixed-methods approach incorporated the results of a literature review, focus groups, and a Delphi process to develop a framework of eHealth capability statements. Participants (N=39) with expertise or experience in eHealth education, practice, or policy provided feedback on the proposed framework, and following the fourth iteration of this process, consensus was achieved. The final framework consisted of 4 higher-level capability statements that describe the learning outcomes expected of university graduates across the domains of (1) digital health technologies, systems, and policies; (2) clinical practice; (3) data analysis and knowledge creation; and (4) technology implementation and codesign. Across the capability statements are 40 performance cues that provide examples of how these capabilities might be demonstrated. The results of this study inform a cross-faculty eHealth curriculum that aligns with workforce expectations. There is a need for educational curriculum to reinforce existing eHealth capabilities, adapt existing capabilities to make them transferable to novel eHealth contexts, and introduce new learning opportunities for interactions with technologies within education and practice encounters. As such, the capability framework developed may assist in the application of eHealth by emerging and existing health care professionals. Future research needs to explore the potential for integration of findings into workforce development programs. ©Melissa Brunner, Deborah Mc

Mobile Technologies Enhance the E-Learning Opportunity

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Chuang, Keh-Wen

2009-01-01

The objective of this paper is to identify the mobile technologies that enhance the E-Learning opportunity, examine the educational benefits and implementation issues in mobile learning, discuss the guidelines for implementing effective mobile learning, identify the current application and operation of mobile learning, and discuss the future of…

E-Learning: opportunity or end of field classes?

Science.gov (United States)

Bloemertz, Lena; Kuhn, Brigitte; Kuhn, Nikolaus J.

2013-04-01

E-Learning is often seen as an opportunity to avoid the costs of field classes by using new digital media to communicate content to students that otherwise could only be seen in the field. However, feeling, tasting and smelling soil on a farm or in a forest cannot be substituted via the internet. To achieve some teaching efficiency, an course on e-learning introduced at the University of Basel therefore took an opposite approach: instead of compromising the field experience, the opportunities to broaden access and generate flexibility for the students and instructors during the lecture room section of a soil science and land use course were maximised. The course has six topics, each e-learning element is designed to take one week of the studentśself study time devoted to the course. Three one-day field classes spread over the term offer an opportunity to the students to become acquainted with common soil types in the region of Basel and typical land use. The latter emphasizes visits to farms to ensure that the perspective of the farmers on their and soils and business is communicated to the students. The field classes also ensure sufficient contact time between instructors and students. The informal time spend together during the days in the field also ensures to address individual questions of the students. Overall, the format of the course ensures that the field experience and instructor presence are offered where needed and that e-learning is used to replace formal contact time where self-study is possible.

The flipped classroom: practices and opportunities for health sciences librarians.

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Youngkin, C Andrew

2014-01-01

The "flipped classroom" instructional model is being introduced into medical and health sciences curricula to provide greater efficiency in curriculum delivery and produce greater opportunity for in-depth class discussion and problem solving among participants. As educators employ the flipped classroom to invert curriculum delivery and enhance learning, health sciences librarians are also starting to explore the flipped classroom model for library instruction. This article discusses how academic and health sciences librarians are using the flipped classroom and suggests opportunities for this model to be further explored for library services.

What motivates health professionals? Opportunities to gain greater insight from theory.

Science.gov (United States)

Buetow, Stephen

2007-07-01

Health care policy-makers and researchers need to pay more attention to understanding the influence of motivation on professional behaviour. Goal setting theory, including two hypotheses - the business case and the pride case - dominates current attempts to motivate professionals. However, the predominance of goal setting theory stifles other approaches to conceptualizing professional motivation. These approaches include other cognitive theories of motivation, such as self-determination theory (concerned with how to use extrinsic rewards that enhance intrinsic motivation), as well as content, psychoanalytic and environmental theories. A valuable opportunity exists to develop and test such theories in addition to possible hybrids, for example, by elaborating goal setting theory in health care. The results can be expected to inform health policy and motivate individual professionals, groups, organizations and workforces to improve and deliver high quality care.

Cyber-Management of People with Chronic Disease: A Potential Solution to eHealth Challenges

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Laakso, E-Liisa; Armstrong, Kylie; Usher, Wayne

2012-01-01

The evolving eHealth agenda presents a range of potential opportunities for the management and prevention of chronic disease. This paper identifies issues and barriers to the uptake of eHealth and describes a strategy ("Healthy Outcomes for Australians"[C]-HOFA) for creating a central knowledge filter and cyber space method for tracking…

National health inequality monitoring: current challenges and opportunities.

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Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne; Boerma, Ties

National health inequality monitoring needs considerably more investment to realize equity-oriented health improvements in countries, including advancement towards the Sustainable Development Goals. Following an overview of national health inequality monitoring and the associated resource requirements, we highlight challenges that countries may encounter when setting up, expanding or strengthening national health inequality monitoring systems, and discuss opportunities and key initiatives that aim to address these challenges. We provide specific proposals on what is needed to ensure that national health inequality monitoring systems are harnessed to guide the reduction of health inequalities.

Active animal health surveillance in European Union Member States: gaps and opportunities.

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Bisdorff, B; Schauer, B; Taylor, N; Rodríguez-Prieto, V; Comin, A; Brouwer, A; Dórea, F; Drewe, J; Hoinville, L; Lindberg, A; Martinez Avilés, M; Martínez-López, B; Peyre, M; Pinto Ferreira, J; Rushton, J; VAN Schaik, G; Stärk, K D C; Staubach, C; Vicente-Rubiano, M; Witteveen, G; Pfeiffer, D; Häsler, B

2017-03-01

Animal health surveillance enables the detection and control of animal diseases including zoonoses. Under the EU-FP7 project RISKSUR, a survey was conducted in 11 EU Member States and Switzerland to describe active surveillance components in 2011 managed by the public or private sector and identify gaps and opportunities. Information was collected about hazard, target population, geographical focus, legal obligation, management, surveillance design, risk-based sampling, and multi-hazard surveillance. Two countries were excluded due to incompleteness of data. Most of the 664 components targeted cattle (26·7%), pigs (17·5%) or poultry (16·0%). The most common surveillance objectives were demonstrating freedom from disease (43·8%) and case detection (26·8%). Over half of components applied risk-based sampling (57·1%), but mainly focused on a single population stratum (targeted risk-based) rather than differentiating between risk levels of different strata (stratified risk-based). About a third of components were multi-hazard (37·3%). Both risk-based sampling and multi-hazard surveillance were used more frequently in privately funded components. The study identified several gaps (e.g. lack of systematic documentation, inconsistent application of terminology) and opportunities (e.g. stratified risk-based sampling). The greater flexibility provided by the new EU Animal Health Law means that systematic evaluation of surveillance alternatives will be required to optimize cost-effectiveness.

Community health centers and community development financial institutions: joining forces to address determinants of health.

Science.gov (United States)

Kotelchuck, Ronda; Lowenstein, Daniel; Tobin, Jonathan N

2011-11-01

Community health centers and community development financial institutions share similar origins and missions and are increasingly working together to meet community needs. Addressing the social and economic determinants of health is a common focus. The availability of new federal grants and tax credits has led these financial institutions to invest in the creation and expansion of community health centers. This article reviews the most recent trends in these two sectors and explores opportunities for further collaboration to transform the health and well-being of the nation's low-income communities.

Socio-technical and organizational challenges to wider e-Health implementation.

Science.gov (United States)

Vitacca, M; Mazzù, M; Scalvini, S

2009-01-01

Recent advances in information communication technology allow contact with patients at home through e-Health services (telemedicine, in particular). We provide insights on the state of the art of e-Health and telemedicine for possible wider future clinical use. Telemedicine opportunities are summarized as i) home telenursing, ii) electronic transfer to specialists and hospitals, iii) teleconsulting between general practitioners and specialists and iv) call centres activities and online health. At present, a priority action of the EU is the Initiative on TM for chronic disease management as home health monitoring and the future Vision for Europe 2020 is based on development of Integrated Telemedicine Services. There are pros and cons in e-Health and telemedicine. Benefits can be classified as benefits for i) citizens, patients and caregivers and ii) health care provider organizations. Institutions and individuals that play key roles in the future of e-Health are doctors, patients and hospitals, while the whole system should be improved at three crucial levels: 1) organizational, 2) regulatory and 3) technological. Quality, access and efficiency are the general key issues for the success of e-Health and telemedicine implementation. The real technology is the human resource available into the organizations. For e-Health and telemedicine to grow, it will be necessary to investigate their long-term efficacy, cost effectiveness, possible improvement in quality of life and impact on public health burden.

Conclusions of the book "eHealth, care and quality of life"

CERN Document Server

Capello, Fabio; Manca, Marco

2014-01-01

The rising of a new era––mostly based on ICT tools and models––for health has brought new perspectives and new opportunities for the care. The implementation of eHealth models is likely to become the future of medicine, able to give new and more effective tools to the doctors and an active role to the patients. Nonetheless, many are the threats that lie beneath these new approaches. A systematic analysis by some of the experts in this field shows the critical issues that developers, decision-makers, and final users have to know and consider in order to avoid a waste of time, resources, and opportunities.

eWALL: An Open-Source Cloud-Based eHealth Platform for Creating Home Caring Environments for Older Adults Living with Chronic Diseases or Frailty

DEFF Research Database (Denmark)

Kyriazakos, Sofoklis; Mihovska, Albena; Prasad, Ramjee

2017-01-01

present eWALL, an innovative open-source eHealth platform that aims to address these challenges by means of an advanced cloud-based infrastructure. eWALL is designed in an innovative manner and achieved technical breakthroughs in eHealth platforms, while prioritizing user and market needs that are often...... abandoned and are the major reason for technically sound solutions that fail. We consider this as an opportunity and we aim to change the eHealth systems’ experience for older adults and break the barriers for the penetration of ICT solutions....

Professional and Educational Initiatives, Supports, and Opportunities for Advanced Training in Public Health

OpenAIRE

Truong, Hoai-An; Patterson, Brooke Y.

2010-01-01

The United States is facing a public health workforce shortage and pharmacists have the opportunity and obligation to address this challenge in health care. There have been initiatives and supports from within and beyond the profession for the pharmacist's role in public health. This article identifies existing professional and educational initiatives for the pharmacist's expanded role in public health, as well as postgraduate and other advanced educational opportunities in public health. Rec...

Health inequality - determinants and policies

DEFF Research Database (Denmark)

Diderichsen, Finn; Andersen, Ingelise; Manual, Celie

2012-01-01

The review ”Health inequality – determinants and policies” identifies key-areas to be addressed with the aim to reduce the social inequality in health. The general life expectancy has steadily been increasing, but the data reveals marked social inequalities in health as well as life expectancy....... The review seeks to identify the causes of this social inequality. The analysis finds 12 areas of great importance for the inequality in health. This is i.e. early child development, schooling and education, the health behavior of the population, and the role of the health system. Within each of the 12 areas...

Counting the opportunity cost of abandoning the omnibus Health ...

African Journals Online (AJOL)

Counting the opportunity cost of abandoning the omnibus Health Professions Authority ... Twenty two years of civil war ruined the healthcare system in South Sudan. Government provides only ... This regulatory vacuum is best resolved by establishing a Health Professions Authority to set the standards, and to supervise and ...

Adoption of e-health technology by physicians: a scoping review

Directory of Open Access Journals (Sweden)

de Grood C

2016-08-01

Full Text Available Chloe de Grood,1 Aida Raissi,2 Yoojin Kwon,3 Maria Jose Santana1 1Department of Community Health Sciences, W21C Research and Innovation Centre, University of Calgary, Calgary, 2University of Alberta, Edmonton, AB, 3Toronto Public Library, Toronto, ON, Canada Objective: The goal of this scoping review was to summarize the current literature identifying barriers and opportunities that facilitate adoption of e-health technology by physicians.Design: Scoping review.Setting: MEDLINE, EMBASE, and PsycINFO databases as provided by Ovid were searched from their inception to July 2015. Studies captured by the search strategy were screened by two reviewers and included if the focus was on barriers and facilitators of e-health technology adoption by physicians.Results: Full-text screening yielded 74 studies to be included in the scoping review. Within those studies, eleven themes were identified, including cost and liability issues, unwillingness to use e-health technology, and training and support.Conclusion: Cost and liability issues, unwillingness to use e-health technology, and training and support were the most frequently mentioned barriers and facilitators to the adoption of e-health technology. Government-level payment incentives and privacy laws to protect health information may be the key to overcome cost and liability issues. The adoption of e-health technology may be facilitated by tailoring to the individual physician’s knowledge of the e-health technology and the use of follow-up sessions for physicians and on-site experts to support their use of the e-health technology. To ensure the effective uptake of e-health technologies, physician perspectives need to be considered in creating an environment that enables the adoption of e-health strategies. Keywords: medical informatics, electronic medical records, diffusion of innovation, attitude of health personnel, information seeking behavior

The social determinants of health: a contribution to the analysis of gender differences in health and illness.

Science.gov (United States)

Ballantyne, P J

1999-12-01

While it is established that socioeconomic status and social integration influence the distribution of health and illness among men and women, little attention has been paid to the different ways in which women and men experience socioeconomic opportunities and social attachments to others. Drawing on evidence from the literature, the position developed in this article is that gender mediates the influence of both socioeconomic status and social integration on health, and for women, these are intricately linked. Women's relationship to the labour market establishes and perpetuates their socioeconomic inequality relative to men, and may produce contradictory influences on women's health. Furthermore, for women, the marital relationship is paradoxical: marriage may at once improve economic and social support opportunities, while diminishing control over paid and unpaid work--potentially increasing as well as compromising the health status of women. The article is intended to contribute to the growing body of literature on gender and the determinants of health.

On measuring and decomposing inequality of opportunity in access to health services among Tunisian children: a new approach for public policy.

Science.gov (United States)

Saidi, Anis; Hamdaoui, Mekki

2017-10-25

The early years in children's life are the key to physical, cognitive-language, and, socio-emotional skills development. So, it is of paramount importance in this period to be interested in different indicators that would influence the child's health. This paper measures inequality of opportunities among Tunisian children concerning access to nutritional and healthy services using Human Opportunity-Index and Shapely decomposition methods. Many disparities between regions have been detected since 1982 until 2012. Tunisian children face unequal opportunities to develop in terms of health, nutrition, cognitive, social, and emotional development. Likewise, we found that, parents' education, wealth, age of household head and geographic factors as key factors determining child development outcomes. Our findings suggested that childhood unequal opportunities in Tunisia are explained by pension funds deficiency and structural problem in the labor market. The results of a health care intervention on human participants "retrospectively registered".

Emerging mHealth and eHealth interventions for serious mental illness: a review of the literature.

Science.gov (United States)

Naslund, John A; Marsch, Lisa A; McHugo, Gregory J; Bartels, Stephen J

2015-01-01

Serious mental illness (SMI) is one of the leading causes of disability worldwide. Emerging mobile health (mHealth) and eHealth interventions may afford opportunities for reaching this at-risk group. To review the evidence on using emerging mHealth and eHealth technologies among people with SMI. We searched MEDLINE, PsychINFO, CINAHL, Scopus, Cochrane Central, and Web of Science through July 2014. Only studies which reported outcomes for mHealth or eHealth interventions, defined as remotely delivered using mobile, online, or other devices, targeting people with schizophrenia, schizoaffective disorder, or bipolar disorder, were included. Forty-six studies spanning 12 countries were included. Interventions were grouped into four categories: (1) illness self-management and relapse prevention; (2) promoting adherence to medications and/or treatment; (3) psychoeducation, supporting recovery, and promoting health and wellness; and (4) symptom monitoring. The interventions were consistently found to be highly feasible and acceptable, though clinical outcomes were variable but offered insight regarding potential effectiveness. Our findings confirm the feasibility and acceptability of emerging mHealth and eHealth interventions among people with SMI; however, it is not possible to draw conclusions regarding effectiveness. Further rigorous investigation is warranted to establish effectiveness and cost benefit in this population.

Moving electronic medical records upstream: incorporating social determinants of health.

Science.gov (United States)

Gottlieb, Laura M; Tirozzi, Karen J; Manchanda, Rishi; Burns, Abby R; Sandel, Megan T

2015-02-01

Knowledge of the biological pathways and mechanisms connecting social factors with health has increased exponentially over the past 25 years, yet in most clinical settings, screening and intervention around social determinants of health are not part of standard clinical care. Electronic medical records provide new opportunities for assessing and managing social needs in clinical settings, particularly those serving vulnerable populations. To illustrate the feasibility of capturing information and promoting interventions related to social determinants of health in electronic medical records. Three case studies were examined in which electronic medical records have been used to collect data and address social determinants of health in clinical settings. From these case studies, we identified multiple functions that electronic medical records can perform to facilitate the integration of social determinants of health into clinical systems, including screening, triaging, referring, tracking, and data sharing. If barriers related to incentives, training, and privacy can be overcome, electronic medical record systems can improve the integration of social determinants of health into healthcare delivery systems. More evidence is needed to evaluate the impact of such integration on health care outcomes before widespread adoption can be recommended. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The Paradox of Equal Opportunities

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Mitja Sardoč

2014-06-01

Full Text Available The basic assumption of the idea of equal opportunities is based on the assertion that all individuals competing for an advantaged social position should have equal opportunities, i.e., that each and every one of them should have fair opportunities to achieve a particular goal. Despite the fact that equal opportunities is one of the basic mechanisms for a just distribution of advantageous social positions, the idea of fair equality of opportunity remains divided between different competing political projects, e.g., egalitarian liberalism, libertarian political theory, multiculturalism, etc. This paper examines two basic dimensions of equal opportunities to which existing conceptions fail to offer a unanimous answer, i.e., a the issue of fairness and b the issue of the currency of fairness. The concluding part of this paper presents two basic paradoxes that determine both the direction of the discussion as well as the possible solutions to the achievement of fair equal opportunities as part of any process for competing for advantageous social positions.

Exploring eHealth Ethics and Multi-Morbidity: Protocol for an Interview and Focus Group Study of Patient and Health Care Provider Views and Experiences of Using Digital Media for Health Purposes

OpenAIRE

Townsend, Anne; Adam, Paul; Li, Linda C; McDonald, Michael; Backman, Catherine L

2013-01-01

Background eHealth is a broad term referring to the application of information and communication technologies in the health sector, ranging from health records to medical consultations (telemedicine) and multiple forms of health education, support, and tools. By providing increased and anytime access to information, opportunities to exchange experiences with others, and self-management support, eHealth has been heralded as transformational. It has the potential to accelerate the shift from tr...

Opportunities and challenges of Web 2.0 within the health care systems: an empirical exploration.

Science.gov (United States)

Lupiáñez-Villanueva, Francisco; Mayer, Miquel Angel; Torrent, Joan

2009-09-01

The Internet has become one of the main drivers of e-health. Whilst its impact and potential is being analysed, the Web 2.0 phenomenon has reached the health field and has emerged as a buzzword that people use to describe a wide range of online activities and applications. The aims of this article are: to explore the opportunities and challenges of the Web 2.0 within the health care system and to identify the gap between the potential of these online activities and applications and the empirical data. The analysis is based on: online surveys to physicians, nurses, pharmacist and patient support groups; static web shot analysis of 1240 web pages and exploration of the most popular Web 2.0 initiatives. The empirical results contrast with the Web 2.0 trends identified. Whereas the main characteristic of the Web 2.0 is the opportunity for social interaction, the health care system at large could currently be characterised by: a lack of interactive communication technologies available on the Internet; a lack of professional production of health care information on the Internet, and a lack of interaction between these professionals and patients on the Internet. These results reveal a scenario away from 2.0 trends.

Moving towards global health equity: Opportunities and threats: An ...

African Journals Online (AJOL)

Background: The theme of the 13th World Congress on Public Health, “Moving Towards Global Health Equity: Opportunities and Threats”, strikes an optimistic note as the gaps within and between countries are greater than at any time in recent history. There is no consensus on what globalization is, but most agree that it will ...

Multisectoral Actions for Health: Challenges and Opportunities in Complex Policy Environments

Directory of Open Access Journals (Sweden)

Viroj Tangcharoensathien

2017-07-01

Full Text Available Multisectoral actions for health, defined as actions undertaken by non-health sectors to protect the health of the population, are essential in the context of inter-linkages between three dimensions of sustainable development: economic, social, and environmental. These multisectoral actions can address the social and economic factors that influence the health of a population at the local, national, and global levels. This editorial identifies the challenges, opportunities and capacity development for effective multisectoral actions for health in a complex policy environment. The root causes of the challenges lie in poor governance such as entrenched political and administrative corruption, widespread clientelism, lack of citizen voice, weak social capital, lack of trust and lack of respect for human rights. This is further complicated by the lack of government effectiveness caused by poor capacity for strong public financial management and low levels of transparency and accountability which leads to corruption. The absence of or rapid changes in government policies, and low salary in relation to living standards result in migration out of qualified staff. Tobacco, alcohol and sugary drink industries are major risk factors for non-communicable diseases (NCDs and had interfered with health policy through regulatory capture and potential law suits against the government. Opportunities still exist. Some World Health Assembly (WHA and United Nations General Assembly (UNGA resolutions are both considered as external driving forces for intersectoral actions for health. In addition, Thailand National Health Assembly under the National Health Act is another tool providing opportunity to form trust among stakeholders from different sectors.

Determinants of Investment Opportunity Set (Degree of Internationalization and Macroeconomic Variables

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Cynthia utama

2015-08-01

Full Text Available The aim of this study is to investigate the influence of internal factors (i.e. the degree of internationalization, profitability, firm size, and financial leverage and external factors (i.e. GNP growth and the inflation rate on firms’ growth opportunities or their Investment Opportunity Set (IOS. The IOS is measured by the market-to-book assets ratio. The result shows that profitability and firms’ size have a positive impact on the IOS whereas the degree of internationalization and financial leverage has a negative influence on the IOS. Finally, the IOS is positively affected by GNP growth while the inflation rate has a negative impact on IOS.

Using the Electronic Health Record in Nursing Research: Challenges and Opportunities.

Science.gov (United States)

Samuels, Joanne G; McGrath, Robert J; Fetzer, Susan J; Mittal, Prashant; Bourgoine, Derek

2015-10-01

Changes in the patient record from the paper to the electronic health record format present challenges and opportunities for the nurse researcher. Current use of data from the electronic health record is in a state of flux. Novel data analytic techniques and massive data sets provide new opportunities for nursing science. Realization of a strong electronic data output future relies on meeting challenges of system use and operability, data presentation, and privacy. Nurse researchers need to rethink aspects of proposal development. Joining ongoing national efforts aimed at creating usable data output is encouraged as a means to affect system design. Working to address challenges and embrace opportunities will help grow the science in a way that answers important patient care questions. © The Author(s) 2015.

Identifying Health Consumers' eHealth Literacy to Decrease Disparities in Accessing eHealth Information.

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Park, Hyejin; Cormier, Eileen; Gordon, Glenna; Baeg, Jung Hoon

2016-02-01

The increasing amount of health information available on the Internet highlights the importance of eHealth literacy skills for health consumers. Low eHealth literacy results in disparities in health consumers' ability to access and use eHealth information. The purpose of this study was to assess the perceived eHealth literacy of a general health consumer population so that healthcare professionals can effectively address skills gaps in health consumers' ability to access and use high-quality online health information. Participants were recruited from three public library branches in a Northeast Florida community. The eHealth Literacy Scale was used. The majority of participants (n = 108) reported they knew how and where to find health information and how to use it to make health decisions; knowledge of what health resources were available and confidence in the ability to distinguish high- from low-quality information were considerably less. The findings suggest the need for eHealth education and support to health consumers from healthcare professionals, in particular, how to access and evaluate the quality of health information.

Colonialism as a Broader Social Determinant of Health

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Karina Czyzewski

2011-05-01

Full Text Available A proposed broader or Indigenized social determinants of health framework includes "colonialism" along with other global processes. What does it mean to understand Canadian colonialism as a distal determinant of Indigenous health? This paper reviews pertinent discourses surrounding Indigenous mental health in Canada.With an emphasis on the notion of intergenerational trauma, there are real health effects of social, political, and economic marginalization embodied within individuals, which can collectively affect entire communities. Colonialism can also be enacted and reinforced within Indigenous mental health discourse, thus influencing scholarly and popular perceptions. Addressing this distal determinant through policy work necessitates that improving Indigenous health is inherently related to improving these relationships, i.e. eliminating colonial relations, and increasing self-determination.

The formal electronic recycling industry: Challenges and opportunities in occupational and environmental health research.

Science.gov (United States)

Ceballos, Diana Maria; Dong, Zhao

2016-10-01

E-waste includes electrical and electronic equipment discarded as waste without intent of reuse. Informal e-waste recycling, typically done in smaller, unorganized businesses, can expose workers and communities to serious chemical health hazards. It is unclear if formalization into larger, better-controlled electronics recycling (e-recycling) facilities solves environmental and occupational health problems. To systematically review the literature on occupational and environmental health hazards of formal e-recycling facilities and discuss challenges and opportunities to strengthen research in this area. We identified 37 publications from 4 electronic databases (PubMed, Web of Science, Environmental Index, NIOSHTIC-2) specific to chemical exposures in formal e-recycling facilities. Environmental and occupational exposures depend on the degree of formalization of the facilities but further reduction is needed. Reported worker exposures to metals were often higher than recommended occupational guidelines. Levels of brominated flame-retardants in worker's inhaled air and biological samples were higher than those from reference groups. Air, dust, and soil concentrations of metals, brominated flame-retardants, dioxins, furans, polycyclic-aromatic hydrocarbons, or polychlorinated biphenyls found inside or near the facilities were generally higher than reference locations, suggesting transport into the environment. Children of a recycler had blood lead levels higher than public health recommended guidelines. With mounting e-waste, more workers, their family members, and communities could experience unhealthful exposures to metals and other chemicals. We identified research needs to further assess exposures, health, and improve controls. The long-term solution is manufacturing of electronics without harmful substances and easy-to-disassemble components. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Health Consumers eHealth Literacy to Decrease Disparities in Accessing eHealth Information.

Science.gov (United States)

Park, Hyejin; Cormier, Eileen; Glenna, Gordon

2016-01-01

The purpose of this study was to assess the perceived eHealth literacy of a general health consumer population so that health care professionals can effectively address skills gaps in health consumers' ability to access and use high quality online health information. Participants were recruited from three public library branches in a Northeast Florida community. The eHealth literacy scale (eHEALS) was used. The majority of participants (n = 108) reported they knew how and where to find health information and how to use it to make health decisions; knowledge of what health resources were available and confidence in the ability to distinguish high from low quality information was considerably less. The findings suggest the need for eHealth education and support to health consumers from health care professionals, in particular, how to access and evaluate the quality of health information.

Rural Public Libraries as Community Change Agents: Opportunities for Health Promotion

Science.gov (United States)

Flaherty, Mary Grace; Miller, David

2016-01-01

Rural residents are at a disadvantage with regard to health status and access to health promotion activities. In many rural communities, public libraries offer support through health information provision; there are also opportunities for engagement in broader community health efforts. In a collaborative effort between an academic researcher and a…

Transgender health and well-being: Gains and opportunities in policy and law.

Science.gov (United States)

Scout, Nfn

2016-01-01

This article discusses gains and opportunities in policy and law in the United States related to transgender health and well-being. Topics include (1) how the bathroom myth has been used every time a trans nondiscrimination bill is considered, (2) transgender nondiscrimination laws and policies, (3) the expansion of gender discrimination, (4) strategies for promoting mental health and well-being among trans people, (5) policy developments supporting the mental health and well-being of trans people, and (6) opportunities for action. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

E-LEARNING CHANGE MANAGEMENT: Challenges and opportunities

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Alaattin PARLAKKILIC

2013-10-01

Full Text Available The role of e-learning technologies entirely depends on the acceptance and execution of required-change in the thinking and behaviour of the users of institutions. The research are constantly reporting that many e-learning projects are falling short of their objectives due to many reasons but on the top is the user resistance to change according to the digital requirements of new era. It is argued that the suitable way for change management in e-learning environment is the training and persuading of users with a view to enhance their digital literacy and thus gradually changing the users’ attitude in positive direction. This paper discusses change management in transition to e-learning system considering pedagogical, cost and technical implications. It also discusses challenges and opportunities for integrating these technologies in higher learning institutions with examples from Turkey GATA (Gülhane Askeri Tıp Akademisi-Gülhane Military Medical Academy.

eHealth in cardiovascular medicine: A clinical update.

Science.gov (United States)

Saner, Hugo; van der Velde, Enno

2016-10-01

Demographic changes, progress in medicine technology and regional problems in providing healthcare to low density populations are posing great challenges to our healthcare systems. Rapid progress in computer sciences and information technologies have a great impact on the way healthcare will be delivered in the near future. This article describes opportunities and challenges of eHealth and telemedicine in the framework of our health systems and, in particular, in the context of today's cardiology services. The most promising applications of eHealth and telemedicine include: (a) prevention and lifestyle interventions; (b) chronic disease management including hypertension, diabetes and heart failure; (c) arrhythmia detection including early detection of atrial fibrillation and telemonitoring of devices such as pacemaker, internal cardioverter defibrillators and implantable rhythm monitoring devices; (d) telerehabilitation. Major obstacles to the integration of eHealth and telemedicine into daily clinical practice include limited large-scale evidence, in particular, for cost-effectiveness, as well as lack of interoperability, inadequate or fragmented legal frameworks and lack of reimbursement. An important challenge for those involved in these new technologies will be to keep the main focus on patient's individual needs and to carefully evaluate the evidence behind the practice. © The European Society of Cardiology 2016.

Opportunities for health and safety professionals in environmental restoration work

International Nuclear Information System (INIS)

Norris, A.E.

1991-01-01

The safety of workers in waste management and in environmental restoration work is regulated in large part by the Occupational Safety and Health Administration (OSHA). Many of the OSHA rules are given in Part 1910, Occupational Safety and Health Standards, of Title 29 of the Code of Federal Regulations (CFR). Section 120 of 29 CFR 1910 specifically addresses hazardous waste operations and emergency response operations. The remainder of this discussion focuses on clean-up operations. The purpose of this paper is to review areas of employment opportunity in environmental restoration work for health and safety professionals. Safety and health risk analyses are mentioned as one area of opportunity, and these analyses are required by the standards. Site safety and health supervisors will be needed during field operations. Those who enjoy teaching might consider helping to meet the training needs that are mandated. Finally, engineering help both to separate workers from hazards and to improve personal protective equipment, when it must be worn, would benefit those actively involved in environmental restoration activities

Determinants of MSK health and disability--social determinants of inequities in MSK health.

Science.gov (United States)

Guillemin, Francis; Carruthers, Erin; Li, Linda C

2014-06-01

Even in most egalitarian societies, disparities in care exist to the disadvantage of some people with chronic musculoskeletal (MSK) disorders and related disability. These situations translate into inequality in health and health outcomes. The goal of this chapter is to review concepts and determinants associated with health inequity, and the effect of interventions to minimize their impact. Health inequities are avoidable, unnecessary, unfair and unjust. Inequities can occur across the health care continuum, from primary and secondary prevention to diagnosis and treatment. There are many ways to define and identify inequities, according for instance to ethical, philosophical, epidemiological, sociological, economic, or public health points of view. These complementary views can be applied to set a framework of analysis, identify determinants and suggest targets of action against inequity. Most determinants of inequity in MSK disorders are similar to those in the general population and other chronic diseases. People may be exposed to inequity as a result of policies and rules set by the health care system, individuals' demographic characteristics (e.g., education level), or some behavior of health professionals and of patients. Osteoarthritis (OA) represents a typical chronic MSK condition. The PROGRESS-Plus framework is useful for identifying the important role that place of residence, race and ethnicity, occupation, gender, education, socioeconomic status, social capital and networks, age, disability and sexual orientation may have in creating or maintaining inequities in this disease. In rheumatoid arthritis (RA), a consideration of international data led to the conclusion that not all RA patients who needed biologic therapy had access to it. The disparity in care was due partly to policies of a country and a health care system, or economic conditions. We conclude this chapter by discussing examples of interventions designed for reducing health inequity

Doctor-patient communication in the e-health era.

Science.gov (United States)

Weiner, Jonathan P

2012-08-28

The digital revolution will have a profound impact on how physicians and health care delivery organizations interact with patients and the community at-large. Over the coming decades, face-to-face patient/doctor contacts will become less common and exchanges between consumers and providers will increasingly be mediated by electronic devices.In highly developed health care systems like those in Israel, the United States, and Europe, most aspects of the health care and consumer health experience are becoming supported by a wide array of technology such as electronic and personal health records (EHRs and PHRs), biometric & telemedicine devices, and consumer-focused wireless and wired Internet applications.In an article in this issue, Peleg and Nazarenko report on a survey they fielded within Israel's largest integrated delivery system regarding patient views on the use of electronic communication with their doctors via direct-access mobile phones and e-mail. A previous complementary paper describes the parallel perspectives of the physician staff at the same organization. These two surveys offer useful insights to clinicians, managers, researchers, and policymakers on how best to integrate e-mail and direct-to-doctor mobile phones into their practice settings. These papers, along with several other recent Israeli studies on e-health, also provide an opportunity to step back and take stock of the dramatic impact that information & communication technology (ICT) and health information technology (HIT) will have on clinician/patient communication moving forward.The main goals of this commentary are to describe the scope of this issue and to offer a framework for understanding the potential impact that e-health tools will have on provider/patient communication. It will be essential that clinicians, managers, policymakers, and researchers gain an increased understanding of this trend so that health care systems around the globe can adapt, adopt, and embrace these rapidly

Doctor-patient communication in the e-health era

Directory of Open Access Journals (Sweden)

Weiner Jonathan P

2012-08-01

Full Text Available Abstract The digital revolution will have a profound impact on how physicians and health care delivery organizations interact with patients and the community at-large. Over the coming decades, face-to-face patient/doctor contacts will become less common and exchanges between consumers and providers will increasingly be mediated by electronic devices. In highly developed health care systems like those in Israel, the United States, and Europe, most aspects of the health care and consumer health experience are becoming supported by a wide array of technology such as electronic and personal health records (EHRs and PHRs, biometric & telemedicine devices, and consumer-focused wireless and wired Internet applications. In an article in this issue, Peleg and Nazarenko report on a survey they fielded within Israel's largest integrated delivery system regarding patient views on the use of electronic communication with their doctors via direct-access mobile phones and e-mail. A previous complementary paper describes the parallel perspectives of the physician staff at the same organization. These two surveys offer useful insights to clinicians, managers, researchers, and policymakers on how best to integrate e-mail and direct-to-doctor mobile phones into their practice settings. These papers, along with several other recent Israeli studies on e-health, also provide an opportunity to step back and take stock of the dramatic impact that information & communication technology (ICT and health information technology (HIT will have on clinician/patient communication moving forward. The main goals of this commentary are to describe the scope of this issue and to offer a framework for understanding the potential impact that e-health tools will have on provider/patient communication. It will be essential that clinicians, managers, policymakers, and researchers gain an increased understanding of this trend so that health care systems around the globe can adapt, adopt

Integration of community health workers into health systems in developing countries: Opportunities and challenges

Directory of Open Access Journals (Sweden)

Collins Otieno Asweto

2016-02-01

Full Text Available Background: Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health workers (CHWs. It is imperative that health care systems focus on improving access to quality continuous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their effectiveness. Objective: To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing countries. Methods: Six databases were examined for quantitative, qualitative, and mixed-methods studies that included the integration of CHWs, their motivation and supervision, and CHW policy making and implementation in developing countries. Thirty-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programs. Thematic coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was synthesized. Results: CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of health. Important facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management meetings. Sustainable integration of CHWs into the health care system requires the formulation and implementation of polices that support their work, as well as financial and nonfinancial incentives, motivation, collaborative and supportive supervision, and a manageable workload. Conclusions: For sustainable integration of CHWs into health care systems, high-performing health systems with sound governance, adequate financing, well-organized service delivery, and adequate supplies and equipment are essential. Similarly, competent communities could contribute to better CHW performance through sound

Developing E-science and Research Services and Support at the University of Minnesota Health Sciences Libraries

Science.gov (United States)

Johnson, Layne M.; Butler, John T.; Johnston, Lisa R.

2013-01-01

This paper describes the development and implementation of e-science and research support services in the Health Sciences Libraries (HSL) within the Academic Health Center (AHC) at the University of Minnesota (UMN). A review of the broader e-science initiatives within the UMN demonstrates the needs and opportunities that the University Libraries face while building knowledge, skills, and capacity to support e-research. These experiences are being used by the University Libraries administration and HSL to apply support for the growing needs of researchers in the health sciences. Several research areas that would benefit from enhanced e-science support are described. Plans to address the growing e-research needs of health sciences researchers are also discussed. PMID:23585706

Developing E-science and Research Services and Support at the University of Minnesota Health Sciences Libraries.

Science.gov (United States)

Johnson, Layne M; Butler, John T; Johnston, Lisa R

2012-01-01

This paper describes the development and implementation of e-science and research support services in the Health Sciences Libraries (HSL) within the Academic Health Center (AHC) at the University of Minnesota (UMN). A review of the broader e-science initiatives within the UMN demonstrates the needs and opportunities that the University Libraries face while building knowledge, skills, and capacity to support e-research. These experiences are being used by the University Libraries administration and HSL to apply support for the growing needs of researchers in the health sciences. Several research areas that would benefit from enhanced e-science support are described. Plans to address the growing e-research needs of health sciences researchers are also discussed.

Health claims on food products in Southeast Asia: regulatory frameworks, barriers, and opportunities.

Science.gov (United States)

Tan, Karin Y M; van der Beek, Eline M; Chan, M Y; Zhao, Xuejun; Stevenson, Leo

2015-09-01

The Association of Southeast Asian Nations aims to act as a single market and allow free movement of goods, services, and manpower. The purpose of this article is to present an overview of the current regulatory framework for health claims in Southeast Asia and to highlight the current barriers and opportunities in the regulatory frameworks in the Association of Southeast Asian Nations. To date, 5 countries in Southeast Asia, i.e., Indonesia, Malaysia, the Philippines, Singapore, and Thailand, have regulations and guidelines to permit the use of health claims on food products. There are inconsistencies in the regulations and the types of evidence required for health claim applications in these countries. A clear understanding of the regulatory frameworks in these countries may help to increase trade in this fast-growing region and to provide direction for the food industry and the regulatory community to develop and market food products with better nutritional quality tailored to the needs of Southeast Asian consumers. © The Author(s) 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Development and formative evaluation of the e-Health Implementation Toolkit (e-HIT

Directory of Open Access Journals (Sweden)

Mair Frances

2010-10-01

Full Text Available Abstract Background The use of Information and Communication Technology (ICT or e-Health is seen as essential for a modern, cost-effective health service. However, there are well documented problems with implementation of e-Health initiatives, despite the existence of a great deal of research into how best to implement e-Health (an example of the gap between research and practice. This paper reports on the development and formative evaluation of an e-Health Implementation Toolkit (e-HIT which aims to summarise and synthesise new and existing research on implementation of e-Health initiatives, and present it to senior managers in a user-friendly format. Results The content of the e-HIT was derived by combining data from a systematic review of reviews of barriers and facilitators to implementation of e-Health initiatives with qualitative data derived from interviews of "implementers", that is people who had been charged with implementing an e-Health initiative. These data were summarised, synthesised and combined with the constructs from the Normalisation Process Model. The software for the toolkit was developed by a commercial company (RocketScience. Formative evaluation was undertaken by obtaining user feedback. There are three components to the toolkit - a section on background and instructions for use aimed at novice users; the toolkit itself; and the report generated by completing the toolkit. It is available to download from http://www.ucl.ac.uk/pcph/research/ehealth/documents/e-HIT.xls Conclusions The e-HIT shows potential as a tool for enhancing future e-Health implementations. Further work is needed to make it fully web-enabled, and to determine its predictive potential for future implementations.

Grand Challenges Canada: inappropriate emphasis and missed opportunities in global health research?

Science.gov (United States)

Larson, Charles P; Haddad, Slim; Birn, Anne-Emanuelle; Cole, Donald C; Labonte, Ronald; Roberts, Janet Hatcher; Schrecker, Ted; Sellen, Daniel; Zakus, David

2011-01-01

In May 2010, Grand Challenges Canada (GCC) was launched with the mandate to identify global challenges in health that could be supported through the Government of Canada's Development Innovations Fund (DIF: $225 million over five years). The GCC offers a potentially excellent mechanism for taking Canada's participation in global health challenges "to a higher level". Recent GCC announcements raise new questions about the emphasis being placed on technological discovery or "catalytic" research. Missing so far are opportunities that the Fund could offer in order to support innovative research addressing i) health systems strengthening, ii) more effective delivery of existing interventions, and iii) policies and programs that address broader social determinants of health. The Canadian Grand Challenges announced to date risk pushing to the sidelines good translational and implementation science and early career-stage scientists addressing important social, environmental and political conditions that affect disease prevalence, progress and treatment; and the many unresolved challenges faced in bringing to scale proven interventions within resource-constrained health systems. We wish to register our concern at the apparent prioritization of biotechnical innovation research and the subordination of the social, environmental, economic and political context in which human health is either protected or eroded.

eHealth indicators

DEFF Research Database (Denmark)

HYPPÖNEN, Hannele; AMMENWERTH, Elske; Nøhr, Christian

2012-01-01

eHealth indicators are needed to measure defined aspects of national eHealth implementations. However, until now, eHealth indicators are ambiguous or unclear. Therefore, an expert workshop "Towards an International Minimum Dataset for Monitoring National Health Information System Implementations......" was organized. The objective was to develop ideas for a minimum eHealth indicator set. The proposed ideas for indicators were classified based on EUnetHTA and De-Lone & McClean, and classification was compared with health IT evaluation criteria classification by Ammenwerth & Keizer. Analysis of the workshop...... results emphasized the need for a common methodological framework for defining and classifying eHealth indicators. It also showed the importance of setting the indicators into context. The results will benefit policy makers, developers and researchers in pursuit of provision and use of evidence...

Private health care sector investment in Brazil: opportunities and obstacles.

Science.gov (United States)

Brandt, Reynaldo

2003-01-01

The Brazilian health system is based upon the constitutional right formulated in 1988, according to which health is the peoples' right and duty of the State. So being, it is essentially the government's responsibility, expressed in the so-called Sistema Unico de Saúde--SUS (single health system) Since its creation, however, it admits the existence of a supplementary health system, left to the private sector. In general terms, the public system is considered unsatisfactory in the services it renders. Its resources are distributed heterogeneously, favoring centers of advanced medical practice, to the detriment of basic health care. The supplementary system is considered of better quality, however with great variations and frequent accusations of being essentially profit driven, instead of being driven to the needs of the assisted population. The growing search for health plans is a direct consequence of the image perceived by the population regarding the quality and accessibility of the public services, as well as of the peoples' growing consciousness of their needs, rights and duties as citizens. The need for continuous quality improvement and cost reduction offers numberless opportunities for actions and investments. Initiatives to identify and implement the best medical practices, medical guidelines and actions are essential regarding those illnesses which are most frequent, of higher cost and of greater risk. Health plans and healthcare providers will necessarily have to focus on their common client. Therefore, organizations must be created in order to develop initiatives aimed to the quality of patient care, as well as to the collection and dissemination of data regarding the production and results of the main service providers. Consequently, immense opportunities are being opened for investments in the area of Information Technology, collection, analysis, and data dissemination. This paper analyses the main trends in the Brazilian health sector and from the

E-Commerce Content in Business School Curriculum: Opportunities and Challenges.

Science.gov (United States)

Krovi, Ravindra; Vijayaraman, B. S.

2000-01-01

Explores the opportunities and challenges of introducing e-commerce concepts in business school curriculums. Examines the knowledge components of electronic commerce, including Web-based technology skills; and discusses the need for faculty training and development. (Author/LRW)

Globalization and Health: Exploring the opportunities and constraints for health arising from globalization

Science.gov (United States)

Yach, Derek

2005-01-01

The tremendous benefits which have been conferred to almost 5 billion people through improved technologies and knowledge highlights the concomitant challenge of bringing these changes to the 1 billion people living mostly in sub-Saharan Africa and South Asia who are yet to benefit. There is a growing awareness of the need to reduce human suffering and of the necessary participation of governments, non-government organizations and industry within this process. This awareness has recently translated into new funding mechanisms to address HIV/Aids and vaccines, a global push for debt relief and better trade opportunities for the poorest countries, and recognition of how global norms that address food safety, infectious diseases and tobacco benefit all. 'Globalization and Health' will encourage an exchange of views on how the global architecture for health governance needs to changes in the light of global threats and opportunities. PMID:15847700

Globalization and Health: Exploring the opportunities and constraints for health arising from globalization.

Science.gov (United States)

Yach, Derek

2005-04-22

The tremendous benefits which have been conferred to almost 5 billion people through improved technologies and knowledge highlights the concomitant challenge of bringing these changes to the 1 billion people living mostly in sub-Saharan Africa and South Asia who are yet to benefit. There is a growing awareness of the need to reduce human suffering and of the necessary participation of governments, non-government organizations and industry within this process. This awareness has recently translated into new funding mechanisms to address HIV/Aids and vaccines, a global push for debt relief and better trade opportunities for the poorest countries, and recognition of how global norms that address food safety, infectious diseases and tobacco benefit all. 'Globalization and Health' will encourage an exchange of views on how the global architecture for health governance needs to changes in the light of global threats and opportunities.

E-Health Literacy and Health Information Seeking Behavior Among University Students in Bangladesh.

Science.gov (United States)

Islam, Md Mohaimenul; Touray, Musa; Yang, Hsuan-Chia; Poly, Tahmina Nasrin; Nguyen, Phung-Anh; Li, Yu-Chuan Jack; Syed Abdul, Shabbir

2017-01-01

Web 2.0 has become a leading health communication platform and will continue to attract young users; therefore, the objective of this study was to understand the impact of Web 2.0 on health information seeking behavior among university students in Bangladesh. A random sample of adults (n = 199, mean 23.75 years, SD 2.87) participated in a cross-sectional, a survey that included the eHealth literacy scale (eHEALS) assessed use of Web 2.0 for health information. Collected data were analyzed using a descriptive statistical method and t-tests. Finally logistic regression analyses were conducted to determine associations between sociodemographic, social determinants, and use of Web 2.0 for seeking and sharing health information. Almost 74% of older Web 2.0 users (147/199, 73.9%) reported using popular Web 2.0 websites, such as Facebook and Twitter, to find and share health information. Current study support that current Web-based health information seeking and sharing behaviors influence health-related decision making.

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

Energy Technology Data Exchange (ETDEWEB)

Sheng, Shuangwen

2015-12-14

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

Resolving the "Cost-Effective but Unaffordable" Paradox: Estimating the Health Opportunity Costs of Nonmarginal Budget Impacts.

Science.gov (United States)

Lomas, James; Claxton, Karl; Martin, Stephen; Soares, Marta

2018-03-01

Considering whether or not a proposed investment (an intervention, technology, or program of care) is affordable is really asking whether the benefits it offers are greater than its opportunity cost. To say that an investment is cost-effective but not affordable must mean that the (implicit or explicit) "threshold" used to judge cost-effectiveness does not reflect the scale and value of the opportunity costs. Existing empirical estimates of health opportunity costs are based on cross-sectional variation in expenditure and mortality outcomes by program budget categories (PBCs) and do not reflect the likely effect of nonmarginal budget impacts on health opportunity costs. The UK Department of Health regularly updates the needs-based target allocation of resources to local areas of the National Health Service (NHS), creating two subgroups of local areas (those under target allocation and those over). These data provide the opportunity to explore how the effects of changes in health care expenditure differ with available resources. We use 2008-2009 data to evaluate two econometric approaches to estimation and explore a range of criteria for accepting subgroup specific effects for differences in expenditure and outcome elasticities across the 23 PBCs. Our results indicate that health opportunity costs arising from an investment imposing net increases in expenditure are underestimated unless account is taken of likely nonmarginal effects. They also indicate the benefits (reduced health opportunity costs or increased value-based price of a technology) of being able to "smooth" these nonmarginal budget impacts by health care systems borrowing against future budgets or from manufacturers offering "mortgage" type arrangements. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Integration of eHealth Tools in the Process of Workplace Health Promotion: Proposal for Design and Implementation

Science.gov (United States)

2018-01-01

Background Electronic health (eHealth) and mobile health (mHealth) tools can support and improve the whole process of workplace health promotion (WHP) projects. However, several challenges and opportunities have to be considered while integrating these tools in WHP projects. Currently, a large number of eHealth tools are developed for changing health behavior, but these tools can support the whole WHP process, including group administration, information flow, assessment, intervention development process, or evaluation. Objective To support a successful implementation of eHealth tools in the whole WHP processes, we introduce a concept of WHP (life cycle model of WHP) with 7 steps and present critical and success factors for the implementation of eHealth tools in each step. Methods We developed a life cycle model of WHP based on the World Health Organization (WHO) model of healthy workplace continual improvement process. We suggest adaptations to the WHO model to demonstrate the large number of possibilities to implement eHealth tools in WHP as well as possible critical points in the implementation process. Results eHealth tools can enhance the efficiency of WHP in each of the 7 steps of the presented life cycle model of WHP. Specifically, eHealth tools can support by offering easier administration, providing an information and communication platform, supporting assessments, presenting and discussing assessment results in a dashboard, and offering interventions to change individual health behavior. Important success factors include the possibility to give automatic feedback about health parameters, create incentive systems, or bring together a large number of health experts in one place. Critical factors such as data security, anonymity, or lack of management involvement have to be addressed carefully to prevent nonparticipation and dropouts. Conclusions Using eHealth tools can support WHP, but clear regulations for the usage and implementation of these tools at the

Tobacco, e-cigarettes, and child health.

Science.gov (United States)

Peterson, Lisa A; Hecht, Stephen S

2017-04-01

The availability of the Children's Health Exposure Assessment Resource funded by the National Institute of Environmental Health Sciences provides new opportunities for exploring the role of tobacco smoke exposure in causing harm to children. Children of smokers are exposed to nicotine and other harmful tobacco smoke chemicals in utero as well as in their environment. This passive exposure to tobacco smoke has a variety of negative effects on children. In-utero exposure to tobacco smoke causes poor birth outcomes and influences lung, cardiovascular, and brain development, placing children at increased risk of a number of adverse health outcomes later in life, such as obesity, behavioral problems, and cardiovascular disease. Furthermore, most smokers start in their adolescence, an age of increased nicotine addiction risk. Biomarkers of tobacco exposure helps clarify the role tobacco chemicals play in influencing health both in childhood and beyond. Although electronic cigarettes (e-cigarettes) appear to be a nicotine delivery device of reduced harm, it appears to be a gateway to the use of combustible cigarette smoking in adolescents. Pediatric researchers interested in elucidating the role of tobacco smoke exposure in adverse outcomes in children should incorporate biomarkers of tobacco exposure in their studies.

Development of a virtual lab for practical eLearning in eHealth.

Science.gov (United States)

Herzog, Juliane; Forjan, Mathias; Sauermann, Stefan; Mense, Alexander; Urbauer, Philipp

2015-01-01

In recent years an ongoing development in educational offers for professionals working in the field of eHealth has been observed. This education is increasingly offered in the form of eLearning courses. Furthermore, it can be seen that simulations are a valuable part to support the knowledge transfer. Based on the knowledge profiles defined for eHealth courses a virtual lab should be developed. For this purpose, a subset of skills and a use case is determined. After searching and evaluating appropriate simulating and testing tools six tools were chosen to implement the use case practically. Within an UML use case diagram the interaction between the tools and the user is represented. Initially tests have shown good results of the tools' feasibility. After an extensive testing phase the tools should be integrated in the eHealth eLearning courses.

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

Energy Technology Data Exchange (ETDEWEB)

Sheng, Shuangwen

2016-10-04

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

E-health readiness assessment framework in iran.

Science.gov (United States)

Rezai-Rad, M; Vaezi, R; Nattagh, F

2012-01-01

Concept of e-readiness is used in many areas such as e-business, e-commerce, e-government, and e-banking. In terms of healthcare, e-readiness is a rather new concept, and is propounded under the title of E-healthcare. E-health readiness refers to the readiness of communities and healthcare institutions for the expected changes brought by programs related to Information and Communications Technology (lCT). The present research is conducted aiming at designing E-health Readiness Assessment Framework (EHRAF) in Iran. The e-health readiness assessment framework was designed based on reviewing literature on e-readiness assessment models and opinions of ICT and health experts. In the next step, Delphi method was used to develop and test the designed framework. Three questionnaires developed to test and modify the model while determining weights of the indices; afterward they were either sent to experts through email or delivered to them in face. The designed framework approved with 4 dimensions, 11 constituents and 58 indices. Technical readiness had the highest importance coefficient (0.256099), and the other dimensions were of the next levels of coefficient importance: core readiness (0.25520), social communication readiness (0.244658), and engagement readiness (0.244039). The framework presents the movement route and investment priorities in e-health in Iran. The proposed framework is a good instrument for measuring the e-readiness in health centers in Iran, and for identifying strengths and weaknesses of these centers to access ICT and its implementation for more effectiveness and for analyzing digital divide between them, as well.

E-Health Readiness Assessment Framework in Iran

Science.gov (United States)

Rezai-Rad, M; Vaezi, R; Nattagh, F

2012-01-01

Background: Concept of e-readiness is used in many areas such as e-business, e-commerce, e-government, and e-banking. In terms of healthcare, e-readiness is a rather new concept, and is propounded under the title of E-healthcare. E-health readiness refers to the readiness of communities and healthcare institutions for the expected changes brought by programs related to Information and Communications Technology (lCT). The present research is conducted aiming at designing E-health Readiness Assessment Framework (EHRAF) in Iran. Methods: The e-health readiness assessment framework was designed based on reviewing literature on e-readiness assessment models and opinions of ICT and health experts. In the next step, Delphi method was used to develop and test the designed framework. Three questionnaires developed to test and modify the model while determining weights of the indices; afterward they were either sent to experts through email or delivered to them in face. Results: The designed framework approved with 4 dimensions, 11 constituents and 58 indices. Technical readiness had the highest importance coefficient (0.256099), and the other dimensions were of the next levels of coefficient importance: core readiness (0.25520), social communication readiness (0.244658), and engagement readiness (0.244039). Conclusion: The framework presents the movement route and investment priorities in e-health in Iran. The proposed framework is a good instrument for measuring the e-readiness in health centers in Iran, and for identifying strengths and weaknesses of these centers to access ICT and its implementation for more effectiveness and for analyzing digital divide between them, as well. PMID:23304661

Multisectoral Actions for Health: Challenges and Opportunities in Complex Policy Environments.

Science.gov (United States)

Tangcharoensathien, Viroj; Srisookwatana, Orapan; Pinprateep, Poldej; Posayanonda, Tipicha; Patcharanarumol, Walaiporn

2017-05-16

Multisectoral actions for health, defined as actions undertaken by non-health sectors to protect the health of the population, are essential in the context of inter-linkages between three dimensions of sustainable development: economic, social, and environmental. These multisectoral actions can address the social and economic factors that influence the health of a population at the local, national, and global levels. This editorial identifies the challenges, opportunities and capacity development for effective multisectoral actions for health in a complex policy environment. The root causes of the challenges lie in poor governance such as entrenched political and administrative corruption, widespread clientelism, lack of citizen voice, weak social capital, lack of trust and lack of respect for human rights. This is further complicated by the lack of government effectiveness caused by poor capacity for strong public financial management and low levels of transparency and accountability which leads to corruption. The absence of or rapid changes in government policies, and low salary in relation to living standards result in migration out of qualified staff. Tobacco, alcohol and sugary drink industries are major risk factors for non-communicable diseases (NCDs) and had interfered with health policy through regulatory capture and potential law suits against the government. Opportunities still exist. Some World Health Assembly (WHA) and United Nations General Assembly (UNGA) resolutions are both considered as external driving forces for intersectoral actions for health. In addition, Thailand National Health Assembly under the National Health Act is another tool providing opportunity to form trust among stakeholders from different sectors. Capacity development at individual, institutional and system level to generate evidence and ensure it is used by multisectoral agencies is as critical as strengthening the health literacy of people and the overall good governance of a

Self-Determination Theory With Application to Employee Health Settings.

Science.gov (United States)

Ross, Brenda M; Barnes, Donelle M

2018-01-01

Occupational health nurses motivate employees to engage in healthy behaviors. Both clinicians and researchers need strong theories on which to base decisions for health programs (e.g., healthy diet) and experimental interventions (e.g., workplace walking). The self-determination theory could be useful as it includes concepts of individual autonomy, competence to perform healthy behaviors, and relationships as predictors of health behaviors and outcomes. In this article, the self-determination theory is described and evaluated using Walker and Avant's criteria. The theory is applied to a population of federal employees who smoke. By increasing employees' ability to autonomously choose smoking cessation programs, support their competence to stop smoking, and improve their relationships with both others who smoke and employee health services, smoking cessation should increase.

Systems change for the social determinants of health.

Science.gov (United States)

Carey, Gemma; Crammond, Brad

2015-07-14

Inequalities in the distribution of the social determinants of health are now a widely recognised problem, seen as requiring immediate and significant action (CSDH. Closing the Gap in a Generation. Geneva: WHO; 2008; Marmot M. Fair Society, Healthy Lives: The Marmot Review. Strategic Review of Health Inequalitites in England Post-2010. London; 2010). Despite recommendations for action on the social determinants of health dating back to the 1980s, inequalities in many countries continue to grow. In this paper we provide an analysis of recommendations from major social determinants of health reports using the concept of 'system leverage points'. Increasingly, powerful and effective action on the social determinants of health is conceptualised as that which targets government action on the non-health issues which drive health outcomes. Recommendations for action from 6 major national reports on the social determinants of health were sourced. Recommendations from each report were coded against two frameworks: Johnston et al's recently developed Intervention Level Framework (ILF) and Meadow's seminal '12 places to intervene in a system' (Johnston LM, Matteson CL, Finegood DT. Systems Science and Obesity Policy: A Novel Framework for Analyzing and Rethinking Population-Level Planning. American journal of public health. 2014;(0):e1-e9; Meadows D. Thinking in Systems. USA: Sustainability Institute; 1999) (N = 166). Our analysis found several major changes over time to the types of recommendations being made, including a shift towards paradigmatic change and away from individual interventions. Results from Meadow's framework revealed a number of potentially powerful system intervention points that are currently underutilised in public health thinking regarding action on the social determinants of health. When viewed through a systems lens, it is evident that the power of an intervention comes not from where it is targeted, but rather how it works to create change within the

Community health clinical education in Canada: part 2--developing competencies to address social justice, equity, and the social determinants of health.

Science.gov (United States)

Cohen, Benita E; Gregory, David

2009-01-01

Recently, several Canadian professional nursing associations have highlighted the expectations that community health nurses (CHNs) should address the social determinants of health and promote social justice and equity. These developments have important implications for (pre-licensure) CHN clinical education. This article reports the findings of a qualitative descriptive study that explored how baccalaureate nursing programs in Canada address the development of competencies related to social justice, equity, and the social determinants of health in their community health clinical courses. Focus group interviews were held with community health clinical course leaders in selected Canadian baccalaureate nursing programs. The findings foster understanding of key enablers and challenges when providing students with clinical opportunities to develop the CHN role related to social injustice, inequity, and the social determinants of health. The findings may also have implications for nursing programs internationally that are addressing these concepts in their community health clinical courses.

eHealth voor Zorgprocesinnovatie : e-book

NARCIS (Netherlands)

Dr. A.L. Cordia

2015-01-01

Het E-book 'eHealth voor Zorgprocesinnovatie' van ir. Anneloes Cordia, expert bij Kenniscentrum Zorginnovatie, heeft als doel eHealth en ICT-systemen in de zorg in verband te brengen met de belangrijke kwaliteitsdoelstellingen zoals doelmatigheid en transparantie. Daarnaast biedt het E-book

eHealth in Denmark

DEFF Research Database (Denmark)

Kierkegaard, Patrick

2013-01-01

Denmark is widely regarded as a leading country in terms of eHealth integration and healthcare delivery services. The push for eHealth adoption over that past 20 years in the Danish health sector has led to the deployment of multiple eHealth technologies. However, in reality the Danish healthcare...... suffers from eHealth system fragmentation which has led to eHealth's inability to reach full potential in delivering quality healthcare service. This paper will presents a case study of the current state of eHealth in the Danish healthcare system and discuss the current challenges the country is facing...

E-cigarettes and the need and opportunities for alternatives to animal testing.

Science.gov (United States)

Hartung, Thomas

2016-01-01

E-cigarettes have become within only one decade an important commodity, changing the market of the most mass-killing commercial product. While a few years ago estimates suggested that in the course of the 21st century one billion people would die prematurely from tobacco consumption, e-cigarettes continuously gaining popularity promise 10-30fold lower health effects, possibly strongly changing this equation. However, they still are not a harmless life-style drug. Acceptability simply depends on whether we compare their use to smoking or to not-smoking. In the absence of long-term follow-up health data of users, additional uncertainty comes from the lack of safety data, though this uncertainty likely only is whether they represent 3 or 10% of the risk of their combustible counterpart. This means that there is little doubt that they represent a prime opportunity for smokers to switch, but also that their use by non-smokers should be avoided where possible. The real safety concerns, however, are that e-cigarettes expose their users to many compounds, contaminants and especially flavors (more than 7,000 according to recent counts), which have mostly not been tested, especially not for long-term inhalation exposure. Neither the precautionary traditional animal testing nor post-marketing surveillance will offer us data of sufficient quality or sufficiently fast to support product development and regulatory decisions. Thus, alternative methods lend themselves to fill this gap, making this new product category a possible engine for new method development and its implementation and validation.

Challenges and Opportunities for Advancing Work on Climate Change and Public Health.

Science.gov (United States)

Gould, Solange; Rudolph, Linda

2015-12-09

Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change's health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities.

Challenges and Opportunities for Advancing Work on Climate Change and Public Health

Science.gov (United States)

Gould, Solange; Rudolph, Linda

2015-01-01

Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change’s health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities. PMID:26690194

[Using eHealth in the Continuity Care of Chronic Kidney Disease: Opportunities and Considerations].

Science.gov (United States)

Chen, Yu-Chi; Chang, Polun

2016-04-01

Kidney disease is a common complication of chronic diseases among adult and elderly populations. As early-stage chronic kidney disease (CKD) is asymptomatic, CKD patients are frequently unaware of their condition and fail to implement requisite self-care in a timely fashion. Furthermore, the shortage of case-management manpower and difficulties in follow-up have led to high incidence rates for CKD worldwide. Integrative and continuous care is key to preventing CKD. How to implement this care effectively is a challenge. However, innovative technologies, online information, and cloud technology are increasingly providing access to good-quality healthcare beyond the traditional limitations of time and location. This environment is not only increasing the participation of patients in their care and collaboration among healthcare team members but is also improving the continuity, accessibility, and promptness of care service in order to promote the effectiveness of disease management. While the primary aim of innovative technologies is to make healthcare more cost-effective, it is also causing disparities in healthcare. Within the high-tech e-healthcare system, the ability of patients to utilize these new services relates directly to their health behaviors and quality of care. Thus, emergent e-healthcare system services should be made as patient-centered as possible in order to maximize the benefits in terms of both cost and patient care. Furthermore, improving the eHealth literacy of patients is crucial to promoting innovative technology within healthcare services.

Political determinants of Health: Lessons for Pakistan.

Science.gov (United States)

Jooma, Rashid; Sabatinelli, Guido

2014-05-01

There is much concern about the capacity of the health system of Pakistan to meet its goals and obligations. Historically, the political thrust has been absent from the health policy formulation and this is reflected in the low and stagnant public allocations to health. Successive political leaderships have averred from considering healthcare is a common good rather than a market commodity and health has not been recognized as a constitutional right. Over 120 of world's nation states have accepted health as a constitutional right but the 1973 Constitution of Pakistan does not mandate health or education as a fundamental right and the recently adopted 18th constitutional amendment missed the opportunity to extend access to primary health care as an obligation of the State. It is argued in this communication that missing from the calculations of policy formulation and agenda setting is the political benefits of providing health and other social services to underserved populations. Across the developing world, many examples are presented of governments undertaking progressive health reforms that bring services where none existed and subsequently reaping electoral benefit. The political determinant of healthcare will be realized when the political leaders of poorly performing countries can be convinced that embracing distributive policies and successfully bringing healthcare to the poor can be major factors in their re-elections.

Not so special after all? Daniels and the social determinants of health.

Science.gov (United States)

Wilson, J

2009-01-01

Just health: meeting health needs fairly is an ambitious book, in which Norman Daniels attempts to bring together in a single framework all his work on health and justice from the past 25 years. One major aim is to reconcile his earlier work on the special moral importance of healthcare with his later work on the social determinants of health. In his earlier work, Daniels argued that healthcare is of special moral importance because it protects opportunity. In this later work, Daniels argues that the social determinants of health (which in fact tend to have a larger effect on health outcomes than healthcare does) should also be considered special. This paper argues that it is a mistake to base a theory of justice for health on the claim that health (or the social determinants of health) are "special", for three reasons. First, once we realise that health is to a large part socially determined by features such as distribution of income, which are also of independent importance for justice, we cannot talk about a theory of justice for health in isolation from an overall theory of justice. Second, when we are trying to work out the place of health in a general theory of justice, being told that health (or the social determinants of health) is special is unhelpful. The relevant starting point should rather be whether health matters in a fundamental way for justice, or whether it matters merely for the effects it has on those goods which are of fundamental importance for justice. Third, treating the social determinants of health as special would in fact be counterproductive in terms of the broad approach to justice Daniels favours.

Opportunities and challenges within urban health and sustainable development

DEFF Research Database (Denmark)

Fisher, Jack E.; Andersen, Zorana J.; Loft, Steffen

2017-01-01

The United Nations’ Sustainable Development Goals mark aunique window of opportunity for both human and planetaryhealth. With rising life expectancy and rapidly expanding urbanpopulations exposed to pollution and sedentary lifestyles, thereis a greater focus on reducing the gap between life...... expectancyand number of healthy years lived, whilst limiting anthropogenicactivities contributing to pollution and climate change. Thus,urban development and policies, which can create win–winsituations for our planet and human health, falls into the realmand expertise of public health. However, some...

The eHealth Enhanced Chronic Care Model: a theory derivation approach.

Science.gov (United States)

Gee, Perry M; Greenwood, Deborah A; Paterniti, Debora A; Ward, Deborah; Miller, Lisa M Soederberg

2015-04-01

Chronic illnesses are significant to individuals and costly to society. When systematically implemented, the well-established and tested Chronic Care Model (CCM) is shown to improve health outcomes for people with chronic conditions. Since the development of the original CCM, tremendous information management, communication, and technology advancements have been established. An opportunity exists to improve the time-honored CCM with clinically efficacious eHealth tools. The first goal of this paper was to review research on eHealth tools that support self-management of chronic disease using the CCM. The second goal was to present a revised model, the eHealth Enhanced Chronic Care Model (eCCM), to show how eHealth tools can be used to increase efficiency of how patients manage their own chronic illnesses. Using Theory Derivation processes, we identified a "parent theory", the Chronic Care Model, and conducted a thorough review of the literature using CINAHL, Medline, OVID, EMBASE PsychINFO, Science Direct, as well as government reports, industry reports, legislation using search terms "CCM or Chronic Care Model" AND "eHealth" or the specific identified components of eHealth. Additionally, "Chronic Illness Self-management support" AND "Technology" AND several identified eHealth tools were also used as search terms. We then used a review of the literature and specific components of the CCM to create the eCCM. We identified 260 papers at the intersection of technology, chronic disease self-management support, the CCM, and eHealth and organized a high-quality subset (n=95) using the components of CCM, self-management support, delivery system design, clinical decision support, and clinical information systems. In general, results showed that eHealth tools make important contributions to chronic care and the CCM but that the model requires modification in several key areas. Specifically, (1) eHealth education is critical for self-care, (2) eHealth support needs to be

Using social media to enhance career development opportunities for health promotion professionals.

Science.gov (United States)

Roman, Leah A

2014-07-01

For health promotion professionals, social media offers many ways to engage with a broader range of colleagues; participate in professional development events; promote expertise, products, or services; and learn about career-enhancing opportunities such as funding and fellowships. Previous work has recommended "building networking into what you are already doing." This article provides updated and new social media resources, as well as practical examples and strategies to promote effective use of social media. Social media offers health promotion professionals cost-effective opportunities to enhance their career by building communities of practice, participating in professional development events, and enriching classroom learning. Developing the skills necessary to use social media for networking is important in the public health workforce, especially as social media is increasingly used in academic and practice settings. © 2014 Society for Public Health Education.

Using Linked Electronic Health Records to Estimate Healthcare Costs: Key Challenges and Opportunities.

Science.gov (United States)

Asaria, Miqdad; Grasic, Katja; Walker, Simon

2016-02-01

This paper discusses key challenges and opportunities that arise when using linked electronic health records (EHR) in health economics and outcomes research (HEOR), with a particular focus on estimating healthcare costs. These challenges and opportunities are framed in the context of a case study modelling the costs of stable coronary artery disease in England. The challenges and opportunities discussed fall broadly into the categories of (1) handling and organising data of this size and sensitivity; (2) extracting clinical endpoints from datasets that have not been designed and collected with such endpoints in mind; and (3) the principles and practice of costing resource use from routinely collected data. We find that there are a number of new challenges and opportunities that arise when working with EHR compared with more traditional sources of data for HEOR. These call for greater clinician involvement and intelligent use of sensitivity analysis.

Nordic eHealth Indicators

DEFF Research Database (Denmark)

Hyppönen, Hannele; Faxvaag, Arild; Gilstad, Heidi

This report describes first results of the Network: eHealth policy analysis and first common Nordic eHealth indicators. The results show similarities and also some differences in the eHealth policies, priorities and implementation. Interesting similarities and differences in availability and use...... of eHealth services in the Nordic countries were found with the first comparable eHealth indicators. The results create a basis for Evidence-based policy making as well as benchmarking and learning best practices from each other....

Associations of eHealth Literacy With Health Behavior Among Adult Internet Users.

Science.gov (United States)

Mitsutake, Seigo; Shibata, Ai; Ishii, Kaori; Oka, Koichiro

2016-07-18

In the rapidly developing use of the Internet in society, eHealth literacy-having the skills to utilize health information on the Internet-has become an important prerequisite for promoting healthy behavior. However, little is known about whether eHealth literacy is associated with health behavior in a representative sample of adult Internet users. The aim of this study was to examine the association between eHealth literacy and general health behavior (cigarette smoking, physical exercise, alcohol consumption, sleeping hours, eating breakfast, eating between meals, and balanced nutrition) among adult Internet users in Japan. The participants were recruited among registrants of a Japanese Internet research service company and asked to answer a cross-sectional Internet-based survey in 2012. The potential respondents (N=10,178) were randomly and blindly invited via email from the registrants in accordance with the set sample size and other attributes. eHealth literacy was assessed using the Japanese version of the eHealth Literacy Scale. The self-reported health behaviors investigated included never smoking cigarettes, physical exercise, alcohol consumption, sleeping hours, eating breakfast, not eating between meals, and balanced nutrition. We obtained details of sociodemographic attributes (sex, age, marital status, educational attainment, and household income level) and frequency of conducting Internet searches. To determine the association of each health behavior with eHealth literacy, we performed a logistic regression analysis; we adjusted for sociodemographic attributes and frequency of Internet searching as well as for other health behaviors that were statistically significant with respect to eHealth literacy in univariate analyses. We analyzed the data of 2115 adults (response rate: 24.04%, 2142/10,178; male: 49.74%, 1052/2115; age: mean 39.7, SD 10.9 years) who responded to the survey. Logistic regression analysis showed that individuals with high eHealth

Determinants of the intention to use e-Health by community dwelling older people.

NARCIS (Netherlands)

Veer, A.J.E. de; Peeters, J.M.; Brabers, A.E.M.; Schellevis, F.G.; Rademakers, J.J.D.J.M.; Francke, A.L.

2015-01-01

Background: In the future, an increasing number of elderly people will be asked to accept care delivered through the Internet. For example, health-care professionals can provide treatment or support via telecare. But do elderly people intend to use such so-called e-Health applications? The objective

Selection gradients, the opportunity for selection, and the coefficient of determination.

Science.gov (United States)

Moorad, Jacob A; Wade, Michael J

2013-03-01

Abstract We derive the relationship between R(2) (the coefficient of determination), selection gradients, and the opportunity for selection for univariate and multivariate cases. Our main result is to show that the portion of the opportunity for selection that is caused by variation for any trait is equal to the product of its selection gradient and its selection differential. This relationship is a corollary of the first and second fundamental theorems of natural selection, and it permits one to investigate the portions of the total opportunity for selection that are involved in directional selection, stabilizing (and diversifying) selection, and correlational selection, which is important to morphological integration. It also allows one to determine the fraction of fitness variation not explained by variation in measured phenotypes and therefore attributable to random (or, at least, unknown) influences. We apply our methods to a human data set to show how sex-specific mating success as a component of fitness variance can be decoupled from that owing to prereproductive mortality. By quantifying linear sources of sexual selection and quadratic sources of sexual selection, we illustrate that the former is stronger in males, while the latter is stronger in females.

Tobacco, E-Cigarettes and Child Health

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Peterson, Lisa A.; Hecht, Stephen S.

2017-01-01

Purpose of the review The availability of the Children’s Health Exposure Assessment Resource funded by the National Institute of Environmental Health Sciences provides new opportunities for exploring the role of tobacco smoke exposure in causing harm to children. Findings Children of smokers are exposed to nicotine and other harmful tobacco smoke chemicals in utero as well as in their environment. This passive exposure to tobacco smoke has a variety of negative effects on children. In utero exposure to tobacco smoke causes poor birth outcomes and influences lung, cardiovascular and brain development, placing children at increased risk of a number of adverse health outcomes later in life such as obesity, behavioral problems and cardiovascular disease. Furthermore, most smokers start in their adolescence, an age of increased nicotine addiction risk. Biomarkers of tobacco exposure helps clarify the role tobacco chemicals play in influencing health both in childhood and beyond. While e-cigarettes appear to be a nicotine delivery device of reduced harm, it appears to be a gateway to the use of combustible cigarette smoking in adolescents. Summary Pediatric researchers interested in elucidating the role of tobacco smoke exposure in adverse outcomes in children should incorporate biomarkers of tobacco exposure in their studies. PMID:28059903

Organisational aspects and benchmarking of e-learning initiatives: a case study with South African community health workers.

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Reisach, Ulrike; Weilemann, Mitja

2016-06-01

South Africa desperately needs a comprehensive approach to fight HIV/AIDS. Education is crucial to reach this goal and Internet and e-learning could offer huge opportunities to broaden and deepen the knowledge basis. But due to the huge societal and digital divide between rich and poor areas, e-learning is difficult to realize in the townships. Community health workers often act as mediators and coaches for people seeking medical and personal help. They could give good advice regarding hygiene, nutrition, protection of family members in case of HIV/AIDS and finding legal ways to earn one's living if they were trained to do so. Therefore they need to have a broader general knowledge. Since learning opportunities in the townships are scarce, a system for e-learning has to be created in order to overcome the lack of experience with computers or the Internet and to enable them to implement a network of expertise. The article describes how the best international resources on basic medical knowledge, HIV/AIDS as well as on basic economic and entrepreneurial skills were benchmarked to be integrated into an e-learning system. After tests with community health workers, researchers developed recommendations on building a self-sustaining system for learning, including a network of expertise and best practice sharing. The article explains the opportunities and challenges for community health workers, which could provide information for other parts of the world with similar preconditions of rural poverty. © The Author(s) 2015.

Predictive modeling in e-mental health: A common language framework

Directory of Open Access Journals (Sweden)

Dennis Becker

2018-06-01

Full Text Available Recent developments in mobile technology, sensor devices, and artificial intelligence have created new opportunities for mental health care research. Enabled by large datasets collected in e-mental health research and practice, clinical researchers and members of the data mining community increasingly join forces to build predictive models for health monitoring, treatment selection, and treatment personalization. This paper aims to bridge the historical and conceptual gaps between the distant research domains involved in this new collaborative research by providing a conceptual model of common research goals. We first provide a brief overview of the data mining field and methods used for predictive modeling. Next, we propose to characterize predictive modeling research in mental health care on three dimensions: 1 time, relative to treatment (i.e., from screening to post-treatment relapse monitoring, 2 types of available data (e.g., questionnaire data, ecological momentary assessments, smartphone sensor data, and 3 type of clinical decision (i.e., whether data are used for screening purposes, treatment selection or treatment personalization. Building on these three dimensions, we introduce a framework that identifies four model types that can be used to classify existing and future research and applications. To illustrate this, we use the framework to classify and discuss published predictive modeling mental health research. Finally, in the discussion, we reflect on the next steps that are required to drive forward this promising new interdisciplinary field.

E-Mental Health Innovations for Aboriginal and Torres Strait Islander Australians: A Qualitative Study of Implementation Needs in Health Services.

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Puszka, Stefanie; Dingwall, Kylie M; Sweet, Michelle; Nagel, Tricia

2016-09-19

Electronic mental health (e-mental health) interventions offer effective, easily accessible, and cost effective treatment and support for mental illness and well-being concerns. However, e-mental health approaches have not been well utilized by health services to date and little is known about their implementation in practice, particularly in diverse contexts and communities. This study aims to understand stakeholder perspectives on the requirements for implementing e-mental health approaches in regional and remote health services for Indigenous Australians. Qualitative interviews were conducted with 32 managers, directors, chief executive officers (CEOs), and senior practitioners of mental health, well-being, alcohol and other drug and chronic disease services. The implementation of e-mental health approaches in this context is likely to be influenced by characteristics related to the adopter (practitioner skill and knowledge, client characteristics, communication barriers), the innovation (engaging and supportive approach, culturally appropriate design, evidence base, data capture, professional development opportunities), and organizational systems (innovation-systems fit, implementation planning, investment). There is potential for e-mental health approaches to address mental illness and poor social and emotional well-being amongst Indigenous people and to advance their quality of care. Health service stakeholders reported that e-mental health interventions are likely to be most effective when used to support or extend existing health services, including elements of client-driven and practitioner-supported use. Potential solutions to obstacles for integration of e-mental health approaches into practice were proposed including practitioner training, appropriate tool design using a consultative approach, internal organizational directives and support structures, adaptations to existing systems and policies, implementation planning and organizational and government

Advancing innovations in social/personality psychology and health: opportunities and challenges.

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Rothman, Alexander J; Klein, William M P; Cameron, Linda D

2013-05-01

Social, personality, and health psychologists have a long tradition of active and productive collaborations that have advanced the development of intervention strategies that promote health and well-being and the specification of the theoretical principles that underlie those strategies. This special issue is designed to continue this tradition of collaboration and to highlight areas of research and investigative strategies that offer opportunities for innovation. This concluding paper examines how investigators construe the interface between theory and practice and, with that lens, considers several themes that have emerged across the papers that comprise this special issue. As evidenced by the papers in this special issue, investigators are well-positioned to leverage advances in understanding of human health and well-being. However, to capitalize on this opportunity, investigators need to commit to cultivating a culture of scientific activity that prioritizes the engagement of theory and practice-the pursuit of both understanding and use. PsycINFO Database Record (c) 2013 APA, all rights reserved.

The sugar tax - An opportunity to advance oral health.

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Wordley, V; Lee, H; Lomazzi, M; Bedi, R

2017-07-07

The new sugar tax was recently announced by Government, aiming to combat obesity through investment in school sports. Dental professionals should seize this rare opportunity to raise awareness of the other adverse effects of sugar; young children continue to suffer alarmingly high rates of dental cavities in the UK. A significant amount of money raised through the levy must be reinvested into ensuring fluoride toothpaste is more affordable. Since daily use of fluoride toothpaste is the most effective evidence-based oral health preventative measure that is widely used, this should receive tax exemption status from the government as a means of universal oral health prevention. There must also be a re-investment in innovative oral health education so that the next generation of children will alter their mind set about sugar. Oral health prevention advice must be tightly integrated into general health messages.

Mapping the scope and opportunities for public health law in liberal democracies.

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Magnusson, Roger S

2007-01-01

The two questions, "What is public health law?" and "How can law improve the public's health?" are perennial ones for public health law scholars. This paper proposes a framework for conceptualizing discussion and debate about the scope and opportunities for public health law within liberal democracies. Part 2 of the paper draws selectively on this framework in order to highlight some areas where law's potential role deserves greater acknowledgment and exploration.

Challenges and Opportunities of Big Data in Health Care: A Systematic Review.

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Kruse, Clemens Scott; Goswamy, Rishi; Raval, Yesha; Marawi, Sarah

2016-11-21

Big data analytics offers promise in many business sectors, and health care is looking at big data to provide answers to many age-related issues, particularly dementia and chronic disease management. The purpose of this review was to summarize the challenges faced by big data analytics and the opportunities that big data opens in health care. A total of 3 searches were performed for publications between January 1, 2010 and January 1, 2016 (PubMed/MEDLINE, CINAHL, and Google Scholar), and an assessment was made on content germane to big data in health care. From the results of the searches in research databases and Google Scholar (N=28), the authors summarized content and identified 9 and 14 themes under the categories Challenges and Opportunities, respectively. We rank-ordered and analyzed the themes based on the frequency of occurrence. The top challenges were issues of data structure, security, data standardization, storage and transfers, and managerial skills such as data governance. The top opportunities revealed were quality improvement, population management and health, early detection of disease, data quality, structure, and accessibility, improved decision making, and cost reduction. Big data analytics has the potential for positive impact and global implications; however, it must overcome some legitimate obstacles. ©Clemens Scott Kruse, Rishi Goswamy, Yesha Raval, Sarah Marawi. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 21.11.2016.

Transgender Stigma and Health: A Critical Review of Stigma Determinants, Mechanisms, and Interventions

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White Hughto, Jaclyn M.; Reisner, Sari L.; Pachankis, John E.

2015-01-01

Rationale Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. Objective This critical review aims to integrate the literature on stigma towards transgender people in the US. Results This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Conclusion Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. PMID:26599625

Challenges and opportunities for implementing integrated mental health care: a district level situation analysis from five low- and middle-income countries.

Directory of Open Access Journals (Sweden)

Charlotte Hanlon

Full Text Available Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda participating in the PRogramme for Improving Mental health carE (PRIME. The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care.A situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts.The PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care.The low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential

Mobile Network Data for Public-Health: Opportunities and Challenges

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Nuria eOliver

2015-08-01

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

Mobile Network Data for Public Health: Opportunities and Challenges

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

2015-01-01

The ubiquity of mobile phones worldwide is generating an unprecedented amount of human behavioral data both at an individual and aggregated levels. The study of this data as a rich source of information about human behavior emerged almost a decade ago. Since then, it has grown into a fertile area of research named computational social sciences with a wide variety of applications in different fields such as social networks, urban and transport planning, economic development, emergency relief, and, recently, public health. In this paper, we briefly describe the state of the art on using mobile phone data for public health, and present the opportunities and challenges that this kind of data presents for public health. PMID:26301211

The Impact of an eHealth Portal on Health Care Professionals' Interaction with Patients: Qualitative Study.

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Das, Anita; Faxvaag, Arild; Svanæs, Dag

2015-11-24

People who undergo weight loss surgery require a comprehensive treatment program to achieve successful outcomes. eHealth solutions, such as secure online portals, create new opportunities for improved health care delivery and care, but depend on the organizational delivery systems and on the health care professionals providing it. So far, these have received limited attention and the overall adoption of eHealth solutions remains low. In this study, a secure eHealth portal was implemented in a bariatric surgery clinic and offered to their patients. During the study period of 6 months, 60 patients and 5 health care professionals had access. The portal included patient information, self-management tools, and communication features for online dialog with peers and health care providers at the bariatric surgery clinic. The aim of this study was to characterize and assess the impact of an eHealth portal on health care professionals' interaction with patients in bariatric surgery. This qualitative case study involved a field study consisting of contextual interviews at the clinic involving observing and speaking with personnel in their actual work environment. Semi-structured in-depth interviews were conducted with health care professionals who interacted with patients through the portal. Analysis of the collected material was done inductively using thematic analysis. The analysis revealed two main dimensions of using an eHealth portal in bariatric surgery: the transparency it represents and the responsibility that follows by providing it. The professionals reported the eHealth portal as (1) a source of information, (2) a gateway to approach and facilitate the patients, (3) a medium for irrevocable postings, (4) a channel that exposes responsibility and competence, and (5) a tool in the clinic. By providing an eHealth portal to patients in a bariatric surgery program, health care professionals can observe patients' writings and revelations thereby capturing patient

Social media as a platform for science and health engagement: challenges and opportunities.

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Dixon, Graham

2016-01-01

Social media has become a major platform for debates on science and health. This commentary argues that while social media can present challenges to communicating important health matters, it can also provide health experts a unique opportunity to engage with and build trust among members of the public.

The National Children's Study: a golden opportunity to advance the health of pregnant women.

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Lyerly, Anne Drapkin; Little, Margaret Olivia; Faden, Ruth R

2009-10-01

With a $3 billion investment by the federal government, the National Children's Study (NCS) recently began recruitment. The NCS is a golden-and potentially missed-opportunity to study one of the most underrepresented populations in clinical research: pregnant women. As the nation's largest-ever study of children's health, the NCS will examine the effects of the environment on children from before birth to 21 years of age, with participants sampled primarily through women during pregnancy. Thus the NCS presents a rare opportunity to study the health of women during and after pregnancy, in addition to the health of their children. On both moral and policy grounds, we make the case for inclusion of women's health outcomes in the NCS.

Understanding Medicaid Managed Care Investments in Members' Social Determinants of Health.

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Gottlieb, Laura; Ackerman, Sara; Wing, Holly; Manchanda, Rishi

2017-08-01

Despite widespread interest in addressing social determinants of health (SDH) as a means to improve health and to reduce health care spending, little information is available about how to develop, sustain, and scale nonmedical interventions in diverse payer environments, including Medicaid Managed Care. This study aimed to explore how Medicaid Managed Care Organization (MMCO) leaders interpret their roles and responsibilities around SDH, how they garner resources to develop and sustain interventions to address SDH, and how they perceive the influences of external organizations on related activities. Semistructured qualitative key informant interviews were conducted with a purposive sample of 26 Medicaid Managed Care corporate executives. Data were analyzed with an iterative coding, thematic development and interpretation process. MMCO leaders' interests and activities around interventions to address SDH are described, as well as their perceptions of existing and potential incentives and barriers to expanding these interventions. Despite significant experimentation and programmatic diversity of interventions addressing social determinants, MMCO leaders struggle with clinical integration, financing, and evaluation efforts that could promote sustainability. Though their efforts are nascent, MMCO leaders are investing in tackling social determinants to improve health and to decrease health care spending in managed care settings that serve low-income populations. Results highlight both opportunities and concerns about sustaining and scaling clinical interventions addressing SDH.

Constructive eHealth evaluation

DEFF Research Database (Denmark)

Høstgaard, Anna Marie Balling

2016-01-01

Despite the existence of an extensive body of knowledge about best practices and factors that contribute to the successful development and adoption of eHealth, many eHealth development-projects still face a number of problems - many of them of an organizational nature. This chapter presents a new...... method: “The Constructive eHealth evaluation method” aimed at supporting real end-user participation - a well-known success factor in eHealth development. It provides an analytical framework for achieving real end-user participation during the different phases in the eHealth lifecycle. The method...... was developed and used for the first time during the evaluation of an EHR planning process in a Danish region. It has proven effective for providing management at more levels on-going information and feedback from end-users, allowing management to change direction during eHealth development in order to achieve...

Legal aspects of E-HEALTH.

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Callens, Stefaan; Cierkens, Kim

2008-01-01

Cross-border activities in health care in the European single market are increasing. Many of these cross-border developments are related to e-Health. E-Health describes the application of information and communication technologies across the whole range of functions that affect the health care sector. E-health attracts a growing interest on the European level that highlights the sharp need of appropriate regulatory framework able to ensure its promotion in the European Union. Some Directives constitute a step in this direction. Both the Data Protection Directive, the E-Commerce Directive, the Medical Device Directive and the Directive on Distance Contracting are some of the most important European legal achievements related to e-Health. Although the directives are not adopted especially for e-health applications, they are indirectly very important for e-Health. Firstly, the Data Protection Directive applies to personal data which form part of a filing system and contains several important principles that have to be complied with by e-Health actors processing personal data concerning health. Secondly, the E-commerce Directive applies to services provided at a distance by electronic means. Many e-Health applications fall within this scope. Thirdly, the Medical Devices Directive is of importance for the e-Health sector, especially with regard to e.g. the medical software that is used in many e-health applications. Finally, the Directive on Distance Contracting applies to contracts for goods or services which make use of one or more means of distance communication; E-Health business may involve the conclusion of contracts. Despite these Directives more developments are needed at the European level in order to make sure that e-Health will play an even more important role in health care systems than is the case today. The new e-Health applications like electronic health records, e-health platforms, health grids and the further use of genetic data and tissue involve new

Ex-ante and ex-post measurement of equality of opportunity in health: a normative decomposition.

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Donni, Paolo Li; Peragine, Vito; Pignataro, Giuseppe

2014-02-01

This paper proposes and discusses two different approaches to the definition of inequality in health: the ex-ante and the ex-post approach. It proposes strategies for measuring inequality of opportunity in health based on the path-independent Atkinson equality index. The proposed methodology is illustrated using data from the British Household Panel Survey; the results suggest that in the period 2000-2005, at least one-third of the observed health equalities in the UK were equalities of opportunity. Copyright © 2013 John Wiley & Sons, Ltd.

Mental health system governance in Nigeria: challenges, opportunities and strategies for improvement.

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Abdulmalik, J; Kola, L; Gureje, O

2016-01-01

A health systems approach to understanding efforts for improving health care services is gaining traction globally. A component of this approach focuses on health system governance (HSG), which can make or mar the successful implementation of health care interventions. Very few studies have explored HSG in low- and middle-income countries, including Nigeria. Studies focusing on mental health system governance, are even more of a rarity. This study evaluates the mental HSG of Nigeria with a view to understanding the challenges, opportunities and strategies for strengthening it. This study was conducted as part of the project, Emerging Mental Health Systems in Low and Middle Income Countries (Emerald). A multi-method study design was utilized to evaluate the mental HSG status of Nigeria. A situational analysis of the health policy and legal environment in the country was performed. Subsequently, 30 key informant interviews were conducted at national, state and district levels to explore the country's mental HSG. The existing policy, legislative and institutional framework for HSG in Nigeria reveals a complete exclusion of mental health in key health sector documents. The revised mental health policy is however promising. Using the Siddiqi framework categories, we identified pragmatic strategies for mental health system strengthening that include a consideration of existing challenges and opportunities within the system. The identified strategies provide a template for the subsequent activities of the Emerald Programme (and other interventions), towards strengthening the mental health system of Nigeria.

Clinicians' ability, motivation, and opportunity to acquire and transfer knowledge: An age-driven perspective.

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Profili, Silvia; Sammarra, Alessia; Dandi, Roberto; Mascia, Daniele

2017-11-08

Many countries are seeing a dramatic increase in the average age of their clinicians. The literature often highlights the challenges of high replacement costs and the need for strategies to retain older personnel. Less discussed are the potential pitfalls of knowledge acquisition and transfer that accompany this aging issue. We propose a conceptual framework for understanding how clinicians' age interact with ability, motivation, and opportunity to predict clinical knowledge transfer and acquisition in health care organizations. This study integrates life-span development perspectives with the ability-motivation-opportunity framework to develop a number of testable propositions on the interaction between age and clinicians' ability, motivation, and opportunity to acquire and transfer clinical knowledge. We posit that the interaction between ability (the knowledge and skills to acquire knowledge), motivation (the willingness to acquire and transfer knowledge), and opportunity (resources required for acquiring and transferring knowledge) is a determinant of successful knowledge management. We also suggest that clinicians' age-and more specifically, the cognitive and motivational changes that accompany aging-moderates these relationships. This study contributes to existing research by offering a set of testable propositions for future research. These propositions will hopefully encourage empirical research into this important topic and lead to guidelines for reducing the risks of organizational knowledge loss due to aging. We suggest several ways that health care organizations can tailor managerial practices in order to help capitalize on the knowledge-based resources held by their younger and older clinicians. Such initiatives may affect employees' ability (e.g., by providing specific training programs), motivation (e.g., by expanding subjective perceptions of future time at work), and opportunities (e.g., by providing mentoring, reverse mentoring, and coaching

Determinants of health-promoting lifestyle behaviour in the rural areas of Hungary.

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Paulik, Edit; Bóka, Ferenc; Kertész, Aranka; Balogh, Sándor; Nagymajtényi, László

2010-09-01

Today chronic non-communicable diseases are the major cause of death and disability worldwide. Chronic diseases are determined by common risk factors (e.g. smoking). The purpose of this study was to develop a health-promoting behaviour index, and to evaluate the impact of the social and the demographic characteristics of the individuals, self-rated health and certain features of settlements on the score of this index. A population-based, cross-sectional health survey was conducted. Altogether 91 settlements with various sizes of population, and at various stages of social, economic and infrastructural development took part in the survey. The survey was based on interviewer-administered questionnaires, 3380 subjects filled in the questionnaires correctly, and the response rate was 82.4%. Questions on lifestyle factors referred to smoking, nutritional habits and physical activity. Low level (5.5%) of people have achieved the 'complete' health-promoting behaviour, including non-smoking, healthy nutrition and physical activity. There were significant associations between health-promoting behaviour and demographic, social and economic characteristics of the individuals and their dwelling place. The lower prevalence of healthy lifestyle activities among lower educated, lower income and aged people living in small settlements call the attention to the higher risk of these people. On planning interventions, special attention should be paid to the geographically, infrastructurally, socially and demographically disadvantaged population groups to provide equal opportunities for them, to live a healthy way of life. The application of the health-promoting index might be used to monitor the effects of interventions to alter lifestyle at community level.

Health Education in India: A Strengths, Weaknesses, Opportunities, and Threats (SWOT) Analysis

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Sharma, Manoj

2005-01-01

The purpose of this study was to conduct a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the health education profession and discipline in India. Materials from CINAHL, ERIC, MEDLINE, and Internet were collected to conduct the open coding of the SWOT analysis. Strengths of health education in India include an elaborate…

[Clip Sheets from BOCES. Opportunities. Health. Careers. = Oportunidades. Salud. Una Camera En...

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State Univ. of New York, Geneseo. Coll. at Geneseo. Migrant Center.

This collection of 83 clip sheets, or classroom handouts, was created to help U.S. migrants learn more about health, careers, and general "opportunities" including education programs. They are written in both English and Spanish and are presented in an easily understandable format. Health clip-sheet topics include the following: Abuse; AIDS;…

Mobile Health Application and e-Health Literacy: Opportunities and Concerns for Cancer Patients and Caregivers.

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Kim, Hyunmin; Goldsmith, Joy V; Sengupta, Soham; Mahmood, Asos; Powell, M Paige; Bhatt, Jay; Chang, Cyril F; Bhuyan, Soumitra S

2017-11-14

Health literacy is critical for cancer patients as they must understand complex procedures or treatment options. Caregivers' health literacy also plays a crucial role in caring for cancer patients. Low health literacy is associated with low adherence to medications, poor health status, and increased health care costs. There is a growing interest in the use of mobile health applications (apps) to improve health literacy. Mobile health apps can empower underserved cancer patients and their caregivers by providing features or functionalities to enhance interactive patient-provider communication and to understand medical information more readily. Despite the potentiality of improving health literacy through mobile health apps, there exist several related concerns: no equal access to mobile technology, no familiarity or knowledge of using mobile health apps, and privacy and security concerns. These elements should be taken into account for health policy making and mobile apps design and development. Importantly, mobile apps should be developed with the goal of achieving a high range of user access by considering all health literacy level and various cultural and linguistic needs.

Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions.

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White Hughto, Jaclyn M; Reisner, Sari L; Pachankis, John E

2015-12-01

Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. This critical review aims to integrate the literature on stigma towards transgender people in the U.S. This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

eHealth Recruitment Challenges

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Thompson, Debbe; Canada, Ashanti; Bhatt, Riddhi; Davis, Jennifer; Plesko, Lisa; Baranowski, Tom; Cullen, Karen; Zakeri, Issa

2006-01-01

Little is known about effective eHealth recruitment methods. This paper presents recruitment challenges associated with enrolling African-American girls aged 8-10 years in an eHealth obesity prevention program, their effect on the recruitment plan, and potential implications for eHealth research. Although the initial recruitment strategy was…

Constructive eHealth evaluation

DEFF Research Database (Denmark)

Høstgaard, Anna Marie Balling; Bertelsen, Pernille Scholdan; Nøhr, Christian

2017-01-01

Abstract Background: Information and communication sources in the healthcare sector are replaced with new eHealth technologies. This has led to problems arising from the lack of awareness of the importance of end-user involvement in eHealth development and of the difficulties caused by using...... traditional summative evaluation methods. The Constructive eHealth evaluation method (CeHEM) provides a solution to these problems by offering an evaluation framework for supporting and facilitating end-user involvement during all phases of eHealth development. The aim of this paper is to support this process...... by sharing experiences of the eHealth evaluation method used in the introduction of electronic health records (EHR) in the North Denmark Region of Denmark. It is the first time the fully developed method and the experiences on using the CeHEM in all five phases of a full lifecycle framework is presented...

mHealth For Aging China: Opportunities and Challenges.

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

2016-01-01

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

Experience of nurses with using eHealth in Gilgit-Baltistan, Pakistan: a qualitative study in primary and secondary healthcare.

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Gulzar, Saleema; Khoja, Shariq; Sajwani, Afroz

2013-03-02

To improve the quality of health care in remote parts of Pakistan, a research project was initiated in the mountainous region of Gilgit-Baltistan using information and communication technology to improve patient care and support continuing education of health providers (eHealth). This paper describes the experience of nurses in using eHealth in their routine practices. All health centres of Gilgit-Baltistan, Pakistan using eHealth as part of this study, were taken as a single case. These include four primary healthcare centres, three secondary care centres and one medical centre. In-depth interviews were conducted using semi-structured interview guide to study nurses' perspective about using eHealth, and its perceived impact on their professional lives. According to the respondents, eHealth enhanced access to care for remote communities, and improved quality of health services by providing opportunities for continuing learning. Nurses also appreciated eHealth for reducing their professional isolation, and providing exposure to new knowledge through teleconsultations and eLearning.The responses categorized under six major headings include: gaps in health services prior to eHealth; role of eHealth in addressing these gaps; benefits of eHealth; challenges in eHealth implementation; community's perception about eHealth; and future recommendations. Low-cost and simple eHealth solutions have shown to benefit nurses, and the communities in the remote mountainous regions of Pakistan.

Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature

Science.gov (United States)

Janssen, Wouter; Johansen, Monika Alise

2018-01-01

Background eHealth has an enormous potential to improve healthcare cost, effectiveness, and quality of care. However, there seems to be a gap between the foreseen benefits of research and clinical reality. Objective Our objective was to systematically review the factors influencing the outcome of eHealth interventions in terms of success and failure. Methods We searched the PubMed database for original peer-reviewed studies on implemented eHealth tools that reported on the factors for the success or failure, or both, of the intervention. We conducted the systematic review by following the patient, intervention, comparison, and outcome framework, with 2 of the authors independently reviewing the abstract and full text of the articles. We collected data using standardized forms that reflected the categorization model used in the qualitative analysis of the outcomes reported in the included articles. Results Among the 903 identified articles, a total of 221 studies complied with the inclusion criteria. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The article frequency analysis did not show a significant discrepancy between the number of reports on failure (392/844, 46.5%) and on success (452/844, 53.6%). The qualitative analysis identified 27 categories that represented the factors for success or failure of eHealth interventions. A quantitative analysis of the results revealed the category quality of healthcare (n=55) as the most mentioned as contributing to the success of eHealth interventions, and the category costs (n=42) as the most mentioned as contributing to failure. For the category with the highest unique article frequency, workflow (n=51), we conducted a full-text review. The analysis of the 23 articles that met the inclusion criteria identified 6 barriers related to workflow: workload (n=12), role definition (n=7), undermining of face-to-face communication (n=6), workflow

Housing mobility and adolescent mental health: The role of substance use, social networks, and family mental health in the Moving to Opportunity Study.

Science.gov (United States)

Schmidt, Nicole M; Glymour, M Maria; Osypuk, Theresa L

2017-12-01

The Moving to Opportunity (MTO) experiment was a housing mobility program begun in the mid-nineties that relocated volunteer low income families from public housing to rental units in higher opportunity neighborhoods in 5 US cities, using the Section 8 affordable housing voucher program. Compared to the control group who stayed behind in public housing, the MTO voucher group exhibited a harmful main effect for boys' mental health, and a beneficial main effect for girls' mental health. But no studies have examined how this social experiment caused these puzzling, opposite gender effects. The present study tests potential mediating mechanisms of the MTO voucher experiment on adolescent mental health (n=2829, aged 12-19 in 2001-2002). Using Inverse Odds Ratio Weighting causal mediation, we tested whether adolescent substance use comorbidity, social networks, or family mental health acted as potential mediators. Our results document that comorbid substance use (e.g. past 30 day alcohol use, cigarette use, and number of substances used) significantly partially mediated the effect of MTO on boys' behavior problems, resulting in -13% to -18% percent change in the total effect. The social connectedness domain was a marginally significant mediator for boys' psychological distress. Yet no tested variables mediated MTO's beneficial effects on girls' psychological distress. Confounding sensitivity analyses suggest that the indirect effect of substance use for mediating boys' behavior problems was robust, but social connectedness for mediating boys' psychological distress was not robust. Understanding how housing mobility policies achieve their effects may inform etiology of neighborhoods as upstream causes of health, and inform enhancement of future affordable housing programs.

Evaluation of the Introduction of an e-Health Skills Component for Dietetics Students.

Science.gov (United States)

Rollo, Megan E; Collins, Clare E; MacDonald-Wicks, Lesley

2017-11-01

Appropriate and effective use of technology within practice is a key competency outlined in Australian dietetics training standards. An e-health skills component (lecture and workshop) was introduced to undergraduate students enrolled in an Australian nutrition and dietetics program. The lecture orientated students to key e-health terms and concepts relating to telehealth and m-health technologies, while the workshop provided an opportunity to apply knowledge. The workshop consisted of four stations with activities relating to (1) orientation to telehealth equipment; (2) comparison of dietetic consultation components completed in person versus remotely via video call; (3) quality assessment of mobile apps; and (4) exploration of advantages and disadvantages, and the ethical, security, and privacy issues relating to use of e-health technologies in dietetic practice. Student experience of the training was evaluated via questionnaire. Forty-five students (62.2% aged ≤19-24 years, 86.7% female) completed the survey. Following the workshop, the level of understanding relating to each key e-health concept improved significantly (p education to support the use of e-health technologies within dietetic practice were rated a high level of importance by most students (78-80%). The majority of students (93.3% to 97.8%) reported a positive experience at each of the four workshop stations, with "informative" the most common word selected to rate each station (37.8% to 44.4% of students across the four stations). The introduction of an e-health skills component resulted in an improved understanding of concepts for using these technologies. These findings provide preliminary support for integration of further e-health training within the dietetics program.

Contexts and Opportunities of e-Health Technology in Medical Care

OpenAIRE

Zaman, Sojib Bin; Hossain, Naznin; Ahammed, Shad; Ahmed, Zubair

2017-01-01

Keeping up with a sound health is a fundamental right for the human beings. It also acts as an indicator of the socio-economic development of a country. However, nowadays keeping sound health is challenging because of rapidly increasing non-communicable diseases. Concurrently, we are on the edge of very fast technological advancement which includes usage of cellular technology, high-speed internet and wireless communications. These technologies and their unique applications are creating lots ...

Acceptance by laypersons and medical professionals of the personalized eHealth platform, eHealthMonitor.

Science.gov (United States)

Griebel, Lena; Kolominsky-Rabas, Peter; Schaller, Sandra; Siudyka, Jakub; Sierpinski, Radoslaw; Papapavlou, Dimitrios; Simeonidou, Aliki; Prokosch, Hans-Ulrich; Sedlmayr, Martin

2017-09-01

Often, eHealth services are not accepted because of factors such as eHealth literacy or trust. Within this study, eHealthMonitor was evaluated in three European countries (Germany, Greece, and Poland) by medical professionals and laypersons with respect to numerous acceptance factors. Questionnaires were created on the basis of factors from literature and with the help of scales which have already been validated. A qualitative survey was conducted in Germany, Poland, and Greece. The eHealth literacy of all participants was medium/high. Laypersons mostly agreed that they could easily become skillful with eHealthMonitor and that other people thought that they should use eHealthMonitor. Amongst medical professionals, a large number were afraid that eHealthMonitor could violate their privacy or the privacy of their patients. Overall, the participants thought that eHealthMonitor was a good concept and that they would use it. The main hindrances to the use of eHealthMonitor were found in trust issues including data privacy. In the future, more research on the linkage of all measured factors is needed, for example, to address the question of whether highly educated people tend to mistrust eHealth information more than people with lower levels of education.

The public health leadership certificate: a public health and primary care interprofessional training opportunity.

Science.gov (United States)

Matson, Christine C; Lake, Jeffrey L; Bradshaw, R Dana; Matson, David O

2014-03-01

This article describes a public health leadership certificate curriculum developed by the Commonwealth Public Health Training Center for employees in public health and medical trainees in primary care to share didactic and experiential learning. As part of the program, trainees are involved in improving the health of their communities and thus gain a blended perspective on the effectiveness of interprofessional teams in improving population health. The certificate curriculum includes eight one-credit-hour didactic courses offered through an MPH program and a two-credit-hour, community-based participatory research project conducted by teams of trainees under the mentorship of health district directors. Fiscal sustainability is achieved by sharing didactic courses with MPH degree students, thereby enabling trainees to take advantage of a reduced, continuing education tuition rate. Public health employee and primary care trainees jointly learn knowledge and skills required for community health improvement in interprofessional teams and gain an integrated perspective through opportunities to question assumptions and broaden disciplinary approaches. At the same time, the required community projects have benefited public health in Virginia.

Ready for eHealth? Health Professionals' Acceptance and Adoption of eHealth Interventions in Inpatient Routine Care.

Science.gov (United States)

Hennemann, Severin; Beutel, Manfred E; Zwerenz, Rüdiger

2017-03-01

eHealth interventions can be effective in treating health problems. However, adoption in inpatient routine care seems limited. The present study therefore aimed to investigate barriers and facilitators to acceptance of eHealth interventions and of online aftercare in particular in health professionals of inpatient treatment. A total of 152 out of 287 health professionals of various professional groups in four inpatient rehabilitation facilities filled out a self-administered web-based questionnaire (response rate: 53%); 128 individuals were eligible for further data analysis. Acceptance and possible predictors were investigated with a complex research model based on the Unified Theory of Acceptance and Use of Technology. Acceptance of eHealth interventions was rather low (M = 2.47, SD = 0.98); however, acceptance of online aftercare was moderate (M = 3.08, SD = 0.96, t(127) = 8.22, p eHealth literacy was elevated. Social influence, performance expectancy, and treatment-related internet and mobile use significantly predicted overall acceptance. No differences were found between professional and age groups. Although acceptance of eHealth interventions was limited in health professionals of inpatient treatment, moderate acceptance of online aftercare for work-related stress implies a basis for future implementation. Tailored eHealth education addressing misconceptions about inferiority and incongruity with conventional treatment considering the systemic aspect of acceptance formation are needed.

Training medical students in the social determinants of health: the Health Scholars Program at Puentes de Salud.

Science.gov (United States)

O'Brien, Matthew J; Garland, Joseph M; Murphy, Katie M; Shuman, Sarah J; Whitaker, Robert C; Larson, Steven C

2014-01-01

Given the large influence of social conditions on health, physicians may be more effective if they are trained to identify and address social factors that impact health. Despite increasing interest in teaching the social determinants of health in undergraduate medical education, few models exist. We present a 9-month pilot course on the social determinants of health for medical and other health professional students, which is based at Puentes de Salud, Philadelphia, PA, USA, a community health center serving a Latino immigrant population. This service-learning course, called the Health Scholars Program (HSP), was developed and implemented by volunteer medical and public health faculty in partnership with the community-based clinic. The HSP curriculum combines didactic instruction with service experiences at Puentes de Salud and opportunities for critical reflection. The HSP curriculum also includes a longitudinal project where students develop, implement, and evaluate an intervention to address a community-defined need. In our quantitative evaluation, students reported high levels of agreement with the HSP meeting stated course goals, including developing an understanding of the social determinants of health and working effectively with peers to implement community-based projects. Qualitative assessments revealed students' perception of learning more about this topic in the HSP than in their formal medical training and of developing a long-term desire to serve vulnerable communities as a result. Our experience with the HSP suggests that partnerships between academic medical centers and community-based organizations can create a feasible, effective, and sustainable platform for teaching medical students about the social determinants of health. Similar medical education programs in the future should seek to achieve a larger scale and to evaluate both students' educational experiences and community-defined outcomes.

Medical student service learning program teaches secondary students about career opportunities in health and medical fields.

Science.gov (United States)

Karpa, Kelly; Vakharia, Kavita; Caruso, Catherine A; Vechery, Colin; Sipple, Lanette; Wang, Adrian

2015-12-01

Engagement of academic medical centers in community outreach provides the public with a better understanding of basic terms and concepts used in biomedical sciences and increases awareness of important health information. Medical students at one academic medical center initiated an educational outreach program, called PULSE, that targets secondary students to foster their interest in healthcare and medicine. High school student participants are engaged in a semester-long course that relies on interactive lectures, problem-based learning sessions, mentoring relationships with medical students, and opportunities for shadowing healthcare providers. To date, the curriculum has been offered for 7 consecutive years. To determine the impact that participation in the curriculum has had on college/career choices and to identify areas for improvement, an electronic questionnaire was sent to former participants. Based on a 32% response rate, 81% of former participants indicated that participation in the course influenced their decision to pursue a medical/science-related career. More than half (67%) of respondents indicated intent to pursue a MD/PhD or other postgraduate degree. Based on responses obtained, additional opportunities to incorporate laboratory-based research and simulation sessions should be explored. In addition, a more formalized mentoring component has been added to the course to enhance communication between medical students and mentees. Health/medicine-related educational outreach programs targeting high school students may serve as a pipeline to introduce or reinforce career opportunities in healthcare and related sciences. Copyright © 2015 The American Physiological Society.

Barriers to using eHealth data for clinical performance feedback in Malawi: A case study.

Science.gov (United States)

Landis-Lewis, Zach; Manjomo, Ronald; Gadabu, Oliver J; Kam, Matthew; Simwaka, Bertha N; Zickmund, Susan L; Chimbwandira, Frank; Douglas, Gerald P; Jacobson, Rebecca S

2015-10-01

Sub-optimal performance of healthcare providers in low-income countries is a critical and persistent global problem. The use of electronic health information technology (eHealth) in these settings is creating large-scale opportunities to automate performance measurement and provision of feedback to individual healthcare providers, to support clinical learning and behavior change. An electronic medical record system (EMR) deployed in 66 antiretroviral therapy clinics in Malawi collects data that supervisors use to provide quarterly, clinic-level performance feedback. Understanding barriers to provision of eHealth-based performance feedback for individual healthcare providers in this setting could present a relatively low-cost opportunity to significantly improve the quality of care. The aims of this study were to identify and describe barriers to using EMR data for individualized audit and feedback for healthcare providers in Malawi and to consider how to design technology to overcome these barriers. We conducted a qualitative study using interviews, observations, and informant feedback in eight public hospitals in Malawi where an EMR system is used. We interviewed 32 healthcare providers and conducted seven hours of observation of system use. We identified four key barriers to the use of EMR data for clinical performance feedback: provider rotations, disruptions to care processes, user acceptance of eHealth, and performance indicator lifespan. Each of these factors varied across sites and affected the quality of EMR data that could be used for the purpose of generating performance feedback for individual healthcare providers. Using routinely collected eHealth data to generate individualized performance feedback shows potential at large-scale for improving clinical performance in low-resource settings. However, technology used for this purpose must accommodate ongoing changes in barriers to eHealth data use. Understanding the clinical setting as a complex adaptive

eHealth recruitment challenges.

Science.gov (United States)

Thompson, Debbe; Canada, Ashanti; Bhatt, Riddhi; Davis, Jennifer; Plesko, Lisa; Baranowski, Tom; Cullen, Karen; Zakeri, Issa

2006-11-01

Little is known about effective eHealth recruitment methods. This paper presents recruitment challenges associated with enrolling African-American girls aged 8-10 years in an eHealth obesity prevention program, their effect on the recruitment plan, and potential implications for eHealth research. Although the initial recruitment strategy was literature-informed, it failed to enroll the desired number of girls within a reasonable time period. Therefore, the recruitment strategy was reformulated to incorporate principles of social marketing and traditional marketing techniques. The resulting plan included both targeted, highly specific strategies (e.g., selected churches), and more broad-based approaches (e.g., media exposure, mass mailings, radio advertisements). The revised plan enabled recruitment goals to be attained. Media appeared to be particularly effective at reaching the intended audience. Future research should identify the most effective recruitment strategies for reaching potential eHealth audiences.

Understanding patient e-loyalty toward online health care services.

Science.gov (United States)

Martínez-Caro, Eva; Cegarra-Navarro, Juan Gabriel; Solano-Lorente, Marcelina

2013-01-01

Public health institutions are making a great effort to develop patient-targeted online services in an attempt to enhance their effectiveness and reduce expenses. However, if patients do not use those services regularly, public health institutions will have wasted their limited resources. Hence, patients' electronic loyalty (e-loyalty) is essential for the success of online health care services. In this research, an extended Technology Acceptance Model was developed to test e-loyalty intent toward online health care services offered by public health institutions. Data from a survey of 256 users of online health care services provided by the public sanitary system of a region in Spain were analyzed. The research model was tested by using the structural equation modeling approach. The results obtained suggest that the core constructs of the Technology Acceptance Model (perceived usefulness, ease of use, and attitude) significantly affected users' behavioral intentions (i.e., e-loyalty intent), with perceived usefulness being the most decisive antecedent of affective variables (i.e., attitude and satisfaction). This study also reveals a general support for patient satisfaction as a determinant of e-loyalty intent in online health care services. Policy makers should focus on striving to get the highest positive attitude in users by enhancing easiness of use and, mainly, perceived usefulness. Because through satisfaction of patients, public hospitals will enlarge their patient e-loyalty intent, health care providers must always work at obtaining satisfied users and to encourage them to continue using the online services.

Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature.

Science.gov (United States)

Granja, Conceição; Janssen, Wouter; Johansen, Monika Alise

2018-05-01

eHealth has an enormous potential to improve healthcare cost, effectiveness, and quality of care. However, there seems to be a gap between the foreseen benefits of research and clinical reality. Our objective was to systematically review the factors influencing the outcome of eHealth interventions in terms of success and failure. We searched the PubMed database for original peer-reviewed studies on implemented eHealth tools that reported on the factors for the success or failure, or both, of the intervention. We conducted the systematic review by following the patient, intervention, comparison, and outcome framework, with 2 of the authors independently reviewing the abstract and full text of the articles. We collected data using standardized forms that reflected the categorization model used in the qualitative analysis of the outcomes reported in the included articles. Among the 903 identified articles, a total of 221 studies complied with the inclusion criteria. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The article frequency analysis did not show a significant discrepancy between the number of reports on failure (392/844, 46.5%) and on success (452/844, 53.6%). The qualitative analysis identified 27 categories that represented the factors for success or failure of eHealth interventions. A quantitative analysis of the results revealed the category quality of healthcare (n=55) as the most mentioned as contributing to the success of eHealth interventions, and the category costs (n=42) as the most mentioned as contributing to failure. For the category with the highest unique article frequency, workflow (n=51), we conducted a full-text review. The analysis of the 23 articles that met the inclusion criteria identified 6 barriers related to workflow: workload (n=12), role definition (n=7), undermining of face-to-face communication (n=6), workflow disruption (n=6), alignment with clinical

Experience of nurses with using eHealth in Gilgit-Baltistan, Pakistan: a qualitative study in primary and secondary healthcare

Science.gov (United States)

2013-01-01

Background To improve the quality of health care in remote parts of Pakistan, a research project was initiated in the mountainous region of Gilgit-Baltistan using information and communication technology to improve patient care and support continuing education of health providers (eHealth). This paper describes the experience of nurses in using eHealth in their routine practices. Methods All health centres of Gilgit-Baltistan, Pakistan using eHealth as part of this study, were taken as a single case. These include four primary healthcare centres, three secondary care centres and one medical centre. In-depth interviews were conducted using semi-structured interview guide to study nurses’ perspective about using eHealth, and its perceived impact on their professional lives. Results According to the respondents, eHealth enhanced access to care for remote communities, and improved quality of health services by providing opportunities for continuing learning. Nurses also appreciated eHealth for reducing their professional isolation, and providing exposure to new knowledge through teleconsultations and eLearning. The responses categorized under six major headings include: gaps in health services prior to eHealth; role of eHealth in addressing these gaps; benefits of eHealth; challenges in eHealth implementation; community’s perception about eHealth; and future recommendations. Conclusions Low-cost and simple eHealth solutions have shown to benefit nurses, and the communities in the remote mountainous regions of Pakistan. PMID:23452373

Factors Influencing Rural End-Users' Acceptance of e-Health in Developing Countries: A study on Portable Health Clinic in Bangladesh.

Science.gov (United States)

Hossain, Nazmul; Yokota, Fumihiko; Sultana, Nazneen; Ahmed, Ashir

2018-04-17

Existing studies regarding e-health are mostly focused on information technology design and implementation, system architecture and infrastructure, and its importance in public health with ancillaries and barriers to mass adoption. However, not enough studies have been conducted to assess the end-users' reaction and acceptance behavior toward e-health, especially from the perspective of rural communities in developing countries. The objective of this study is to explore the factors that influence rural end users' acceptance of e-health in Bangladesh. Data were collected between June and July 2016 through a field survey with structured questionnaire form 292 randomly selected rural respondents from Bheramara subdistrict, Bangladesh. Technology Acceptance Model was adopted as the research framework. Logistic regression analysis was performed to test the theoretical model. The study found social reference as the most significantly influential variable (Coef. = 2.28, odds ratio [OR] = 9.73, p acceptance behavior. The model explains 54.70% deviance (R 2  = 0.5470) in the response variable with its constructs. The "Hosmer-Lemeshow" goodness-of-fit score (0.539) is also above the standard threshold (0.05), which indicates that the data fit well with the model. The study provides guidelines for the successful adoption of e-health among rural communities in developing countries. This also creates an opportunity for e-health technology developers and service providers to have a better understanding of their end users.

eHealth literacy and Web 2.0 health information seeking behaviors among baby boomers and older adults.

Science.gov (United States)

Tennant, Bethany; Stellefson, Michael; Dodd, Virginia; Chaney, Beth; Chaney, Don; Paige, Samantha; Alber, Julia

2015-03-17

Baby boomers and older adults, a subset of the population at high risk for chronic disease, social isolation, and poor health outcomes, are increasingly utilizing the Internet and social media (Web 2.0) to locate and evaluate health information. However, among these older populations, little is known about what factors influence their eHealth literacy and use of Web 2.0 for health information. The intent of the study was to explore the extent to which sociodemographic, social determinants, and electronic device use influences eHealth literacy and use of Web 2.0 for health information among baby boomers and older adults. A random sample of baby boomers and older adults (n=283, mean 67.46 years, SD 9.98) participated in a cross-sectional, telephone survey that included the eHealth literacy scale (eHEALS) and items from the Health Information National Trends Survey (HINTS) assessing electronic device use and use of Web 2.0 for health information. An independent samples t test compared eHealth literacy among users and non-users of Web 2.0 for health information. Multiple linear and logistic regression analyses were conducted to determine associations between sociodemographic, social determinants, and electronic device use on self-reported eHealth literacy and use of Web 2.0 for seeking and sharing health information. Almost 90% of older Web 2.0 users (90/101, 89.1%) reported using popular Web 2.0 websites, such as Facebook and Twitter, to find and share health information. Respondents reporting use of Web 2.0 reported greater eHealth literacy (mean 30.38, SD 5.45, n=101) than those who did not use Web 2.0 (mean 28.31, SD 5.79, n=182), t217.60=-2.98, P=.003. Younger age (b=-0.10), more education (b=0.48), and use of more electronic devices (b=1.26) were significantly associated with greater eHealth literacy (R(2) =.17, R(2)adj =.14, F9,229=5.277, Pinformation (OR 2.63, Wald= 8.09, df=1, P=.004). Finally, more education predicted greater use of Web 2.0 for health

[Constraints and opportunities for inter-sector health promotion initiatives: a case study].

Science.gov (United States)

Magalhães, Rosana

2015-07-01

This article analyzes the implementation of inter-sector initiatives linked to the Family Grant, Family Health, and School Health Programs in the Manguinhos neighborhood in the North Zone of Rio de Janeiro, Brazil. The study was conducted in 2010 and 2011 and included document review, local observation, and 25 interviews with program managers, professionals, and staff. This was an exploratory case study using a qualitative approach that identified constraints and opportunities for inter-sector health experiences, contributing to the debate on the effectiveness of health promotion and poverty relief programs.

Global health partnership for student peer-to-peer psychiatry e-learning: Lessons learned.

Science.gov (United States)

Keynejad, Roxanne C

2016-12-03

Global 'twinning' relationships between healthcare organizations and institutions in low and high-resource settings have created growing opportunities for e-health partnerships which capitalize upon expanding information technology resources worldwide. E-learning approaches to medical education are increasingly popular but remain under-investigated, whilst a new emphasis on global health teaching has coincided with university budget cuts in many high income countries. King's Somaliland Partnership (KSP) is a paired institutional partnership health link, supported by Tropical Health and Education Trust (THET), which works to strengthen the healthcare system and improve access to care through mutual exchange of skills, knowledge and experience between Somaliland and King's Health Partners, UK. Aqoon, meaning knowledge in Somali, is a peer-to-peer global mental health e-learning partnership between medical students at King's College London (KCL) and Hargeisa and Amoud Universities, Somaliland. It aims to extend the benefits of KSP's cross-cultural and global mental health education work to medical students and has reported positive results, including improved attitudes towards psychiatry in Somaliland students. The process of devising, piloting, evaluating, refining, implementing, re-evaluating and again refining the Aqoon model has identified important barriers to successful partnership. This article describes lessons learned during this process, sharing principles and recommendations for readers wishing to expand their own global health link beyond qualified clinicians, to the healthcare professionals of the future.

Health determinants and podiatry.

Science.gov (United States)

Brodie, B S

2001-09-01

Public health and podiatry have a natural union both through historical development and a shared interest in prevention. Podiatry is considered in terms of health determinants such as income, social support, education and environment. The author considers that podiatry has a constructive role to play in the improvement of health and well-being in terms of the previously unrecognised relationship of the profession to the determinants of health and population health promotion.

Fair equality of opportunity critically reexamined: the family and the sustainability of health care systems.

Science.gov (United States)

Engelhardt, H Tristram

2012-12-01

A complex interaction of ideological, financial, social, and moral factors makes the financial sustainability of health care systems a challenge across the world. One difficulty is that some of the moral commitments of some health care systems collide with reality. In particular, commitments to equality in access to health care and to fair equality of opportunity undergird an unachievable promise, namely, to provide all with the best of basic health care. In addition, commitments to fair equality of opportunity are in tension with the existence of families, because families are aimed at advantaging their own members in preference to others. Because the social-democratic state is committed to fair equality of opportunity, it offers a web of publicly funded entitlements that make it easier for persons to exit the family and to have children outside of marriage. In the United States, in 2008, 41% of children were born outside of wedlock, whereas, in 1940, the percentage was only 3.8%, and in 1960, 5%, with the further consequence that the social and financial capital generated through families, which aids in supporting health care in families, is diminished. In order to explore the challenge of creating a sustainable health care system that also supports the traditional family, the claims made for fair equality of opportunity in health care are critically reconsidered. This is done by engaging the expository device of John Rawls's original position, but with a thin theory of the good that is substantively different from that of Rawls, one that supports a health care system built around significant copayments, financial counseling, and compulsory savings, with a special focus on enhancing the financial and social capital of the family. This radical recasting of Rawls, which draws inspiration from Singapore, is undertaken as a heuristic to aid in articulating an approach to health care allocation that can lead past the difficulties of social-democratic policy.

Message design strategies to raise public awareness of social determinants of health and population health disparities.

Science.gov (United States)

Niederdeppe, Jeff; Bu, Q Lisa; Borah, Porismita; Kindig, David A; Robert, Stephanie A

2008-09-01

Raising public awareness of the importance of social determinants of health (SDH) and health disparities presents formidable communication challenges. This article reviews three message strategies that could be used to raise awareness of SDH and health disparities: message framing, narratives, and visual imagery. Although few studies have directly tested message strategies for raising awareness of SDH and health disparities, the accumulated evidence from other domains suggests that population health advocates should frame messages to acknowledge a role for individual decisions about behavior but emphasize SDH. These messages might use narratives to provide examples of individuals facing structural barriers (unsafe working conditions, neighborhood safety concerns, lack of civic opportunities) in efforts to avoid poverty, unemployment, racial discrimination, and other social determinants. Evocative visual images that invite generalizations, suggest causal interpretations, highlight contrasts, and create analogies could accompany these narratives. These narratives and images should not distract attention from SDH and population health disparities, activate negative stereotypes, or provoke counterproductive emotional responses directed at the source of the message. The field of communication science offers valuable insights into ways that population health advocates and researchers might develop better messages to shape public opinion and debate about the social conditions that shape the health and well-being of populations. The time has arrived to begin thinking systematically about issues in communicating about SDH and health disparities. This article offers a broad framework for these efforts and concludes with an agenda for future research to refine message strategies to raise awareness of SDH and health disparities.

E-health

DEFF Research Database (Denmark)

Elkjaer, Margarita

2012-01-01

decrease the use of endoscopy in some cases. The findings corresponded well with action plan for a European e-Health Area and could be a helpful tool to provide more efficient health care for UC patients. Widespread implementation of the "Constant-Care" is possible, but it may require a reshaping...

E-learning for grass-roots emergency public health personnel: Preliminary lessons from a national program in China.

Science.gov (United States)

Xu, Wangquan; Jiang, Qicheng; Qin, Xia; Fang, Guixia; Hu, Zhi

2016-07-19

In China, grass-roots emergency public health personnel have relatively limited emergency response capabilities and they are constantly required to update their professional knowledge and skills due to recurring and new public health emergencies. However, professional training, a principal solution to this problem, is inadequate because of limitations in manpower and financial resources at grass-roots public health agencies. In order to provide a cost-effective and easily expandable way for grass-roots personnel to acquire knowledge and skills, the National Health Planning Commission of China developed an emergency response information platform and provided trial access to this platform in Anhui and Heilongjiang provinces in China. E-learning was one of the modules of the platform and this paper has focused on an e-learning pilot program. Results indicated that e-learning had satisfactorily improved the knowledge and ability of grass-roots emergency public health personnel, and the program provided an opportunity to gain experience in e-course design and implementing e-learning. Issues such as the lack of personalized e-courses and the difficulty of evaluating the effectiveness of e-learning are topics for further study.

Opportunities and Challenges of Digital Technology for HIV Treatment and Prevention.

Science.gov (United States)

Simoni, Jane M; Kutner, Bryan A; Horvath, Keith J

2015-12-01

Novel eHealth interventions are creating exciting opportunities for health promotion along the continuum of HIV care and prevention. Reviews of recent work indicate the use of multiple platforms (e.g., smartphones, social media), with trends toward individualized approaches and real-time assessments. However, the field needs more rigorous investigations to provide evidence of long-term impact on clinical indicators and should expand its targets beyond men who have sex with men and medication adherence. Challenges to the field include working within restricted funding timelines and disseminating eHealth interventions to those most in need.

Predictors of High eHealth Literacy in Primary Lung Cancer Survivors.

Science.gov (United States)

Milne, Robin A; Puts, Martine T E; Papadakos, Janet; Le, Lisa W; Milne, Victoria C; Hope, Andrew J; Catton, Pamela; Giuliani, Meredith E

2015-12-01

Lung cancer survivors are likely to have low health literacy which is an independent risk factor for poorer health outcomes. The eHealth literacy in lung cancer survivors has not been reported. The purposes of this study were to determine self-perceived eHealth literacy levels in lung cancer survivors and to explore predictors of higher eHealth literacy. A cross-sectional study was conducted at the Princess Margaret Cancer Centre in Toronto, Canada. Survivors completed a survey that collected demographic, self-perceived eHealth literacy (using the eHealth Literacy Scale), and quality of life information. Tumor and treatment details were extracted from medical records. Demographic data was summarized using descriptive statistics and compared against those with high and low eHealth literacy using Fisher's exact test. Eighty-three survivors were enrolled over 7 months. Median age was 71 years (range 44-89); 41 survivors (49%) were male. Forty-six (55%) survivors had some college education or higher. Most had access to eResources (78%) via computer, Internet, or smartphone. Fifty-seven (69%) scored 5 or greater (7=excellent) on the overall health scale. Twenty-eight (33.7%) perceived themselves to have high eHealth literacy. There was no statistically significant correlation between eHealth literacy groups and age (p=1.00), gender (p=0.82), living situation (p=1.00), overall health (p=1.00), overall quality of life (QoL) (p=1.00), or histology (p=0.74). High eHealth literacy correlated with the level of education received (p=0.003) and access to eResources (p=0.004). The self-perceived eHealth literacy of lung cancer survivors is generally low.

Pesquisa em saúde, política de saúde e eqüidade na América Latina Health research, health policy and equity in Latin America

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Alberto Pellegrini Filho

2004-06-01

Full Text Available O autor analisa as relações entre pesquisa de saúde, políticas de saúde e eqüidade na América Latina. Descreve novas tendências no modo de produção do conhecimento, que permitem maior integração entre as necessidades sociais e a pesquisa, facilitando o vínculo entre esta e o processo de definição de políticas. Analisa as manifestações das novas tendências na América Latina e finaliza com a descrição de algumas iniciativas promovidas pela OPAS no sentido de aproveitar as oportunidades abertas pelas novas tendências para a melhoria das condições de saúde na região. Busca defender a tese de que a informação e o conhecimento são bens públicos essenciais e que as iniqüidades de acesso a esses bens são importantes determinantes das iniqüidades em saúde. Para que as políticas de saúde e as políticas de pesquisa em saúde se integrem e se consolidem como políticas públicas voltadas a atender ao interesse público e à promoção da eqüidade, é necessário o fortalecimento do processo democrático de definição das mesmas, multiplicando os atores envolvidos, os espaços e oportunidades de interação entre eles e instrumentando sua participação com o acesso eqüitativo a informações e conhecimentos científicos pertinentes que permitam a defesa fundamentada de seus interesses.The author analyzes the relationships between health research, health policies and equity in Latin America. He describes new trends in the mode of knowledge production that enhance the integration between social needs and research, facilitating the ties between research and the policy making process. The author also analyzes the manifestations of these new trends in Latin America, and describes some initiatives promoted by the PAHO aimed to take advantage of the opportunities opened by these trends to improve health conditions in the region. Throughout the article the author defends the thesis that information and knowledge are

eHealth literacy and preferences for eHealth resources in parents of children with complex CHD.

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Kasparian, Nadine A; Lieu, Nathan; Winlaw, David S; Cole, Andrew; Kirk, Edwin; Sholler, Gary F

2017-05-01

Introduction This study aimed to (a) examine eHealth literacy, beliefs, and behaviours in parents of children with complex CHD, and (b) identify parents' preferences for the content, format, features, and functions of eHealth resources for CHD. Materials and methods Families (n=198) of children born between 2008 and 2011 and diagnosed with CHD requiring surgery were mailed a survey assessing a range of variables including eHealth literacy, beliefs, and behaviours as well as preferences for the format, functions, features, and content of eHealth resources for CHD. A total of 132 parents (83 mothers, 49 fathers) completed the survey (response rate: 50%). Mothers (96%) were more likely to access eHealth resources than fathers (83%, χ2=6.74, p=0.009). Despite high eHealth resource use, eHealth literacy was relatively low, with results demonstrating considerable and widespread gaps in awareness of, access to, and communication about eHealth resources. Over 50% of parents reported that decisions regarding their child's healthcare were influenced, to some extent, by web-based resources. Barriers to doctor-patient communication about eHealth included limited consultation time and concern about doctors' disapproval. Participants demonstrated a strong desire for "eHealth prescriptions" from their child's healthcare team, and perceived a wide range of eHealth topics as highly important, including treatment-related complications as well as physical, cognitive, and emotional development in children with CHD. Discussion Results suggest a need for stronger, more proactive partnerships between clinicians, researchers, educators, technologists, and patients and families to bring about meaningful innovations in the development and implementation of eHealth interventions in paediatric cardiology.

Prioritizing health: a systematic approach to scoping determinants in health impact assessment

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Lindsay McCallum

2016-08-01

Full Text Available The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of Health Impact Assessment (HIA, the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted including both primary and grey literature. A total of 10 HIA Scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors such as impact, public concern and data availability to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programmed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool.

Development of the eHealth Literacy Assessment Toolkit, eHLA

DEFF Research Database (Denmark)

Lauritzen, Dorthe Furstrand; Kayser, Lars

2015-01-01

In a world with rising focus on the use of eHealth, the match between the competences of the individual and the demands of eHealth systems becomes increasingly important, thus making assessment of eHealth literacy as a measure of user competences a vital element. We propose the eHealth Literacy...

eHealth program to empower patients in returning to normal activities and work after gynecological surgery: intervention mapping as a useful method for development.

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Vonk Noordegraaf, Antonie; Huirne, Judith A F; Pittens, Carina A; van Mechelen, Willem; Broerse, Jacqueline E W; Brölmann, Hans A M; Anema, Johannes R

2012-10-19

Full recovery after gynecological surgery takes much longer than expected regardless of surgical technique or the level of invasiveness. After discharge, detailed convalescence recommendations are not provided to patients typically, and postoperative care is fragmented, poorly coordinated, and given only on demand. For patients, this contributes to irrational beliefs and avoidance of resumption of activities and can result in a prolonged sick leave. To develop an eHealth intervention that empowers gynecological patients during the perioperative period to obtain timely return to work (RTW) and prevent work disability. The intervention mapping (IM) protocol was used to develop the eHealth intervention. A literature search about behavioral and environmental conditions of prolonged sick leave and delayed RTW in patients was performed. Patients' needs, attitudes, and beliefs regarding postoperative recovery and resumption of work were identified through focus group discussions. Additionally, a literature search was performed to obtain determinants, methods, and strategies for the development of a suitable interactive eHealth intervention to empower patients to return to normal activities after gynecological surgery, including work. Finally, the eHealth intervention was evaluated by focus group participants, medical doctors, and eHealth specialists through questionnaires. Twenty-one patients participated in the focus group discussions. Sufficient, uniform, and tailored information regarding surgical procedures, complications, and resumption of activities and work were considered most essential. Knowing who to contact in case of mental or physical complaints, and counseling and tools for work reintegration were also considered important. Finally, opportunities to exchange experiences with other patients were a major issue. Considering the determinants of the Attitude-Social influence-self-Efficacy (ASE) model, various strategies based on a combination of theory and

What is eHealth (6)? Development of a Conceptual Model for eHealth: Qualitative Study with Key Informants.

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Shaw, Tim; McGregor, Deborah; Brunner, Melissa; Keep, Melanie; Janssen, Anna; Barnet, Stewart

2017-10-24

Despite rapid growth in eHealth research, there remains a lack of consistency in defining and using terms related to eHealth. More widely cited definitions provide broad understanding of eHealth but lack sufficient conceptual clarity to operationalize eHealth and enable its implementation in health care practice, research, education, and policy. Definitions that are more detailed are often context or discipline specific, limiting ease of translation of these definitions across the breadth of eHealth perspectives and situations. A conceptual model of eHealth that adequately captures its complexity and potential overlaps is required. This model must also be sufficiently detailed to enable eHealth operationalization and hypothesis testing. This study aimed to develop a conceptual practice-based model of eHealth to support health professionals in applying eHealth to their particular professional or discipline contexts. We conducted semistructured interviews with key informants (N=25) from organizations involved in health care delivery, research, education, practice, governance, and policy to explore their perspectives on and experiences with eHealth. We used purposeful sampling for maximum diversity. Interviews were coded and thematically analyzed for emergent domains. Thematic analyses revealed 3 prominent but overlapping domains of eHealth: (1) health in our hands (using eHealth technologies to monitor, track, and inform health), (2) interacting for health (using digital technologies to enable health communication among practitioners and between health professionals and clients or patients), and (3) data enabling health (collecting, managing, and using health data). These domains formed a model of eHealth that addresses the need for clear definitions and a taxonomy of eHealth while acknowledging the fluidity of this area and the strengths of initiatives that span multiple eHealth domains. This model extends current understanding of eHealth by providing clearly

The rise of E-learning and opportunities for Indian family physicians

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Chayan Datta

2012-01-01

Full Text Available The IT (information technology revolution is sweeping across the globe. Distance, location and costs have become irrelevant. With availability of newer communication tools, medical education and practice are bound to be transformed. Rapid advancement of science requires medical professionals to update their knowledge constantly. Online interface for CME (Continued Medical Education presents an exciting opportunity as an E learning tool.

The interface of mental health and human rights in Indigenous peoples: triple jeopardy and triple opportunity.

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Tarantola, Daniel

2007-01-01

Insufficient understanding of the reciprocal interactions between health and human rights, mental health and human rights and the realization of all human rights by Indigenous peoples constitute a triple jeopardy in how these topics are currently being addressed and/or openly antagonized. This paper will attempt to show how a combined health and human rights approach to mental health in Indigenous peoples can transform a triple jeopardy into a triple opportunity. The vast and growing body of literature on mental health, health as a whole, and human rights as these relate to health and to Indigenous peoples will be used to frame the discussion. Attention to the complex interactions of health and human rights can guide policy formulation and action by offering a method of analysis, a process of participatory decision and a framework for accountability. In addition, mental health can find its rightful place in the health and human rights discourse through efforts to help policymakers and practitioners broaden their vision of mental illness to holistically encompass aspects of physical, social, emotional and cultural wellbeing. Finally, connecting the role that rights realization plays in determining health and wellbeing will add power to the rightful claims by Indigenous peoples to the promotion and protection of all their human rights--civil, political, economic, social and cultural. Broadening the research agenda by applying systematically a health and human rights analytical framework to the understanding of social determinants of health would minimize the risk of assigning health outcome merely to behaviours, practices and lifestyles, uncovering structural determinants of holistic health entrenched in policies and governmental conduct. Building the evidence of the negative impact of human rights violation on health and the negative impact of ill-health on the fulfilment of other human rights can help in designing comprehensive interventions, building on the

Challenges and opportunities of using recommender systems for personalized health education.

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Fernandez-Luque, Luis; Karlsen, Randi; Vognild, Lars K

2009-01-01

The use of computers in health education started more than a decade ago, mainly for tailoring health educational resources. Nowadays, many of the computer-tailoring health education systems are using the Internet for delivering different types of health education. Traditionally, these systems are designed for a specific health problem, with a predefined library of educational resources. These systems do not take advantage of the increasing amount of educational resources available on the Internet. One of the reasons is that the high availability of content is making it more difficult to find the relevant one. The problem of information overload has been addressed for many years in the field of recommender systems. This paper is focused on the challenges and opportunities of merging recommender systems with personalized health education. It also discusses the usage of social networks and semantic technologies within this approach.

Big Data and Health Economics: Strengths, Weaknesses, Opportunities and Threats.

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Collins, Brendan

2016-02-01

'Big data' is the collective name for the increasing capacity of information systems to collect and store large volumes of data, which are often unstructured and time stamped, and to analyse these data by using regression and other statistical techniques. This is a review of the potential applications of big data and health economics, using a SWOT (strengths, weaknesses, opportunities, threats) approach. In health economics, large pseudonymized databases, such as the planned care.data programme in the UK, have the potential to increase understanding of how drugs work in the real world, taking into account adherence, co-morbidities, interactions and side effects. This 'real-world evidence' has applications in individualized medicine. More routine and larger-scale cost and outcomes data collection will make health economic analyses more disease specific and population specific but may require new skill sets. There is potential for biomonitoring and lifestyle data to inform health economic analyses and public health policy.

eHealth literacy, Internet and eHealth service usage: a survey among cancer patients and their relatives.

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Halwas, Nikolaus; Griebel, Lena; Huebner, Jutta

2017-11-01

The aim of our study was to investigate Internet and eHealth usage, with respect to eHealth literacy, by cancer patients and their relatives. Using a standardized questionnaire we asked patients who attended lectures on complementary medicine in 2016. We received 142 questionnaires. The frequency of general Internet usage was directly associated with younger age and better Internet connection. Younger participants were not only more confident in allocating health-related Internet information into reliable or unreliable facts, but also more confident and capable of gaining medical knowledge through eHealth services. A regular use of eHealth services facilitated the decision-making process. Reading ability was associated with a better understanding regarding eHealth offers. In a modern health care system, emphasis should be on skills contributing to eHealth literacy among patients to improve their ability to profit from eHealth offers and improve health care.

Standardization and Innovation for Smart e-Health Monitoring Devices

DEFF Research Database (Denmark)

Mihovska, Albena D.; Kyriazakos, Sofoklis; Mihaylov, Mihail Rumenov

2015-01-01

The challenges faced by standardization in relation to the potential of wireless communication technologies to deliver lower cost, higher efficiency, enhanced quality of experience and diversified smart e-Health services, are multi-fold and determined by the complexity of the myriad of emerging...... user and usage scenarios. In addition, there is the challenge of protection of privacy and the maintenance of trust. This paper aims to show the evidence of the correlation between standardization and innovation in the area of ehealth technology. It describes a capability framework proposed...... for the delivery of e-Health services in support of independent living. The proposed framework incorporates innovative research and standardized solutions. The paper addresses the correlation between standardization and innovation, in particular for the area of e-Health. It analyzes the potential of research...

Nordic eHealth Indicators

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Hyppönen, Hannele; Faxvaag, Arild; Gilstad, Heidi

2013-01-01

eHealth indicator and benchmarking activities are rapidly increasing nationally and internationally. The work is rarely based on a transparent methodology for indicator definition. This article describes first results of testing an indicator methodology for defining eHealth indicators, which...... was reported at the Medical Informatics Europe conference in 2012. The core elements of the methodology are illustrated, demonstrating validation of each of them in the context of Nordic eHealth Indicator work. Validation proved the importance of conducting each of the steps of the methodology, with several...

eHealth literacy research-Quo vadis?

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Griebel, Lena; Enwald, Heidi; Gilstad, Heidi; Pohl, Anna-Lena; Moreland, Julia; Sedlmayr, Martin

2017-10-18

The concept of electronic health (eHealth) literacy evolved from the social and information sciences and describes competencies necessary to use electronic health services. As it is a rather new topic, and as there is no current overview of the state of the art in research, it is not possible to identify research gaps. Therefore, the objective of this viewpoint article is to increase knowledge on the current state of the art of research in eHealth literacy and to identify gaps in scientific research which should be focused on by the research community in the future. The article provides a current viewpoint of the concept of eHealth literacy and related research. Gaps can be found in terms of a missing "gold standard" regarding both the definition and the measurement of eHealth literacy. Furthermore, there is a need for identifying the implications on eHealth developers, which evolve from the measurement of eHealth literacy in eHealth users. Finally, a stronger inclusion of health professionals, both in the evolving concept and in the measurement of eHealth literacy, is needed in the future.

A Human Rights-Based Approach to Farmworker Health: An Overarching Framework to Address the Social Determinants of Health.

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Ramos, Athena K

2018-01-01

Migrant and seasonal workers have a right to the highest attainable standard of health. Unfortunately, these farmworkers face a multitude of challenges. They are employed in one of the most dangerous industries and face serious occupational health risks, while positioned at the bottom of the social hierarchy. They often lack formal education and training, English language proficiency, legal status, access to information, and equitable opportunities to health and healthcare. This article will explore the international human rights conventions that support farmworkers' right to health and healthcare in the United States. International human rights may provide a valuable legal framework that could be used to advocate on behalf of farmworkers and address the social determinants of health. Therefore, a Human Rights-Based Approach to Farmworker health will be presented along with recommendations for how to advance health and access to healthcare among this population. Fostering the health and well-being of migrant and seasonal farmworkers is critical to advancing equity, social justice, and maintaining the workforce required to meet production needs and safeguard the economic competitiveness of the industry.

Structural Determinants and Children's Oral Health: A Cross-National Study.

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Baker, S R; Foster Page, L; Thomson, W M; Broomhead, T; Bekes, K; Benson, P E; Aguilar-Diaz, F; Do, L; Hirsch, C; Marshman, Z; McGrath, C; Mohamed, A; Robinson, P G; Traebert, J; Turton, B; Gibson, B J

2018-03-01

Much research on children's oral health has focused on proximal determinants at the expense of distal (upstream) factors. Yet, such upstream factors-the so-called structural determinants of health-play a crucial role. Children's lives, and in turn their health, are shaped by politics, economic forces, and social and public policies. The aim of this study was to examine the relationship between children's clinical (number of decayed, missing, and filled teeth) and self-reported oral health (oral health-related quality of life) and 4 key structural determinants (governance, macroeconomic policy, public policy, and social policy) as outlined in the World Health Organization's Commission for Social Determinants of Health framework. Secondary data analyses were carried out using subnational epidemiological samples of 8- to 15-y-olds in 11 countries ( N = 6,648): Australia (372), New Zealand (three samples; 352, 202, 429), Brunei (423), Cambodia (423), Hong Kong (542), Malaysia (439), Thailand (261, 506), United Kingdom (88, 374), Germany (1498), Mexico (335), and Brazil (404). The results indicated that the type of political regime, amount of governance (e.g., rule of law, accountability), gross domestic product per capita, employment ratio, income inequality, type of welfare regime, human development index, government expenditure on health, and out-of-pocket (private) health expenditure by citizens were all associated with children's oral health. The structural determinants accounted for between 5% and 21% of the variance in children's oral health quality-of-life scores. These findings bring attention to the upstream or structural determinants as an understudied area but one that could reap huge rewards for public health dentistry research and the oral health inequalities policy agenda.

Work, Health, And Worker Well-Being: Roles And Opportunities For Employers.

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McLellan, Robert K

2017-02-01

Work holds the promise of supporting and promoting health. It also carries the risk of injury, illness, and death. In addition to harms posed by traditional occupational health hazards, such as physically dangerous workplaces, work contributes to health problems with multifactorial origins such as unhealthy lifestyles, psychological distress, and chronic disease. Not only does work affect health, but the obverse is true: Unhealthy workers are more frequently disabled, absent, and less productive, and they use more health care resources, compared to their healthy colleagues. The costs of poor workforce health are collectively borne by workers, employers, and society. For business as well as altruistic reasons, employers may strive to cost-effectively achieve the safest, healthiest, and most productive workforce possible. Narrowly focused health goals are giving way to a broader concept of employee well-being. This article explores the relationship between health and work, outlines opportunities for employers to make this relationship health promoting, and identifies areas needing further exploration. Project HOPE—The People-to-People Health Foundation, Inc.

UDENTE (Universal Dental E-Learning) a golden opportunity for dental education.

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Reynolds, Patricia

2012-01-10

The incorporation of technological advancements in higher education has started to bridge the gap in local, national and global delivery of dental courses. This gap, including the global decrease in senior clinical academics, has influenced the development of new teaching and learning techniques. Institutional virtual learning environments (VLE) and other e-learning resources are now in higher demand. This paper describes how one such innovative solutions has been IVIDENT (International Virtual Dental School), has enabled secure and seamless access to high quality e-content and tools through an innovative, universal flexible learning platform. IVIDENT, now UDENTE (Universal Dental E-learning) has been shown to offer new learning experiences for students of dentistry, but its approach can apply across all educational domains. UDENTE also benefits staff as it allows them to contribute and access resources through peer reviewed publishing processes, which ensure the highest quality in education. UDENTE was developed thanks to a £2.3 million grant from the Higher Education Funding Council for England (HEFCE) and the Department of Health. http://www.udente.org. This academically led educational research project involved dental schools in seven countries. An initially scoping of requirements was followed by elaboration of the tools needed. Pilot testing of the tools, systems and learning resources in particular and the impact of the UDENTE in general were carried out. The pilots revealed evidence of positive impact of a space for learning, teaching, development and communication, with tools for planning of electives and administrative support. The results of these initial pilots have been positive and encouraging, describing UDENTE as an accessible, user friendly platform providing tools that otherwise would be difficult to access in a single space. However, attention to supporting faculty to embrace these new learning domains is essential if such technology enhanced

Transforming public health education in India through networking and collaborations: opportunities and challenges.

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Sharma, Anjali; Zodpey, Sanjay P

2013-01-01

A competent and motivated health workforce is indispensable to achieve the best health outcomes possible through given available resources and circumstances. However, apart from the shortages and unequal distribution, the workforce has fallen short of responding to the public health challenges of 21 st century also because of primarily the traditional training of health professionals. Although, health professionals have made enormous contributions to health and development over the past century, the 20 th century educational strategies are unfit to tackle 21 st century challenges. One of the key recommendations of the Lancet Commission on Education of Health Professionals is to improve health through reforms of professional education by establishing networks and partnerships which takes advantage of information and communication linkages. The primary goal of this manuscript is to highlight the potential of networks and partnerships in advancing the agenda of educational reforms to revitalize public health education in India. It outlines the current status and expanding scope of public health education in India, existing networks of public health professionals and public health education institutions in the country, and opportunities, advantages and challenges for such networks. Although, we have networks of individuals and institutions in the country, there potential to bring about change has still not being utilized fully and effectively. Immediate collaborative efforts could be directed towards designing and adaptation of competency driven curriculum frameworks suitable of addressing public health challenges of 21 st century, shifting the current focus of curriculum to multidisciplinary public health outlook, developing accreditation mechanisms for both the programs and institutions, engaging in creating job opportunities and designing career pathways for public health professionals in public and private sector. These efforts could certainly be facilitated

Development of Saudi e-health literacy scale for chronic diseases in Saudi Arabia: using integrated health literacy dimensions.

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Zakaria, Nasriah; AlFakhry, Ohoud; Matbuli, Abeer; Alzahrani, Asma; Arab, Noha Samir Sadiq; Madani, Alaa; Alshehri, Noura; Albarrak, Ahmed I

2018-05-01

Health literacy has become a global issue, and it is important that patients and individuals are able to use information technology to access health information and educational services. The research objective is to develop a Saudi e-health literacy scale (SeHL) for measuring e-health literacy among Saudis suffering from non-communicable diseases (NCD). Overall, 14 relevant papers in related interdisciplinary fields were reviewed to select the most useful literacy dimensions. From these articles, we extracted the most common dimensions used to measure e-health literacy across the disciplines. Multiple workshops with multidisciplinary team members reviewed and evaluated items for SeHL. Four key aspects of e-health literacy-use of technology/media, information-seeking, usefulness and confidence-were identified and integrated as e-health literacy dimensions. These will be used to measure e-health literacy among Saudi patients with NCDs. A translation from Arabic to English was performed in order to ensure that translation process was accurate. A SeHL scale was developed to measure e-health literacy among Saudi patients. By understanding e-health literacy levels, we will be able to create a patient-education system to be used by patients in Saudi Arabia. As information technology is increasingly used by people of all ages all over the world, e-health literacy has been identified as a key factor in determining health outcomes. To date, no comprehensive scale exists to assess e-health literacy levels among speakers of Arabic, particularly among people with NCD such as diabetes, cardiovascular diseases and hypertension.

The Effect of Banking Personnel's Access to E-Learning Opportunities on Their Professional Achievement

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Karaaslan, Ilknur Aydogdu

2013-01-01

Developments in information and communication technology create the spread of education and economic opportunities. E-learning is one of them. For companies in the banking sector, web-based training is a new

The use of e-health and m-health tools in health promotion and primary prevention among older adults: a systematic literature review.

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Kampmeijer, Ramon; Pavlova, Milena; Tambor, Marzena; Golinowska, Stanisława; Groot, Wim

2016-09-05

The use of e-health and m-health technologies in health promotion and primary prevention among older people is largely unexplored. This study provides a systematic review of the evidence on the scope of the use of e-health and m-health tools in health promotion and primary prevention among older adults (age 50+). A systematic literature review was conducted in October 2015. The search for relevant publications was done in the search engine PubMed. The key inclusion criteria were: e-health and m-health tools used, participants' age 50+ years, focus on health promotion and primary prevention, published in the past 10 years, in English, and full-paper can be obtained. The text of the publications was analyzed based on two themes: the characteristics of e-health and m-health tools and the determinants of the use of these tools by older adults. The quality of the studies reviewed was also assessed. The initial search resulted in 656 publications. After we applied the inclusion and exclusion criteria, 45 publications were selected for the review. In the publications reviewed, various types of e-health/m-health tools were described, namely apps, websites, devices, video consults and webinars. Most of the publications (60 %) reported studies in the US. In 37 % of the publications, the study population was older adults in general, while the rest of the publications studied a specific group of older adults (e.g. women or those with overweight). The publications indicated various facilitators and barriers. The most commonly mentioned facilitator was the support for the use of the e-health/m-health tools that the older adults received. E-health and m-health tools are used by older adults in diverse health promotion programs, but also outside formal programs to monitor and improve their health. The latter is hardly studied. The successful use of e-health/m-health tools in health promotion programs for older adults greatly depends on the older adults' motivation and support

Social Determinants of Maternal Health in Afghanistan: A Review

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Said Ahmad Maisam Najafizada

2017-03-01

Methods: This narrative review was conducted using Arksey and O’Malley’s framework of (1 defining the question, (2 searching the literature, (3 assessing the studies, (4 synthesizing selected evidence in context, and (5 summarizing potential programmatic implication of the context. We searched Medline, CABI global health database, and Google Scholar for relevant publications. Results: A total of 38 articles/reports were included in this review. We found that social determinants such as maternal education, sociocultural practices, and social infrastructure have a significant impact on maternal health. Health care may be the immediate determinant, but it is influenced by other determinants that must be addressed in order to alleviate the burden on health care, as well as to achieve long-term reduction in maternal mortality. Conclusion: Because of the importance of social factors for maternal health outcomes, committed involvement of multiple government sectors (i.e. education, labor and social affairs, information and culture, transport and rural development among others, alongside health care is the long-term solution to the maternal health problems in Afghanistan. National and international organizations’ long-term commitment to social investment such as education, local economy, cultural change, and social infrastructure is recommended for Afghanstan and globally.

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

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Elesban Kihuba

2016-06-01

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

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

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Kihuba, Elesban; Gheorghe, Adrian; Bozzani, Fiammetta; English, Mike; Griffiths, Ulla K.

2016-01-01

Background Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. Design We reviewed policy documents, and conducted field observations and semi-structured interviews with key informants in the health sector. We used an adapted Human, Organization and Technology fit (HOT-fit) framework to analyze the components and standards of a cost accounting system. Results Among the opportunities for a viable cost accounting system, we identified a supportive broad policy environment, political will, presence of a national data reporting architecture, good implementation experience with electronic medical records systems, and the availability of patient clinical and resource use data. However, several practical issues need to be considered in the design of the system, including the lack of a framework to guide the costing process, the lack of long-term investment, the lack of appropriate incentives for ground-level staff, and a risk of overburdening the current health management information system. Conclusion To facilitate the implementation of cost accounting into the health sector, the design of any proposed system needs to remain simple and attuned to the local context. PMID:27357072

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

Science.gov (United States)

Kihuba, Elesban; Gheorghe, Adrian; Bozzani, Fiammetta; English, Mike; Griffiths, Ulla K

2016-01-01

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

Relationships Between eHealth Literacy and Health Behaviors in Korean Adults.

Science.gov (United States)

Kim, Sun-Hee; Son, Youn-Jung

2017-02-01

The Internet is a useful and accessible source for health-related information for modern healthcare consumers. Individuals with adequate eHealth literacy have an incentive to use the Internet to access health-related information, and they consider themselves capable of using Web-based knowledge for health. This cross-sectional study aimed to describe the relationship between eHealth literacy and health behaviors. A total of 230 adults aged 18 to 39 years and residing in South Korea participated in the study. The mean (SD) score for eHealth literacy was 25.52 (4.35) of a total possible score of 40. The main source of health information was the Internet. Using hierarchical linear regression, the results showed that eHealth literacy was the strongest predictor of health behaviors after adjusting for general characteristics. These findings indicate that eHealth literacy can be an important factor in promoting individual health behaviors. Further research on eHealth literacy and actual health behaviors including intention and self-reported health behaviors are required to explain the impact of eHealth literacy on overall health status.

Globalization and social determinants of health: Introduction and methodological background (part 1 of 3)

Science.gov (United States)

Labonté, Ronald; Schrecker, Ted

2007-01-01

Globalization is a key context for the study of social determinants of health (SDH). Broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives. In this first article of a three-part series, we describe the origins of the series in work conducted for the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health and in the Commission's specific concern with health equity. We explain our rationale for defining globalization with reference to the emergence of a global marketplace, and the economic and political choices that have facilitated that emergence. We identify a number of conceptual milestones in studying the relation between globalization and SDH over the period 1987–2005, and then show that because globalization comprises multiple, interacting policy dynamics, reliance on evidence from multiple disciplines (transdisciplinarity) and research methodologies is required. So, too, is explicit recognition of the uncertainties associated with linking globalization – the quintessential "upstream" variable – with changes in SDH and in health outcomes. PMID:17578568

Missed Opportunities for Chronic Diseases Prevention in a Primary Health Care Center in Istanbul

Directory of Open Access Journals (Sweden)

Ahmet Topuzoglu

2011-12-01

Full Text Available Aim: The aim of the study was to investigate missed opportunities about chronic diseases and related risk factors in a primary health care center in Istanbul. Method: This cross sectional study was held in a Primary Health Care Center in Istanbul with the study population consisted of 500 people which were applicated in one month period. Participants were asked; if they were questioned by their physician about major risk factors (smoking, obesity, diabetes mellitus, hypertension, coroner heart disease in family, glysemic level, cholesterol level and regular exercise practice according to Primary Care 2006 Guidelines. The data was evaluated by descriptive statatistics, chi square test. Results: The median age of the participants were 40 (25.p; 32-75.p;52 and 76.4% of them were female. 50.4% of participants were overweight, 20.8% of them were obese. 36.2% of them were smoking, 22.0% were hypertensive, 10.4% were hiperglysemic. There were around 90.0% missing opportunities screening and management of obesity and blood cholesterol level, 70.0% about hypertension and 85.0% about diabetes. Conclusion: Opportunities about chronic diseases and their risk factors are being missed and asking about risk factors are neglected in primary health care center. [TAF Prev Med Bull 2011; 10(6.000: 665-674

Investing in e-health

CERN Document Server

Gustafson, David H; Hawkins, Robert P

2007-01-01

As the Internet's presence in health care grows more pervasive, an increasing number of health care providers have begun to implement eHealth innovations in their practice. This book explores the development of a model to predict and explain the degree of success it is possible to achieve in implementing e-health systems. This model allows an institution to benchmark its progress towards IHCS implementation and advises administrators where to invest resources to increase the chance of successful implementation. A set of case studies highlights key features of the model, with each case study fu

Patient-, health worker-, and health facility-level determinants of correct malaria case management at publicly funded health facilities in Malawi: results from a nationally representative health facility survey.

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Steinhardt, Laura C; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

2014-02-20

Prompt and effective case management is needed to reduce malaria morbidity and mortality. However, malaria diagnosis and treatment is a multistep process that remains problematic in many settings, resulting in missed opportunities for effective treatment as well as overtreatment of patients without malaria. Prior to the widespread roll-out of malaria rapid diagnostic tests (RDTs) in late 2011, a national, cross-sectional, complex-sample, health facility survey was conducted in Malawi to assess patient-, health worker-, and health facility-level factors associated with malaria case management quality using multivariate Poisson regression models. Among the 2,019 patients surveyed, 34% had confirmed malaria defined as presence of fever and parasitaemia on a reference blood smear. Sixty-seven per cent of patients with confirmed malaria were correctly prescribed the first-line anti-malarial, with most cases of incorrect treatment due to missed diagnosis; 31% of patients without confirmed malaria were overtreated with an anti-malarial. More than one-quarter of patients were not assessed for fever or history of fever by health workers. The most important determinants of correct malaria case management were patient-level clinical symptoms, such as spontaneous complaint of fever to health workers, which increased both correct treatment and overtreatment by 72 and 210%, respectively (pfacility-level factors were significantly associated with case management quality. Introduction of RDTs holds potential to improve malaria case management in Malawi, but health workers must systematically assess all patients for fever, and then test and treat accordingly, otherwise, malaria control programmes might miss an opportunity to dramatically improve malaria case management, despite better diagnostic tools.

eHealth promotion and social innovation with youth: using social and visual media to engage diverse communities.

Science.gov (United States)

Norman, Cameron D; Yip, Andrea L

2012-01-01

Social media and the multimedia networks that they support provide a platform for engaging youth and young adults across diverse contexts in a manner that supports different forms of creative expression. Drawing on more than 15 years of experience using eHealth promotion strategies to youth engagement, the Youth Voices Research Group (YVRG) and its partners have created novel opportunities for young people to explore health topics ranging from tobacco use, food security, mental health, to navigation of health services. Through applying systems and design thinking, the YVRG approach to engaging youth will be presented using examples from its research and practice that combine social organizing with arts-informed methods for creative expression using information technology. This presentation focuses on the way in which the YVRG has introduced interactive blogging, photographic elicitation, and video documentaries, alongside real-world social action projects, to promote youth health and to assist in research and evaluation. Opportunities and barriers including literacy and access to technology are discussed and presented along with emerging areas of research including more effective use of smartphones and social networking platforms such as Twitter, Facebook, and YouTube in health promotion and public health.

Social Determinants of Maternal Health in Afghanistan: A Review.

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Najafizada, Said Ahmad Maisam; Bourgeault, Ivy Lynn; Labonté, Ronald

2017-01-01

Afghanistan has a high maternal mortality rate of 400 per 100,000 live births. Although direct causes of maternal morbidity and mortality in Afghanistan include hemorrhage, obstructed labor, infection, high blood pressure, and unsafe abortion, the high burden of diseases responsible for maternal mortality arises in large part due to social determinants of health. The focus of this literature review is to examine the impact of various social determinants of health on maternal health in Afghanistan, filling an important gap in the existing literature. This narrative review was conducted using Arksey and O'Malley's framework of (1) defining the question, (2) searching the literature, (3) assessing the studies, (4) synthesizing selected evidence in context, and (5) summarizing potential programmatic implication of the context. We searched Medline, CABI global health database, and Google Scholar for relevant publications. A total of 38 articles/reports were included in this review. We found that social determinants such as maternal education, sociocultural practices, and social infrastructure have a significant impact on maternal health. Health care may be the immediate determinant, but it is influenced by other determinants that must be addressed in order to alleviate the burden on health care, as well as to achieve long-term reduction in maternal mortality. Because of the importance of social factors for maternal health outcomes, committed involvement of multiple government sectors (i.e. education, labor and social affairs, information and culture, transport and rural development among others, alongside health care) is the long-term solution to the maternal health problems in Afghanistan. National and international organizations' long-term commitment to social investment such as education, local economy, cultural change, and social infrastructure is recommended for Afghanstan and globally.

Health Professionals' Expanding eHealth Competences for Supporting Patients' Self-Management.

Science.gov (United States)

Kujala, Sari; Rajalahti, Elina; Heponiemi, Tarja; Hilama, Pirjo

2018-01-01

An increasing number of new eHealth services that support patients' self-management has changed health professionals' work and has created a need for a new eHealth competence. In this study, we evaluated the health professionals' eHealth competences and training needs in a public health organization in Finland. The target organization's goal was to increase the number of eHealth services provided to patients, and health professionals and their competences were seen as critical for the adoption of services. Data was collected through an online survey of 701 health professionals working in the target organization. Professionals perceived their basic computer skills as good and they were mostly willing to use eHealth services in patient work. However, health professionals need guidance, especially in their patient work in the new eHealth-enabled environment. They were less confident about their competence to motivate and advise patients to use eHealth services and how to communicate with patients using eHealth solutions. The results also imply that eHealth competence is not merely about an individual's skills but that organizations need to develop new working processes, work practices and distribution of work. We suggest that the training and support needs identified be considered in curricula and lifelong learning.

Addressing the social determinants of health at the local level: Opportunities and challenges.

Science.gov (United States)

Fosse, E; Helgesen, M K; Hagen, S; Torp, S

2018-02-01

The gradient in health inequalities reflects a relationship between health and social circumstance, demonstrating that health worsens as you move down the socio-economic scale. For more than a decade, the Norwegian National government has developed policies to reduce social inequalities in health by levelling the social gradient. The adoption of the Public Health Act in 2012 was a further movement towards a comprehensive policy. The main aim of the act is to reduce social health inequalities by adopting a Health in All Policies approach. The municipalities are regarded key in the implementation of the act. The SODEMIFA project aimed to study the development of the new public health policy, with a particular emphasis on its implementation in municipalities. In the SODEMIFA project, a mixed-methods approach was applied, and the data consisted of surveys as well as qualitative interviews. The informants were policymakers at the national and local level. Our findings indicate that the municipalities had a rather vague understanding of the concept of health inequalities, and even more so, the concept of the social gradient in health. The most common understanding was that policy to reduce social inequalities concerned disadvantaged groups. Accordingly, policies and measures would be directed at these groups, rather than addressing the social gradient. A movement towards an increased understanding and adoption of the new, comprehensive public health policy was observed. However, to continue this process, both local and national levels must stay committed to the principles of the act.

Opportunities and Challenges of Digital Technology for HIV Treatment and Prevention

OpenAIRE

Simoni, Jane M.; Kutner, Bryan A.; Horvath, Keith J.

2015-01-01

Novel eHealth interventions are creating exciting opportunities for health promotion along the continuum of HIV care and prevention. Reviews of recent work indicate the use of multiple platforms (e.g., smartphones, social media), with trends toward individualized approaches and real-time assessments. However, the field needs more rigorous investigations to provide evidence of long-term impact on clinical indicators and should expand its targets beyond men who have sex with men and medication ...

Social determinants of health inequalities: towards a theoretical perspective using systems science.

Science.gov (United States)

Jayasinghe, Saroj

2015-08-25

A systems approach offers a novel conceptualization to natural and social systems. In recent years, this has led to perceiving population health outcomes as an emergent property of a dynamic and open, complex adaptive system. The current paper explores these themes further and applies the principles of systems approach and complexity science (i.e. systems science) to conceptualize social determinants of health inequalities. The conceptualization can be done in two steps: viewing health inequalities from a systems approach and extending it to include complexity science. Systems approach views health inequalities as patterns within the larger rubric of other facets of the human condition, such as educational outcomes and economic development. This anlysis requires more sophisticated models such as systems dynamic models. An extension of the approach is to view systems as complex adaptive systems, i.e. systems that are 'open' and adapt to the environment. They consist of dynamic adapting subsystems that exhibit non-linear interactions, while being 'open' to a similarly dynamic environment of interconnected systems. They exhibit emergent properties that cannot be estimated with precision by using the known interactions among its components (such as economic development, political freedom, health system, culture etc.). Different combinations of the same bundle of factors or determinants give rise to similar patterns or outcomes (i.e. property of convergence), and minor variations in the initial condition could give rise to widely divergent outcomes. Novel approaches using computer simulation models (e.g. agent-based models) would shed light on possible mechanisms as to how factors or determinants interact and lead to emergent patterns of health inequalities of populations.

Opportunities and strategies in contemporary health system executive leadership.

Science.gov (United States)

McCausland, Maureen P

2012-01-01

The contemporary health care environment presents opportunities for nurse executive leadership that is patient and family centered, satisfying to professional nurses and their colleagues, and results in safe quality care that is fiscally responsible and evidence based. This article focuses on the strategic areas of systemness, people, performance, and innovation and offers strategies and tactics to help move nursing in integrated delivery systems from important entity-based services to a system approach where the nursing leadership team and entity chief nursing officers are recognized as major contributors to system success.

Addressing the Social Determinants of Health to Reduce Tobacco-Related Disparities.

Science.gov (United States)

Garrett, Bridgette E; Dube, Shanta R; Babb, Stephen; McAfee, Tim

2015-08-01

Comprehensive tobacco prevention and control efforts that include implementing smoke-free air laws, increasing tobacco prices, conducting hard-hitting mass media campaigns, and making evidence-based cessation treatments available are effective in reducing tobacco use in the general population. However, if these interventions are not implemented in an equitable manner, certain population groups may be left out causing or exacerbating disparities in tobacco use. Disparities in tobacco use have, in part, stemmed from inequities in the way tobacco control policies and programs have been adopted and implemented to reach and impact the most vulnerable segments of the population that have the highest rates of smokings (e.g., those with lower education and incomes). Education and income are the 2 main social determinants of health that negatively impact health. However, there are other social determinants of health that must be considered for tobacco control policies to be effective in reducing tobacco-related disparities. This article will provide an overview of how tobacco control policies and programs can address key social determinants of health in order to achieve equity and eliminate disparities in tobacco prevention and control. Tobacco control policy interventions can be effective in addressing the social determinants of health in tobacco prevention and control to achieve equity and eliminate tobacco-related disparities when they are implemented consistently and equitably across all population groups. Taking a social determinants of health approach in tobacco prevention and control will be necessary to achieve equity and eliminate tobacco-related disparities. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cost Comparison Model: Blended eLearning versus traditional training of community health workers.

Science.gov (United States)

Sissine, Mysha; Segan, Robert; Taylor, Mathew; Jefferson, Bobby; Borrelli, Alice; Koehler, Mohandas; Chelvayohan, Meena

2014-01-01

Another one million community healthcare workers are needed to address the growing global population and increasing demand of health care services. This paper describes a cost comparison between two training approaches to better understand costs implications of training community health workers (CHWs) in Sub-Saharan Africa. Our team created a prospective model to forecast and compare the costs of two training methods as described in the Dalburge Report - (1) a traditional didactic training approach ("baseline") and (2) a blended eLearning training approach ("blended"). After running the model for training 100,000 CHWs, we compared the results and scaled up those results to one million CHWs. A substantial difference exists in total costs between the baseline and blended training programs. RESULTS indicate that using a blended eLearning approach for training community health care workers could provide a total cost savings of 42%. Scaling the model to one million CHWs, the blended eLearning training approach reduces total costs by 25%. The blended eLearning savings are a result of decreased classroom time, thereby reducing the costs associated with travel, trainers and classroom costs; and using a tablet with WiFi plus a feature phone rather than a smartphone with data plan. The results of this cost analysis indicate significant savings through using a blended eLearning approach in comparison to a traditional didactic method for CHW training by as much as 67%. These results correspond to the Dalberg publication which indicates that using a blended eLearning approach is an opportunity for closing the gap in training community health care workers.

Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities.

Science.gov (United States)

Carey, Gemma; Friel, Sharon

2015-10-11

Many of the societal level factors that affect health - the 'social determinants of health (SDH)' - exist outside the health sector, across diverse portfolios of government, and other major institutions including non-governmental organisations (NGOs) and the private sector. This has created growing interest in how to create and implement public policies which will drive better and fairer health outcomes. While designing policies that can improve the SDH is critical, so too is ensuring they are appropriately administered and implemented. In this paper, we draw attention to an important area for future public health consideration - how policies are managed and implemented through complex administrative layers of 'the state.' Implementation gaps have long been a concern of public administration scholarship. To precipitate further work in this area, in this paper, we provide an overview of the scholarly field of public administration and highlight its role in helping to understand better the challenges and opportunities for implementing policies and programs to improve health equity. © 2015 by Kerman University of Medical Sciences.

Advancing the practice of health impact assessment in Canada: Obstacles and opportunities

Energy Technology Data Exchange (ETDEWEB)

McCallum, Lindsay C., E-mail: lindsay.mccallum@mail.utoronto.ca [University of Toronto, Department of Physical and Environmental Sciences, 1265 Military Trail, Toronto, Ontario M1C 1A4 (Canada); Intrinsik Environmental Sciences Inc., 6605 Hurontario Street, Mississauga, Ontario L5T0A3 (Canada); Ollson, Christopher A., E-mail: collson@intrinsik.com [Intrinsik Environmental Sciences Inc., 6605 Hurontario Street, Mississauga, Ontario L5T0A3 (Canada); Stefanovic, Ingrid L., E-mail: fenvdean@sfu.ca [Simon Fraser University, Faculty of Environment, 8888 University Drive, Burnaby, British Columbia V5A 1S6 (Canada)

2015-11-15

Health Impact Assessment (HIA) is recognized as a useful tool that can identify potential health impacts resulting from projects or policy initiatives. Although HIA has become an established practice in some countries, it is not yet an established practice in Canada. In order to enable broader support for HIA, this study provides a comprehensive review and analysis of the peer-reviewed and gray literature on the state of HIA practice. The results of this review revealed that, although there is an abundance of publications relating to HIA, there remains a lack of transparent, consistent and reproducible approaches and methods throughout the process. Findings indicate a need for further research and development on a number of fronts, including: 1) the nature of HIA triggers; 2) consistent scoping and stakeholder engagement approaches; 3) use of evidence and transparency of decision-making; 4) reproducibility of assessment methods; 5) monitoring and evaluation protocols; and, 6) integration within existing regulatory frameworks. Addressing these issues will aid in advancing the more widespread use of HIA in Canada. - Highlights: • Reviewed current state of practice in the field of HIA • Identified key obstacles and opportunities for HIA advancement • Major issues include lack of consistent approach and methodology. • No national regulatory driver hinders opportunity for widespread use of HIA. • Identified research opportunities vital to developing HIA practice in Canada.

"Never mind the logic, give me the numbers": former Australian health ministers' perspectives on the social determinants of health.

Science.gov (United States)

Baum, Frances E; Laris, Paul; Fisher, Matthew; Newman, Lareen; Macdougall, Colin

2013-06-01

The articulation of strong evidence and moral arguments about the importance of social determinants of health (SDH) and health equity has not led to commensurate action to address them. Policy windows open when, simultaneously, an issue is recognised as a problem, policy formulation and refinement happens and the political will for action is present. We report on qualitative interviews with 20 former Australian Federal, State or Territory health ministers conducted between September 2011 and January 2012 concerning their views about how and why the windows of policy opportunity on the SDH did or did not open during their tenure. Almost all ex-health ministers were aware of the existence of health inequalities and SDH but their complexity meant that this awareness rarely crystalised into a clear problem other than as a focus on high needs groups, especially Aboriginal people. Formulation of policies about SDH was assisted by cross-portfolio structures, policy entrepreneurs, and evidence from reviews and reports. It was hindered by the complexity of SDH policy, the dominance of medical power and paradigms and the weakness of the policy community advocating for SDH. The political stream was enabling when the general ideological climate was supportive of redistributive policies, the health care sector was not perceived to be in crisis, there was support for action from the head of government and cabinet colleagues, and no opposition from powerful lobby groups. There have been instances of Australian health policy which addressed the SDH over the past twenty five years but they are rare and the windows of opportunity that made them possible did not stay open for long. Copyright © 2013 Elsevier Ltd. All rights reserved.

The potential contributions of geographic information science to the study of social determinants of health in Iran.

Science.gov (United States)

Rabiei-Dastjerdi, Hamidreza; Matthews, Stephen A

2018-01-01

Recent interest in the social determinants of health (SDOH) and the effects of neighborhood contexts on individual health and well-being has grown exponentially. In this brief communication, we describe recent developments in both analytical perspectives and methods that have opened up new opportunities for researchers interested in exploring neighborhoods and health research within a SDOH framework. We focus specifically on recent advances in geographic information science, statistical methods, and spatial analytical tools. We close with a discussion of how these recent developments have the potential to enhance SDOH research in Iran.

Potential growth and opportunities for Kenyan small sized firms online : E-business adoption for small boutiques and the new customer online

OpenAIRE

Mbare, Candy

2016-01-01

The purpose of this thesis is to identify the online growth opportunities for the small sized firm in Kenya. Kenya is the most developed nation in East-Africa. E-commerce is a rapidly rising trend in developing nations, that provides small sized firms with growth opportunities. The e-commerce trend also comes with changes in consumer behavior. Sufficient use of e-commerce by small sized firms in Kenya, can open a opportunity to reach a wider range of audience and increase profits by expan...

FACTORS THAT INFLUENCE THE SELECTION OF LEARNING OPPORTUNITIES FOR STUDENT NURSES IN PRIMARY HEALTH CARE

Directory of Open Access Journals (Sweden)

H. lita

2002-11-01

The study therefore focused on the following objective: To identify the factors that influence the selection of learning opportunities for primary health care in hospital units. A qualitative research design utilising focus group discussions were used. The population consisted of conveniently selected lecturers, student nurses and registered nurses. The same initial question was asked in each focus group to initiate the discussions. The data were analysed according to Tesch's method. The results indicated that there is positive commitment from the lecturers and registered nurses to be involved in selecting appropriate learning opportunities. The student nurses also demonstrated a willingness to learn and to be exposed to learning opportunities in primary health care. There were however certain constraints that emerged as themes, namely: • Managerial constraints • Educational constraints Under the theme "managerial constraints" categories such as workload, nursing staff shortages and communication problems were identified. Under the theme "educational constraints" categories such as a lack of guidance, and the correlation of theory and practice emerged. Recommendations based on this research report include improvement of in-service education on managerial and educational aspects to facilitate the primary health care approach in hospitals.

Education projects: an opportunity for student fieldwork in global health academic programs.

Science.gov (United States)

Fyfe, Molly V

2012-01-01

Universities, especially in higher-income countries, increasingly offer programs in global health. These programs provide different types of fieldwork projects, at home and abroad, including: epidemiological research, community health, and clinical electives. I illustrate how and why education projects offer distinct learning opportunities for global health program fieldwork. As University of California students, we partnered in Tanzania with students from Muhimbili University of Health and Allied Science (MUHAS) to assist MUHAS faculty with a curricular project. We attended classes, clinical rounds, and community outreach sessions together, where we observed teaching, materials used, and the learning environment; and interviewed and gathered data from current students, alumni, and health professionals during a nationwide survey. We learned together about education of health professionals and health systems in our respective institutions. On the basis of this experience, I suggest some factors that contribute to the productivity of educational projects as global health fieldwork.

[A first analysis of research on social determinants of health in Mexico: 2005-2012].

Science.gov (United States)

Salgado-de Snyder, V Nelly; Guerra-y Guerra, Germán

2014-01-01

To examine the research on social determinants of health (SDH) produced in Mexico during the period 2005-2012, based on the characterization of the national health research system and the scientific production on this topic. Two-stage analyses: Review of Mexican documents and official sources on health research and systematic bibliographic review of the literature on SDH. Although SDH were mentioned in the Specific Action Plan for Health Research 2007-2012, they are not implemented in strategies and goals, as the emphasis is put mostly in infrastructure and administrative aspects of research. In the period studied, 145 articles were published on SDH topics such as health conditions, health systems and nutrition and obesity. In spite of the availability of research on SDH in Mexico, the operationalization of such findings into health policies has not been possible. The current Sectorial Program on Health 2013-2018 represents a window of opportunity to position research findings that promote health equity policies.

A systematic review of missed opportunities for improving tuberculosis and HIV/AIDS control in Sub-saharan Africa: what is still missed by health experts?

Science.gov (United States)

Keugoung, Basile; Fouelifack, Florent Ymele; Fotsing, Richard; Macq, Jean; Meli, Jean; Criel, Bart

2014-01-01

In sub-Saharan Africa, HIV/AIDS and tuberculosis are major public health problems. In 2010, 64% of the 34 million of people infected with HIV were reported to be living in sub-Saharan Africa. Only 41% of eligible HIV-positive people had access to antiretroviral therapy (ART). Regarding tuberculosis, in 2010, the region had 12% of the world's population but reported 26% of the 8.8 million incident cases and 254000 tuberculosis-related deaths. This paper aims to review missed opportunities for improving HIV/AIDS and tuberculosis prevention and care. We conducted a systematic review in PubMed using the terms 'missed'(Title) AND 'opportunities'(Title). We included systematic review and original research articles done in sub-Saharan Africa on missed opportunities in HIV/AIDS and/or tuberculosis care. Missed opportunities for improving HIV/AIDS and/or tuberculosis care can be classified into five categories: i) patient and community; ii) health professional; iii) health facility; iv) local health system; and v) vertical programme (HIV/AIDS and/or tuberculosis control programmes). None of the reviewed studies identified any missed opportunities related to health system strengthening. Opportunities that are missed hamper tuberculosis and/or HIV/AIDS care in sub-Saharan Africa where health systems remain weak. What is still missing in the analysis of health experts is the acknowledgement that opportunities that are missed to strengthen health systems also undermine tuberculosis and HIV/AIDS prevention and care. Studying why these opportunities are missed will help to understand the rationales behind the missed opportunities, and customize adequate strategies to seize them and for effective diseases control.

The determinants of excellent health: different from the determinants of ill-health?

NARCIS (Netherlands)

Mackenbach, J. P.; van den Bos, J.; Joung, I. M.; van de Mheen, H.; Stronks, K.

1994-01-01

In the famous definition of the World Health Organization, health is 'a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity'. Until now, the distribution and determinants of the positive end of the health spectrum have not been studied

Dissemination, Implementation, and Improvement Science Research in Population Health: Opportunities for Public Health and CTSAs.

Science.gov (United States)

Kuo, Tony; Gase, Lauren N; Inkelas, Moira

2015-12-01

The complex, dynamic nature of health systems requires dissemination, implementation, and improvement (DII) sciences to effectively translate emerging knowledge into practice. Although they hold great promise for informing multisector policies and system-level changes, these methods are often not strategically used by public health. More than 120 stakeholders from Southern California, including the community, federal and local government, university, and health services were convened to identify key priorities and opportunities for public health departments and Clinical and Translational Science Awards programs (CTSAs) to advance DII sciences in population health. Participants identified challenges (mismatch of practice realities with narrowly focused research questions; lack of iterative learning) and solutions (using methods that fit the dynamic nature of the real world; aligning theories of change across sectors) for applying DII science research to public health problems. Pragmatic steps that public health and CTSAs can take to facilitate DII science research include: employing appropriate study designs; training scientists and practicing professionals in these methods; securing resources to advance this work; and supporting team science to solve complex-systems issues. Public health and CTSAs represent a unique model of practice for advancing DII research in population health. The partnership can inform policy and program development in local communities. © 2015 Wiley Periodicals, Inc.

Integrating human health into environmental impact assessment: an unrealized opportunity for environmental health and justice.

Science.gov (United States)

Bhatia, Rajiv; Wernham, Aaron

2008-08-01

The National Environmental Policy Act and related state laws require many public agencies to analyze and disclose potentially significant environmental effects of agency actions, including effects on human health. In this paper we review the purpose and procedures of environmental impact assessment (EIA), existing regulatory requirements for health effects analysis, and potential barriers to and opportunities for improving integration of human health concerns within the EIA process. We use statutes, regulations, guidelines, court opinions, and empirical research on EIA along with recent case examples of integrated health impact assessment (HIA)/EIA at both the state and federal level. We extract lessons and recommendations for integrated HIA/EIA practice from both existing practices as well as case studies. The case studies demonstrate the adequacy, scope, and power of existing statutory requirements for health analysis within EIA. The following support the success of integrated HIA/EIA: a proponent recognizing EIA as an available regulatory strategy for public health; the openness of the agency conducting the EIA; involvement of public health institutions; and complementary objectives among community stakeholders and health practitioners. We recommend greater collaboration among institutions responsible for EIA, public health institutions, and affected stakeholders along with guidance, resources, and training for integrated HIA/EIA practice.

Identifying PHM market and network opportunities.

Science.gov (United States)

Grube, Mark E; Krishnaswamy, Anand; Poziemski, John; York, Robert W

2015-11-01

Two key processes for healthcare organizations seeking to assume a financially sustainable role in population health management (PHM), after laying the groundwork for the effort, are to identify potential PHM market opportunities and determine the scope of the PHM network. Key variables organizations should consider with respect to market opportunities include the patient population, the overall insurance/employer market, and available types of insurance products. Regarding the network's scope, organizations should consider both traditional strategic criteria for a viable network and at least five additional criteria: network essentiality and PHM care continuum, network adequacy, service distribution right-sizing, network growth strategy, and organizational agility.

How do physicians discuss e-health with patients? the relationship of physicians' e-health beliefs to physician mediation styles.

Science.gov (United States)

Fujioka, Yuki; Stewart, Erin

2013-01-01

A survey of 104 physicians examined the role of physicians' evaluation of the quality of e-health and beliefs about the influence of patients' use of e-health in how physicians discuss e-health materials with patients. Physicians' lower (poor) evaluation of the quality of e-health content predicted more negative mediation (counter-reinforcement of e-health content). Perceived benefits of patients' e-health use predicted more positive (endorsement of e-health content). Physician's perceived concerns (negative influence) regarding patients' e-health use were not a significant predictor for their mediation styles. Results, challenging the utility of restrictive mediation, suggested reconceptualizing it as redirective mediation in a medical interaction. The study suggested that patient-generated e-health-related inquiries invite physician mediation in medical consultations. Findings and implications are discussed in light of the literature of physician-patient interaction, incorporating the theory of parental mediation of media into a medical context.

eHealth in Denmark: a case study.

Science.gov (United States)

Kierkegaard, Patrick

2013-12-01

Denmark is widely regarded as a leading country in terms of eHealth integration and healthcare delivery services. The push for eHealth adoption over that past 20 years in the Danish health sector has led to the deployment of multiple eHealth technologies. However, in reality the Danish healthcare suffers from eHealth system fragmentation which has led to eHealth's inability to reach full potential in delivering quality healthcare service. This paper will presents a case study of the current state of eHealth in the Danish healthcare system and discuss the current challenges the country is facing today.

Involving patients with E-health

DEFF Research Database (Denmark)

Nielsen, Karen Dam

2015-01-01

With e-health technologies, patients are invited as co-producers of data and information. The invitation sparks new expectations, yet often results in disappointments. With persistent ambitions to involve patients by means of e-health, it seems crucial to gain a better understanding of the nature......, sources and workings of the expectations that come with being invited. I analyse the use of an e-health system for ICD-patients, focusing on how patients sought to serve as information providers. Continuing STS-research on invisible work in technology use, I show how using the system involved complex work...... that understanding the dialogic dynamics and ‘overflows’ of information filtration work can help unpack the challenges of facilitating (patient) participation with e-health and other filtration devices....

E-health progresses in Romania.

Science.gov (United States)

Moisil, Ioana; Jitaru, Elena

2006-01-01

The paper is presenting the recent evolution of e-health aspects in Romania. Data presented are based on governmental reports. Surveys organized by the "Lucian Blaga" University of Sibiu and studies carried on by the national Institute for Research and Development in Informatics (I.C.I.) have shown that Romania has important health problems, from cardio vascular diseases (CVD) to cancer and infectious diseases, a high score on mortality and morbidity and a low one on natality. Poor management of the health sector did not help to solve all these problems. In the last 14 years there were several attempts to reform healthcare but none succeeded until now. The health insurance system is operational but needs still to be improved. Acknowledging the deep crisis of the health system the Prime Minister nominated a new minister of health and important changes in the health management approach are to be envisaged. One of this is the introduction of the e-procurement system for all health related goods. In spite of the crisis of the health system, e-health applications are flourishing. We can distinguish applications at national and local level and also punctual applications. The main applications refer to hospital information systems (HIS), electronic health records (EHR), e-procurement, image processing, diagnosis and treatment aids, telediagnosis, teleconsultation, education, research and domain oriented web support services. Most academic clinical hospital is now members of a web community "mednet". Unfortunately a lot of medical web sites have disappeared for lack of funds. As the health sector is in general funded from the public budget and the health crisis is deepened in the last years, the driving force in implementing e-health concepts and technologies is not the Ministry of Health but the Information Technology (IT) community, with a strong support from the Ministry of Information Technology and Communications and also from the Ministry of Education and Research

Opportunities for Launch Site Integrated System Health Engineering and Management

Science.gov (United States)

Waterman, Robert D.; Langwost, Patricia E.; Waterman, Susan J.

2005-01-01

The launch site processing flow involves operations such as functional verification, preflight servicing and launch. These operations often include hazards that must be controlled to protect human life and critical space hardware assets. Existing command and control capabilities are limited to simple limit checking durig automated monitoring. Contingency actions are highly dependent on human recognition, decision making, and execution. Many opportunities for Integrated System Health Engineering and Management (ISHEM) exist throughout the processing flow. This paper will present the current human-centered approach to health management as performed today for the shuttle and space station programs. In addition, it will address some of the more critical ISHEM needs, and provide recommendations for future implementation of ISHEM at the launch site.

Neighborhood Child Opportunity and Individual-Level Pediatric Acute Care Use and Diagnoses.

Science.gov (United States)

Kersten, Ellen E; Adler, Nancy E; Gottlieb, Laura; Jutte, Douglas P; Robinson, Sarah; Roundfield, Katrina; LeWinn, Kaja Z

2018-05-01

: media-1vid110.1542/5751513300001PEDS-VA_2017-2309 Video Abstract OBJECTIVES: Although health care providers and systems are increasingly interested in patients' nonmedical needs as a means to improve health, little is known about neighborhood conditions that contribute to child health problems. We sought to determine if a novel, publicly available measure of neighborhood context, the Child Opportunity Index, was associated with pediatric acute care visit frequency and diagnoses. This cross-sectional study included San Francisco residents <18 years of age with an emergency department and/or urgent care visit to any of 3 medical systems ( N = 47 175) between 2007 and 2011. Hot-spot analysis was used to compare the spatial distribution of neighborhood child opportunity and income. Generalized estimating equation logistic regression models were used to examine independent associations between neighborhood child opportunity and frequent acute care use (≥4 visits per year) and diagnosis group after adjusting for neighborhood income and patient age, sex, race and/or ethnicity, payer, and health system. Neighborhood child opportunity and income had distinct spatial distributions, and we identified different clusters of high- and low-risk neighborhoods. Children living in the lowest opportunity neighborhoods had significantly greater odds of ≥4 acute care visits per year (odds ratio 1.33; 95% confidence interval 1.03-1.73) compared with those in the highest opportunity neighborhoods. Neighborhood child opportunity was negatively associated with visits for respiratory conditions, asthma, assault, and ambulatory care-sensitive conditions but positively associated with injury-related visits. The Child Opportunity Index could be an effective tool for identifying neighborhood factors beyond income related to child health. Copyright © 2018 by the American Academy of Pediatrics.

The use of eHealth to promote physical activity in cancer survivors: a systematic review.

Science.gov (United States)

Haberlin, Ciarán; O'Dwyer, Tom; Mockler, David; Moran, Jonathan; O'Donnell, Dearbhaile M; Broderick, Julie

2018-06-16

Achieving adequate levels of physical activity (PA) and avoiding sedentary behaviour are particularly important in cancer survivors. eHealth, which includes, but is not limited to, the delivery of health information through Internet and mobile technologies, is an emerging concept in healthcare which may present opportunities to improve PA in cancer survivors. The aim of this systematic review was to explore the effects of eHealth in the promotion of PA among cancer survivors. Suitable articles were searched using PubMed, CINAHL, EMBASE, PsychInfo, Web of Science and SCOPUS databases using a combination of keywords and medical subject headings. Articles were included if they described an eHealth intervention designed to improve PA in cancer survivors. Two reviewers screened studies for inclusion. In total, 1065 articles were considered. Ten studies met eligibility criteria. A variety of platforms designed to increase PA were described in these studies: web application (app) (n = 5), web and mobile application (n = 2), mobile app (n = 1), website only (n = 1), e-mail based (n = 1). All studies measured PA using self-report outcome measures with the exception of one study which measured steps using a Fitbit. Meta-analysis was not performed because of variations in study design and interventions. All studies reported improvements in PA, with 8/10 studies reporting statistically significant changes. The use of eHealth to promote PA in cancer survivors is a relatively new concept, which is supported by the recent emergent evidence described in this review. eHealth shows promise as a means of promoting and increasing daily PA, but further high-quality, longer term studies are needed to establish the feasibility and effectiveness of eHealth platforms aimed at that goal.

Getting Australia more active: challenges and opportunities for health promotion.

Science.gov (United States)

Hills, A P; Street, S J; Harris, N

2014-04-01

A growing body of evidence demonstrates that regular physical activity promotes health and assists in the prevention of non-communicable diseases but this is presently curtailed by low and unhealthy participation rates in Australia and comparable industrialised countries. Compounding the problem is knowledge that physical inactivity is independently associated with poor health outcomes. Despite physical activity being described as public health's 'best bet' or 'best buy', motivating individuals and groups to adopt and maintain physical activity continues to be a major challenge for health professionals. Global advocacy for prevention efforts must be operationalised through national to local strategies to promote and support physical activity in multiple settings including the home, schools and workplace. The Australian health promotion community has and continues to play a leadership role in physical activity promotion. However, there is an urgent need to continue to promote the importance of physical activity, along with its pivotal role in the prevention of non-communicable diseases, alongside related agendas including healthy diets, tobacco control and environmental sustainability. This commentary overviews the contemporary status of physical activity promotion in Australia and identifies key challenges and opportunities moving forward.

Saúde ambiental e saúde do trabalhador na atenção primária à saúde, no SUS: oportunidades e desafios Environmental and workers' health, within the framework of primary health care in the Brazilian National Health System (SUS: opportunities and challenges

Directory of Open Access Journals (Sweden)

Elizabeth Costa Dias

2009-12-01

Full Text Available O texto busca contribuir para a discussão dos entrecruzamentos entre os campos da saúde ambiental e da saúde do trabalhador, referenciada no cenário brasileiro das relações produção/trabalho, ambiente e saúde e nas mudanças na organização do SUS, com destaque para o papel da atenção primária à saúde (APS, e se destina a contribuir para as discussões no processo de preparação da 1ª Conferência Nacional de Saúde Ambiental (1ª CNSA, prevista para ser realizada em dezembro de 2009. São descritos, de modo sintético, aspectos históricos e conceituais desses campos, algumas das características compartilhadas e as ações esperadas do sistema de saúde, com destaque para o papel da APS e a importância do diálogo com o movimento social. Finalizando, são identificados pontos para uma agenda de trabalho comum.This paper has the purpose of contributing to the discussion of the crossing areas between Environmental Health and Workers´ Health, in the Brazilian context of Labor, Production, Environment and Health. This paper emerges in the context of the current organizational changes of the Brazilian National Health System (SUS, with a major focus on Primary Health Care, having in mind, also, the preparation of the 1st National Environmental Health Conference (1ª CNSA to be held in December of 2009. So, historical and conceptual aspects of those fields are described in a summarized manner, as well as some shared features and expected actions of the Health System, with emphasis to the role of Primary Health Care and to the importance of the dialogue with the social movement. Finally, some topics for a common agenda were identified by the authors.

[Mental Health: Concepts, Measures, Determinants].

Science.gov (United States)

Doré, Isabelle; Caron, Jean

Objectives This article aims to situate the concept of mental health in a historical perspective. This article presents the most commonly used measurement tools in Canada and elsewhere in the world to assess specific and multiple dimensions of mental health; when available, psychometric properties are discussed. Finally, research findings on quality of life and mental health determinants are presented.Methods A literature review of concepts, measurement and determinants of mental health is presented in this paper. The selection of measurement scales presented is based on the findings of the research reports conducted by the second author, an expert on mental health measures, for Health Canada and Statistics Canada.Results Mental health is more than the absence of mental illness; rather it is a state of complete well-being, which refers to our ability to enjoy life and deal with the challenges we face. Accordingly, mental health and mental illness are not extremes of the same continuum, but distinct yet correlated concepts. The traditional conceptualization suggesting that mental health represents simply the absence of mental illness has been replaced, in the last few decades, by a more holistic characterization, which directly concerns public health. The components of mental health include emotional well-being/quality of life (QOL) and psychological and social well-being. Mental health influences the personal and social functioning of individuals, justifying the importance of intervening upstream to promote mental health. Specific scales are relevant for obtaining a detailed measure of one aspect of well-being in particular (emotional/quality of life, psychological or social well-being); however, to account for the global mental health status, measurement tools that integrate all three forms of well-being (emotional, psychological and social) should be privileged. A diversity of determinants at the individual, social and neighbourhood levels influence quality of

Scope of Policy Issues in eHealth: Results From a Structured Literature Review

Science.gov (United States)

Durrani, Hammad; Nayani, Parvez; Fahim, Ammad

2012-01-01

Background eHealth is widely used as a tool for improving health care delivery and information. However, distinct policies and strategies are required for its proper implementation and integration at national and international levels. Objective To determine the scope of policy issues faced by individuals, institutions, or governments in implementing eHealth programs. Methods We conducted a structured review of both peer-reviewed and gray literature from 1998–2008. A Medline search for peer-reviewed articles found 40 papers focusing on different aspects of eHealth policy. In addition, a Google search found 20 national- and international-level policy papers and documents. We reviewed these articles to extract policy issues and solutions described at different levels of care. Results The literature search found 99 policy issues related to eHealth. We grouped these issues under the following themes: (1) networked care, (2) interjurisdictional practice, (3) diffusion of eHealth/digital divide, (4) eHealth integration with existing systems, (5) response to new initiatives, (6) goal-setting for eHealth policy, (7) evaluation and research, (8) investment, and (9) ethics in eHealth. Conclusions We provide a list of policy issues that should be understood and addressed by policy makers at global, jurisdictional, and institutional levels, to facilitate smooth and reliable planning of eHealth programs. PMID:22343270

Enhancing the Career Planning Self-Determination of Young Adults with Mental Health Challenges.

Science.gov (United States)

Sowers, Jo-Ann; Swank, Paul

2017-01-01

The impact of an intervention on the self-determination and career planning engagement of young adults with mental health challenges was studied. Sixty-seven young adults, 20 to 30 years of age, with mental health diagnoses (e.g., depression, bipolar disorder) were randomly assigned to intervention and control groups. Statistically significant greater increases were made by the intervention group versus the control group for self-determination and career planning engagement, and self-determination at least partially mediated increases in career planning engagement. With career planning self-determination interventions, young adults with mental health challenges might be able to achieve better career and life outcomes than is typical for this population.

Breaking the entry barriers of startup companies to offer AAL services through integrated eHealth solutions based on a hybrid business model

DEFF Research Database (Denmark)

Kyriazakos, Sofoklis

Healthcare sector is one of the main pillars of the economy at a global level that involves patients, physicians, National Health Systems, insurance companies, pharmaceuticals, vendors, researchers and providers. Healthcare sector represents a good portion of the GDP of any Government and attracts...... billion dollar investments every year. The technology and Internet evolution have contributed significantly to the creation of eHealth within the Healthcare sector that aims to improve citizens’ health and wellbeing. Nevertheless, the barriers to entry in this highly regulated business sector are huge...... and therefore integrated eHealth solutions fail to reach high levels of penetration. Considering this as big challenge, the paper presents a hybrid business models that is able to efficiently address the Healthcare sector stakeholders and create prosperous opportunities for eHealth solutions for startup...

Globalização, pobreza e saúde Globalization, poverty and health

Directory of Open Access Journals (Sweden)

Paulo Marchiori Buss

2007-12-01

Full Text Available O presente artigo analisa as relações entre globalização, pobreza e saúde. Conceitua e apresenta as principais características da globalização contemporânea. Também conceitua e apresenta as características da pobreza nos dias de hoje, nos planos mundial e regional. Revisando artigos e relatórios de amplitude mundial, apresenta um conjunto de evidências sobre as relações entre globalização e pobreza e suas influências sobre o campo da saúde. Apresenta, ainda, as oportunidades trazidas pela globalização, através de uma série de iniciativas globais resultantes da ação entre países, no âmbito das Nações Unidas como um todo e na OMS, em particular, assim como de alianças e coalizões intergovernamentais e com outros atores da sociedade civil.This paper analyses the relationship between globalization, poverty and health, defining and presenting the main characteristics of contemporary globalization. It also establishes the characteristics of poverty today, both globally and regionally. Reviewing articles and world reports, it presents a set of evidence on the relationships between globalization and poverty, as well as their influence on health. Furthermore, it presents the opportunities offered by globalization, through a series of worldwide initiatives prompted by actions among countries under the aegis of the United Nations in general and the WHO in particular, in addition to intergovernmental alliances and coalitions and other civil society representatives.

Contextual factors and challenges to e-health literacy

Directory of Open Access Journals (Sweden)

Bolanle A. Olaniran

2015-12-01

Full Text Available We live in a digital world or digital era. Hence, People will argue that not only do information communication technologies (ICTs make e-health possible but rather that it is an innovation advance whose time has come. Notwithstanding, e-health while hoping to create well needed improvement in health care, it is rife with certain challenges which are not limited to e-health literacy. However, this paper looks specifically at e-health literacy. The paper, in particular overviews e-health while addressing the impacts of key contextual factors that impacts e-health and e-health literacy regarding the propensity to adopt and use e-health in LEDCs.

Social Determinants of Health Are Associated with Markers of Renal Injury in Adolescents with Type 1 Diabetes.

Science.gov (United States)

Cummings, Laura A M; Clarke, Antoine; Sochett, Etienne; Daneman, Denis; Cherney, David Z; Reich, Heather N; Scholey, James W; Dunger, David B; Mahmud, Farid H

2018-05-08

To examine the relationship between the social determinants of health and markers of early renal injury in adolescent patients with type 1 diabetes (T1D). Renal outcomes included estimated glomerular filtration rate (eGFR) and albumin-creatinine excretion ratio (ACR). Differences in urinary and serum inflammatory markers also were assessed in relation to social determinants of health. Regression analysis was used to evaluate the association between the Ontario Marginalization Index (ON-Marg) as a measure of the social determinants of health, patient characteristics, ACR, eGFR, and renal filtration status (hyperfiltration vs normofiltration). Participants with T1D (n = 199) with a mean age of 14.4 ± 1.7 years and diabetes duration of 7.2 ± 3.1 years were studied. Mean eGFR was 122.0 ± 19.4 mL/min/1.73 m 2 . Increasing marginalization was positively associated with eGFR (P social and biological determinants of health in adolescents with T1D. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Social Health Inequalities and eHealth: A Literature Review With Qualitative Synthesis of Theoretical and Empirical Studies.

Science.gov (United States)

Latulippe, Karine; Hamel, Christine; Giroux, Dominique

2017-04-27

eHealth is developing rapidly and brings with it a promise to reduce social health inequalities (SHIs). Yet, it appears that it also has the potential to increase them. The general objective of this review was to set out how to ensure that eHealth contributes to reducing SHIs rather than exacerbating them. This review has three objectives: (1) identifying characteristics of people at risk of experiencing social inequality in health; (2) determining the possibilities of developing eHealth tools that avoid increasing SHI; and (3) modeling the process of using an eHealth tool by people vulnerable to SHI. Following the EPPI approach (Evidence for Policy and Practice of Information of the Institute of Education at the University of London), two databases were searched for the terms SHIs and eHealth and their derivatives in titles and abstracts. Qualitative, quantitative, and mixed articles were included and evaluated. The software NVivo (QSR International) was employed to extract the data and allow for a metasynthesis of the data. Of the 73 articles retained, 10 were theoretical, 7 were from reviews, and 56 were based on empirical studies. Of the latter, 40 used a quantitative approach, 8 used a qualitative approach, 4 used mixed methods approach, and only 4 were based on participatory research-action approach. The digital divide in eHealth is a serious barrier and contributes greatly to SHI. Ethnicity and low income are the most commonly used characteristics to identify people at risk of SHI. The most promising actions for reducing SHI via eHealth are to aim for universal access to the tool of eHealth, become aware of users' literacy level, create eHealth tools that respect the cultural attributes of future users, and encourage the participation of people at risk of SHI. eHealth has the potential to widen the gulf between those at risk of SHI and the rest of the population. The widespread expansion of eHealth technologies calls for rigorous consideration of

[Monitoring social determinants of health].

Science.gov (United States)

Espelt, Albert; Continente, Xavier; Domingo-Salvany, Antonia; Domínguez-Berjón, M Felicitas; Fernández-Villa, Tania; Monge, Susana; Ruiz-Cantero, M Teresa; Perez, Glòria; Borrell, Carme

2016-11-01

Public health surveillance is the systematic and continuous collection, analysis, dissemination and interpretation of health-related data for planning, implementation and evaluation of public health initiatives. Apart from the health system, social determinants of health include the circumstances in which people are born, grow up, live, work and age, and they go a long way to explaining health inequalities. A surveillance system of the social determinants of health requires a comprehensive and social overview of health. This paper analyses the importance of monitoring social determinants of health and health inequalities, and describes some relevant aspects concerning the implementation of surveillance during the data collection, compilation and analysis phases, as well as dissemination of information and evaluation of the surveillance system. It is important to have indicators from sources designed for this purpose, such as continuous records or periodic surveys, explicitly describing its limitations and strengths. The results should be published periodically in a communicative format that both enhances the public's ability to understand the problems that affect them, whilst at the same time empowering the population, with the ultimate goal of guiding health-related initiatives at different levels of intervention. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Managing the Interoperability and Privacy of e-Health Systems as an Interdisciplinary Challenge

Directory of Open Access Journals (Sweden)

Alexandru Soceanu

2016-10-01

Full Text Available The growing number of patients with chronic diseases, the ageing population worldwide, the rapid increase in hospital costs and in the cost of care personnel as well as the achieving medical objectives "increase the patient quality of life and survival" face Europe with a huge challenge. One of the solutions for reaching these challenges in the future is the deployment of complex eHealth systems in support of all the healthcare aspects on the way between patient home and healthcare provider. In the last decade the European Commission (EC in cooperation with healthcare associations and standardization institutes announced large frameworks for supporting research and development of various components of the future eHealth systems. This may be considered as an immediate interdisciplinary opportunity for European researchers and developers to create jointly the spine of future healthcare systems. After a short introduction to eHealth architecture, interoperability, security and privacy the talk refers to the interdisciplinary solutions which approach these healthcare huge overall challenge. Two case studies will be addressed: a interdisciplinary partnership for conducting jointly European research concerning remote control and management of future wearable dialysis devices, and b ERASMUS supported international education programs for creating future interdisciplinary expert networks working on developing and implementing a better healthcare system.

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

Science.gov (United States)

Li, Zhaoqin; Xu, Dandan; Guo, Xulin

2014-11-07

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

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

Directory of Open Access Journals (Sweden)

Zhaoqin Li

2014-11-01

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

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

Science.gov (United States)

Li, Zhaoqin; Xu, Dandan; Guo, Xulin

2014-01-01

Maintaining a healthy ecosystem is essential for maximizing sustainable ecological services of the best quality to human beings. Ecological and conservation research has provided a strong scientific background on identifying ecological health indicators and correspondingly making effective conservation plans. At the same time, ecologists have asserted a strong need for spatially explicit and temporally effective ecosystem health assessments based on remote sensing data. Currently, remote sensing of ecosystem health is only based on one ecosystem attribute: vigor, organization, or resilience. However, an effective ecosystem health assessment should be a comprehensive and dynamic measurement of the three attributes. This paper reviews opportunities of remote sensing, including optical, radar, and LiDAR, for directly estimating indicators of the three ecosystem attributes, discusses the main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system, and provides some future perspectives. The main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system are: (1) scale issue; (2) transportability issue; (3) data availability; and (4) uncertainties in health indicators estimated from remote sensing data. However, the Radarsat-2 constellation, upcoming new optical sensors on Worldview-3 and Sentinel-2 satellites, and improved technologies for the acquisition and processing of hyperspectral, multi-angle optical, radar, and LiDAR data and multi-sensoral data fusion may partly address the current challenges. PMID:25386759

Community Based Research Network: Opportunities for Coordination of Care, Public Health Surveillance, and Farmworker Research

OpenAIRE

Cooper, Sharon P.; Heyer, Nicholas; Shipp, Eva M.; Ryder, E. Roberta; Hendrikson, Edward; Socias, Christina M; del Junco, Deborah J.; Valerio, Melissa; Partida, Sylvia

2014-01-01

Introduction: The lack of aggregated longitudinal health data on farmworkers has severely limited opportunities to conduct research to improve their health status. To correct this problem, we have created the infrastructure necessary to develop and maintain a national Research Data Repository of migrant and seasonal farmworker patients and other community members receiving medical care from Community and Migrant Health Centers (C/MHCs). Project specific research databases can be easily extrac...

eHealth literacy among undergraduate nursing students.

Science.gov (United States)

Tubaishat, Ahmad; Habiballah, Laila

2016-07-01

The Internet has become a major source of health related information. Nursing students, as future healthcare providers, should be skilled in locating, using and evaluating online health information. The main purpose of this study was to assess eHealth literacy among nursing students in Jordan, as well as to explore factors associated with eHealth literacy. A descriptive cross sectional survey was conducted in two universities in Jordan, one public and one private. A total of 541 students completed the eHealth literacy scale (eHEALS). Some additional personal and demographical variables were collected to explore their relation to eHealth literacy. Students have a moderate self-perceived level of eHealth literacy (M=3.62, SD=0.58). They are aware of the available online health resources and know how to search, locate, and use these resources. Yet, they lack skills to evaluate them and cannot differentiate between high and low quality resources. Factors that are related to eHealth literacy include type of university, type of student admission, academic level, students' internet skills, and their perception of the usefulness and importance of the internet. On the other hand, age, gender, grade point average (GPA), and frequency of internet use were found not to significantly affect eHealth literacy. This study represents a baseline reference for eHealth literacy in Jordan. Students have some of the necessary skills, while others still need to be improved. Nursing educators and administrators should incorporate eHealth literacy skills into the curriculum. Copyright © 2016 Elsevier Ltd. All rights reserved.

THEORETIC INCURSION IN THE IDENTIFICATION OF DETERMINANTS AND E-GOVERNMENT STRATEGY. EMPIRIC STUDY OVER THE GRADE OF IMPLEMENTATION OF E-GOVERNMENT IN BIHOR COUNTY

Directory of Open Access Journals (Sweden)

Pop Cohut Ioana

2012-07-01

Full Text Available We are currently witnessing an unprecedented development of new technologies, that offers great opportunities for the modernization of the society, it changes radically the way governments, businesses and citizens have the opportunity to obtain goods and services, the way in which public services are provided that become increasingly important for citizens, the way of obtaining and transmitting information, the way in which business connections are done, the interaction between different communities, etc.. From this point of view we research the way in which public strategies of achievement and implementation of model of e-government are shaped, model which can exploit the opportunities offered by new technologies and can implement roles for the citizen and public policy makers and implicitly of local and regional development. How the public sector should support the implementation of strategies of e-government, to polarize at the highest level all communities of interest, to provide a framework for planning and action across the board, covering local administration, institutions, organizations and government agencies, to empower appropriate training for implementation of IT strategies, can lead to stimulation of generators factors of local and regional development. We also, intend to identify, from carrying out an empirical study in Bihor county, by analysis of 30 public institutions, the degree of implementation of new technologies in public administration, human resources readiness for appropriate use of IT facilities and what level of implementation of e-government in these institutions, in order to outline the main characteristics and determinants of e-government implementation. The present paper is of interest to policy-makers, researchers, local communities through analysis how the introduction of new technology development in developing and implementing public policies, particularly by networking government and e-government, can cause

Validity and Reliability of the Iranian Version of eHealth Literacy Scale

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Soheila Bazm

2016-06-01

Full Text Available Abstract: Introduction:  The eHEALS is an 8-item measure of eHealth literacy developed to measure consumers’ combined knowledge, comfort, and perceived skills at finding, evaluating, and applying electronic health information to health problems. The current study aims to measure validity and reliability of the Iranian version of eHEALS questionnaire in a population context. Materials & Methods: A cross-sectional study was done on 525 youths people who has been chosen randomly in Iran, Yazd. We determined content validity, construct validity and predictive validity of the translated questionnaire. Principal components factor analysis was used to determine the theoretical fit of the measures with the data. The internal consistency of the translated questionnaire was evaluated using Cronbach α coefficient. The results were analyzed in SPSSv16. Results: The principal component analysis (PCA produced a single factor solution (70.48% of variance with factor loading ranging from 0.723 to 0.862. The internal consistency of the scale was sufficient (alpha=0.88 , P<0.001 and the test-retest coefficients for the items were reliable (r= 0.96, P<0.001. Discussion: The results of the study showed that the items in the translated questionnaire were equivalent to the original scale .The version of the eHEALS questionnaire showed both good reliability and validity for the screening of eHealth literacy of Iranian people.

Professionalism in a digital age: opportunities and considerations for using social media in health care.

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Gagnon, Kendra; Sabus, Carla

2015-03-01

Since the beginning of the millennium, there has been a remarkable change in how people access and share information. Much of this information is user-generated content found on social media sites. As digital technologies and social media continue to expand, health care providers must adapt their professional communication to meet the expectations and needs of consumers. This adaptation may include communication on social media sites. However, many health care providers express concerns that professional social media use, particularly interactions with patients, is ethically problematic. Social media engagement does not create ethical dissonance if best practices are observed and online communication adheres to terms of service, professional standards, and organizational policy. A well-executed social media presence provides health care providers, including physical therapists, the opportunity-and perhaps a professional obligation-to use social media sites to share or create credible health care information, filling a consumer void for high-quality online information on fitness, wellness, and rehabilitation. This perspective article provides a broad review of the emergence of social media in society and health care, explores policy implications of organizational adoption of health care social media, and proposes individual opportunities and guidelines for social media use by the physical therapy professional. © 2015 American Physical Therapy Association.

Why Business Modeling is Crucial in the Development of eHealth Technologies

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van Gemert-Pijnen, Julia EWC; Nijland, Nicol; Ossebaard, Hans C; Hendrix, Ron MG; Seydel, Erwin R

2011-01-01

The impact and uptake of information and communication technologies that support health care are rather low. Current frameworks for eHealth development suffer from a lack of fitting infrastructures, inability to find funding, complications with scalability, and uncertainties regarding effectiveness and sustainability. These issues can be addressed by defining a better implementation strategy early in the development of eHealth technologies. A business model, and thus business modeling, help to determine such an implementation strategy by involving all important stakeholders in a value-driven dialogue on what the technology should accomplish. This idea also seems promising to eHealth, as it can contribute to the whole development of eHealth technology. We therefore suggest that business modeling can be used as an effective approach to supporting holistic development of eHealth technologies. The contribution of business modeling is elaborated in this paper through a literature review that covers the latest business model research, concepts from the latest eHealth and persuasive technology research, evaluation and insights from our prior eHealth research, as well as the review conducted in the first paper of this series. Business modeling focuses on generating a collaborative effort of value cocreation in which all stakeholders reflect on the value needs of the others. The resulting business model acts as the basis for implementation. The development of eHealth technology should focus more on the context by emphasizing what this technology should contribute in practice to the needs of all involved stakeholders. Incorporating the idea of business modeling helps to cocreate and formulate a set of critical success factors that will influence the sustainability and effectiveness of eHealth technology. PMID:22204896

Why business modeling is crucial in the development of eHealth technologies.

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van Limburg, Maarten; van Gemert-Pijnen, Julia E W C; Nijland, Nicol; Ossebaard, Hans C; Hendrix, Ron M G; Seydel, Erwin R

2011-12-28

The impact and uptake of information and communication technologies that support health care are rather low. Current frameworks for eHealth development suffer from a lack of fitting infrastructures, inability to find funding, complications with scalability, and uncertainties regarding effectiveness and sustainability. These issues can be addressed by defining a better implementation strategy early in the development of eHealth technologies. A business model, and thus business modeling, help to determine such an implementation strategy by involving all important stakeholders in a value-driven dialogue on what the technology should accomplish. This idea also seems promising to eHealth, as it can contribute to the whole development of eHealth technology. We therefore suggest that business modeling can be used as an effective approach to supporting holistic development of eHealth technologies. The contribution of business modeling is elaborated in this paper through a literature review that covers the latest business model research, concepts from the latest eHealth and persuasive technology research, evaluation and insights from our prior eHealth research, as well as the review conducted in the first paper of this series. Business modeling focuses on generating a collaborative effort of value cocreation in which all stakeholders reflect on the value needs of the others. The resulting business model acts as the basis for implementation. The development of eHealth technology should focus more on the context by emphasizing what this technology should contribute in practice to the needs of all involved stakeholders. Incorporating the idea of business modeling helps to cocreate and formulate a set of critical success factors that will influence the sustainability and effectiveness of eHealth technology.

Patient Communication in Health Care Settings: new Opportunities for Augmentative and Alternative Communication.

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Blackstone, Sarah W; Pressman, Harvey

2016-01-01

Delivering quality health care requires effective communication between health care providers and their patients. In this article, we call on augmentative and alternative communication (AAC) practitioners to offer their knowledge and skills in support of a broader range of patients who confront communication challenges in health care settings. We also provide ideas and examples about ways to prepare people with complex communication needs for the inevitable medical encounters that they will face. We argue that AAC practitioners, educators, and researchers have a unique role to play, important expertise to share, and an extraordinary opportunity to advance the profession, while positively affecting patient outcomes across the health care continuum for a large number of people.

Factors determining access to oral health services among children aged less than 12 years in Peru.

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Azañedo, Diego; Hernández-Vásquez, Akram; Casas-Bendezú, Mixsi; Gutiérrez, César; Agudelo-Suárez, Andrés A; Cortés, Sandra

2017-01-01

Background: Understanding problems of access to oral health services requires knowledge of factors that determine access. This study aimed to evaluate factors that determine access to oral health services among children aged Encuesta Demográfica y de Salud Familiar - ENDES). Children's access to oral health services within the previous 6 months was used as the dependent variable (i.e. Yes/No), and the Andersen and col model was used to select independent variables. Predisposing (e.g., language spoken by  tutor or guardian, wealth level, caregivers' educational level, area of residence, natural region of residence, age, and sex) and enabling factors (e.g. type of health insurance) were considered. Descriptive statistics were calculated, and multivariate analysis was performed using generalized linear models (Poisson family). Results: Of all the children, 51% were males, 56% were aged oral health services among children aged oral health services.

E-commerce opens up new opportunities for energy trading in the competitive markets; eCommerce: Neue Chancen im Energiewettbewerb

Energy Technology Data Exchange (ETDEWEB)

Titzrath, B. [Anderson Consulting Unternehmensberatung GmbH, Duesseldorf (Germany); Scholtissek, S.

2000-09-01

The article discusses the opportunities opened up for energy supply companies in building or maintaining their competitive edge in the rapidly changing competitive environment. Pitfalls are described, and successful e-commerce strategies employing all available tools are explained, referring to the business-to-business segment as well as customer relationship management. (orig./CB) [German] Die Electronic Economy stellt die Energieversorgungsunternehmen (EVU) nicht nur vor Herausforderungen, sondern eroeffnet auch grosse Chancen. Es ist jedoch Vorsicht geboten. Wer hier nicht seine eigene eCommerce-Strategie entwickelt und implementiert, dem drohen Marktanteilsverluste. (orig./CB)

Strategic leadership will be essential for dietitian eHealth readiness: A qualitative study exploring dietitian perspectives of eHealth readiness.

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Maunder, Kirsty; Walton, Karen; Williams, Peter; Ferguson, Maree; Beck, Eleanor

2018-05-16

To explore dietitians' perspectives on the eHealth readiness of Australian dietitians, and to identify strategies to improve eHealth readiness of the profession. Dietitians who met the criteria for nutrition informatics experts participated in semi-structured interviews between June 2016 and March 2017. The interviews were recorded and transcribed verbatim. Thematic analysis using coding was undertaken until consensus was reached by the researchers regarding key themes, topics and exemplar quotes. Interviews with 10 nutrition informatics experts revealed 25 discussion topics grouped into four main themes: benefits of eHealth for dietitians; risks of dietitians not being involved in eHealth; dietitians are not ready for eHealth; and strategies to improve eHealth readiness. The strategies identified for improving eHealth readiness included: collaboration and representation, education, offering of incentives and mentoring, as well as development of a national strategy, organisational leaders, nutrition informatics champions and a supportive environment. These findings suggest that dietitians may not be ready for eHealth. Strategic leadership and the actioning of other identified strategies will be imperative to preparing dietitians for eHealth to ensure the profession can practice effectively in the digital age, optimise nutrition care and support research for eHealth. If dietitians do not engage in eHealth, others may take their place, or dietitians may be forced to use eHealth in ways that are not the most effective for practice or maximising patient outcomes. © 2018 Dietitians Association of Australia.

Training medical students in the social determinants of health: the Health Scholars Program at Puentes de Salud

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O’Brien MJ

2014-09-01

Full Text Available Matthew J O’Brien,1–4 Joseph M Garland,4,5 Katie M Murphy,4,6,7 Sarah J Shuman,3,4 Robert C Whitaker,1,3,8 Steven C Larson4,9 1Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA; 2Department of Medicine, Section of General Internal Medicine, Temple University of Medicine, Philadelphia, PA, USA; 3Department of Public Health, Temple University, Philadelphia, PA, USA; 4Puentes de Salud Health Center, Philadelphia, PA, USA; 5Department of Medicine, Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 6Master of Public Health Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 7Graduate School of Education, University of Pennsylvania, Philadelphia, PA, USA; 8Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA, USA; 9Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Purpose: Given the large influence of social conditions on health, physicians may be more effective if they are trained to identify and address social factors that impact health. Despite increasing interest in teaching the social determinants of health in undergraduate medical education, few models exist. Participants and methods: We present a 9-month pilot course on the social determinants of health for medical and other health professional students, which is based at Puentes de Salud, Philadelphia, PA, USA, a community health center serving a Latino immigrant population. This service-learning course, called the Health Scholars Program (HSP, was developed and implemented by volunteer medical and public health faculty in partnership with the community-based clinic. The HSP curriculum combines didactic instruction with service experiences at Puentes de Salud and opportunities for critical reflection. The HSP curriculum also includes a longitudinal project where

Value-added benefits of technology: e-procurement and e-commerce related to the health care industry.

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Smith, Alan D; Correa, Joseph

2005-01-01

To provide insights into the current supply chain for original equipment manufacturers (OEM) in the radiology diagnostic imaging equipment business. As is common in many manufacturing and service firms, the rationale of bridging suppliers of OEMs is the ability to leverage technology, software, and accessories pertaining to the various pieces of equipment. Several models of e-procurement and e-commerce related to the health care industry are presented. Although the radiology capital equipment market presents numerous idiosyncrasies that must be addressed to successfully implement an e-business strategy effectively, incredible opportunities exist all along the supply chain for e-business strategies to both eliminate costs and acquire strategic initiatives. Those firms that most successfully listen to their customers and address the barriers to efficiency (B2E) will help move the industry toward more effective utilization of the benefits e-business can create and also obtain first mover advantages. Although the efficiencies that e-business provides are extremely important in the radiology capital equipment market, the main value of e-business in this industry of high-priced and relatively infrequently purchased equipment may well be the value-added benefits the technology brings to its customers, as illustrated in the modeling process. The OEMs that eventually market their finished product directly to hospital and imaging centers via a direct sales force can best take advantage of the connectivity and accessibility of e-commerce.

CLOUD-POWERED e-HEALTH

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Liviu Cristian STEFAN

2013-09-01

Full Text Available During the last years, the global economic crisis has affected all domains, including the health sector. Many governments have considered that the solution to this problem is to reduce public expenses on healthcare, to decrease the budgets for health services, to rationalize the medical plans for the population, to increase the share of health expenditure paid by patients and to select the products on the pharmaceutical market.In order to improve the medical service whilst maintaining reduced infrastructure costs, the new digital technologies offer the solution of cloud-based services for the e-health systems.In this paper we present the cloud-hosted healthcare applications concept, the advantages of using e-Health on distributed platforms and some considerations about the security levels. Also, we further present an experiment based on the free OpenEMR solution, which has also a cloud version, ZH-Services OpenEMR.

Opportunities and challenges to promoting oral health in primary schools.

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Gill, P; Chestnutt, I G; Channing, D

2009-09-01

Inequalities in oral health in areas of socio-economic disadvantage are well recognised. As children spend a considerable proportion of their lives in education, schools can play a significant role in promoting children's health and oral health. However, to what extent schools are able to do this is unclear. The aim of this study was therefore to investigate opportunities and challenges to promoting oral health in primary schools. A purposive sample of 20 primary schools from socially and economically disadvantaged areas of Cardiff, UK were selected to participate in this qualitative study. Data were collected through semi-structured interviews conducted with head teachers or their nominated deputies. General awareness of health and oral health was good, with all schools promoting the consumption of fruit, water and milk and discouraging products such as carbonated drinks and confectionaries. Health promotion schemes wereimplemented primarily to improve the health of the children, although schools felt they also offered the potential to improve classroom behaviour and attendance. However, oral health was viewed as a separate entity to general health and perceived to be inadequately promoted. Successful health promotion schemes were also influenced by the attitudes of headteachers. Most schools had no or limited links with local dental services and, or oral health educators, although such input, when it occurred, was welcomed and highly valued. Knowledge of how to handle dental emergencies was limited and only two schools operated toothbrushing schemes, although all expressed an interest in such programmes. This study identified a positive predisposition to promoting health in primary schools. The challenge for the dental team, however, is to promote and integrate oral health into mainstream health promotion activities in schools. The paper also makes recommendations for further research.

Survey determinant factors of telemedicine strategic planning from the managers and experts perspective in the health department, isfahan university of medical sciences.

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Keshvari, Hamid; Haddadpoor, Asefeh; Taheri, Behjat; Nasri, Mehran; Aghdak, Pezhman

2014-10-01

Awareness of Outlook, objectives, benefits and impact of telemedicine technology that can promote services quality, reduce costs, increase access to Specialized and subspecialty services, and immediately guide the health system subconsciously to the introduction greater use of technology. Therefore, the aim of this study was to determine the strengths, weaknesses, opportunities and threats in the telemedicine strategic planning from the managers and experts perspective in the health department, Isfahan University of Medical Sciences, in order to take a step towards facilitating strategic planning and approaching the equity aim in health in the province. This is a descriptive-analytical study, that data collection was done cross-sectional. The study population was composed of all managers and certified experts at the health department in Isfahan university of Medical Sciences. The sample size was 60 patients according to inclusion criteria. Information was collected by interview method. Researcher attempted to use the structured and specific questionnaire Then were investigated the viewpoints of experts and managers about determinative factors (strengths, weaknesses, opportunities and threats) in the strategic planning telemedicine. Data were analyzed using descriptive statistics (frequency, mean) and software SPSS 19. Data analysis showed that change management (100%) and continuity of supply of credit (79/3%) were weakness point within the organization and strengths of the program were, identity and health telemedicine programs (100%), goals and aspirations of the current directors of the organization and its compliance with the goals of telemedicine (100%), human resources interested using computers in daily activities in peripheral levels (93/1%). Also organization in the field of IT professionals, had opportunities, and repayment specialist's rights by insurance organizations is a threat for it. According to the strengths, weaknesses, opportunities and threats

Multi-Sectoral Action for Addressing Social Determinants of Noncommunicable Diseases and Mainstreaming Health Promotion in National Health Programmes in India

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Monika Arora

2011-01-01

Full Text Available Major noncommunicable diseases (NCDs share common behavioral risk factors and deep-rooted social determinants. India needs to address its growing NCD burden through health promoting partnerships, policies, and programs. High-level political commitment, inter-sectoral coordination, and community mobilization are important in developing a successful, national, multi-sectoral program for the prevention and control of NCDs. The World Health Organization′s "Action Plan for a Global Strategy for Prevention and Control of NCDs" calls for a comprehensive plan involving a whole-of-Government approach. Inter-sectoral coordination will need to start at the planning stage and continue to the implementation, evaluation of interventions, and enactment of public policies. An efficient multi-sectoral mechanism is also crucial at the stage of monitoring, evaluating enforcement of policies, and analyzing impact of multi-sectoral initiatives on reducing NCD burden in the country. This paper presents a critical appraisal of social determinants influencing NCDs, in the Indian context, and how multi-sectoral action can effectively address such challenges through mainstreaming health promotion into national health and development programs. India, with its wide socio-cultural, economic, and geographical diversities, poses several unique challenges in addressing NCDs. On the other hand, the jurisdiction States have over health, presents multiple opportunities to address health from the local perspective, while working on the national framework around multi-sectoral aspects of NCDs.

E-learning for health professionals.

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Vaona, Alberto; Banzi, Rita; Kwag, Koren H; Rigon, Giulio; Cereda, Danilo; Pecoraro, Valentina; Tramacere, Irene; Moja, Lorenzo

2018-01-21

The use of e-learning, defined as any educational intervention mediated electronically via the Internet, has steadily increased among health professionals worldwide. Several studies have attempted to measure the effects of e-learning in medical practice, which has often been associated with large positive effects when compared to no intervention and with small positive effects when compared with traditional learning (without access to e-learning). However, results are not conclusive. To assess the effects of e-learning programmes versus traditional learning in licensed health professionals for improving patient outcomes or health professionals' behaviours, skills and knowledge. We searched CENTRAL, MEDLINE, Embase, five other databases and three trial registers up to July 2016, without any restrictions based on language or status of publication. We examined the reference lists of the included studies and other relevant reviews. If necessary, we contacted the study authors to collect additional information on studies. Randomised trials assessing the effectiveness of e-learning versus traditional learning for health professionals. We excluded non-randomised trials and trials involving undergraduate health professionals. Two authors independently selected studies, extracted data and assessed risk of bias. We graded the certainty of evidence for each outcome using the GRADE approach and standardised the outcome effects using relative risks (risk ratio (RR) or odds ratio (OR)) or standardised mean difference (SMD) when possible. We included 16 randomised trials involving 5679 licensed health professionals (4759 mixed health professionals, 587 nurses, 300 doctors and 33 childcare health consultants).When compared with traditional learning at 12-month follow-up, low-certainty evidence suggests that e-learning may make little or no difference for the following patient outcomes: the proportion of patients with low-density lipoprotein (LDL) cholesterol of less than 100 mg

Building National eHealth Platforms

DEFF Research Database (Denmark)

Vassilakopoulou, Polyxeni; Grisot, Miria; Jensen, Tina Blegind

2017-01-01

, the coordination of work among multiple contributors, and, the handling of technical heterogeneity within the pre-existing and continuous evolving eHealth landscape. Inclusiveness is related both to the character of public platforms as “common goods”, and, to growth ambitions for public eHealth. The aim...

Gay-Straight Alliances as Settings to Discuss Health Topics: Individual and Group Factors Associated with Substance Use, Mental Health, and Sexual Health Discussions

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Poteat, V. P.; Heck, N. C.; Yoshikawa, H.; Calzo, J. P.

2017-01-01

Sexual minority (e.g. lesbian, gay, bisexual, questioning; LGBQ) and gender minority (e.g. transgender) youth experience myriad health risks. Gay-Straight Alliances (GSAs) are school-based settings where they may have opportunities to discuss substance use, mental health, and sexual health issues in ways that are safe and tailored to their…

Application of strengths, weaknesses, opportunities and threats analysis in the development of a health technology assessment program.

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Gibis, B; Artiles, J; Corabian, P; Meiesaar, K; Koppel, A; Jacobs, P; Serrano, P; Menon, D

2001-10-01

There has been recent interest in developing a health technology assessment (HTA) function in Estonia. A group of individuals knowledgeable about HTA in Canada, Germany, Romania and Spain, along with representatives of the University of Tartu, Estonia, was convened by the Institute of Health Economics in Edmonton, Canada, to consider options for such a function. In a one-day workshop strengths, weaknesses, opportunities and threats (SWOT) analyses of HTA were conducted, first at a 'global' level, and then of the Estonian situation. The 'global' SWOT analysis yielded a large number of items that pertain to institutionalized HTA in a generic sense, i.e. not based on any individual HTA agency. The 'Estonian' SWOT yielded a subset of items, which pertain to development of HTA in that country. Ten actionable steps were then developed on the basis of this subset, which could be used to initiate the creation of an HTA body in Estonia.

National eHealth strategy toolkit

CERN Document Server

2012-01-01

Worldwide the application of information and communication technologies to support national health-care services is rapidly expanding and increasingly important. This is especially so at a time when all health systems face stringent economic challenges and greater demands to provide more and better care especially to those most in need. The National eHealth Strategy Toolkit is an expert practical guide that provides governments their ministries and stakeholders with a solid foundation and method for the development and implementation of a national eHealth vision action plan and monitoring fram

Health Informatics and E-health Curriculum for Clinical Health Profession Degrees.

Science.gov (United States)

Gray, Kathleen; Choo, Dawn; Butler-Henderson, Kerryn; Whetton, Sue; Maeder, Anthony

2015-01-01

The project reported in this paper models a new approach to making health informatics and e-health education widely available to students in a range of Australian clinical health profession degrees. The development of a Masters level subject uses design-based research to apply educational quality assurance practices which are consistent with university qualification frameworks, and with clinical health profession education standards; at the same time it gives recognition to health informatics as a specialised profession in its own right. The paper presents details of (a) design with reference to the Australian Qualifications Framework and CHIA competencies, (b) peer review within a three-university teaching team, (c) external review by experts from the professions, (d) cross-institutional interprofessional online learning, (e) methods for evaluating student learning experiences and outcomes, and (f) mechanisms for making the curriculum openly available to interested parties. The project has sought and found demand among clinical health professionals for formal health informatics and e-health education that is designed for them. It has helped the educators and organisations involved to understand the need for nuanced and complementary health informatics educational offerings in Australian universities. These insights may aid in further efforts to address substantive and systemic challenges that clinical informatics faces in Australia.

Examining E-Loyalty in a Sexual Health Website: Cross-Sectional Study.

Science.gov (United States)

Nunn, Alexandra; Crutzen, Rik; Haag, Devon; Chabot, Cathy; Carson, Anna; Ogilvie, Gina; Shoveller, Jean; Gilbert, Mark

2017-11-02

deliberately engender. Our findings indicate that understanding a website contributes to active trust, thereby highlighting the importance of considering eHealth literacy in designing health promotion websites. Our study confirms the relevance of e-loyalty as an outcome for evaluating the antecedents of the use and efficacy of online public health interventions across disciplines by adapting and validating an existing e-loyalty framework to the field of sexual health promotion. Our findings suggest that e-loyalty is positively associated with measures of website efficacy, including increased knowledge and intent to change behavior. Longitudinal research with larger samples could further investigate the relationships between e-loyalty, website understandability, and outcomes of online health interventions to determine how the manipulation of website characteristics may impact user perceptions and e-loyalty. ©Alexandra Nunn, Rik Crutzen, Devon Haag, Cathy Chabot, Anna Carson, Gina Ogilvie, Jean Shoveller, Mark Gilbert. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 02.11.2017.

[NAFTA: a challenge and an opportunity for environmental health. The case of the maquila industry].

Science.gov (United States)

Espinosa-Torres, F; Hernández-Avila, M; López-Carrillo, L

1994-01-01

The three countries that have signed the North American Free Trade Agreement (NAFTA) have focused particular interest and concern on the potential impact that this agreement will have on the environmental health, based on the premise that economical development should not detriment neither the environment nor the human health. In this paper, the NAFTA is presented as an opportunity to improve environmental and occupational health in Mexico and assumes that the study of the potential impact of NAFTA could help to find the solutions of the former and actual environmental health problems. From this perspective, the north-border maquila industry is analyzed as a case study for the purpose of identifying and predicting the impact of NAFTA on environmental and the occupational health. Preventive as well as control measurements are suggested. The general characteristics of the U.S.-Mexico border and the maquila industry are presented. The lack of both social investment and urban planning along with population and economical growth are described. An explanation of the impact that these factors have had on the environmental and occupational problems is discussed. Special emphasis is given to the human health problems including that of water, air and soil contamination by industrial toxic residues. Also, some possible health impact of NAFTA are outlined. Finally a sustainable developmental intervention is suggested, based on NAFTA as an opportunity to take advantage of coming structural changes that will improve the environmental health conditions at the northern-border and in the entire country.

20 CFR 664.420 - What are leadership development opportunities?

Science.gov (United States)

2010-04-01

..., including team leadership training; (e) Training in decision-making, including determining priorities; and... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are leadership development opportunities? 664.420 Section 664.420 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF...

The Importance of Computer Science for Public Health Training: An Opportunity and Call to Action.

Science.gov (United States)

Kunkle, Sarah; Christie, Gillian; Yach, Derek; El-Sayed, Abdulrahman M

2016-01-01

A century ago, the Welch-Rose Report established a public health education system in the United States. Since then, the system has evolved to address emerging health needs and integrate new technologies. Today, personalized health technologies generate large amounts of data. Emerging computer science techniques, such as machine learning, present an opportunity to extract insights from these data that could help identify high-risk individuals and tailor health interventions and recommendations. As these technologies play a larger role in health promotion, collaboration between the public health and technology communities will become the norm. Offering public health trainees coursework in computer science alongside traditional public health disciplines will facilitate this evolution, improving public health's capacity to harness these technologies to improve population health.

E-smoking: Emerging public health problem?

Directory of Open Access Journals (Sweden)

Mateusz Jankowski

2017-06-01

Full Text Available E-cigarette use has become increasingly popular, especially among the young. Its long-term influence upon health is unknown. Aim of this review has been to present the current state of knowledge about the impact of e-cigarette use on health, with an emphasis on Central and Eastern Europe. During the preparation of this narrative review, the literature on e-cigarettes available within the network PubMed was retrieved and examined. In the final review, 64 research papers were included. We specifically assessed the construction and operation of the e-cigarette as well as the chemical composition of the e-liquid; the impact that vapor arising from the use of e-cigarette explored in experimental models in vitro; and short-term effects of use of e-cigarettes on users’ health. Among the substances inhaled by the e-smoker, there are several harmful products, such as: formaldehyde, acetaldehyde, acroleine, propanal, nicotine, acetone, o-methyl-benzaldehyde, carcinogenic nitrosamines. Results from experimental animal studies indicate the negative impact of e-cigarette exposure on test models, such as ascytotoxicity, oxidative stress, inflammation, airway hyper reactivity, airway remodeling, mucin production, apoptosis, and emphysematous changes. The short-term impact of e-cigarettes on human health has been studied mostly in experimental setting. Available evidence shows that the use of e-cigarettes may result in acute lung function responses (e.g., increase in impedance, peripheral airway flow resistance and induce oxidative stress. Based on the current available evidence, e-cigarette use is associated with harmful biologic responses, although it may be less harmful than traditional cigarettes. Int J Occup Med Environ Health 2017;30(3:329–344

An e-learning supported Train-the-Trainer program to implement a suicide practice guideline. Rationale, content and dissemination in Dutch mental health care.

NARCIS (Netherlands)

Groot, M. de; Beurs, D.P. de; Keijser, J. de; Kerkhof, A.F.J.M.

2015-01-01

An e-learning supported Train-the-Trainer program was developed to implement the Dutch suicide practice guideline inmental health care. Literature on implementation strategies has been restricted to the final reporting of studieswith little opportunity to describe relevant contextual, developmental

How to improve eHealth interventions in Health Psychology and Behavioral Medicine

NARCIS (Netherlands)

van Gemert-Pijnen, Julia E.W.C.; Kulyk, Olga Anatoliyivna; Wentzel, M.J.; Sieverink, Floor; Beerlage-de Jong, Nienke; Kelders, Saskia Marion

2014-01-01

Introduction: eHealth is gaining more and more ground in health psychology and behavioural medicine to support wellbeing, a healthier lifestyle or adherence to medications. Despite the large number of eHealth projects to date, the actual use of eHealth interventions is lower than expected. Many

The great opportunity: Evolutionary applications to medicine and public health.

Science.gov (United States)

Nesse, Randolph M; Stearns, Stephen C

2008-02-01

Evolutionary biology is an essential basic science for medicine, but few doctors and medical researchers are familiar with its most relevant principles. Most medical schools have geneticists who understand evolution, but few have even one evolutionary biologist to suggest other possible applications. The canyon between evolutionary biology and medicine is wide. The question is whether they offer each other enough to make bridge building worthwhile. What benefits could be expected if evolution were brought fully to bear on the problems of medicine? How would studying medical problems advance evolutionary research? Do doctors need to learn evolution, or is it valuable mainly for researchers? What practical steps will promote the application of evolutionary biology in the areas of medicine where it offers the most? To address these questions, we review current and potential applications of evolutionary biology to medicine and public health. Some evolutionary technologies, such as population genetics, serial transfer production of live vaccines, and phylogenetic analysis, have been widely applied. Other areas, such as infectious disease and aging research, illustrate the dramatic recent progress made possible by evolutionary insights. In still other areas, such as epidemiology, psychiatry, and understanding the regulation of bodily defenses, applying evolutionary principles remains an open opportunity. In addition to the utility of specific applications, an evolutionary perspective fundamentally challenges the prevalent but fundamentally incorrect metaphor of the body as a machine designed by an engineer. Bodies are vulnerable to disease - and remarkably resilient - precisely because they are not machines built from a plan. They are, instead, bundles of compromises shaped by natural selection in small increments to maximize reproduction, not health. Understanding the body as a product of natural selection, not design, offers new research questions and a framework for

Missed Opportunities for Chronic Diseases Prevention in a Primary Health Care Center in Istanbul

OpenAIRE

Ahmet Topuzoglu; Seyhan Hidiroglu; M.Fatih Onsuz; Gulsen Polat

2011-01-01

Aim: The aim of the study was to investigate missed opportunities about chronic diseases and related risk factors in a primary health care center in Istanbul. Method: This cross sectional study was held in a Primary Health Care Center in Istanbul with the study population consisted of 500 people which were applicated in one month period. Participants were asked; if they were questioned by their physician about major risk factors (smoking, obesity, diabetes mellitus, hypertension, coroner hear...

Security Attacks and Solutions in Electronic Health (E-health) Systems.

Science.gov (United States)

Zeadally, Sherali; Isaac, Jesús Téllez; Baig, Zubair

2016-12-01

For centuries, healthcare has been a basic service provided by many governments to their citizens. Over the past few decades, we have witnessed a significant transformation in the quality of healthcare services provided by healthcare organizations and professionals. Recent advances have led to the emergence of Electronic Health (E-health), largely made possible by the massive deployment and adoption of information and communication technologies (ICTs). However, cybercriminals and attackers are exploiting vulnerabilities associated primarily with ICTs, causing data breaches of patients' confidential digital health information records. Here, we review recent security attacks reported for E-healthcare and discuss the solutions proposed to mitigate them. We also identify security challenges that must be addressed by E-health system designers and implementers in the future, to respond to threats that could arise as E-health systems become integrated with technologies such as cloud computing, the Internet of Things, and smart cities.

Determinants of use of health facility for childbirth in rural Hadiya zone, Southern Ethiopia.

Science.gov (United States)

Asseffa, Netsanet Abera; Bukola, Fawole; Ayodele, Arowojolu

2016-11-16

Maternal mortality remains a major global public health concern despite many international efforts. Facility-based childbirth increases access to appropriate skilled attendance and emergency obstetric care services as the vast majority of obstetric complications occur during delivery. The purpose of the study was to determine the proportion of facility delivery and assess factors influencing utilization of health facility for childbirth. A cross-sectional study was conducted in two rural districts of Hadiya zone, southern Ethiopia. Participants who delivered within three years of the survey were selected by stratified random sampling. Trained interviewers administered a pre-tested semi-structured questionnaire. We employed bivariate analysis and logistic regression to identify determinants of facility-based delivery. Data from 751 participants showed that 26.9% of deliveries were attended in health facilities. In bivariate analysis, maternal age, education, husband's level of education, possession of radio, antenatal care, place of recent ANC attended, planned pregnancy, wealth quintile, parity, birth preparedness and complication readiness, being a model family and distance from the nearest health facility were associated with facility delivery. On multiple logistic regression, age, educational status, antenatal care, distance from the nearest health facility, wealth quintile, being a model family, planned pregnancy and place of recent ANC attended were the determinants of facility-based childbirth. Efforts to improve institutional deliveries in the region must strengthen initiatives that promote female education, opportunities for wealth creation, female empowerment and increased uptake of family planning among others. Service related barriers and cultural influences on the use of health facility for childbirth require further evaluation.

eHealth and mHealth initiatives in Bangladesh: A scoping study

Science.gov (United States)

2014-01-01

Background The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. Methods This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O’Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Results Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. Conclusion This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth

eHealth and mHealth initiatives in Bangladesh: a scoping study.

Science.gov (United States)

Ahmed, Tanvir; Lucas, Henry; Khan, Azfar Sadun; Islam, Rubana; Bhuiya, Abbas; Iqbal, Mohammad

2014-06-16

The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O'Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth and mHealth initiatives successfully

E-smoking: Emerging public health problem?

Science.gov (United States)

Jankowski, Mateusz; Brożek, Grzegorz; Lawson, Joshua; Skoczyński, Szymon; Zejda, Jan Eugeniusz

2017-05-08

E-cigarette use has become increasingly popular, especially among the young. Its long-term influence upon health is unknown. Aim of this review has been to present the current state of knowledge about the impact of e-cigarette use on health, with an emphasis on Central and Eastern Europe. During the preparation of this narrative review, the literature on e-cigarettes available within the network PubMed was retrieved and examined. In the final review, 64 research papers were included. We specifically assessed the construction and operation of the e-cigarette as well as the chemical composition of the e-liquid; the impact that vapor arising from the use of e-cigarette explored in experimental models in vitro; and short-term effects of use of e-cigarettes on users' health. Among the substances inhaled by the e-smoker, there are several harmful products, such as: formaldehyde, acetaldehyde, acroleine, propanal, nicotine, acetone, o-methyl-benzaldehyde, carcinogenic nitrosamines. Results from experimental animal studies indicate the negative impact of e-cigarette exposure on test models, such as ascytotoxicity, oxidative stress, inflammation, airway hyper reactivity, airway remodeling, mucin production, apoptosis, and emphysematous changes. The short-term impact of e-cigarettes on human health has been studied mostly in experimental setting. Available evidence shows that the use of e-cigarettes may result in acute lung function responses (e.g., increase in impedance, peripheral airway flow resistance) and induce oxidative stress. Based on the current available evidence, e-cigarette use is associated with harmful biologic responses, although it may be less harmful than traditional cigarettes. Int J Occup Med Environ Health 2017;30(3):329-344. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Peace corps partnered health services implementation research in global health: opportunity for impact.

Science.gov (United States)

Dykens, Andrew; Hedrick, Chris; Ndiaye, Youssoupha; Linn, Annē

2014-09-01

, the contributions of each partner are as follows: the local community and health system leadership guides the work in consideration of local priorities and context; the Peace Corps provides logistical support, community expertise, and local trust; and the academic institutions offer professional technical and public health educational and training resources and research support. The Peace Corps offers the opportunity to enhance a community-academic partnership in LMICs through community-level guidance, logistical assistance, and research support for community based participatory primary health-care services implementation research that addresses local primary healthcare priorities.

eHealth Literacy: Essential Skills for Consumer Health in a Networked World.

Science.gov (United States)

Norman, Cameron D; Skinner, Harvey A

2006-06-16

Electronic health tools provide little value if the intended users lack the skills to effectively engage them. With nearly half the adult population in the United States and Canada having literacy levels below what is needed to fully engage in an information-rich society, the implications for using information technology to promote health and aid in health care, or for eHealth, are considerable. Engaging with eHealth requires a skill set, or literacy, of its own. The concept of eHealth literacy is introduced and defined as the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem. In this paper, a model of eHealth literacy is introduced, comprised of multiple literacy types, including an outline of a set of fundamental skills consumers require to derive direct benefits from eHealth. A profile of each literacy type with examples of the problems patient-clients might present is provided along with a resource list to aid health practitioners in supporting literacy improvement with their patient-clients across each domain. Facets of the model are illustrated through a set of clinical cases to demonstrate how health practitioners can address eHealth literacy issues in clinical or public health practice. Potential future applications of the model are discussed.

Innovative Approaches in Chronic Disease Management: Health Literacy Solutions and Opportunities for Research Validation.

Science.gov (United States)

Villaire, Michael; Gonzalez, Diana Peña; Johnson, Kirby L

2017-01-01

This chapter discusses the need for innovative health literacy solutions to combat extensive chronic disease prevalence and costs. The authors explore the intersection of chronic disease management and health literacy. They provide specific examples of successful health literacy interventions for managing several highly prevalent chronic diseases. This is followed by suggestions on pairing research and practice to support effective disease management programs. In addition, the authors discuss strategies for collection and dissemination of knowledge gained from collaborations between researchers and practitioners. They identify current challenges specific to disseminating information from the health literacy field and offer potential solutions. The chapter concludes with a brief look at future directions and organizational opportunities to integrate health literacy practices to address the need for effective chronic disease management.

An integrative ICT platform for eHealth

CSIR Research Space (South Africa)

Alberts, Ronell

2014-05-01

Full Text Available Both eHealth and mHealth have much potential for efficient and effective health service delivery. However, fragmentation of applications and the lack of interoperability have been identified as major challenges for the effective deployment of eHealth...

An e-health trend plan for the Jordanian health care system: a review.

Science.gov (United States)

Rawabdeh, Ali Ahamd Awad

2007-01-01

The purpose of this research is to examine the potential of e-health by focusing explicitly on the delivery of health care products and services. The examination of e-health activity is guided by one broad research question, "What is the potential for constructing e-health strategy as an innovative health technology?". A great amount of attention has been given to e-health activity in the present day. However important this form of e-health is, this type of service simply does not face the same constraints that must be addressed by those actually delivering health care services. The researchers employed a qualitative data collection technique to formulate more examples and cases to derive lessons for Jordan. Phone interviews in a random sample were conducted with corporate officers in Jordan in order to reveal the internal organizational structure and business trends, interface issues, marketing strategies, as well as comparing and contrasting the online health world to the traditional health care realm. Internet-related projects is a top priority for health care information technology executives in the present day, with a cautious approach toward "e-health", as many products have yet to mature, and that the "click and mortar" model may perhaps be the optimal strategy for e-health in Jordan. This paper reviews the e-health trends to demonstrate the tremendous potential for health-related commercial activity on the internet. However, the researcher examining the barriers facing e-health to the Jordanian health system also pointed out almost insurmountable challenges. Despite the apparent promise of e-health, its instability is measured by its failure so far to systematically penetrate the organization of health care. Beyond the pragmatic negotiation of e-health in the immediate context of clinical practice, there are wider issues about how the development/implementation of e-health is funded, about its organization and management at the policy level; and about its

eWALL Innovation for Smart e-Health Monitoring Devices

DEFF Research Database (Denmark)

Mihovska, Albena Dimitrova; Kyriazakos, Sofoklis

2017-01-01

E-health environments should be designed to provide personalized services and applications to their primary users (i.e. the patients) by breaking the barrier of technology acceptance and addressing their daily needs, under strict regulation and security constraints. A typical scenario would employ...... wireless and wired sensors and local or cloud-based processing units to collect, process, store and communicate data related to the patients’ needs and condition. E-health devices can be located on the patients’ bodies or immediate environments to monitor and interact with the patients, while they perform...

A Machine-to-Machine protocol benchmark for eHealth applications - Use case: Respiratory rehabilitation.

Science.gov (United States)

Talaminos-Barroso, Alejandro; Estudillo-Valderrama, Miguel A; Roa, Laura M; Reina-Tosina, Javier; Ortega-Ruiz, Francisco

2016-06-01

M2M (Machine-to-Machine) communications represent one of the main pillars of the new paradigm of the Internet of Things (IoT), and is making possible new opportunities for the eHealth business. Nevertheless, the large number of M2M protocols currently available hinders the election of a suitable solution that satisfies the requirements that can demand eHealth applications. In the first place, to develop a tool that provides a benchmarking analysis in order to objectively select among the most relevant M2M protocols for eHealth solutions. In the second place, to validate the tool with a particular use case: the respiratory rehabilitation. A software tool, called Distributed Computing Framework (DFC), has been designed and developed to execute the benchmarking tests and facilitate the deployment in environments with a large number of machines, with independence of the protocol and performance metrics selected. DDS, MQTT, CoAP, JMS, AMQP and XMPP protocols were evaluated considering different specific performance metrics, including CPU usage, memory usage, bandwidth consumption, latency and jitter. The results obtained allowed to validate a case of use: respiratory rehabilitation of chronic obstructive pulmonary disease (COPD) patients in two scenarios with different types of requirement: Home-Based and Ambulatory. The results of the benchmark comparison can guide eHealth developers in the choice of M2M technologies. In this regard, the framework presented is a simple and powerful tool for the deployment of benchmark tests under specific environments and conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stakeholder driven indicators for eHealth performance management.

Science.gov (United States)

Vedlūga, Tomas; Mikulskienė, Birutė

2017-08-01

The goal of the present article is to compile a corpus of indicators of eHealth development evaluation that would essentially reflect stakeholder approaches and complement technical indicators of assessment of an eHealth system. Consequently, the assessment of the development of an eHealth system would reflect stakeholder approaches and become an innovative solution in attempting to improve productivity of IT projects in the field of health care. The compiled minimum set of indicators will be designed to monitor implementation of the national eHealth information system. To ensure reliability of the quality research, the respondents were grouped in accordance to the geographical distribution and diversity of the levels and types of the represented jobs and institutions. The applied analysis implies several managerial insights on the hierarchy of eHealth indicators. These insights may be helpful in recommending priority activities in implementation of an eHealth data system on the national or international level. The research is practically useful as it is the first to deal with the topic in Lithuania and its theoretical and practical aspect are particularly relevant in implementation of an eHealth data system in Lithuania. The eHealth assessment indicators presented in the article may be practically useful in two aspects: (1) as key implementation guidelines facilitating the general course of eHealth system development and (2) as a means to evaluate eHealth outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

The randomised controlled trial design: unrecognized opportunities for health sciences librarianship.

Science.gov (United States)

Eldredge, Jonathan D

2003-06-01

to describe the essential components of the Randomised Controlled Trial (RCT) and its major variations; to describe less conventional applications of the RCT design found in the health sciences literature with potential relevance to health sciences librarianship; to discuss the limited number of RCTs within health sciences librarianship. narrative review supported to a limited extent with PubMed and Library Literature database searches consistent with specific search parameters. In addition, more systematic methods, including handsearching of specific journals, to identify health sciences librarianship RCTs. While many RCTs within the health sciences follow more conventional patterns, some RCTs assume certain unique features. Selected examples illustrate the adaptations of this experimental design to answering questions of possible relevance to health sciences librarians. The author offers several strategies for controlling bias in library and informatics applications of the RCT and acknowledges the potential of the electronic era in providing many opportunities to utilize the blinding aspects of RCTs. RCTs within health sciences librarianship inhabit a limited number of subject domains such as education. This limited scope offers both advantages and disadvantages for making Evidence-Based Librarianship (EBL) a reality. The RCT design offers the potential to answer far more EBL questions than have been addressed by the design to date. Librarians need only extend their horizons through use of the versatile RCT design into new subject domains to facilitate making EBL a reality.

[Immigration and work. Roles and opportunities for occupational medicine in the health and safety of migrant workers].

Science.gov (United States)

Porru, S; Arici, Cecilia

2010-01-01

It is estimated that in Italy there are 4 million migrant workers, accounting for about 10 percent of the total workforce. They contribute to national economic development but they are also heavily involved in the so-called "3D jobs" (dangerous, dirty and demanding/degrading). To draw occupational physicians' (OP) attention to the necessity of dealing with occupational health and safety problems related to migrant workers, highlighting his/her role and opportunities, in order to guarantee access to health services and prevent occupational health inequalities. The available data on occupational diseases and accidents among migrant workers are discussed, as well as conditions of individual susceptibility; as an example, data are commented obtained in many years of health surveillance in a foundry. Migrant workers may suffer from occupational health inequalities. The OP, by means of focused risk assessment, health surveillance, fitness for work and health promotion, can substantially improve migrant workers' health. In fact, data from our experience showed how a migrant workforce may be well characterized and also represent an opportunity, instead of being a "risk factor". Within the framework of needs for further methodological and applied research, the OP can play a proactive role in workplaces, aimed at real integration of migrant workers, with overall benefits for workers, enterprises and society.

Striking a balance between in-person care and the use of eHealth to support the older rural population with chronic pain

Directory of Open Access Journals (Sweden)

Anne Roberts

2015-09-01

Full Text Available New and existing information communication technologies (ICT are playing an increasingly important role in the delivery of health and social care services. eHealth1 has the potential to supplement in-person home visits for older, rural adults with chronic pain. The Technology to support Older Adults' Personal and Social Interaction project—TOPS—examines interactions between older people and their health/social care providers and considers how eHealth could play a part in enhancing the life experiences of older people with chronic pain, who live in remote/rural areas. This paper reports findings from the TOPS study, drawing upon observations of health/social care home visits to chronic pain patients and interviews with patients and health/social care providers in rural Scotland. Patients and care professionals believe in-person care promotes the general well-being of older people with pain. However, our findings show that the potential recipients of eHealth are open to the use of such technologies and that although they cannot be expected to replace existing models of care, eHealth may provide opportunities to sustain and enhance these interactions.

Making non-discrimination and equal opportunity a reality in Kenya's health provider education system: results of a gender analysis.

Science.gov (United States)

Newman, Constance; Kimeu, Anastasiah; Shamblin, Leigh; Penders, Christopher; McQuide, Pamela A; Bwonya, Judith

2011-01-01

IntraHealth International's USAID-funded Capacity Kenya project conducted a performance needs assessment of the Kenya health provider education system in 2010. Various stakeholders shared their understandings of the role played by gender and identified opportunities to improve gender equality in health provider education. Findings suggest that occupational segregation, sexual harassment and discrimination based on pregnancy and family responsibilities present problems, especially for female students and faculty. To grow and sustain its workforce over the long term, Kenyan human resource leaders and managers must act to eliminate gender-based obstacles by implementing existing non-discrimination and equal opportunity policies and laws to increase the entry, retention and productivity of students and faculty. Families and communities must support girls' schooling and defer early marriage. All this will result in a fuller pool of students, faculty and matriculated health workers and, ultimately, a more robust health workforce to meet Kenya's health challenges.

Community health workers for ART in sub-Saharan Africa: learning from experience – capitalizing on new opportunities

Directory of Open Access Journals (Sweden)

Schouten Erik

2009-04-01

Full Text Available Abstract Low-income countries with high HIV/AIDS burdens in sub-Saharan Africa must deal with severe shortages of qualified human resources for health. This situation has triggered the renewed interest in community health workers, as they may play an important role in scaling-up antiretroviral treatment for HIV/AIDS by taking over a number of tasks from the professional health workers. Currently, a wide variety of community health workers are active in many antiretroviral treatment delivery sites. This article investigates whether present community health worker programmes for antiretroviral treatment are taking into account the lessons learnt from past experiences with community health worker programmes in primary health care and to what extent they are seizing the new antiretroviral treatment-specific opportunities. Based on a desk review of multi-purpose community health worker programmes for primary health care and of recent experiences with antiretroviral treatment-related community health workers, we developed an analytic framework of 10 criteria: eight conditions for successful large-scale antiretroviral treatment-related community health worker programmes and two antiretroviral treatment-specific opportunities. Our appraisal of six community health worker programmes, which we identified during field work in Ethiopia, Malawi and Uganda in 2007, shows that while some lessons from the past have been learnt, others are not being sufficiently considered and antiretroviral treatment-specific opportunities are not being sufficiently seized. In particular, all programmes have learnt the lesson that without adequate remuneration, community health workers cannot be retained in the long term. Yet we contend that the apparently insufficient attention to issues such as quality supervision and continuous training will lead to decreasing quality of the programmes over time. The life experience of people living with HIV/AIDS is still a relatively

Health literacy screening instruments for eHealth applications: a systematic review.

Science.gov (United States)

Collins, Sarah A; Currie, Leanne M; Bakken, Suzanne; Vawdrey, David K; Stone, Patricia W

2012-06-01

To systematically review current health literacy (HL) instruments for use in consumer-facing and mobile health information technology screening and evaluation tools. The databases, PubMed, OVID, Google Scholar, Cochrane Library and Science Citation Index, were searched for health literacy assessment instruments using the terms "health", "literacy", "computer-based," and "psychometrics". All instruments identified by this method were critically appraised according to their reported psychometric properties and clinical feasibility. Eleven different health literacy instruments were found. Screening questions, such as asking a patient about his/her need for assistance in navigating health information, were evaluated in seven different studies and are promising for use as a valid, reliable, and feasible computer-based approach to identify patients that struggle with low health literacy. However, there was a lack of consistency in the types of screening questions proposed. There is also a lack of information regarding the psychometric properties of computer-based health literacy instruments. Only English language health literacy assessment instruments were reviewed and analyzed. Current health literacy screening tools demonstrate varying benefits depending on the context of their use. In many cases, it seems that a single screening question may be a reliable, valid, and feasible means for establishing health literacy. A combination of screening questions that assess health literacy and technological literacy may enable tailoring eHealth applications to user needs. Further research should determine the best screening question(s) and the best synthesis of various instruments' content and methodologies for computer-based health literacy screening and assessment. Copyright © 2012 Elsevier Inc. All rights reserved.

E-health readiness assessment for e-health framework for Africa: a case study of hospitals in South Africa

CSIR Research Space (South Africa)

Coleman, A

2011-11-01

Full Text Available This study assessed e-healthcare readiness of rural and urban hospitals in North West Province of South Africa. Outcome of assessment led to creation of e-health architectural framework for e-health solutions. Assessment was conducted in usage...

Mental health services in Cambodia, challenges and opportunities in a post-conflict setting.

Science.gov (United States)

Jegannathan, Bhoomikumar; Kullgren, Gunnar; Deva, Parameshvara

2015-02-01

Cambodia had suffered enormously due to war and internecine conflict during the latter half of the twentieth century, more so during the Vietnam War. Total collapse of education and health systems during the Pol Pot era continues to be a challenge for developing the necessary infrastructure and human resources to provide basic minimum mental health care which is compounded by the prevailing cultural belief and stigma over mental, neurological and substance abuse disorders (MNSDs). The mental health research and services in Cambodia had been predominantly 'trauma focused', a legacy of war, and there is a need to move toward epidemiologically sound public health oriented mental health policy and service development. Integrating mental health program with primary health care services with specifically stated minimum package of activities at primary level and complementary package of activities at secondary level is an opportunity to meet the needs and rights of persons with mental, neurological and substance abuse disorders (PWMNSDs) in Cambodia, provided there is mental health leadership, government commitment and political will. Copyright © 2014 Elsevier B.V. All rights reserved.

Assessing user preferences for e-readers and tablets.

Science.gov (United States)

Le Ber, Jeanne M; Lombardo, Nancy T; Honisett, Amy; Jones, Peter Stevens; Weber, Alice

2013-01-01

Librarians purchased 12 e-readers and six tablets to provide patrons the opportunity to experiment with the latest mobile technologies. After several train-the-trainer sessions, librarians shared device information with the broader health sciences community. Devices were cataloged and made available for a two-week checkout. A limited number of books and applications (apps) were preloaded for all the devices, and patrons were allowed to download their own content. Each tablet has Google Books, iBooks, Kindle, and Nook apps available to allow choice in reading e-books. Upon return, patrons were asked to complete a ten-question survey to determine preferences for device use.

Health literacy in the eHealth era: A systematic review of the literature.

Science.gov (United States)

Kim, Henna; Xie, Bo

2017-06-01

This study aimed to identify studies on online health service use by people with limited health literacy, as the findings could provide insights into how health literacy has been, and should be, addressed in the eHealth era. To identify the relevant literature published since 2010, we performed four rounds of selection-database selection, keyword search, screening of the titles and abstracts, and screening of full texts. This process produced a final of 74 publications. The themes addressed in the 74 publications fell into five categories: evaluation of health-related content, development and evaluation of eHealth services, development and evaluation of health literacy measurement tools, interventions to improve health literacy, and online health information seeking behavior. Barriers to access to and use of online health information can result from the readability of content and poor usability of eHealth services. We need new health literacy screening tools to identify skills for adequate use of eHealth services. Mobile apps hold great potential for eHealth and mHealth services tailored to people with low health literacy. Efforts should be made to make eHealth services easily accessible to low-literacy individuals and to enhance individual health literacy through educational programs. Copyright © 2017 Elsevier B.V. All rights reserved.

e-Health Tools for Targeting and Improving Melanoma Screening: A Review

International Nuclear Information System (INIS)

Tyagi, A.; Miller, K.; Cockburn, M.

2012-01-01

The key to improved prognosis for melanoma is early detection and diagnosis, achieved by skin surveillance and secondary prevention (screening). However, adherence to screening guidelines is low, with population-based estimates of approximately 26% for physician-based skin cancer screening and 20-25% for skin self-examination. The recent proliferation of melanoma detection "e-Health"tools, digital resources that facilitate screening in patients often outside of the clinical setting, may offer new strategies to promote adherence and expand the proportion and range of individuals performing skin self-examination. The purpose of this paper is to catalog and categorize melanoma screening e-Health tools to aid in the determination of their efficacy and potential for adoption. The availability and accessibility of such tools, their costs, target audience, and, where possible, information on their efficacy, will be discussed with potential benefits and limitations considered. While e-Health tools targeting melanoma screening are widely available, little has been done to formally evaluate their efficacy and ability to aid in overcoming screening barriers. Future research needs to formally evaluate the potential role of e-Health tools in melanoma prevention.

Big Data and Health Economics: Opportunities, Challenges and Risks

Directory of Open Access Journals (Sweden)

Diego Bodas-Sagi

2018-03-01

Full Text Available Big Data offers opportunities in many fields. Healthcare is not an exception. In this paper we summarize the possibilities of Big Data and Big Data technologies to offer useful information to policy makers. In a world with tight public budgets and ageing populations we feel necessary to save costs in any production process. The use of outcomes from Big Data could be in the future a way to improve decisions at a lower cost than today. In addition to list the advantages of properly using data and technologies from Big Data, we also show some challenges and risks that analysts could face. We also present an hypothetical example of the use of administrative records with health information both for diagnoses and patients.

Governance structures impact on eHealth

DEFF Research Database (Denmark)

Kierkegaard, Patrick

2015-01-01

Background National eHealth implementation efforts need to move beyond the scope of making technology the primary focus and instead consider the broader spectrum of influences that can either hinder or facilitate eHealth adoption such as governance structures and policies. In this study, Denmark...... serves as an ideal candidate for further examination due to the country׳s rich history of intertwining events that have played an important role in the dynamic relationship between governance and eHealth success and failures. Methods A case study approach was used to gather a combination of primary...... and secondary data sources. All data collection was carried out through desk-research. Data collection relied on performing an extensive search of literature for relevant studies using combinations of keywords that reflected eHealth and governance-related topics. Inclusion and exclusion criteria׳s were applied...

Exploring eHealth Ethics and Multi-Morbidity: Protocol for an Interview and Focus Group Study of Patient and Health Care Provider Views and Experiences of Using Digital Media for Health Purposes.

Science.gov (United States)

Townsend, Anne; Adam, Paul; Li, Linda C; McDonald, Michael; Backman, Catherine L

2013-10-17

eHealth is a broad term referring to the application of information and communication technologies in the health sector, ranging from health records to medical consultations (telemedicine) and multiple forms of health education, support, and tools. By providing increased and anytime access to information, opportunities to exchange experiences with others, and self-management support, eHealth has been heralded as transformational. It has the potential to accelerate the shift from traditional "passive patient" to an informed, engaged, and empowered "patient as partner," equipped to take part in shared decision-making, and take personal responsibility for self-managing their illness. The objective of our study is to examine how people with chronic illness use eHealth in their daily lives, how it affects patient-provider relationships, and the ethical and practical ramifications for patients, providers, and service delivery. This two-phase qualitative study is ongoing. We will purposively sample 60-70 participants in British Columbia, Canada. To be eligible, patient participants have to have arthritis and at least one other chronic health condition; health care providers (HCPs) need a caseload of patients with multi-morbidity (>25%). To date we have recruited 36 participants (18 patients, 18 HCPs). The participants attended 7 focus groups (FGs), 4 with patients and 3 with rehabilitation professionals and physicians. We interviewed 4 HCPs who were unable to attend a FG. In phase 2, we will build on FG findings and conduct 20-24 interviews with equal numbers of patients and HCPs (rehabilitation professionals and physicians). As in the FGs conducted in phase I, the interviews will use a semistructured, but flexible, discussion guide. All discussions are being audiotaped and transcribed verbatim. Constant comparisons and a narrative approach guides the analyses. A relational ethics conceptual lens is being applied to the data to identify emergent ethical issues. This study

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

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Coast, Joanna; Kinghorn, Philip; Mitchell, Paul

2015-04-01

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

Physicians’ experience adopting the electronic transfer of care communication tool: barriers and opportunities

Directory of Open Access Journals (Sweden)

de Grood C

2015-01-01

Full Text Available Chloe de Grood, Katherine Eso, Maria Jose Santana Department of Community Health Sciences, W21C Research and Innovation Centre, Institute of Public Health, University of Calgary, Calgary, AB, Canada Purpose: The purpose of this study was to assess physicians' perceptions on a newly developed electronic transfer of care (e-TOC communication tool and identify barriers and opportunities toward its adoption. Participants and methods: The study was conducted in a tertiary care teaching center as part of a randomized controlled trial assessing the efficacy of an e-TOC communication tool. The e-TOC technology was developed through iterative consultation with stakeholders. This e-TOC summary was populated by acute care physicians (AcPs and communicated electronically to community care physicians (CcPs. The AcPs consisted of attending physicians, resident trainees, and medical students rotating through the Medical Teaching Unit. The CcPs were health care providers caring for patients discharged from hospital to the community. AcPs and CcPs completed validated surveys assessing their experience with the newly developed e-TOC tool. Free text questions were added to gather general comments from both groups of physicians. Units of analysis were individual physicians. Data from the surveys were analyzed using mixed methods. Results: AcPs completed 138 linked pre- and post-rotation surveys. At post-rotation, each AcP completed an average of six e-TOC summaries, taking an average of 37 minutes per e-TOC summary. Over 100 CcPs assessed the quality of the TOC summaries, with an overall rating of 8.3 (standard deviation: 1.48; on a scale of 1–10. Thematic analyses revealed barriers and opportunities encountered by physicians toward the adoption of the e-TOC tool. While the AcPs highlighted issues with timeliness, usability, and presentation, the CcPs identified barriers accessing the web-based TOC summaries, emphasizing that the summaries were timely and the

Sexually Transmitted Disease Prevention Policies in the United States: Evidence and Opportunities.

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Leichliter, Jami S; Seiler, Naomi; Wohlfeiler, Dan

2016-02-01

Policies are an important part of public health interventions, including in the area of sexually transmitted disease (STD) prevention. Similar to other tools used in public health, policies are often evaluated to determine their usefulness. Therefore, we conducted a nonsystematic review of policy evidence for STD prevention. Our review considers assessments or evaluations of STD prevention-specific policies, health care system policies, and other, broader policies that have the potential to impact STD prevention through social determinants of health. We also describe potential policy opportunity in these areas. It should be noted that we found gaps in policy evidence for some areas; thus, additional research would be useful for public health policy interventions for STD prevention.

Engagement with eHealth Self-Monitoring in a Primary Care-Based Weight Management Intervention.

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Wolin, Kathleen Y; Steinberg, Dori M; Lane, Ilana B; Askew, Sandy; Greaney, Mary L; Colditz, Graham A; Bennett, Gary G

2015-01-01

While eHealth approaches hold promise for improving the reach and cost-effectiveness of behavior change interventions, they have been challenged by declining participant engagement over time, particularly for self-monitoring behaviors. These are significant concerns in the context of chronic disease prevention and management where durable effects are important for driving meaningful changes. "Be Fit, Be Well" was an eHealth weight loss intervention that allowed participants to self-select a self-monitoring modality (web or interactive voice response (IVR)). Participants could change their modality. As such, this study provides a unique opportunity to examine the effects of intervention modality choice and changing modalities on intervention engagement and outcomes. Intervention participants, who were recruited from community health centers, (n = 180) were expected to self-monitor health behaviors weekly over the course of the 24-month intervention. We examined trends in intervention engagement by modality (web, IVR, or changed modality) among participants in the intervention arm. The majority (61%) of participants chose IVR self-monitoring, while 39% chose web. 56% of those who selected web monitoring changed to IVR during the study versus no change in those who initially selected IVR. Self-monitoring declined in both modalities, but completion rates were higher in those who selected IVR. There were no associations between self-monitoring modality and weight or blood pressure outcomes. This is the first study to compare web and IVR self-monitoring in an eHealth intervention where participants could select and change their self-monitoring modality. IVR shows promise for achieving consistent engagement.

Health Literacy Screening Instruments for eHealth Applications: A Systematic Review

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Collins, Sarah A.; Currie, Leanne M.; Bakken, Suzanne; Vawdrey, David K.; Stone, Patricia W.

2012-01-01

Objective To systematically review current health literacy (HL) instruments for use in consumer-facing and mobile health information technology screening and evaluation tools. Design The databases, PubMed, OVID, Google Scholar, Cochrane Library and Science Citation Index, were searched for health literacy assessment instruments using the terms “health”, “literacy”, “computer-based,” and “psychometrics”. All instruments identified by this method were critically appraised according to their reported psychometric properties and clinical feasibility. Results Eleven different health literacy instruments were found. Screening questions, such as asking a patient about his/her need for assistance in navigating health information, were evaluated in 7 different studies and are promising for use as a valid, reliable, and feasible computer-based approach to identify patients that struggle with low health literacy. However, there was a lack of consistency in the types of screening questions proposed. There is also a lack of information regarding the psychometric properties of computer-based health literacy instruments. Limitations Only English language health literacy assessment instruments were reviewed and analyzed. Conclusions Current health literacy screening tools demonstrate varying benefits depending on the context of their use. In many cases, it seems that a single screening question may be a reliable, valid, and feasible means for establishing health literacy. A combination of screening questions that assess health literacy and technological literacy may enable tailoring eHealth applications to user needs. Further research should determine the best screening question(s) and the best synthesis of various instruments’ content and methodologies for computer-based health literacy screening and assessment. PMID:22521719

Artemisinin-resistant malaria: research challenges, opportunities, and public health implications.

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Fairhurst, Rick M; Nayyar, Gaurvika M L; Breman, Joel G; Hallett, Rachel; Vennerstrom, Jonathan L; Duong, Socheat; Ringwald, Pascal; Wellems, Thomas E; Plowe, Christopher V; Dondorp, Arjen M

2012-08-01

Artemisinin-based combination therapies are the most effective drugs to treat Plasmodium falciparum malaria. Reduced sensitivity to artemisinin monotherapy, coupled with the emergence of parasite resistance to all partner drugs, threaten to place millions of patients at risk of inadequate treatment of malaria. Recognizing the significance and immediacy of this possibility, the Fogarty International Center and the National Institute of Allergy and Infectious Diseases of the U.S. National Institutes of Health convened a conference in November 2010 to bring together the diverse array of stakeholders responding to the growing threat of artemisinin resistance, including scientists from malarious countries in peril. This conference encouraged and enabled experts to share their recent unpublished data from studies that may improve our understanding of artemisinin resistance. Conference sessions addressed research priorities to forestall artemisinin resistance and fostered collaborations between field- and laboratory-based researchers and international programs, with the aim of translating new scientific evidence into public health solutions. Inspired by this conference, this review summarizes novel findings and perspectives on artemisinin resistance, approaches for translating research data into relevant public health information, and opportunities for interdisciplinary collaboration to combat artemisinin resistance.

Health Information Professionals in a Global eHealth World: Ethical and legal arguments for the international certification and accreditation of health information professionals.

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Kluge, Eike-Henner W

2017-01-01

Issues such as privacy, security, quality, etc. have received considerable attention in discussions of eHealth, mHealth and pHealth. However, comparatively little attention has been paid to the fact that these methods of delivering health care situate Health Information Professionals (HIPs) in an ethical context that is importantly different from that of traditional health care because they assign a fiduciary role to HIPs that they did not have before, their previous technical involvement notwithstanding. Even less attention has been paid to the fact that when these methods of health care delivery are interjurisdictional, they situate HIPs in an ethical fabric that does not exist in the intra-jurisdictional setting. Privacy and other informatic patient rights in the context of traditional health care are identified and the role that HIPs play in this connection is analysed and distinguished from the role HIPs play in eHealth in order to determine whether the 2002 IMIA Code of Ethics provides sufficient guidance for HIPs in eHealth and associated settings. The position of inter-jurisdictional corporate eHealth providers is also touched upon. It is found that in eHealth, mHealth and pHealth the ethical and legal position of HIPs differs importantly from that in traditional technologically-assisted health care because HIPs have fiduciary obligations they did not have before. It is also found that the 2002 IMIA Code of Ethics, which provides the framework for the codes of ethics that are promulgated by its various member organizations, provides insufficient guidance for dealing with issues that arise in this connection because they do not acknowledge this important change. It is also found that interjurisdictional eHealth etc. raises new ethical and legal issues for the corporate sector that transcend contractual arrangements. The 2002 IMIA Code of Ethics should be revised and updated to provide guidance for HIPs who are engaged in eHealth and related methods of health

Opportunities and challenges in conducting secondary analysis of HIV programmes using data from routine health information systems and personal health information.

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Gloyd, Stephen; Wagenaar, Bradley H; Woelk, Godfrey B; Kalibala, Samuel

2016-01-01

HIV programme data from routine health information systems (RHIS) and personal health information (PHI) provide ample opportunities for secondary data analysis. However, these data pose unique opportunities and challenges for use in health system monitoring, along with process and impact evaluations. Analyses focused on retrospective case reviews of four of the HIV-related studies published in this JIAS supplement. We identify specific opportunities and challenges with respect to the secondary analysis of RHIS and PHI data. Challenges working with both HIV-related RHIS and PHI included missing, inconsistent and implausible data; rapidly changing indicators; systematic differences in the utilization of services; and patient linkages over time and different data sources. Specific challenges among RHIS data included numerous registries and indicators, inconsistent data entry, gaps in data transmission, duplicate registry of information, numerator-denominator incompatibility and infrequent use of data for decision-making. Challenges specific to PHI included the time burden for busy providers, the culture of lax charting, overflowing archives for paper charts and infrequent chart review. Many of the challenges that undermine effective use of RHIS and PHI data for analyses are related to the processes and context of collecting the data, excessive data requirements, lack of knowledge of the purpose of data and the limited use of data among those generating the data. Recommendations include simplifying data sources, analysis and reporting; conducting systematic data quality audits; enhancing the use of data for decision-making; promoting routine chart review linked with simple patient tracking systems; and encouraging open access to RHIS and PHI data for increased use.

The determinants of employee participation in occupational health and safety management.

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Masso, Märt

2015-01-01

This article focuses on employee direct participation in occupational health and safety (OHS) management. The article explains what determines employee opportunities to participate in OHS management. The explanatory framework focuses on safety culture and safety management at workplaces. The framework is empirically tested using Estonian cross-sectional, multilevel data of organizations and their employees. The analysis indicates that differences in employee participation in OHS management in the Estonian case could be explained by differences in OHS management practices rather than differences in safety culture. This indicates that throughout the institutional change and shift to the European model of employment relations system, change in management practices has preceded changes in safety culture which according to theoretical argument is supposed to follow culture change.

Internet use and eHealth literacy of low-income parents whose children have special health care needs.

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Knapp, Caprice; Madden, Vanessa; Wang, Hua; Sloyer, Phyllis; Shenkman, Elizabeth

2011-09-29

The Internet has revolutionized the way in which many Americans search for health care information. Unfortunately, being able to use the Internet for this purpose is predicated on having access to the Internet and being able to understand and comprehend online health information. This is especially important for parents of children with special health care needs who are forced to make many medical decisions throughout the lives of their children. Yet, no information is available about this vulnerable group. For parents of children with special health care needs we sought to (1) describe their Internet access and use, (2) determine which child and household factors were associated with Internet use, (3) describe eHealth literacy of Internet users, and (4) determine which child and household factors were associated with greater eHealth literacy. This was a cross-sectional telephone survey of 2371 parents whose children with special health care needs were enrolled in Florida's Medicaid and State Children's Health Insurance Plan (SCHIP) programs (4072 parents were approached). To be enrolled in the program, families must have incomes that are less than or equal to 200% of the federal poverty level. The eHealth Literacy Scale (eHEALS) was used to measure eHealth literacy. Descriptive and multivariate analyses were conducted to address the study objectives. The survey response rate was 58.2%. Participating parents were mainly female (2154/2371, 91%), white non-Hispanic (915/2371, 39%), English speaking (1827/2371, 77%), high school graduates (721/2371, 30%), married (1252/2371, 53%), and living in a two-parent household (1212/2371, 51%). Additionally, 82% of parents (1945/2371) in the sample reported that they used the Internet, and 49% of those parents used it daily (1158/2371). Almost three-quarters of Internet users had access to the Internet at home while about one-half had access at work. Parents who were African American, non-English speaking, older, and not

The Affordable Care Act, Accountable Care Organizations, and Mental Health Care for Older Adults: Implications and Opportunities

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Bartels, Stephen J.; Gill, Lydia; Naslund, John A.

2015-01-01

Abstract The Patient Protection and Affordable Care Act (ACA) represents the most significant legislative change in the United States health care system in nearly half a century. Key elements of the ACA include reforms aimed at addressing high-cost, complex, vulnerable patient populations. Older adults with mental health disorders are a rapidly growing segment of the population and are among the most challenging subgroups within health care, and they account for a disproportionate amount of costs. What does the ACA mean for geriatric mental health? We address this question by highlighting opportunities for reaching older adults with mental health disorders by leveraging the diverse elements of the ACA. We describe nine relevant initiatives: (1) accountable care organizations, (2) patient-centered medical homes, (3) Medicaid-financed specialty health homes, (4) hospital readmission and health care transitions initiatives, (5) Medicare annual wellness visit, (6) quality standards and associated incentives, (7) support for health information technology and telehealth, (8) Independence at Home and 1915(i) State Plan Home and Community-Based Services program, and (9) Medicare-Medicaid Coordination Office, Center for Medicare and Medicaid Innovation, and the Patient-Centered Outcomes Research Institute. We also consider potential challenges to full implementation of the ACA and discuss novel solutions for advancing geriatric mental health in the context of projected workforce shortages and the opportunities afforded by the ACA. PMID:25811340

eHealth development: a holistic approach

NARCIS (Netherlands)

Lentferink, Aniek

2016-01-01

This presentation was held during the course 'eHealth development a holistic approach' at the University of Twente. The presentation included information about the project Quantified Self at Work and specifically the approach of co-creation during eHealth design with important stakeholders.

Global health in medical education: a call for more training and opportunities.

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Drain, Paul K; Primack, Aron; Hunt, D Dan; Fawzi, Wafaie W; Holmes, King K; Gardner, Pierce

2007-03-01

Worldwide increases in global migration and trade have been making communicable diseases a concern throughout the world and have highlighted the connections in health and medicine among and between continents. Physicians in developed countries are now expected to have a broader knowledge of tropical disease and newly emerging infections, while being culturally sensitive to the increasing number of international travelers and ethnic minority populations. Exposing medical students to these global health issues encourages students to enter primary care medicine, obtain public health degrees, and practice medicine among the poor and ethnic minorities. In addition, medical students who have completed an international clinical rotation often report a greater ability to recognize disease presentations, more comprehensive physical exam skills with less reliance on expensive imaging, and greater cultural sensitivity. American medical students have become increasingly more interested and active in global health, but medical schools have been slow to respond. The authors review the evidence supporting the benefits of promoting more global health teaching and opportunities among medical students. Finally, the authors suggest several steps that medical schools can take to meet the growing global health interest of medical students, which will make them better physicians and strengthen our medical system.

Sexual health is dead in my body: participatory assessment of sexual health determinants by refugees, asylum seekers and undocumented migrants in Belgium and The Netherlands.

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Keygnaert, Ines; Vettenburg, Nicole; Roelens, Kristien; Temmerman, Marleen

2014-05-01

Although migrants constitute an important proportion of the European population, little is known about migrant sexual health. Existing research mainly focuses on migrants' sexual health risks and accessibility issues while recommendations on adequate sexual health promotion are rarely provided. Hence, this paper explores how refugees, asylum seekers and undocumented migrants in Belgium and The Netherlands define sexual health, search for sexual health information and perceive sexual health determinants. Applying Community-based Participatory Research as the overarching research approach, we conducted 223 in-depth interviews with refugees, asylum seekers and undocumented migrants in Belgium and The Netherlands. The Framework Analysis Technique was used to analyse qualitative data. We checked the extensiveness of the qualitative data and analysed the quantitative socio-demographic data with SPSS. Our results indicate that gender and age do not appear to be decisive determinants. However, incorporated cultural norms and education attainment are important to consider in desirable sexual health promotion in refugees, asylum seekers and undocumented migrants in Belgium and The Netherlands. Furthermore, our results demonstrate that these migrants have a predominant internal health locus of control. Yet, most of them feel that this personal attitude is hugely challenged by the Belgian and Dutch asylum system and migration laws which force them into a structural dependent situation inducing sexual ill-health. Refugees, asylum seekers and undocumented migrants in Belgium and The Netherlands are at risk of sexual ill-health. Incorporated cultural norms and attained education are important determinants to address in desirable sexual health promotion. Yet, as their legal status demonstrates to be the key determinant, the prime concern is to alter organizational and societal factors linked to the Belgian and Dutch asylum system. Refugees, asylum seekers and undocumented migrants

E-learning in neurology education: Principles, opportunities and challenges in combating neurophobia.

Science.gov (United States)

Chhetri, Suresh Kumar

2017-10-01

Neurophobia, the fear of clinical neurology, affects not only medical students but also non-career neurologists globally. This can have significant implications on patient care, especially given the increasing burden of chronic neurological disorders. The negative perception and lack of confidence amongst general practitioners and hospital physicians may lead to increased referrals to neurology, thereby increasing waiting times and inpatient stay. The onus, therefore, should be on improving training and stimulating interest in neurology. There is emerging evidence that integrating e-learning to traditional pedagogies can improve delivery of neurology education and help combat neurophobia. However, embracing e-learning may be challenging for contemporary neurologists, mostly 'digital immigrants', involved in the training of tomorrow's doctors who are largely 'digital natives'. This paper reviews the principles, opportunities and challenges of incorporating e-learning in neurology education to help improve learners' perception of clinical neurology, facilitate delivery of self-directed experiential learning and perhaps breed 'neurophilia'. Copyright © 2017 Elsevier Ltd. All rights reserved.

Measuring rural allied health workforce turnover and retention: what are the patterns, determinants and costs?

Science.gov (United States)

Chisholm, Marita; Russell, Deborah; Humphreys, John

2011-04-01

To measure variations in patterns of turnover and retention, determinants of turnover, and costs of recruitment of allied health professionals in rural areas. Data were collected on health service characteristics, recruitment costs and de-identified individual-level employment entry and exit data for dietitians, occupational therapists, physiotherapists, podiatrists, psychologists, social workers and speech pathologists employed between 1 January 2004 and 31 December 2009. Health services providing allied health services within Western Victoria were stratified by geographical location and town size. Eighteen health services were sampled, 11 participated. Annual turnover rates, stability rates, median length of stay in current position, survival probabilities, turnover hazards and median costs of recruitment were calculated. Analysis of commencement and exit data from 901 allied health professionals indicated that differences in crude workforce patterns according to geographical location emerge 12 to 24 months after commencement of employment, although the results were not statistically significant. Proportional hazards modelling indicated profession and employee age and grade upon commencement were significant determinants of turnover risk. Costs of replacing allied health workers are high. An opportunity for implementing comprehensive retention strategies exists in the first year of employment in rural and remote settings. Benchmarks to guide workforce retention strategies should take account of differences in patterns of allied health turnover and retention according to geographical location. Monitoring allied health workforce turnover and retention through analysis of routinely collected data to calculate selected indicators provides a stronger evidence base to underpin workforce planning by health services and regional authorities. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

eHealth literacy: extending the digital divide to the realm of health information.

Science.gov (United States)

Neter, Efrat; Brainin, Esther

2012-01-27

eHealth literacy is defined as the ability of people to use emerging information and communications technologies to improve or enable health and health care. The goal of this study was to explore whether literacy disparities are diminished or enhanced in the search for health information on the Internet. The study focused on (1) traditional digital divide variables, such as sociodemographic characteristics, digital access, and digital literacy, (2) information search processes, and (3) the outcomes of Internet use for health information purposes. We used a countrywide representative random-digital-dial telephone household survey of the Israeli adult population (18 years and older, N = 4286). We measured eHealth literacy; Internet access; digital literacy; sociodemographic factors; perceived health; presence of chronic diseases; as well as health information sources, content, search strategies, and evaluation criteria used by consumers. Respondents who were highly eHealth literate tended to be younger and more educated than their less eHealth-literate counterparts. They were also more active consumers of all types of information on the Internet, used more search strategies, and scrutinized information more carefully than did the less eHealth-literate respondents. Finally, respondents who were highly eHealth literate gained more positive outcomes from the information search in terms of cognitive, instrumental (self-management of health care needs, health behaviors, and better use of health insurance), and interpersonal (interacting with their physician) gains. The present study documented differences between respondents high and low in eHealth literacy in terms of background attributes, information consumption, and outcomes of the information search. The association of eHealth literacy with background attributes indicates that the Internet reinforces existing social differences. The more comprehensive and sophisticated use of the Internet and the subsequent increased

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

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

2011-01-01

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

Social Determinants of LGBT Cancer Health Inequities.

Science.gov (United States)

Matthews, Alicia K; Breen, Elizabeth; Kittiteerasack, Priyoth

2018-02-01

To describe the extant literature on social determinants of health as they relate to the cancer disparities and to highlight the research findings relating to lesbian, gay, bisexual, and transgender (LGBT) populations. Published scientific literature and clinical literature, and published reports from the World Health Organization and US Department of Health and Human Services. The larger literature on health inequities is moving beyond individual-level predictors of risk to evaluate the influence of social determinants of health on the persistent health inequalities in a population. As it has for other groups, additional research into social determinants of health for LGBT persons of color may play an important role in identifying and reducing cancer inequities for this group. Increased awareness of the factors that contribute to health inequities for the LGBT population may provide insight into improving patient-provider relationships with LGBT patients. A large body of experiential and clinical knowledge positions nurses to conduct meaningful research to expand the current understanding of the social determinants of LGBT cancer health inequities. Copyright © 2017 Elsevier Inc. All rights reserved.

Nurse executives: new roles, new opportunities.

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Kleinman, C S

1999-01-01

As women have been nursing since the earliest days of recorded civilization, so nurses have been associated with health care since the earliest days of recorded medical history. Gender and function have been inextricably woven in ways that created a struggle for success within a male-dominated industry. Nurses, as women, have been undervalued as, until recently, their role in health care has been similarly undervalued. Changing realities in the health care environment have created an opportunity for women's unique skills and talents to be revalued in a way that offers new opportunities for nurses. Teamwork, global thinking, multitasking, creativity, and flexibility are characteristics that have assumed new importance in the marketplace. Nursing leaders possess these attributes, along with a strong clinical foundation that is integrated with knowledge of sound business principles. This combination now positions nurse executives to reach the highest levels of heath care administration. Critical to this achievement is the professional credibility obtained through education at the master's degree level in health care and nursing administration programs that provide the essential tools for professional success. New opportunities for nurse executives afford educators in health care and nursing administration similar opportunities to develop and market programs to this large group of health care professionals who are seeking graduate education in increasing numbers.

Modeling patients' acceptance of provider-delivered e-health.

Science.gov (United States)

Wilson, E Vance; Lankton, Nancy K

2004-01-01

Health care providers are beginning to deliver a range of Internet-based services to patients; however, it is not clear which of these e-health services patients need or desire. The authors propose that patients' acceptance of provider-delivered e-health can be modeled in advance of application development by measuring the effects of several key antecedents to e-health use and applying models of acceptance developed in the information technology (IT) field. This study tested three theoretical models of IT acceptance among patients who had recently registered for access to provider-delivered e-health. An online questionnaire administered items measuring perceptual constructs from the IT acceptance models (intrinsic motivation, perceived ease of use, perceived usefulness/extrinsic motivation, and behavioral intention to use e-health) and five hypothesized antecedents (satisfaction with medical care, health care knowledge, Internet dependence, information-seeking preference, and health care need). Responses were collected and stored in a central database. All tested IT acceptance models performed well in predicting patients' behavioral intention to use e-health. Antecedent factors of satisfaction with provider, information-seeking preference, and Internet dependence uniquely predicted constructs in the models. Information technology acceptance models provide a means to understand which aspects of e-health are valued by patients and how this may affect future use. In addition, antecedents to the models can be used to predict e-health acceptance in advance of system development.

78 FR 21607 - National Institute for Occupational Safety and Health Partnership Opportunity on a Research...

Science.gov (United States)

2013-04-11

... Institute for Occupational Safety and Health Partnership Opportunity on a Research Project To Evaluate the... disposable (single use) gown submitted; (3) A minimum of 200 ``new'' (unprocessed, unused, unwashed) reusable... performance criteria for single-use and reusable isolation gowns. The research objective is to evaluate...

Globalization and social determinants of health: The role of the global marketplace (part 2 of 3

Directory of Open Access Journals (Sweden)

Schrecker Ted

2007-06-01

Full Text Available Abstract Globalization is a key context for the study of social determinants of health (SDH: broadly stated, SDH are the conditions in which people live and work, and that affect their opportunities to lead healthy lives. In the first article in this three part series, we described the origins of the series in work conducted for the Globalization Knowledge Network of the World Health Organization's Commission on Social Determinants of Health and in the Commission's specific concern with health equity. We identified and defended a definition of globalization that gives primacy to the drivers and effects of transnational economic integration, and addressed a number of important conceptual and methodological issues in studying globalization's effects on SDH and their distribution, emphasizing the need for transdisciplinary approaches that reflect the complexity of the topic. In this second article, we identify and describe several, often interacting clusters of pathways leading from globalization to changes in SDH that are relevant to health equity. These involve: trade liberalization; the global reorganization of production and labour markets; debt crises and economic restructuring; financial liberalization; urban settings; influences that operate by way of the physical environment; and health systems changed by the global marketplace.

Moving toward holistic wellness, empowerment and self-determination for Indigenous peoples in Canada: Can traditional Indigenous health care practices increase ownership over health and health care decisions?

Science.gov (United States)

Auger, Monique; Howell, Teresa; Gomes, Tonya

2016-12-27

This study aimed to understand the role that traditional Indigenous health care practices can play in increasing individual-level self-determination over health care and improving health outcomes for urban Indigenous peoples in Canada. This project took place in Vancouver, British Columbia and included the creation and delivery of holistic workshops to engage community members (n = 35) in learning about aspects of traditional health care practices. Short-term and intermediate outcomes were discussed through two gatherings involving focus groups and surveys. Data were transcribed, reviewed, thematically analyzed, and presented to the working group for validation. When participants compared their experiences with traditional health care to western health care, they described barriers to care that they had experienced in accessing medical doctors (e.g., racism, mistrust), as well as the benefits of traditional healing (e.g., based on relationships, holistic approach). All participants also noted that they had increased ownership over their choices around, and access to, health care, inclusive of both western and traditional options. They stressed that increased access to traditional health care is crucial within urban settings. Self-determination within Indigenous urban communities, and on a smaller scale, ownership for individuals, is a key determinant of health for Indigenous individuals and communities; this was made clear through the analysis of the research findings and is also supported within the literature. This research also demonstrates that access to traditional healing can enhance ownership for community members. These findings emphasize that there is a continued and growing need for support to aid urban Indigenous peoples in accessing traditional health care supports.

Career development. Opportunity 2000.

Science.gov (United States)

Adams, J

Opportunity 2000 is an initiative designed to increase the role of women in the workforce and to promote equal opportunities in the workplace. The NHS Management Executive has set up a women's unit to put Opportunity 2000 into practice and to develop more 'women-friendly' working practices. The unit has produced a good practice handbook. The article discusses the eight goals produced by the NHSME to be achieved by health authorities and trusts by this year.

Analysis of e-learning opportunities in Slovenia during the years 2006 and 2015

Directory of Open Access Journals (Sweden)

Tina Godina

2016-12-01

Full Text Available The author examines the characteristics of e-learning opportunities for adults in Slovenia during the years 2006 and 2015. At the outset, some of the characteristics of this form of education and its development are described. E-learning is a form of education, which is characterized by openness and flexibility, and is as such particularly suitable for the adult population. The year 2006 was chosen as a starting point because this was also the year when the last analysis of the e-learning provisions in Slovenia was published (Zagmajster, 2006. The author compared this year with the year 2015. Data were obtained from the catalogue of the educational offer, which can be accessed at the web portal “Kam po znanje? [Where to Get Knowledge?]”, the latter being is managed by Slovenian Institute for Adult Education.

e-Labs and Work Objects: Towards Digital Health Economies

Science.gov (United States)

Ainsworth, John D.; Buchan, Iain E.

The optimal provision of healthcare and public health services requires the synthesis of evidence from multiple disciplines. It is necessary to understand the genetic, environmental, behavioural and social determinants of disease and health-related states; to balance the effectiveness of interventions with their costs; to ensure the maximum safety and acceptability of interventions; and to provide fair access to care services for given populations. Ever expanding databases of knowledge and local health information, and the ability to employ computationally expensive methods, promises much for decisions to be both supported by best evidence and locally relevant. This promise will, however, not be realised without providing health professionals with the tools to make sense of this information rich environment and to collaborate across disciplines. We propose, as a solution to this problem, the e-Lab and Work Objects model as a sense-making platform for digital health economies - bringing together data, methods and people for timely health intelligence.