WorldWideScience

Sample records for future averted health

  1. Selection of a discount rate for use in NRC regulatory analyses and application of discount rates to future averted health effects

    International Nuclear Information System (INIS)

    Paananen, O.H.; Hendrickson, P.L.

    1993-01-01

    The principal objective of this report is to provide background information and recommendations on the use of discount rates in the regulatory analysis process. The report focuses on two issues selecting the appropriate discount rate or rates to use when conducting a regulatory analysis, and applying the selected discount rate to future health-related benefits estimated to result from alternative regulatory actions

  2. Averting a holocaust

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    Koeberg nuclear power station is running computer software developed in South Africa to maximise the health and safety of both staff and public. Escom has prepared an extensive and costly emergency plan, and should be able to identify some potential problem areas and thus avert accidents

  3. Averting HIV infections in New York City: a modeling approach estimating the future impact of additional behavioral and biomedical HIV prevention strategies.

    Science.gov (United States)

    Kessler, Jason; Myers, Julie E; Nucifora, Kimberly A; Mensah, Nana; Kowalski, Alexis; Sweeney, Monica; Toohey, Christopher; Khademi, Amin; Shepard, Colin; Cutler, Blayne; Braithwaite, R Scott

    2013-01-01

    New York City (NYC) remains an epicenter of the HIV epidemic in the United States. Given the variety of evidence-based HIV prevention strategies available and the significant resources required to implement each of them, comparative studies are needed to identify how to maximize the number of HIV cases prevented most economically. A new model of HIV disease transmission was developed integrating information from a previously validated micro-simulation HIV disease progression model. Specification and parameterization of the model and its inputs, including the intervention portfolio, intervention effects and costs were conducted through a collaborative process between the academic modeling team and the NYC Department of Health and Mental Hygiene. The model projects the impact of different prevention strategies, or portfolios of prevention strategies, on the HIV epidemic in NYC. Ten unique interventions were able to provide a prevention benefit at an annual program cost of less than $360,000, the threshold for consideration as a cost-saving intervention (because of offsets by future HIV treatment costs averted). An optimized portfolio of these specific interventions could result in up to a 34% reduction in new HIV infections over the next 20 years. The cost-per-infection averted of the portfolio was estimated to be $106,378; the total cost was in excess of $2 billion (over the 20 year period, or approximately $100 million per year, on average). The cost-savings of prevented infections was estimated at more than $5 billion (or approximately $250 million per year, on average). Optimal implementation of a portfolio of evidence-based interventions can have a substantial, favorable impact on the ongoing HIV epidemic in NYC and provide future cost-saving despite significant initial costs.

  4. AVERT - Tutorial Homepage

    Science.gov (United States)

    Find the index of Training Modules for AVERT, with instructions for using the training and what you'll need. AVERT can be used to estimate the potential of energy efficiency and renewable energy programs to reduce air pollution.

  5. AVERT User Manual

    Science.gov (United States)

    AVERT is a flexible modeling framework with a simple user interface designed specifically to meet the needs of state air quality planners and other interested stakeholders. Use this guide to get started.

  6. Future Earth Health Knowledge-Action Network.

    Science.gov (United States)

    Shrivastava, Paul; Raivio, Kari; Kasuga, Fumiko; Tewksbury, Joshua; Haines, Andy; Daszak, Peter

    Future Earth is an international research platform providing the knowledge and support to accelerate our transformations to a sustainable world. Future Earth 2025 Vision identified eight key focal challenges, and challenge #6 is to "Improve human health by elucidating, and finding responses to, the complex interactions amongst environmental change, pollution, pathogens, disease vectors, ecosystem services, and people's livelihoods, nutrition and well-being." Several studies, including the Rockefeller Foundation/Lancet Planetary Health Commission Report of 2015, the World Health Organization/Convention on Biological Diversity report and those by oneHEALTH (former ecoHEALTH), have been conducted over the last 30 years. Knowledge-Action Networks (KANs) are the frameworks to apply Future Earth principles of research to related activities that respond to societal challenges. Future Earth Health Knowledge-Action Network will connect health researchers with other natural and social scientists, health and environmental policy professionals and leaders in government, the private sector and civil society to provide research-based solutions based on better, integrated understanding of the complex interactions between a changing global environment and human health. It will build regional capacity to enhance resilience, protect the environment and avert serious threats to health and will also contribute to achieving Sustainable Development Goals. In addition to the initial partners, Future Earth Health Knowledge-Action Network will further nourish collaboration with other on-going, leading research programmes outside Future Earth, by encouraging them in active participation.

  7. Crisis averted: How consumers experienced a police and clinical early response (PACER) unit responding to a mental health crisis.

    Science.gov (United States)

    Evangelista, Eloisa; Lee, Stuart; Gallagher, Angela; Peterson, Violeta; James, Jo; Warren, Narelle; Henderson, Kathryn; Keppich-Arnold, Sandra; Cornelius, Luke; Deveny, Elizabeth

    2016-08-01

    When mental health crisis situations in the community are poorly handled, it can result in physical and emotional injuries. The purpose of this study was to ascertain the experiences and opinions of consumers about the way police and mental health services worked together, specifically via the Alfred Police and Clinical Early Response (A-PACER) model, to assist people experiencing a mental health crisis. Semi-structured in-depth interviews were conducted with 12 mental health consumers who had direct contact with the A-PACER team between June 2013 and March 2015. The study highlighted that people who encountered the A-PACER team generally valued and saw the benefit of a joint police-mental health clinician team response to a mental health crisis situation in the community. In understanding what worked well in how the A-PACER team operated, consumers perspectives can be summarized into five themes: communication and de-escalation, persistence of the A-PACER team, providing a quick response and working well under pressure, handover of information, and A-PACER helped consumers achieve a preferred outcome. All consumers acknowledged the complementary roles of the police officer and mental health clinician, and described the A-PACER team's supportive approach as critical in gaining their trust, engagement and in de-escalating the crises. Further education and training for police officers on how to respond to people with a mental illness, increased provision of follow-up support to promote rehabilitation and prevent future crises, and measures to reduce public scrutiny for the consumer when police responded, were proposed opportunities for improvement. © 2016 Australian College of Mental Health Nurses Inc.

  8. Future of Health

    Science.gov (United States)

    Corbett, Jennie; d'Angelo, Camilla; Gangitano, Lorenzo; Freeman, Jon

    2018-01-01

    Abstract This article presents findings from a survey conducted by RAND Europe at the request of the National Institute for Health Research (NIHR) to gather and synthesise stakeholder views on the future of health and healthcare in England in 20 to 30 years' time. The aim of the research was to generate an evidenced-based picture of the future health and healthcare needs, and how it might differ from today, in order to inform strategic discussions about the future priorities of the NIHR and the health and social care research communities more broadly. The survey provided a rich and varied dataset based on responses from 300 stakeholders in total. A wide range of fields were represented, including public health, social care, primary care, cancer, genomics, mental health, geriatrics, child health, patient advocacy and health policy. The respondent group also included a number of professional and private stakeholder categories, such as clinicians, policy experts, academics and patient and public representatives. The study findings validate a number of prominent health research priorities currently visible in England, such as antimicrobial resistance, the burden of dementia and age-related multi-morbidity, digital health and genomics. Interest in these areas and other themes, such as mental health, health inequalities and transforming health service models, cut across multiple disciplinary boundaries. However, it is clear that there are a variety of views among stakeholders on the relative importance of these areas of focus, and the best approach to manage their emergence in the coming decades. The full dataset of survey responses, for which permission to share was given, is a useful resource for those seeking to engage with a particular issue in more depth. The dataset can be found on NIHR's website at: http://nihr.ac.uk/news-and-events/documents/quotes.xls. PMID:29607245

  9. Valutazione economica dello studio AVERT

    Directory of Open Access Journals (Sweden)

    Simona De Portu

    2007-10-01

    Full Text Available Introduction: the AVERT study (“Aggressive lipid-lowering therapy compared with angioplasty in stable coronary artery disease” compared aggressive cholesterol-lowering (with the statin atorvastatin to angioplasty in patients with mild to moderate coronary artery disease. Aim: our aim was to investigate the economic consequence of high dose of atorvastatin vs percutaneous coronary revascularization followed by standard therapy in Italian patients with stable coronary artery disease Methods: clinical information were taken from the AVERT study. We conducted a cost-effectiveness analysis, comparing high dose of atorvastatin (80 mg/die versus angioplasty in the perspective of the Italian National Health Service. We identified and quantified medical costs: drug costs according to the Italian National Therapeutic Formulary and hospitalizations were quantified based on the Italian National Health Service tariffs (2006. Effects were measured in terms of mortality and morbidity reduction (number of deaths, life years gained and frequency of hospitalizations. We considered an observation period of 18 months. The costs borne after the first 12 months were discounted using an annual rate of 3%. We conducted one and multi-way sensitivity analyses on unit cost and effectiveness. We also conducted a threshold analysis. Results: the cost of atorvastatin therapy or angioplasty over the 18 months period amounted to approximately 779 euro and 5.5 millions euro per 1,000 patients respectively. Atorvastatin was more efficacious compared to angioplasty and the overall cost of care per 1,000 patients over 18 months of follow-up was estimated at 1.8 millions euro in the atorvastatin group and 7.2 millions euro in the angioplasty group, resulting into a cost saving of 5.4 millions euro that is 74,9% of total costs occurred in the angioplasty group. Discussion: this study demonstrates that high does atorvastatin treatment leads to a reduction of direct costs for the

  10. Averting comfortable lifestyle crises.

    Science.gov (United States)

    Bilton, Rod

    2013-01-01

    : alternative non-sugar sweeteners; toxic side-effects of aspartame. Stevia and xylitol as healthy sugar replacements; the role of food processing in dietary health; and beneficial effects of resistant starch in natural and processed foods. The rise of maize and soya-based vegetable oils have led to omega-6 fat overload and imbalance in the dietary ratio of omega-3 to omega-6 fats. This has led to toxicity studies with industrial trans fats; investigations on health risks associated with stress and comfort eating; and abdominal obesity. Other factors to consider are: diet, cholesterol and oxidative stress, as well as the new approaches to the chronology of eating and the health benefits of intermittent fasting.

  11. The personal health future

    NARCIS (Netherlands)

    Spil, Antonius A.M.; Klein, Richard

    2015-01-01

    Despite several personal health record (PHR) product offerings from major technology sector players over the past years, the notion of tracking and maintaining one׳s personal health information electronically has failed to takeoff among consumers. Accordingly, we explore factors potentially shaping

  12. The monetary value of the averted dose for public exposure

    International Nuclear Information System (INIS)

    Katona, T.; Eged, K.; Kanyar, B.; Kis, Z.; Nenvei, A.

    2002-01-01

    In general, the concept of optimisation in radiation protection and safety appears as cost-minimisation in new procedures, methods in practices, and/or protective actions following unacceptable contamination. In the practical implementation of the concept, the cost of protective actions should be balanced with the benefits of exposure reduction. The monetary value of the averted dose can be assessed by the product of the cost of unit avoided collective dose (alpha-value) and the averted collective dose (ICRP 1991, 1993). According to the ICRP and others, the monetary value of the averted dose - in addition to the avoided health detriment - needs to take into account economical and social circumstances, ethical factors etc. (ICRP 1993, 2000; IBSS 1995; Oughton 2000). Most of the alpha-value assessments have been performed for workers (Hardeman et al. 1998; Lefaure 1998). Due to the different dose limitations and action levels for public exposures the monetary value of the averted dose may vary whether the averted dose refers to workers or to the public. Until now, only a few investigations have been performed to the public exposures. Eeckhoudt et al. (1999) proposed a method based on compensation dependency and on comparisons between the workers and the general public. The present paper includes the results obtained by the WTP method for the public. The questionnaire and analysis were developed by the CEPN (Centre d'Etude sur L'Evaluation de la Protection dans le Domaine Nucleaire, France) for specialists in the nuclear field (Leblanc et al. 1994). In 2000, questionnaire modifications were first introduced to adjust the Hungarian factors (Eged et al. 2001, 2002). The questionnaire was further modified in 2001 to take into account the Hungarian public factors

  13. The Future Is Coming: Electronic Health Records

    Science.gov (United States)

    ... Current Issue Past Issues The Future Is Coming: Electronic Health Records Past Issues / Spring 2009 Table of Contents For ... special conference on the cutting-edge topic of electronic health records (EHR) on May 20-21, 2009, on the ...

  14. Federal health web sites: current & future roles.

    Science.gov (United States)

    Cronin, Carol

    2002-09-01

    An examination of the current and possible future roles of federal health Web sites, this paper provides an overview of site categories, functions, target audiences, marketing approaches, knowledge management, and evaluation strategies. It concludes with a look at future opportunities and challenges for the federal government in providing health information online.

  15. The Future of Home Health Care

    Science.gov (United States)

    Landers, Steven; Madigan, Elizabeth; Leff, Bruce; Rosati, Robert J.; McCann, Barbara A.; Hornbake, Rodney; MacMillan, Richard; Jones, Kate; Bowles, Kathryn; Dowding, Dawn; Lee, Teresa; Moorhead, Tracey; Rodriguez, Sally; Breese, Erica

    2016-01-01

    The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on “The Future of Home Health Care,” the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework. PMID:27746670

  16. Future directions in population health.

    Science.gov (United States)

    Hancock, T

    1999-01-01

    The long-term health of the population will be influenced by a number of major forces in the next century. In this brief review, particular emphasis is placed on environmental and economic forces. Major global environmental changes include climate change and global warming, resource depletion, ecotoxicity and reduced biodiversity. We do not yet know the impact on longevity of lifetime exposure to a mix of persistent toxic chemicals in our environment, since it has only been widespread in the past 40-50 years. The health impacts of global warming are only just beginning to be understood and could be profound. But perhaps the most profound threat to population health is economic growth, to the extent that it undermines environmental and social sustainability. We need a new form of capitalism, one that simultaneously increases environmental, social, economic and human capital, if population health is to be maintained in the 21st century.

  17. The Public Health Practitioner of the Future.

    Science.gov (United States)

    Erwin, Paul Campbell; Brownson, Ross C

    2017-08-01

    The requisite capacities and capabilities of the public health practitioner of the future are being driven by multiple forces of change, including public health agency accreditation, climate change, health in all policies, social media and informatics, demographic transitions, globalized travel, and the repercussions of the Affordable Care Act. We describe five critical capacities and capabilities that public health practitioners can build on to successfully prepare for and respond to these forces of change: systems thinking and systems methods, communication capacities, an entrepreneurial orientation, transformational ethics, and policy analysis and response. Equipping the public health practitioner with the requisite capabilities and capacities will require new content and methods for those in public health academia, as well as a recommitment to lifelong learning on the part of the practitioner, within an increasingly uncertain and polarized political environment.

  18. Climate change and health in Earth's future

    Science.gov (United States)

    Bowles, Devin C.; Butler, Colin D.; Friel, Sharon

    2014-02-01

    Threats to health from climate change are increasingly recognized, yet little research into the effects upon health systems is published. However, additional demands on health systems are increasingly documented. Pathways include direct weather impacts, such as amplified heat stress, and altered ecological relationships, including alterations to the distribution and activity of pathogens and vectors. The greatest driver of demand on future health systems from climate change may be the alterations to socioeconomic systems; however, these "tertiary effects" have received less attention in the health literature. Increasing demands on health systems from climate change will impede health system capacity. Changing weather patterns and sea-level rise will reduce food production in many developing countries, thus fostering undernutrition and concomitant disease susceptibility. Associated poverty will impede people's ability to access and support health systems. Climate change will increase migration, potentially exposing migrants to endemic diseases for which they have limited resistance, transporting diseases and fostering conditions conducive to disease transmission. Specific predictions of timing and locations of migration remain elusive, hampering planning and misaligning needs and infrastructure. Food shortages, migration, falling economic activity, and failing government legitimacy following climate change are also "risk multipliers" for conflict. Injuries to combatants, undernutrition, and increased infectious disease will result. Modern conflict often sees health personnel and infrastructure deliberately targeted and disease surveillance and eradication programs obstructed. Climate change will substantially impede economic growth, reducing health system funding and limiting health system adaptation. Modern medical care may be snatched away from millions who recently obtained it.

  19. Creating a Future for Occupational Health.

    Science.gov (United States)

    Peckham, Trevor K; Baker, Marissa G; Camp, Janice E; Kaufman, Joel D; Seixas, Noah S

    2017-01-01

    Economic, social, technical, and political drivers are fundamentally changing the nature of work and work environments, with profound implications for the field of occupational health. Nevertheless, researchers and practitioners entering the field are largely being trained to assess and control exposures using approaches developed under old models of work and risks. A speaker series and symposium were organized to broadly explore current challenges and future directions for the occupational health field. Broad themes identified throughout these discussions are characterized and discussed to highlight important future directions of occupational health. Despite the relatively diverse group of presenters and topics addressed, some important cross-cutting themes emerged. Changes in work organization and the resulting insecurity and precarious employment arrangements change the nature of risk to a large fraction of the workforce. Workforce demographics are changing, and economic disparities among working groups are growing. Globalization exacerbates the 'race to the bottom' for cheap labor, poor regulatory oversight, and limited labor rights. Largely, as a result of these phenomena, the historical distinction between work and non-work exposures has become largely artificial and less useful in understanding risks and developing effective public health intervention models. Additional changes related to climate change, governmental and regulatory limitations, and inadequate surveillance systems challenge and frustrate occupational health progress, while new biomedical and information technologies expand the opportunities for understanding and intervening to improve worker health. The ideas and evidences discussed during this project suggest that occupational health training, professional practice, and research evolve towards a more holistic, public health-oriented model of worker health. This will require engagement with a wide network of stakeholders. Research and

  20. The Equity Impact Vaccines May Have On Averting Deaths And Medical Impoverishment In Developing Countries.

    Science.gov (United States)

    Chang, Angela Y; Riumallo-Herl, Carlos; Perales, Nicole A; Clark, Samantha; Clark, Andrew; Constenla, Dagna; Garske, Tini; Jackson, Michael L; Jean, Kévin; Jit, Mark; Jones, Edward O; Li, Xi; Suraratdecha, Chutima; Bullock, Olivia; Johnson, Hope; Brenzel, Logan; Verguet, Stéphane

    2018-02-01

    With social policies increasingly directed toward enhancing equity through health programs, it is important that methods for estimating the health and economic benefits of these programs by subpopulation be developed, to assess both equity concerns and the programs' total impact. We estimated the differential health impact (measured as the number of deaths averted) and household economic impact (measured as the number of cases of medical impoverishment averted) of ten antigens and their corresponding vaccines across income quintiles for forty-one low- and middle-income countries. Our analysis indicated that benefits across these vaccines would accrue predominantly in the lowest income quintiles. Policy makers should be informed about the large health and economic distributional impact that vaccines could have, and they should view vaccination policies as potentially important channels for improving health equity. Our results provide insight into the distribution of vaccine-preventable diseases and the health benefits associated with their prevention.

  1. My Health, My Choice, My Future Preconception Health

    Centers for Disease Control (CDC) Podcasts

    2012-10-01

    Preconception health means taking care of your own health now so you’ll be healthy for yourself and your future baby.  Created: 10/1/2012 by National Center on Birth Defects and Developmental Disabilities (NCBDDD).   Date Released: 10/1/2012.

  2. Future and potential spending on health 2015-40

    NARCIS (Netherlands)

    Dieleman, Joseph L.; Campbell, Madeline; Chapin, Abigail; Eldrenkamp, Erika; Fan, Victoria Y.; Haakenstad, Annie; Kates, Jennifer; Li, Zhiyin; Matyasz, Taylor; Micah, Angela; Reynolds, Alex; Sadat, Nafis; Schneider, Matthew T.; Sorensen, Reed; Abbas, Kaja M.; Abera, Semaw Ferede; Ahmad Kiadaliri, Aliasghar; Ahmed, Muktar Beshir; Alam, Khurshid; Alizadeh-Navaei, Reza; Alkerwi, A.; Amini, Erfan; Ammar, Walid; Antonio, Carl Abelardo T.; Atey, Tesfay Mehari; Avila-Burgos, Leticia; Awasthi, Ashish; Barac, Aleksandra; Berheto, Tezera Moshago; Beyene, Addisu Shunu; Beyene, Tariku Jibat; Birungi, Charles; Bizuayehu, Habtamu Mellie; Breitborde, Nicholas J.K.; Cahuana-Hurtado, Lucero; Castro, Ruben Estanislao; Catalá-López, Ferran; Dalal, Koustuv; Dandona, Lalit; Dharmaratne, Rakhi Dandona Samath D.; Dubey, Manisha; Faro, Andé; Feigl, Andrea B.; Fischer, Florian; Anderson Fitchett, Joseph R.; Foigt, Nataliya; Giref, Ababi Zergaw; Gupta, Rahul; Hamidi, Samer; Harb, Hilda L.; Hay, Simon I.; Hendrie, Delia; Horino, Masako; Jürisson, Mikk; Jakovljevic, Mihajlo B.; Javanbakht, Mehdi; John, Denny; Jonas, Jost B.; Karimi, Seyed M.; Khang, Young Ho; Khubchandani, Jagdish; Kim, Yun Jin; Kinge, Jonas M.; Krohn, Kristopher J.; Kumar, G.A.; Leung, Ricky; Magdy Abd El Razek, Hassan; Magdy Abd El Razek, Mohammed; Majeed, Azeem; Malekzadeh, Reza; Malta, Deborah Carvalho; Meretoja, Atte; Miller, Ted R.; Mirrakhimov, Erkin M.; Mohammed, Shafiu; Molla, Gedefaw; Nangia, Vinay; Olgiati, Stefano; Owolabi, Mayowa O.; Patel, Tejas; Paternina Caicedo, Angel J.; Pereira, David M.; Perelman, Julian; Polinder, Suzanne; Rafay, Anwar; Rahimi-Movaghar, Vafa; Rai, Rajesh Kumar; Ram, Usha; Ranabhat, Chhabi Lal; Roba, Hirbo Shore; Savic, Miloje; Sepanlou, Sadaf G.; Ao, Te Braden J.; Tesema, Azeb Gebresilassie; Thomson, Alan J.; Tobe-Gai, Ruoyan; Topor-Madry, Roman; Undurraga, Eduardo A.; Vargas, Veronica; Vasankari, Tommi; Violante, Francesco S.; Wijeratne, Tissa; Xu, Gelin; Yonemoto, Naohiro; Younis, Mustafa Z.; Yu, Chuanhua; Zaidi, Zoubida; Sayed Zaki, El Maysaa; Murray, Christopher J.L.

    2017-01-01

    Background: The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future

  3. Matrix analysis and risk management to avert depression and suicide among workers

    OpenAIRE

    Takeuchi, Takeaki

    2010-01-01

    Abstract Suicide is among the most tragic outcomes of all mental disorders, and the prevalence of suicide has risen dramatically during the last decade, particularly among workers. This paper reviews and proposes strategies to avert suicide and depression with regard to the mind body medicine equation hypothesis, metrics analysis of mental health problems from a public health and clinical medicine view. In occupational fields, the mind body medicine hypothesis has to deal with working environ...

  4. [Health centers: history and future prospects.].

    Science.gov (United States)

    Colin, Marie-Pierre; Acker, Dominique

    2009-03-29

    Health houses and health centers are often hailed as specifically modern forms of medical practice in mobile healthcare provision. Yet the concept of health center emerged in the seventeenth century. The founding principles of these institutions were to promote access to good-quality universal healthcare and to practice a form of healthcare that treated patients in their globality (i.e. within their social and environmental context) based on public healthcare measures. Though they constitute a response to a specific healthcare project, healthcare centers face a number of specific difficulties that pose a challenge to their durability and development. Payment per consultation is ill-adapted to the remuneration of their services, and methods of remuneration that may be applicable to independent medical practitioners do not apply in the context of health centers, which may struggle to survive without the support of territorial collectivities (i.e. regional and local authorities) or associations. Health houses face similar difficulties in terms of their structural expenses. Expectations are high for trying out new methods of remuneration. The perspective and experience of healthcare centers will likely prove to be essential in this context. Their future needs to be envisaged alongside health houses and medical hubs. The growth of precarity and the increasing difficulties affecting access to healthcare provision need to be taken into account. The choice of the specific type of structure will depend on local realities, on the political will of regional authorities and on the specific projects of healthcare professionals. Yet whatever solution is envisaged, it will not be possible without public funding.

  5. Knowledge is power: averting safety-compromising events in the OR.

    Science.gov (United States)

    Catalano, Kathleen

    2008-12-01

    Surgical procedures can be unpredictable, and safety-compromising events can jeopardize patient safety. Perioperative nurses should be watchful for factors that can contribute to safety-compromising events, as well as the errors that can follow, and know how to avert them if possible. Knowledge is power and increased awareness of patient safety issues and the resources that are available to both health care practitioners and consumers can help perioperative nurses ward off patient safety problems before they occur.

  6. Technology and the Future of Mental Health Treatment

    Science.gov (United States)

    ... Health Intervention Technology? Join a Study Learn More Technology and the Future of Mental Health Treatment Introduction ... What is NIMH’s Role in Mental Health Intervention Technology? Between FY2009 and FY2015, NIMH awarded 404 grants ...

  7. Anticipating the Future of Mental Health Needs on Campus

    Science.gov (United States)

    Bonfiglio, Robert A.

    2016-01-01

    The provision of college mental health services is undergoing a dynamic evolution. The ability of mental health practitioners and administrators to balance multiple and sometimes opposing trends may determine the future course of mental health services in higher education.

  8. Cost-benefit of ventilation and averted radon in dwellings

    International Nuclear Information System (INIS)

    Katona, T.; Kanyar, B.

    2003-01-01

    To assess an economically optimal ventilation rate we have introduced a cost-benefit analysis taking into account the cost of heating and benefit of averted dose due to ventilation. The cost of heating due to the elevated ventilation for mitigation of radon content in dwellings can be compensated by the monetary benefit of the averted dose, in case of higher (annually 3-10 mSv) exposure. During the heating season the economically optimal ventilation takes 0.1-0.5 h -1 , meanwhile the radon concentration in the indoor air decreases to 200-800 Bq/m 3 , depending on the exhalation of radon, number of persons living in the dwellings and other local parameters. Our results from the optimal planning correspond to the radon concentrations recommended by the international organizations as action levels. In general, the periodic ventilation in daytime provides a higher averted dose than the constant one in case of the same heating cost. (authors)

  9. A Systematic Review of Cost-Effectiveness Studies Reporting Cost-per-DALY Averted.

    Directory of Open Access Journals (Sweden)

    Peter J Neumann

    Full Text Available Calculating the cost per disability-adjusted life years (DALYs averted associated with interventions is an increasing popular means of assessing the cost-effectiveness of strategies to improve population health. However, there has been no systematic attempt to characterize the literature and its evolution.We conducted a systematic review of cost-effectiveness studies reporting cost-per-DALY averted from 2000 through 2015. We developed the Global Health Cost-Effectiveness Analysis (GHCEA Registry, a repository of English-language cost-per-DALY averted studies indexed in PubMed. To identify candidate studies, we searched PubMed for articles with titles or abstracts containing the phrases "disability-adjusted" or "DALY". Two reviewers with training in health economics independently reviewed each article selected in our abstract review, gathering information using a standardized data collection form. We summarized descriptive characteristics on study methodology: e.g., intervention type, country of study, study funder, study perspective, along with methodological and reporting practices over two time periods: 2000-2009 and 2010-2015. We analyzed the types of costs included in analyses, the study quality on a scale from 1 (low to 7 (high, and examined the correlation between diseases researched and the burden of disease in different world regions.We identified 479 cost-per-DALY averted studies published from 2000 through 2015. Studies from Sub-Saharan Africa comprised the largest portion of published studies. The disease areas most commonly studied were communicable, maternal, neonatal, and nutritional disorders (67%, followed by non-communicable diseases (28%. A high proportion of studies evaluated primary prevention strategies (59%. Pharmaceutical interventions were commonly assessed (32% followed by immunizations (28%. Adherence to good practices for conducting and reporting cost-effectiveness analysis varied considerably. Studies mainly included

  10. Implementing a complex rehabilitation intervention in a stroke trial: a qualitative process evaluation of AVERT.

    Science.gov (United States)

    Luker, Julie A; Craig, Louise E; Bennett, Leanne; Ellery, Fiona; Langhorne, Peter; Wu, Olivia; Bernhardt, Julie

    2016-05-10

    The implementation of multidisciplinary stroke rehabilitation interventions is challenging, even when the intervention is evidence-based. Very little is known about the implementation of complex interventions in rehabilitation clinical trials. The aim of study was to better understand how the implementation of a rehabilitation intervention in a clinical trial within acute stroke units is experienced by the staff involved. This qualitative process evaluation was part of a large Phase III stroke rehabilitation trial (AVERT). A descriptive qualitative approach was used. We purposively sampled 53 allied health and nursing staff from 19 acute stroke units in Australia, New Zealand and Scotland. Semi-structured interviews were conducted by phone, voice-internet, or face to face. Digitally recorded interviews were transcribed and analysed by two researchers using rigorous thematic analysis. Our analysis uncovered ten important themes that provide insight into the challenges of implementing complex new rehabilitation practices within complex care settings, plus factors and strategies that assisted implementation. Themes were grouped into three main categories: staff experience of implementing the trial intervention, barriers to implementation, and overcoming the barriers. Participation in the trial was challenging but had personal rewards and improved teamwork at some sites. Over the years that the trial ran some staff perceived a change in usual care. Barriers to trial implementation at some sites included poor teamwork, inadequate staffing, various organisational barriers, staff attitudes and beliefs, and patient-related barriers. Participants described successful implementation strategies that were built on interdisciplinary teamwork, education and strong leadership to 'get staff on board', and developing different ways of working. The AVERT stroke rehabilitation trial required commitment to deliver an intervention that needed strong collaboration between nurses and

  11. Economic Valuation of the Global Burden of Cleft Disease Averted by a Large Cleft Charity.

    Science.gov (United States)

    Poenaru, Dan; Lin, Dan; Corlew, Scott

    2016-05-01

    This study attempts to quantify the burden of disease averted through the global surgical work of a large cleft charity, and estimate the economic impact of this effort over a 10-year period. Anonymized data of all primary cleft lip and cleft palate procedures in the Smile Train database were analyzed and disability-adjusted life years (DALYs) calculated using country-specific life expectancy tables, established disability weights, and estimated success of surgery and residual disability probabilities; multiple age weighting and discounting permutations were included. Averted DALYs were calculated and gross national income (GNI) per capita was then multiplied by averted DALYs to estimate economic gains. 548,147 primary cleft procedures were performed in 83 countries between 2001 and 2011. 547,769 records contained complete data available for the study; 58 % were cleft lip and 42 % cleft palate. Averted DALYs ranged between 1.46 and 4.95 M. The mean economic impact ranged between USD 5510 and 50,634 per person. This corresponded to a global economic impact of between USD 3.0B and 27.7B USD, depending on the DALY and GNI values used. The estimated cost of providing these procedures based on an average reimbursement rate was USD 197M (0.7-6.6 % of the estimated impact). The immense economic gain realized through procedures focused on a small proportion of the surgical burden of disease highlights the importance and cost-effectiveness of surgical treatment globally. This methodology can be applied to evaluate interventions for other conditions, and for evidence-based health care resource allocation.

  12. The future of European health policies.

    Science.gov (United States)

    Koivusalo, Meri Tuulikki

    2005-01-01

    The role of the European Union in health policies is changing. The European social model is under threat due to shifts in E.U. policies on liberalization of service provision, limited public budgets, a focus on the health sector as a productive sector in the context of broader European policies and the Lisbon strategy, and changes in the context of the new Constitutional Treaty. These changes are evident in a new reflection paper on European health strategy and its focus. E.U. health policies are at a critical juncture. The danger is that the current processes will lead European health policies and the health systems of member states more in the direction of U.S. health policies and the commercialization of health systems than toward improvement of the current situation.

  13. COMMENTARY: GLOBALIZATION, HEALTH SECTOR REFORM, AND THE HUMAN RIGHT TO HEALTH: IMPLICATIONS FOR FUTURE HEALTH POLICY.

    Science.gov (United States)

    Schuftan, Claudio

    2015-01-01

    The author here distills his long-time personal experience with the deleterious effects of globalization on health and on the health sector reforms embarked on in many of the more than 50 countries where he has worked in the last 25 years. He highlights the role that the "human right to health" framework can and should play in countering globalization's negative effects on health and in shaping future health policy. This is a testimonial article.

  14. INTEGRATING HEALTH INTO BUILDINGS OF THE FUTURE.

    Science.gov (United States)

    Heidari, Leila; Younger, Margalit; Chandler, George; Gooch, James; Schramm, Paul

    2016-01-01

    The health and wellbeing of building occupants should be a key priority in the design, building, and operation of new and existing buildings. Buildings can be designed, renovated, and constructed to promote healthy environments and behaviors and mitigate adverse health outcomes. This paper highlights health in terms of the relationship between occupants and buildings, as well as the relationship of buildings to the community. In the context of larger systems, smart buildings and green infrastructure strategies serve to support public health goals. At the level of the individual building, interventions that promote health can also enhance indoor environmental quality and provide opportunities for physical activity. Navigating the various programs that use metrics to measure a building's health impacts reveals that there are multiple co-benefits of a "healthy building," including those related to the economy, environment, society, transportation, planning, and energy efficiency.

  15. Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40.

    Science.gov (United States)

    2018-05-05

    Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040. We extracted historical data on gross domestic product (GDP) and health spending for 188 countries from 1995 to 2015, and projected annual GDP, development assistance for health, and government, out-of-pocket, and prepaid private health spending from 2015 through to 2040 as a reference scenario. These estimates were generated using an ensemble of models that varied key demographic and socioeconomic determinants. We generated better and worse alternative future scenarios based on the global distribution of historic health spending growth rates. Last, we used stochastic frontier analysis to investigate the association between pooled health resources and UHC index, a measure of a country's UHC service coverage. Finally, we estimated future UHC performance and the number of people covered under the three future scenarios. In the reference scenario, global health spending was projected to increase from US$10 trillion (95% uncertainty interval 10 trillion to 10 trillion) in 2015 to $20 trillion (18 trillion to 22 trillion) in 2040. Per capita health spending was projected to increase fastest in upper-middle-income countries, at 4·2% (3·4-5·1) per year, followed by lower-middle-income countries (4·0%, 3·6-4·5) and low-income countries (2·2%, 1·7-2·8). Despite global growth, per capita health spending was projected to range from only $40 (24-65) to $413 (263-668) in 2040 in low-income countries, and from $140 (90-200) to $1699 (711-3423) in lower-middle-income countries. Globally, the share of health spending

  16. Future health care technology and the hospital

    NARCIS (Netherlands)

    Banta, H.D.

    1990-01-01

    The past decades have been a time of rapid technological change in health care, but technological change will probably accelerate during the next decade or so. This will bring problems, but it will also present certain opportunities. In particular, the health care system is faced with the need to

  17. Food for thought: food systems, livestock futures and animal health.

    Science.gov (United States)

    Wilkinson, Angela

    2013-12-01

    Global food security, livestock production and animal health are inextricably bound. However, our focus on the future tends to disaggregate food and health into largely separate domains. Indeed, much foresight work is either food systems or health-based with little overlap in terms of predictions or narratives. Work on animal health is no exception. Part of the problem is the fundamental misunderstanding of the role, nature and impact of the modern futures tool kit. Here, I outline three key issues in futures research ranging from methodological confusion over the application of scenarios to the failure to effectively integrate multiple methodologies to the gap between the need for more evidence and power and control over futures processes. At its core, however, a better understanding of the narrative and worldview framing much of the futures work in animal health is required to enhance the value and impact of such exercises.

  18. Future preparation of occupational health nurse managers.

    Science.gov (United States)

    Scalzi, C C; Wilson, D L; Ebert, R

    1991-03-01

    This article presents the results of a national survey of job activities of corporate level occupational health nurse managers. The survey was designed to identify the relative amount of time spent and importance attributed to specific areas of their current job. In general this sample tended to have more management experience and educational preparation than previously cited studies: over 50% had completed a graduate degree. The scores for importance and time spent were highly correlated. That is, occupational health corporate nurse managers seemed to allocate their time to job responsibilities they considered most important. Management activities related to policy, practice standards, quality assurance, staff development, and systems for client care delivery appear to represent the core responsibilities of occupational health nursing management. Curriculum recommendations for management positions in occupational health include: health policy, program planning, and evaluation; business strategy; applications of management information systems; quality assurance; and marketing.

  19. Health care delivery in the future.

    Science.gov (United States)

    Harnar, R

    1983-01-01

    India's health care system, despite several significant achievements, suffers from some weaknesses and deficiencies. There has been a preoccupation with the promotion of curative and clinical services through city based hospitals which have essentially catered to certain sections of the urban population. The concept of health in its totality, with preventive and promotive health care services in addition to the curative, has yet to be made operational. There has been an overdependence on the states for health care measures and voluntary and local effort has not been able to accept responsibility in any significant way. The involvement of the people in solving their health problems has been almost nonexistent. Health needs to be viewed as part of the strategy of human resources development. Horizontal and vertical linkages must be obtained among all the interrelated programs--protected water supply environmental sanitation and hygiene, nutrition, education, family planning, and maternal and child welfare. Only with such linkages can the benefits of the various programs be optimized. An attack on the problems of diseases cannot be completely successful unless it is accompanied by an attack on poverty. For this reason the 6th plan assigns a high priority to programs of promotion, or gainful employment, eradication of poverty, population control, and meeting the basic human needs of the population. The Alma Alta Declaration of 1977 has become the accepted health policy of India, simplified into the slogan "health for all by 2000." To realize this goaL, the Planning Commission recommends in the 6th 5-Year Plan a restructing and reorientation of the country's health services. The proposed alternative scheme is more decentralized and provides for many more people to be trained at the grassroots level. People would be involved in tackling their health problems and community participation would be encouraged. Finally, the alternative strongly urges the screening of patients

  20. Averting Behavior Framework for Perceived Risk of Yersinia enterocolitica Infections.

    Science.gov (United States)

    Aziz, Sonia N; Aziz, Khwaja M S

    2012-01-01

    The focus of this research is to present a theoretical model of averting actions that households take to avoid exposure to Yersinia enterocolitica in contaminated food. The cost of illness approach only takes into account the value of a cure, while the averting behavior approach can estimate the value of preventing the illness. The household, rather than the individual, is the unit of analysis in this model, where one household member is primarily responsible for procuring uncontaminated food for their family. Since children are particularly susceptible and live with parents who are primary decision makers for sustenance, the designated household head makes the choices that are investigated in this paper. This model uses constrained optimization to characterize activities that may offer protection from exposure to Yersinia enterocolitica contaminated food. A representative household decision maker is assumed to allocate family resources to maximize utility of an altruistic parent, an assumption used in most research involving economics of the family.

  1. Averting Behavior Framework for Perceived Risk of Yersinia enterocolitica Infections

    Directory of Open Access Journals (Sweden)

    Sonia N. Aziz

    2012-01-01

    Full Text Available The focus of this research is to present a theoretical model of averting actions that households take to avoid exposure to Yersinia enterocolitica in contaminated food. The cost of illness approach only takes into account the value of a cure, while the averting behavior approach can estimate the value of preventing the illness. The household, rather than the individual, is the unit of analysis in this model, where one household member is primarily responsible for procuring uncontaminated food for their family. Since children are particularly susceptible and live with parents who are primary decision makers for sustenance, the designated household head makes the choices that are investigated in this paper. This model uses constrained optimization to characterize activities that may offer protection from exposure to Yersinia enterocolitica contaminated food. A representative household decision maker is assumed to allocate family resources to maximize utility of an altruistic parent, an assumption used in most research involving economics of the family.

  2. [Health disparities: local realities and future challenges].

    Science.gov (United States)

    Bodenmann, P; Green, A R

    2012-11-28

    Since 1887, the Policlinique Médicale Universitaire (PMU) has brought care to vulnerable populations who are at risk of poor physical, mental and social health. These include marginalised Swiss natives and immigrant communities (asylum seekers, undocumented immigrants). These patients are at risk of health disparities given their poor access to the health care system and lack of adapted quality care. Clinical approach must address these potential disparities, reinforced by a research describing them in order to explain their cause, and propose possible solutions, and a medical training addressing these topics from the undergraduate to the attending level. Through those holistic clinical approach, robust research and improved medical training, health providers will contribute to give quality care to all citizens, without exception!

  3. Measuring a leader's ability to identify and avert crisis

    OpenAIRE

    Jamie Brownlee-Turgeon

    2017-01-01

    Leaders often have influence over the impact of pending crises by either preventing or minimizing the crisis (Pearson and Mitroff, 1993; Bonvillian, 2013). With crisis looming just around the corner, a leader’s ability to identify, avert, and manage a crisis has become a fundamental element in organizational sustainability. Yet, most literature on crisis is focused in the field of communication or crisis management during the actual event. Wooten and James (2008) provide a conceptual model...

  4. Community health nursing vision for 2020: shaping the future.

    Science.gov (United States)

    Schofield, Ruth; Ganann, Rebecca; Brooks, Sandy; McGugan, Jennifer; Dalla Bona, Kim; Betker, Claire; Dilworth, Katie; Parton, Laurie; Reid-Haughian, Cheryl; Slepkov, Marlene; Watson, Cori

    2011-12-01

    As health care is shifting from hospital to community, community health nurses (CHNs) are directly affected. This descriptive qualitative study sought to understand priority issues currently facing CHNs, explore development of a national vision for community health nursing, and develop recommendations to shape the future of the profession moving toward the year 2020. Focus groups and key informant interviews were conducted across Canada. Five key themes were identified: community health nursing in crisis now, a flawed health care system, responding to the public, vision for the future, and CHNs as solution makers. Key recommendations include developing a common definition and vision of community health nursing, collaborating on an aggressive plan to shift to a primary health care system, developing a comprehensive social marketing strategy, refocusing basic baccalaureate education, enhancing the capacity of community health researchers and knowledge in community health nursing, and establishing a community health nursing center of excellence.

  5. Oral health in Libya: addressing the future challenges | Peeran ...

    African Journals Online (AJOL)

    Libya is a vast country situated in North Africa, having a relatively better functioning economy with a scanty population. This article is the first known attempt to review the current state of oral health care in Libya and to explore the present trends and future challenges. Libyan health system, oral health care, and human ...

  6. Future of Military Health Care Final Report

    Science.gov (United States)

    2007-12-20

    AND+third. 15 Ibid. 16 Ibid. 17 32 C.F.R. §199.17(p)(5)(ii) (2005). 18 See http://mytoc.tma.osd.mil/AccessToCare/ TOC /ATC.htm. 19 File name...responsible sexual behavior; mental health; injury and violence; environmental quality; immunization; and access to care.11 Responsibility The Assistant

  7. Public health protection in the future

    International Nuclear Information System (INIS)

    Frigren, S.

    2000-01-01

    The role of nuclear energy in the future will depend on how nuclear safety is developing and also on how it is perceived. Worries about insufficient safety in Eastern and Central European Countries have led to a substantial assistance programme where the EU and its member states still are the largest contributors. For those countries that have applied for EU membership, nuclear safety will be one of the crucial issues and all kind of assistance and co-operation efforts are made to facilitate the process. At the same time, public awareness of both prospects and problems with nuclear is developing quickly, also outside of the EU. And so are methods and processes to involve local institutions and the public in decision making. What this will mean for the future role of nuclear energy in summary is impossible to say. It will depend on how convincing politicians, industry and experts will be in the eyes of the public, and how that works out in the democratic process

  8. Future Research in Health Information Technology: A Review.

    Science.gov (United States)

    Hemmat, Morteza; Ayatollahi, Haleh; Maleki, Mohammad Reza; Saghafi, Fatemeh

    2017-01-01

    Currently, information technology is considered an important tool to improve healthcare services. To adopt the right technologies, policy makers should have adequate information about present and future advances. This study aimed to review and compare studies with a focus on the future of health information technology. This review study was completed in 2015. The databases used were Scopus, Web of Science, ProQuest, Ovid Medline, and PubMed. Keyword searches were used to identify papers and materials published between 2000 and 2015. Initially, 407 papers were obtained, and they were reduced to 11 papers at the final stage. The selected papers were described and compared in terms of the country of origin, objective, methodology, and time horizon. The papers were divided into two groups: those forecasting the future of health information technology (seven papers) and those providing health information technology foresight (four papers). The results showed that papers related to forecasting the future of health information technology were mostly a literature review, and the time horizon was up to 10 years in most of these studies. In the health information technology foresight group, most of the studies used a combination of techniques, such as scenario building and Delphi methods, and had long-term objectives. To make the most of an investment and to improve planning and successful implementation of health information technology, a strategic plan for the future needs to be set. To achieve this aim, methods such as forecasting the future of health information technology and offering health information technology foresight can be applied. The forecasting method is used when the objectives are not very large, and the foresight approach is recommended when large-scale objectives are set to be achieved. In the field of health information technology, the results of foresight studies can help to establish realistic long-term expectations of the future of health information

  9. Personalizing health care: feasibility and future implications.

    Science.gov (United States)

    Godman, Brian; Finlayson, Alexander E; Cheema, Parneet K; Zebedin-Brandl, Eva; Gutiérrez-Ibarluzea, Inaki; Jones, Jan; Malmström, Rickard E; Asola, Elina; Baumgärtel, Christoph; Bennie, Marion; Bishop, Iain; Bucsics, Anna; Campbell, Stephen; Diogene, Eduardo; Ferrario, Alessandra; Fürst, Jurij; Garuoliene, Kristina; Gomes, Miguel; Harris, Katharine; Haycox, Alan; Herholz, Harald; Hviding, Krystyna; Jan, Saira; Kalaba, Marija; Kvalheim, Christina; Laius, Ott; Lööv, Sven-Ake; Malinowska, Kamila; Martin, Andrew; McCullagh, Laura; Nilsson, Fredrik; Paterson, Ken; Schwabe, Ulrich; Selke, Gisbert; Sermet, Catherine; Simoens, Steven; Tomek, Dominik; Vlahovic-Palcevski, Vera; Voncina, Luka; Wladysiuk, Magdalena; van Woerkom, Menno; Wong-Rieger, Durhane; Zara, Corrine; Ali, Raghib; Gustafsson, Lars L

    2013-08-13

    Considerable variety in how patients respond to treatments, driven by differences in their geno- and/ or phenotypes, calls for a more tailored approach. This is already happening, and will accelerate with developments in personalized medicine. However, its promise has not always translated into improvements in patient care due to the complexities involved. There are also concerns that advice for tests has been reversed, current tests can be costly, there is fragmentation of funding of care, and companies may seek high prices for new targeted drugs. There is a need to integrate current knowledge from a payer's perspective to provide future guidance. Multiple findings including general considerations; influence of pharmacogenomics on response and toxicity of drug therapies; value of biomarker tests; limitations and costs of tests; and potentially high acquisition costs of new targeted therapies help to give guidance on potential ways forward for all stakeholder groups. Overall, personalized medicine has the potential to revolutionize care. However, current challenges and concerns need to be addressed to enhance its uptake and funding to benefit patients.

  10. Antibiotic innovation for future public health needs.

    Science.gov (United States)

    Theuretzbacher, U

    2017-10-01

    The public health threat of antibiotic resistance has gained attention at the highest political levels globally, and recommendations on how to respond are being considered for implementation. Among the recommended responses being explored for their feasibility is the introduction of economic incentives to promote research and development of new antibiotics. There is broad agreement that public investment should stimulate innovation and be linked to policies promoting sustainable and equitable access to antibiotics. Though commonly used, the term 'innovation' is not based on a common understanding. This article aims to initiate discussion on the meaning of 'innovation' in this context. Literature and expert opinion. As the definition of a novel class (novel scaffold, novel pharmacophore), a novel target (novel binding site) and a novel mode of action-the three traditional criteria for 'innovation' in this context-may be confounded by the complexities of antibacterial drug discovery, a biological and outcome-oriented definition of innovation is presented to initiate discussion. Such an expanded definition of innovation in this specific context is based on the overarching requirement that a drug not be affected by cross-resistance to existing drugs in the organisms and indications for which it is intended to be used, and that it have low potential for high-frequency, high-level single-step resistance if intended as a single drug therapy. Policy makers, public health authorities and funders could use such a comprehensive definition of innovation to prioritize where publicly funded incentives should be applied. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  11. Implementing a complex rehabilitation intervention in a stroke trial: a qualitative process evaluation of AVERT

    Directory of Open Access Journals (Sweden)

    Julie A Luker

    2016-05-01

    Full Text Available Abstract Background The implementation of multidisciplinary stroke rehabilitation interventions is challenging, even when the intervention is evidence-based. Very little is known about the implementation of complex interventions in rehabilitation clinical trials. The aim of study was to better understand how the implementation of a rehabilitation intervention in a clinical trial within acute stroke units is experienced by the staff involved. This qualitative process evaluation was part of a large Phase III stroke rehabilitation trial (AVERT. Methods A descriptive qualitative approach was used. We purposively sampled 53 allied health and nursing staff from 19 acute stroke units in Australia, New Zealand and Scotland. Semi-structured interviews were conducted by phone, voice-internet, or face to face. Digitally recorded interviews were transcribed and analysed by two researchers using rigorous thematic analysis. Results Our analysis uncovered ten important themes that provide insight into the challenges of implementing complex new rehabilitation practices within complex care settings, plus factors and strategies that assisted implementation. Themes were grouped into three main categories: staff experience of implementing the trial intervention, barriers to implementation, and overcoming the barriers. Participation in the trial was challenging but had personal rewards and improved teamwork at some sites. Over the years that the trial ran some staff perceived a change in usual care. Barriers to trial implementation at some sites included poor teamwork, inadequate staffing, various organisational barriers, staff attitudes and beliefs, and patient-related barriers. Participants described successful implementation strategies that were built on interdisciplinary teamwork, education and strong leadership to ‘get staff on board’, and developing different ways of working. Conclusions The AVERT stroke rehabilitation trial required commitment to deliver

  12. Epigenomic programing: a future way to health?

    Directory of Open Access Journals (Sweden)

    Boris A. Shenderov

    2014-05-01

    Full Text Available It is now generally accepted that the ‘central genome dogma’ (i.e. a causal chain going from DNA to RNA to proteins and downstream to biological functions should be replaced by the ‘fluid genome dogma’, that is, complex feed-forward and feed-back cycles that interconnect organism and environment by epigenomic programing – and reprograming – throughout life and at all levels, sometimes also down the generations. The epigenomic programing is the net sum of interactions derived from own metabolism and microbiota as well as external factors such as diet, pharmaceuticals, environmental compounds, and so on. It is a growing body of results indicating that many chronic metabolic and degenerative disorders and diseases – often called ‘civilization diseases’ – are initiated and/or influenced upon by non-optimal epigenomic programing, often taking place early in life. In this context, the first 1,000 days of life – from conception into early infancy – is often called the most important period of life. The following sections present some major mechanisms for epigenomic programing as well as some factors assumed to be of importance. The need for more information about own genome and metagenome, as well as a substantial lack of adequate information regarding dietary and environmental databases are also commented upon. However, the mere fact that we can influence epigenomic health programing opens up the way for prophylactic and therapeutic interventions. The authors underline the importance of creating a ‘Human Gut Microbiota and Epigenomic Platform’ in order to facilitate interdisciplinary collaborations among scientists and clinicians engaged in host microbial ecology, nutrition, metagenomics, epigenomics and metabolomics as well as in disease epidemiology, prevention and treatment.

  13. Epigenomic programing: a future way to health?

    Science.gov (United States)

    Shenderov, Boris A; Midtvedt, Tore

    2014-01-01

    It is now generally accepted that the 'central genome dogma' (i.e. a causal chain going from DNA to RNA to proteins and downstream to biological functions) should be replaced by the 'fluid genome dogma', that is, complex feed-forward and feed-back cycles that interconnect organism and environment by epigenomic programing - and reprograming - throughout life and at all levels, sometimes also down the generations. The epigenomic programing is the net sum of interactions derived from own metabolism and microbiota as well as external factors such as diet, pharmaceuticals, environmental compounds, and so on. It is a growing body of results indicating that many chronic metabolic and degenerative disorders and diseases - often called 'civilization diseases' - are initiated and/or influenced upon by non-optimal epigenomic programing, often taking place early in life. In this context, the first 1,000 days of life - from conception into early infancy - is often called the most important period of life. The following sections present some major mechanisms for epigenomic programing as well as some factors assumed to be of importance. The need for more information about own genome and metagenome, as well as a substantial lack of adequate information regarding dietary and environmental databases are also commented upon. However, the mere fact that we can influence epigenomic health programing opens up the way for prophylactic and therapeutic interventions. The authors underline the importance of creating a 'Human Gut Microbiota and Epigenomic Platform' in order to facilitate interdisciplinary collaborations among scientists and clinicians engaged in host microbial ecology, nutrition, metagenomics, epigenomics and metabolomics as well as in disease epidemiology, prevention and treatment.

  14. The Future of Nursing: Leading Change, Advancing Health

    Science.gov (United States)

    National Academies Press, 2011

    2011-01-01

    "The Future of Nursing" explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single…

  15. The future of health/fitness/sports performance

    NARCIS (Netherlands)

    Foster, Carl; Cortis, Cristina; Fusco, Andrea; Bok, Daniel; Boullosa, Daniel A.; Capranica, Laura; de Koning, Jos J.; Haugen, Thomas; Olivera-Silva, Iranse; Periara, Julien; Porcari, John P.; Pyne, David Bruce; Sandbakk, Oyvind

    2017-01-01

    Exercise relative to health/fitness and sports performance has displayed an evolutionary role over time. Large scale, overriding, factors are present which are likely to help us understand the likely future evolutionary path of health/fitness and sports performance. These factors include: 1) the

  16. Quantitative health impact assessment: current practice and future directions

    NARCIS (Netherlands)

    J.L. Veerman (Lennert); J.J.M. Barendregt (Jan); J.P. Mackenbach (Johan)

    2005-01-01

    textabstractSTUDY OBJECTIVE: To assess what methods are used in quantitative health impact assessment (HIA), and to identify areas for future research and development. DESIGN: HIA reports were assessed for (1) methods used to quantify effects of policy on determinants of health

  17. Corporate social responsibility and the future health care manager.

    Science.gov (United States)

    Collins, Sandra K

    2010-01-01

    The decisions and actions of health care managers are oftentimes heavily scrutinized by the public. Given the current economic climate, managers may feel intense pressure to produce higher results with fewer resources. This could inadvertently test their moral fortitude and their social consciousness. A study was conducted to determine what corporate social responsibility orientation and viewpoint future health care managers may hold. The results of the study indicate that future health care managers may hold patient care in high regard as opposed to profit maximization. However, the results of the study also show that future managers within the industry may continue to need rules, laws, regulations, and legal sanctions to guide their actions and behavior.

  18. Future of Christian health services – an economic perspective

    Directory of Open Access Journals (Sweden)

    Steffen Flessa

    2016-01-01

    Full Text Available Although Christian Health Services have a proud history of healing and compassion especially in developing countries, their future is affected by secular changes in the financing and provision of health care services. However, the nature of life as it is evolving in modern society promises a need for the capacity to deal with increasing dynamics, complexity and uncertainty. In these circumstances the potential capacity of Christians in their institutions and churches to provide Unconditional Reliability suggests a new opportunity. The components of Unconditional Reliability and how they affect the portfolio of Christian Health Services is explained. Effective Christian Health Services will require appropriate analysis of their portfolios.

  19. Current and future impact of osteoarthritis on health care

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  20. Future of Health: Findings from a survey of stakeholders on the future of health and healthcare in England.

    Science.gov (United States)

    Corbett, Jennie; d'Angelo, Camilla; Gangitano, Lorenzo; Freeman, Jon

    2018-04-01

    This article presents findings from a survey conducted by RAND Europe at the request of the National Institute for Health Research (NIHR) to gather and synthesise stakeholder views on the future of health and healthcare in England in 20 to 30 years' time. The aim of the research was to generate an evidenced-based picture of the future health and healthcare needs, and how it might differ from today, in order to inform strategic discussions about the future priorities of the NIHR and the health and social care research communities more broadly. The survey provided a rich and varied dataset based on responses from 300 stakeholders in total. A wide range of fields were represented, including public health, social care, primary care, cancer, genomics, mental health, geriatrics, child health, patient advocacy and health policy. The respondent group also included a number of professional and private stakeholder categories, such as clinicians, policy experts, academics and patient and public representatives. The study findings validate a number of prominent health research priorities currently visible in England, such as antimicrobial resistance, the burden of dementia and age-related multi-morbidity, digital health and genomics. Interest in these areas and other themes, such as mental health, health inequalities and transforming health service models, cut across multiple disciplinary boundaries. However, it is clear that there are a variety of views among stakeholders on the relative importance of these areas of focus, and the best approach to manage their emergence in the coming decades. The full dataset of survey responses, for which permission to share was given, is a useful resource for those seeking to engage with a particular issue in more depth. The dataset can be found on NIHR's website at: http://nihr.ac.uk/news-and-events/documents/quotes.xls.

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

    Science.gov (United States)

    Kao, Cheng-Kai; Liebovitz, David M

    2017-05-01

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

  2. Worksite health promotion research: challenges, current state and future directions

    Directory of Open Access Journals (Sweden)

    Georg F. Bauer

    2007-12-01

    Full Text Available

    Background: Worksite health promotion (WHP addresses diverse individual and work-related health determinants. Thus, multiple, non-standardized interventions as well as company outcomes other than health have to be considered in WHP research.

    Methods: The article builds primarily on published research reviews in WHP and related fields. It discusses key practical and research challenges of the workplace setting. The evidence available on the effectiveness of WHP is summarised and conclusions are drawn for future WHP practice and research.

    Results: WHP research on health-oriented, behavioural interventions shows that the level of evidence ranges from suggestive to acceptable for key prevention areas such as physical activity, nutrition, fitness, smoking, alcohol and stress. Such interventions are effective if key conditions are met. Future research is needed on long-term effects, on multi-component programs and on programs, which address environmental determinants of health behaviour as well. Research on work-related determinants of health shows the economic and public health relevance of WHP interventions. Reviews of work-oriented, organisational interventions show that they produce a range of individual and organisational outcomes. However, due to the complexity of the organisational context, the generalisability and predictability of such outcomes remain limited.

    Conclusions: WHP research shows success factors of WHP and provides evidence of its effectiveness. In future, the evidence base should be expanded by developing adaptive, company-driven intervention approaches which allow for continuous optimisation of companies from a health perspective. Also, approaches for active dissemination of such a systemic-salutogenic occupational health management approach should be developed to increase the public health impact of WHP.

  3. The Future of Occupational Health Nursing in a Changing Health Care System.

    Science.gov (United States)

    McCauley, Linda; Peterman, Katherine

    2017-04-01

    Repealing the Affordable Care Act (ACA) has significant implications for the future of occupational health nursing practice. As changes are proposed and implemented, occupational health nurses must continue to prioritize preventive care, chronic disease management, healthy communities, environmental health, and sustainability. In particular, immigrant workers are a vulnerable population needing attention by occupational health nurses.

  4. Materialism, Stress and Health Behaviors among Future Educators

    Science.gov (United States)

    Brouskeli, Vasiliki; Loumakou, Maria

    2014-01-01

    In this study we investigated materialism among future educators and its relationship with stress and a number of health behaviors. Participants were 228 students (Mean = 20.64 years of age, S.D = 2.571) of the Department of Education Sciences in Early Childhood of the University of Thrace, Greece. The instrument consisted of a short form of the…

  5. Food and Health Some Current Issues and Future Trends

    OpenAIRE

    Gormley, T. R. (Thomas Ronan)

    1991-01-01

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

  6. Comparing the cost-per-QALYs gained and cost-per-DALYs averted literatures.

    Science.gov (United States)

    Neumann, Peter J; Anderson, Jordan E; Panzer, Ari D; Pope, Elle F; D'Cruz, Brittany N; Kim, David D; Cohen, Joshua T

    2018-01-18

    Background : We examined the similarities and differences between studies using two common metrics used in cost-effectiveness analyses (CEAs): cost per quality-adjusted life years (QALYs) gained and cost per disability-adjusted life year (DALY) averted. Methods : We used the Tufts Medical Center CEA Registry, which contains English-language cost-per-QALY gained studies, and  Global Cost-Effectiveness Analysis (GHCEA) Registry, which contains cost-per-DALY averted studies. We examined study characteristics including intervention type, sponsor, country, and primary disease, and also analysed the number of CEAs versus disease burden estimates for major diseases and conditions across three geographic regions. Results : We identified 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 and observed rapid growth in publication rates for both literatures. Cost-per-QALY studies were most likely to examine pharmaceuticals and interventions in high-income countries. Cost-per-DALY studies predominantly focused on infectious disease interventions and interventions in low and lower-middle income countries. We found discrepancies in the number of published CEAs for certain diseases and conditions in certain regions, suggesting "under-studied" areas (e.g., cardiovascular disease in Southeast Asia, East Asia, and Oceania and "overstudied" areas (e.g., HIV in Sub Saharan Africa) relative to disease burden in those regions. Conclusions : The number of cost-per QALY and cost-per-DALY analyses has grown rapidly with applications to diverse interventions and diseases.  Discrepancies between the number of published studies and disease burden suggest funding opportunities for future cost-effectiveness research.

  7. Future-proofing global health: Governance of priorities.

    Science.gov (United States)

    Bennett, Belinda; Cohen, I Glenn; Davies, Sara E; Gostin, Lawrence O; Hill, Peter S; Mankad, Aditi; Phelan, Alexandra L

    2018-05-01

    The year 2015 was a significant anniversary for global health: 15 years since the adoption of the Millennium Development Goals and the creation of the Global Alliance for Vaccines and Immunization, followed two years later by the Global Fund to Fight AIDS, TB and Malaria. 2015 was also the 10-year anniversary of the adoption of the International Health Regulations (May 2005) and the formal entering into force of the Framework Convention on the Tobacco Control (February 2005). The anniversary of these frameworks and institutions illustrates the growth and contribution of 'global' health diplomacy. Each initiative has also revealed on-going issues with compliance, sustainable funding and equitable attention in global health governance. In this paper, we present four thematic challenges that will continue to challenge prioritisation within global health governance into the future unless addressed: framing and prioritising within global health governance; identifying stakeholders of the global health community; understanding the relationship between health and behaviour; and the role of governance and regulation in supporting global health.

  8. South African Academic Health--the future challenge.

    Science.gov (United States)

    van Zyl, G J

    2004-02-01

    In South Africa, significant changes in Academic Health have taken place since the first democratic elections in 1994. Academic Health came from a separated academic hospital, departmental-based curriculum and research focussed on achievement, and an abundance of money, to a position of integrated service delivery with specific reference to primary health care, separation of service levels, a new integrated curriculum, research focussed according to the need and contract research, and financial constraints with limited budgets. The management of this change is a task challenging the manager in all fields of Academic Health. Leaders need to know their environment and organisation to be able to manage change. Academic Health centres are experiencing major changes as a result of the effects of managed care, reduced rate and growing expenditure on health services. In addition to restructuring of the clinical services, Academic Health centres are being challenged to sustain their academic mission and priorities in the face of resource constraints. In order to tackle these challenges, institutions need physicians in administrative positions at all levels who can provide leadership and thoughtful managerial initiatives. The future challenge for managers focuses on service delivery, research, health education and training, Academic Health management, professionalism and financial management.

  9. A perspective on the future public health practitioner.

    Science.gov (United States)

    Hanlon, Phil; Carlisle, Sandra; Hannah, Margaret; Lyon, Andrew; Reilly, David

    2012-09-01

    In the centuries following the Enlightenment, scientific and technological developments gave 'modern people' an unprecedented ability to understand, predict and control the natural world. This has brought health and social benefits unimaginable to our ancestors and sets us apart from all previous generations. Yet there is a wide-ranging body of evidence that suggests that modernity is now in decline, largely because its methods and mindset are increasingly recognized as unsustainable. Problems are manifest in the emergence of new public health epidemics such as obesity and addictive behaviours, the loss of well-being and increase in anxiety and depression in affluent society, and the persistence of ever-widening health and social inequalities at national and global levels. Still larger problems now confront us, such as climate change, peak oil and the loss of biodiversity, all of which are linked to the 'modern' way of life. We are potentially faced with the collapse of certain aspects of modern society: we are certainly faced with the prospect of inevitable change. While the broad public health community has an important role to play in developing workable solutions to such daunting problems, we argue that some profound changes will be needed in order for us to cope successfully. No blueprints for dealing with change exist, which means that we will need to learn our way into the future. In this paper we take a perspective on the role and nature of the future practitioner in public health and health promotion. We argue that future practitioners will need to develop new ways of thinking, being and doing; new perspectives and new forms of understanding the world. We believe our discipline - and people generally - to be capable of such development, as insights from multiple sources tell us that human nature is malleable, not fixed. We use this analysis to trace, as examples, the imagined lives of five women living in different eras over the course of history in a

  10. A see through future: augmented reality and health information systems.

    Science.gov (United States)

    Monkman, Helen; Kushniruk, Andre W

    2015-01-01

    Augmented Reality (AR) is a method whereby virtual objects are superimposed on the real world. AR technology is becoming increasingly accessible and affordable and it has many potential health applications. This paper discusses current research on AR health applications such as medical education and medical practice. Some of the potential future uses for this technology (e.g., health information systems, consumer health applications) will also be presented. Additionally, there will be a discussion outlining some of usability and human factors challenges associated with AR in healthcare. It is expected that AR will become increasingly prevalent in healthcare; however, further investigation is required to demonstrate that they provide benefits over traditional methods. Moreover, AR applications must be thoroughly tested to ensure they do not introduce new errors into practice and have patient safety implications.

  11. 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.

  12. 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.

  13. 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

  14. Workshop salutogenesis and the future of health promotion and public health.

    Science.gov (United States)

    Lindström, Bengt

    2018-02-01

    This presentation is a synthesis of a workshop on Salutogenesis and the Future of Health Promotion and Public Health at the Nordic Health Promotion Research Conference in June 2016. A brief historical review of Public Health and Health Promotion development in a Nordic perspective is included. However, the main thrust of the article is to present how the salutogenic theory and approach could strengthen society's organised efforts to prevent disease, promote health and prolong life. A critical view based on existing evidence is maintained through the presentation that arrives at the conclusion it would be worthwhile to invest in effective theory driven approaches to the development of Public Health and Health Promotion in the future.

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

    Science.gov (United States)

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

    2013-01-01

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

  16. Divorce and health: current trends and future directions.

    Science.gov (United States)

    Sbarra, David A

    2015-04-01

    Social relationships play a vital role in health and well-being, and it follows that loss experiences can be highly stressful for some people. This article reviews what is known about the association between marital separation, divorce, and health outcomes. Key findings in the area of divorce and health are discussed, and the review outlines a series of specific questions for future research. In particular, the article integrates research in social epidemiology with research in social psychophysiology. The former approach provides a broad-based estimate of the association between marital status and health outcomes, whereas the latter approach studies mechanisms of action and individual differences associated with increased risk for poor outcomes. The experience of separation or divorce confers risk for poor health outcomes, including a 23% higher mortality rate. However, most people cope well and are resilient after their marriage or long-term relationship ends. Despite the fact that resilience is the most common response, a small percentage of people (approximately 10%-15%) struggle quite substantially, and it seems that the overall elevated adverse health risks are driven by the poor functioning of this group. Several candidate mechanisms and novel (ambulatory) assessment techniques that may elucidate the poor outcomes among people who adapt poorly to separation are discussed. To increase knowledge on the association between divorce and health, three primary areas require more research: a) genetic and third variable explanations for divorce-related health outcomes, (b) better studies of objective social behavior after separation, and (c) increased attention to interventions targeting high-risk adults.

  17. Global health and economic impacts of future ozone pollution

    International Nuclear Information System (INIS)

    Selin, N E; Nam, K M; Reilly, J M; Paltsev, S; Prinn, R G; Webster, M D; Wu, S

    2009-01-01

    We assess the human health and economic impacts of projected 2000-2050 changes in ozone pollution using the MIT Emissions Prediction and Policy Analysis - Health Effects (EPPA-HE) model, in combination with results from the GEOS-Chem global tropospheric chemistry model of climate and chemistry effects of projected future emissions. We use EPPA-HE to assess the human health damages (including mortality and morbidity) caused by ozone pollution, and quantify their economic impacts in sixteen world regions. We compare the costs of ozone pollution under scenarios with 2000 and 2050 ozone precursor and greenhouse gas emissions (using the Intergovernmental Panel on Climate Change (IPCC) Special Report on Emissions Scenarios (SRES) A1B scenario). We estimate that health costs due to global ozone pollution above pre-industrial levels by 2050 will be $580 billion (year 2000$) and that mortalities from acute exposure will exceed 2 million. We find that previous methodologies underestimate costs of air pollution by more than a third because they do not take into account the long-term, compounding effects of health costs. The economic effects of emissions changes far exceed the influence of climate alone.

  18. [Ecology and health in Chile: present and future development].

    Science.gov (United States)

    Oyarzún, M

    1997-09-01

    In response to the progressive environmental deterioration, the Ecological Society of America has made a proposal, called "Sustainable Biosphere Initiative", to do research, teaching and decision making processes on biodiversity, global change and the effects of human activities on environment. The goal of appropriate environmental protection and welfare for mankind includes health and quality of life. Presently, Chile faces a number of environmental problems such as pollution, excessive urban growth, loss of agricultural areas, disposal of solid waste and species extinction. The lack of education and information in Chile, on these problems, is worrisome. The role of universities to overcome this deficit should be crucial in the future sustainable development of Chile.

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

    Science.gov (United States)

    Safaei, Jalil

    2015-01-01

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

  20. OT - Education for the health services of the future

    DEFF Research Database (Denmark)

    Hansen, Bodil Winther; Sørensen, Annette; Hove, Anne

    OT - Education for the health services of the future This presentation offers knowledge about which qualifications the health services and OT practice in general demand from Occupational Therapists. The study was developed in a wider context of the constant reflection within higher education...... as a result of the rapid pace of change in society. The Faculty of Occupational Therapy in Copenhagen wanted to enable the graduates in the best possible way to meet the employers’ demands as to qualifications. Furthermore, the aim was to develop and guarantee the quality of the educations offered...... by University College Oeresund. To express the level of education to be achieved in terms of competences and learning outcome, the study was inspired by the tuning process of educational structures in Europe, which is part of the Bologna process to integrate higher education area in Europe. The study is based...

  1. Health technology assessment: research trends and future priorities in Europe.

    Science.gov (United States)

    Nielsen, Camilla Palmhøj; Funch, Tina Maria; Kristensen, Finn Børlum

    2011-07-01

    To provide an overview of health services research related to health technology assessment (HTA) and to identify research priorities from a European perspective. Several methods were used: systematic review of articles indexed with the MeSH term 'technology assessment' in PubMed from February 1999-2009; online survey among experts; and conference workshop discussions. Research activity in HTA varies considerably across Europe. The research was categorised into six areas: (1) the breadth of analysis in HTA (such as economic, organizational and social aspects); (2) HTA products developed to meet the needs of policy-makers (such as horizon scanning, mini-HTA, and core HTA); (3) handling life-cycle perspectives in relation to technologies; (4) topics that challenge existing methods and for which HTA should be developed to address the themes more comprehensively (such as public health interventions and organizational interventions); (5) development of HTA capacity and programmes; and (6) links between policy and HTA. An online survey showed that the three areas that were given priority were the relationship between HTA and policy-making (71%), the impact of HTA (62%) and incorporating patient aspects in HTA (50%). Policy-makers highlighted HTA and innovation processes as their main research priority (42%). Areas that the systematic review identified as future priorities include issues within the six existing research areas such as disinvestment, developing evidence for new technologies, assessing the wider effects of technology use, and determining how HTA affects decision-making. In addition, relative effectiveness and individualized treatments are areas of growing interest. The research priorities identified are important for obtaining high quality and cost-effective health care in Europe. Managing the introduction, use and phasing out of technologies challenges health services throughout Europe, and these processes need to be improved to successfully manage future

  2. Market-oriented health care reforms: trends and future options.

    Science.gov (United States)

    van de Ven, W P

    1996-09-01

    In many (predominantly) publicly financed health care systems market-oriented health care reforms are being implemented or have been proposed. The purpose of these reforms is to make resource allocation in health care more efficient, more innovative and more responsive to consumers preferences while maintaining equity. At the same time, the advances in technology result in a divergence of consumers' preferences with respect to health care and urge society to (re)think about the meaning of the solidarity principle in health care. In this paper we indicate some international trends in health care reforms and explore some potential future options. From an international perspective we can observe a trend towards universal mandatory health insurance, contracts between third-party purchasers and the providers of care, competition among providers of care and a strengthening of primary care. These trends can be expected to continue. A more controversial issue is whether there should also be competition among the third-party purchasers and whether in the long run there will occur a convergence towards some "ideal" model. Although regulated competition in health care can be expected to yield more value for money, it might yield both more efficiency and higher total costs. It has been argued that equity can be maintained in a competitive health care system if we interpret equity as "equal access to cost-effective care within a reasonable period of time". Because the effectiveness of care has to be considered in relation to the medical indication and the condition of the patient, the responsibility for cost-effective care rests primarily with the providers of care. Guidelines and protocols should be developed by the profession and sustained by financial incentives embedded in contracts. It has been argued that the third-party purchasers could start to concentrate on the contracts with the primary care physicians. Contracts with other providers could then be a natural

  3. Veterinary public health in India: current status and future needs.

    Science.gov (United States)

    Ghatak, S; Singh, B B

    2015-12-01

    Veterinary public health (VPH) assumes huge significance in developing countries such as India. However, the implementation of VPH services throughout the country is still in its infancy. From 1970 onwards, many institutes, national and international organisations, professional societies, policies and personalities have contributed towards the development of VPH in India. Nevertheless, there is an urgent need to develop VPH still further as there are many issues, such as high population density, the re-emergence of zoonotic pathogens, environmental pollution and antimicrobial resistance, that require attention. The time has surely come to involve all stakeholders, ranging from primary producers (e.g., farmers) to policy-makers, so as to garner support for the holistic implementation of VPH services in India. To improve VPH activities and services, science-based policies enforced through stringent regulation are required to improve human, animal and environmental health. The emergence of the 'One Health' concept has ushered in new hopes for the resurrection of VPH in India. Applying tools such as the World Organisation for Animal Health (OlE) Day One Competencies and the OlE Tool for the Evaluation of Performance of Veterinary Services (PVS Tool) is essential to improve the quality of national Veterinary Services and to identify gaps and weaknesses in service provision, which can be remedied to comply with the OlE international standards. VPH initiatives started modestly but they continue to grow. The present review is focused on the current status and future needs of VPH in India.

  4. Matrix analysis and risk management to avert depression and suicide among workers

    Directory of Open Access Journals (Sweden)

    Takeuchi Takeaki

    2010-11-01

    Full Text Available Abstract Suicide is among the most tragic outcomes of all mental disorders, and the prevalence of suicide has risen dramatically during the last decade, particularly among workers. This paper reviews and proposes strategies to avert suicide and depression with regard to the mind body medicine equation hypothesis, metrics analysis of mental health problems from a public health and clinical medicine view. In occupational fields, the mind body medicine hypothesis has to deal with working environment, working condition, and workers' health. These three factors chosen in this paper were based on the concept of risk control, called San-kanri, which has traditionally been used in Japanese companies, and the causation concepts of host, agent, and environment. Working environment and working condition were given special focus with regard to tackling suicide problems. Matrix analysis was conducted by dividing the problem of working conditions into nine cells: three prevention levels (primary, secondary, and tertiary were proposed for each of the three factors of the mind body medicine hypothesis (working environment, working condition, and workers' health. After using these main strategies (mind body medicine analysis and matrix analysis to tackle suicide problems, the paper talks about the versatility of case-method teaching, "Hiyari-Hat activity," routine inspections by professionals, risk assessment analysis, and mandatory health check-up focusing on sleep and depression. In the risk assessment analysis, an exact assessment model was suggested using a formula based on multiplication of the following three factors: (1 severity, (2 frequency, and (3 possibility. Mental health problems, including suicide, are rather tricky to deal with because they involve evaluation of individual cases. The mind body medicine hypothesis and matrix analysis would be appropriate tactics for suicide prevention because they would help the evaluation of this issue as a

  5. Pharmacy travel health services: current perspectives and future prospects

    Directory of Open Access Journals (Sweden)

    Houle SKD

    2018-03-01

    Full Text Available Sherilyn KD HouleSchool of Pharmacy, University of Waterloo, Waterloo, ON, CanadaAbstract: Rates of international travel are increasing annually, with particular growth observed in travel to Southeast Asia and to emerging economies. While all patients traveling across geographic regions are recommended to receive a pre-travel consultation to consider their individual risks, many do not, or receive care and recommendations that are not consistent with current evidence-based guidelines. As experts in drug therapy, and given the largely preventive nature of most travel health recommendations, pharmacists are well suited to help address this need. Pharmacists generally possess a high degree of knowledge and confidence with more commonly observed travel health topics in community practice such as travelers’ diarrhea; however, training in more specialized travel health topics such as travel vaccinations and traveling at altitude has generally been lacking from pharmacy curricula. Pharmacists with an interest in providing pre-travel consultations are encouraged to pursue additional training in this specialty and to consider Certificate in Travel Health designation from the International Society of Travel Medicine. Future roles for pharmacists to include the prescribing of medications and vaccines for travel and the in-pharmacy administration of travel vaccinations may improve patient access to pre-travel consultations and recommended preventive measures, improving the health of travelers and potentially reducing the burden of communicable disease worldwide. Pharmacists providing travel care to patients are also reminded to consider noninfectious risks of illness and injury abroad and to counsel patients on strategies to minimize these risks in addition to providing drug and vaccine recommendations.Keywords: pharmacist, community pharmacy, travel, vaccination

  6. How wearable technologies will impact the future of health care.

    Science.gov (United States)

    Barnard, Rick; Shea, J Timothy

    2004-01-01

    After four hundred years of delivering health care in hospitals, industrialized countries are now shifting towards treating patients at the "point of need". This trend will likely accelerate demand for, and adoption of, wearable computing and smart fabric and interactive textile (SFIT) solutions. These healthcare solutions will be designed to provide real-time vital and diagnostic information to health care providers, patients, and related stakeholders in such a manner as to improve quality of care, reduce the cost of care, and allow patients greater control over their own health. The current market size for wearable computing and SFIT solutions is modest; however, the future outlook is extremely strong. Venture Development Corporation, a technology market research and strategy firm, was founded in 1971. Over the years, VDC has developed and implemented a unique and highly successful methodology for forecasting and analyzing highly dynamic technology markets. VDC has extensive experience in providing multi-client and proprietary analysis in the electronic components, advanced materials, and mobile computing markets.

  7. Supporting Active Patient and Health Care Collaboration: A Prototype for Future Health Care Information Systems.

    Science.gov (United States)

    Åhlfeldt, Rose-Mharie; Persson, Anne; Rexhepi, Hanife; Wåhlander, Kalle

    2016-12-01

    This article presents and illustrates the main features of a proposed process-oriented approach for patient information distribution in future health care information systems, by using a prototype of a process support system. The development of the prototype was based on the Visuera method, which includes five defined steps. The results indicate that a visualized prototype is a suitable tool for illustrating both the opportunities and constraints of future ideas and solutions in e-Health. The main challenges for developing and implementing a fully functional process support system concern both technical and organizational/management aspects. © The Author(s) 2015.

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

    Directory of Open Access Journals (Sweden)

    Safaei J

    2015-12-01

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

  9. A future task for health-promotion research: Integration of health promotion and sustainable development.

    Science.gov (United States)

    Jelsøe, Erling; Thualagant, Nicole; Holm, Jesper; Kjærgård, Bente; Andersen, Heidi Myglegård; From, Ditte-Marie; Land, Birgit; Pedersen, Kirsten Bransholm

    2018-02-01

    Based on previous studies and reflections collected from participants in a workshop at the 8th Nordic Health Promotion Research Network conference, we reveal current tendencies and discuss future challenges for health-promotion research regarding integration of sustainable development principles. Despite obvious interfaces and interactions between the two, our contention is that strategies for health promotion are not sufficiently integrated with strategies for sustainable development and that policies aimed at solving health or sustainability problems may therefore cause new, undesired and unforeseen environmental and health problems. As illustrated in previous research and as deliberated in the above-mentioned workshop, a number of barriers are identified. These are believed to be related to historical segregation, the conceptual understandings of health promotion and sustainable development, as well as the politics and implementation of policy goals in both areas. Three focal points are proposed as important challenges to address in future research: (a) the duality of health promotion and sustainability and how it can be handled in order to enhance mutually supportive processes between them; (b) the social dimension of sustainability and how it can be strengthened in the development of strategies for health promotion and sustainable development; and (c) exploring and identifying policy approaches and strategies for integrating health promotion and sustainable development.

  10. Establishment of sustainable health science for future generations: from a hundred years ago to a hundred years in the future.

    Science.gov (United States)

    Mori, Chisato; Todaka, Emiko

    2009-01-01

    Recently, we have investigated the relationship between environment and health from a scientific perspective and developed a new academic field, "Sustainable Health Science" that will contribute to creating a healthy environment for future generations. There are three key points in Sustainable Heath Science. The first key point is "focusing on future generations"-society should improve the environment and prevent possible adverse health effects on future generations (Environmental Preventive Medicine). The second key point is the "precautious principle". The third key point is "transdisciplinary science", which means that not only medical science but also other scientific fields, such as architectural and engineering science, should be involved. Here, we introduce our recent challenging project "Chemiless Town Project", in which a model town is under construction with fewer chemicals. In the project, a trial of an education program and a health-examination system of chemical exposure is going to be conducted. In the future, we are aiming to establish health examination of exposure to chemicals of women of reproductive age so that the risk of adverse health effects to future generations will decrease and they can enjoy a better quality of life. We hope that society will accept the importance of forming a sustainable society for future generations not only with regard to chemicals but also to the whole surrounding environment. As the proverb of American native people tells us, we should live considering the effects on seven generations in the future.

  11. Future prospects of health management systems using cellular phones.

    Science.gov (United States)

    Kim, Hun-Sung; Hwang, Yunji; Lee, Jae-Ho; Oh, Hye Young; Kim, Yi-Jun; Kwon, Hyeon Yoon; Kang, Hyoseung; Kim, Hyunah; Park, Rae Woong; Kim, Ju Han

    2014-06-01

    Cellular phones enable communication between healthcare providers and patients for prevention, diagnosis, and treatment of diseases. However, few studies have examined the user-friendliness or effectiveness of cellular phone-based medical informatics (CPBMI) for healthcare. This study investigated the use of CPBMI to identify its current status within the medical field, advantages and disadvantages, practicability, clinical effectiveness, costs, and cost-saving potential. CPBMI was validated in terms of practicality and provision of medical benefits. It is critical to use CPBMI in accordance with the different features of each disease and condition. Use of CPBMI is expected to be especially useful for patients with chronic disease. We discussed the current status of the clinical use, benefits, and risks of CPBMI. CPBMI and information technology-based health management tools are anticipated to become useful and effective components of healthcare management in the future.

  12. Health Care Students’ Attitudes Towards Addressing Sexual Health in Their Future Professional Work

    DEFF Research Database (Denmark)

    Gerbild, H.; Larsen, C. M.; Rolander, B.

    2017-01-01

    Students’ attitudes and educational needs regarding sexual health are important, since their ability to promote sexual health in their future profession can be challenged by their attitudes and knowledge of sexuality and sexual health. There are no existing Danish instruments able to measure...... students’ attitudes towards working with and communicating about sexual health; thus, to be able to use the Students’ Attitudes Towards Addressing Sexual Health (SA-SH) questionnaire in a Danish context, it is necessary to translate and test the translated questionnaire psychometrically. The aim...... of the SA-SH (SA-SH-D) had a Cronbach’s alpha of 0.67. The content validity index showed high relevance (item context validity index 0.82–1.0), and item scale correlation was satisfactory. The SA-SH-D is a valid and reliable questionnaire, which can be used to measure health care professional students...

  13. A future task for Health Promotion research: Integration of Health Promotion and sustainable development

    DEFF Research Database (Denmark)

    Jelsøe, Erling; Thualagant, Nicole; Holm, Jesper

    2018-01-01

    Based on previous studies and reflections collected from participants in a workshop at the 8th Nordic Health Promotion Research Network conference, we reveal current tendencies and discuss future challenges for health promotion research regarding integration of sustainable development principles....... Despite obvious interfaces and interactions between the two, our contention is that strategies for health promotion are not sufficiently integrated with strategies for sustainable development and that policies aimed at solving health or sustainability problems may therefore cause new, undesired...... and unforeseen environmental and health problems. As illustrated in previous research and as deliberated in the above-mentioned workshop, a number of barriers are identified: these are believed to be related to historical segregation, the conceptual understandings of health promotion and sustainable development...

  14. Mental health literacy as theory: current challenges and future directions.

    Science.gov (United States)

    Spiker, Douglas A; Hammer, Joseph H

    2018-02-13

    Mental health literacy (MHL) is one increasingly researched factor thought to influence mental health behaviors. Researchers have argued for expanding the definition of MHL to include additional constructs, but no consensus has yet been reached on what constructs should be included as part of MHL. The purpose of this paper is to (i) elucidate how the expansion of the MHL construct has impeded the growth of MHL research and (ii) through the lens of construct and theory development, highlight how these challenges might be remedied. An inclusive search of the literature was undertaken to identify MHL studies. The principles of construct and theory development guided a critical analysis of MHL. The review of the literature found that MHL violates many principles of what constitutes an acceptable construct definition. To address these concerns, we proposed conceptualizing MHL as a theory and recommended principles of theory development that should be taken into consideration. A theory of MHL can guide future researchers to clearly delineate important constructs and their interrelationships. For practitioners, a theory of MHL can help inform how to improve MHL at both the individual and community level.

  15. Positive futures? The impact of HIV infection on achieving health, wealth and future planning.

    Science.gov (United States)

    Harding, Richard; Molloy, Tim

    2008-05-01

    Although HIV is now cast as a chronic condition with favourable clinical outcomes under new treatments, it is unclear how living with HIV affects expectations and planning for the future. This mixed-methods study aimed to investigate UK gay men's expectations of their own future when living with HIV, and to identify the heath and social interventions required to enhance roles, participation and personal fulfilment. A preliminary focus group identified relevant domains of enquiry for a subsequent online cross-sectional survey. A total of 347 gay men living in the UK with HIV participated in the survey, and 56.6% were currently on treatment. However, high 7-day prevalence of psychological and physical symptoms was identified (42.6% in pain, 80.2% worrying); 57.8% perceived reduced career options due to their infection and 71.8% reduced life expectancy. Being on treatment was not significantly associated with perceived life expectancy. Coded open-ended survey data identified eight principle themes related to goal planning and attainment. The integrated open and closed data items offer an understanding of barriers and challenges that focus on poor mental health due to clinical inattention, discrimination and stigma, poor career and job opportunities due to benefit and workplace inflexibility and lack of understanding, a lack of personal goals and associated skills deficit related to confidence and self esteem. Gay men living with HIV require an integrated holistic approach to wellbeing that incorporates clinical, social and individual intervention in order to lead productive lives with maximum benefit from treatment gains.

  16. Averting obesity and type 2 diabetes in India through sugar-sweetened beverage taxation: an economic-epidemiologic modeling study.

    Directory of Open Access Journals (Sweden)

    Sanjay Basu

    2014-01-01

    Full Text Available Taxing sugar-sweetened beverages (SSBs has been proposed in high-income countries to reduce obesity and type 2 diabetes. We sought to estimate the potential health effects of such a fiscal strategy in the middle-income country of India, where there is heterogeneity in SSB consumption, patterns of substitution between SSBs and other beverages after tax increases, and vast differences in chronic disease risk within the population.Using consumption and price variations data from a nationally representative survey of 100,855 Indian households, we first calculated how changes in SSB price alter per capita consumption of SSBs and substitution with other beverages. We then incorporated SSB sales trends, body mass index (BMI, and diabetes incidence data stratified by age, sex, income, and urban/rural residence into a validated microsimulation of caloric consumption, glycemic load, overweight/obesity prevalence, and type 2 diabetes incidence among Indian subpopulations facing a 20% SSB excise tax. The 20% SSB tax was anticipated to reduce overweight and obesity prevalence by 3.0% (95% CI 1.6%-5.9% and type 2 diabetes incidence by 1.6% (95% CI 1.2%-1.9% among various Indian subpopulations over the period 2014-2023, if SSB consumption continued to increase linearly in accordance with secular trends. However, acceleration in SSB consumption trends consistent with industry marketing models would be expected to increase the impact efficacy of taxation, averting 4.2% of prevalent overweight/obesity (95% CI 2.5-10.0% and 2.5% (95% CI 1.0-2.8% of incident type 2 diabetes from 2014-2023. Given current consumption and BMI distributions, our results suggest the largest relative effect would be expected among young rural men, refuting our a priori hypothesis that urban populations would be isolated beneficiaries of SSB taxation. Key limitations of this estimation approach include the assumption that consumer expenditure behavior from prior years, captured in price

  17. Averting obesity and type 2 diabetes in India through sugar-sweetened beverage taxation: an economic-epidemiologic modeling study.

    Science.gov (United States)

    Basu, Sanjay; Vellakkal, Sukumar; Agrawal, Sutapa; Stuckler, David; Popkin, Barry; Ebrahim, Shah

    2014-01-01

    Taxing sugar-sweetened beverages (SSBs) has been proposed in high-income countries to reduce obesity and type 2 diabetes. We sought to estimate the potential health effects of such a fiscal strategy in the middle-income country of India, where there is heterogeneity in SSB consumption, patterns of substitution between SSBs and other beverages after tax increases, and vast differences in chronic disease risk within the population. Using consumption and price variations data from a nationally representative survey of 100,855 Indian households, we first calculated how changes in SSB price alter per capita consumption of SSBs and substitution with other beverages. We then incorporated SSB sales trends, body mass index (BMI), and diabetes incidence data stratified by age, sex, income, and urban/rural residence into a validated microsimulation of caloric consumption, glycemic load, overweight/obesity prevalence, and type 2 diabetes incidence among Indian subpopulations facing a 20% SSB excise tax. The 20% SSB tax was anticipated to reduce overweight and obesity prevalence by 3.0% (95% CI 1.6%-5.9%) and type 2 diabetes incidence by 1.6% (95% CI 1.2%-1.9%) among various Indian subpopulations over the period 2014-2023, if SSB consumption continued to increase linearly in accordance with secular trends. However, acceleration in SSB consumption trends consistent with industry marketing models would be expected to increase the impact efficacy of taxation, averting 4.2% of prevalent overweight/obesity (95% CI 2.5-10.0%) and 2.5% (95% CI 1.0-2.8%) of incident type 2 diabetes from 2014-2023. Given current consumption and BMI distributions, our results suggest the largest relative effect would be expected among young rural men, refuting our a priori hypothesis that urban populations would be isolated beneficiaries of SSB taxation. Key limitations of this estimation approach include the assumption that consumer expenditure behavior from prior years, captured in price elasticities

  18. Governance of global health research consortia: Sharing sovereignty and resources within Future Health Systems.

    Science.gov (United States)

    Pratt, Bridget; Hyder, Adnan A

    2017-02-01

    Global health research partnerships are increasingly taking the form of consortia that conduct programs of research in low and middle-income countries (LMICs). An ethical framework has been developed that describes how the governance of consortia comprised of institutions from high-income countries and LMICs should be structured to promote health equity. It encompasses initial guidance for sharing sovereignty in consortia decision-making and sharing consortia resources. This paper describes a first effort to examine whether and how consortia can uphold that guidance. Case study research was undertaken with the Future Health Systems consortium, performs research to improve health service delivery for the poor in Bangladesh, China, India, and Uganda. Data were thematically analysed and revealed that proposed ethical requirements for sharing sovereignty and sharing resources are largely upheld by Future Health Systems. Facilitating factors included having a decentralised governance model, LMIC partners with good research capacity, and firm budgets. Higher labour costs in the US and UK and the funder's policy of allocating funds to consortia on a reimbursement basis prevented full alignment with guidance on sharing resources. The lessons described in this paper can assist other consortia to more systematically link their governance policy and practice to the promotion of health equity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Internet Research: Implications for The Future of Health Care

    Science.gov (United States)

    Shortliffe, Ted

    1999-01-01

    The phenomenal growth in Internet usage, largely due to the success of the World Wide Web, has stressed the international networking infrastructure in ways that were never contemplated when the early ARPAnet emerged from research laboratories in the 1970s. Some of the challenges are logistical and legal, and have to do with management of domain names, intellectual-property agreements, and international business activities. Others are technical, resulting both because we are envisioning applications that the current Internet cannot support, and because the existing infrastructure cannot scale to a world in which a huge portion of the world's population is online and individual homes and businesses may have IP addresses for tens of electronic devices, such as appliances, heating systems, or security alarms. In this presentation, I will discuss some of the US research and testbed activities that are currently underway in an effort to respond to the technical challenges. These include the Internet-2 testbed created by a consortium of academic institutions, and the federal government's Next Generation Internet research initiative. I will explain the difference between these two programs and identify some of the technical requirements other than a simple increase in bandwidth that have been identified for the evolving Internet. This will lead to a discussion of the limitations of the current Internet that have constrained its use in health care and that accordingly help to define the networking research agenda that is of greatest importance to the biomedical community. Policy and regulatory issues that arise because of health care's use of the Internet will also be discussed, as will those technical requirements that may be unique to biomedical applications. One goal of the discussion will be to motivate an international discussion of the ways in which the medical informatics community should be engaged in both basic and applied research in the area of networking and the

  20. Health behind bars: can exploring the history of prison health systems impact future policy?

    Science.gov (United States)

    Weston, Kathryn M; McCarthy, Louella R; Meyering, Isobelle Barrett; Hampton, Stephen; Mackinnon, Tobias

    2018-02-01

    The value of history is, indeed, not scientific but moral … it prepares us to live more humanely in the present, and to meet rather than to foretell, the future - Carl Becker. Becker's quote reminds us of the importance of revealing and understanding historical practices in order to influence actions in the future. There are compelling reasons for uncovering this history, in particular to better inform government policy makers and health advocates, and to address the impacts of growing community expectations to 'make the punishment fit the crime'. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  1. Canadian Library Human Resources Short‐Term Supply and Demand Crisis Is Averted, But a Significant Long‐Term Crisis Must Be Addressed. A review of: 8Rs Research Team. The Future of Human Resources in Canadian Libraries February 2005. Edmonton, AB: University of Alberta. 21 February 2007 .

    Directory of Open Access Journals (Sweden)

    Julie McKenna

    2007-03-01

    insurance (95%, pension plan (92%, and medical benefits (88%. Librarians (80% and paraprofessionals (70% are satisfied with their benefits. Although a low percentage of librarians agreed that they have little job stress (24%and only 39% found their workload to be manageable, 62% of librarians agree that their work allows work, family and personal life balance. The statistics are slightly more positive for paraprofessionals. There is a gap between the desire to be treated with respect (98% for all workers and the perception that respect is conveyed (77% of librarians and 75% of paraprofessionals. A similar gap exists between desire to be involved in decision making and actual involvement. The two most important factors for job satisfaction for all library workers are respectful treatment and a job that allows them to learn new skills and grow. Numerical Librarian Demand‐Supply Match (Section J Libraries hired more librarians than they lost in 2002, for a net three per cent increase. Many library administrators believe that there will be a five‐year increased demand for librarians (77% and paraprofessionals(81%.T he short‐term supply (next 5 years of new librarians to replace departures due to retirements is predicted to have the capacity to fill 98 per cent of the current librarian positions; the capacity to replace library technicians is 99 per cent. The long‐term supply (next 10 years of new librarians to replace departures due to retirements is predicted to have the capacity to fill 89 percent of the current librarian positions; the capacity to fill technician positions is identical. These predictions are based on no growth in the number of positions in the future. Match Between Organizational Job Function Demand and Individual Staff Supply of Skills, Abilities, Talents, Interests (Section K Libraries report that increased use of information technologies (87% and reengineering (61% have contributed the greatest change in the roles of librarians. Libraries report

  2. Climate and health implications of future aerosol emission scenarios

    Science.gov (United States)

    Partanen, Antti-Ilari; Landry, Jean-Sébastien; Damon Matthews, H.

    2018-02-01

    Anthropogenic aerosols have a net cooling effect on climate and also cause adverse health effects by degrading air quality. In this global-scale sensitivity study, we used a combination of the aerosol-climate model ECHAM-HAMMOZ and the University of Victoria Earth System Climate Model to assess the climate and health effects of aerosols emissions from three Representative Concentration Pathways (RCP2.6, RCP4.5, and RCP8.5) and two new (LOW and HIGH) aerosol emission scenarios derived from RCP4.5, but that span a wider spectrum of possible future aerosol emissions. All simulations had CO2 emissions and greenhouse gas forcings from RCP4.5. Aerosol forcing declined similarly in the standard RCP aerosol emission scenarios: the aerosol effective radiative forcing (ERF) decreased from -1.3 W m-2 in 2005 to between -0.1 W m-2 and -0.4 W m-2 in 2100. The differences in ERF were substantially larger between LOW (-0.02 W m-2 in 2100) and HIGH (-0.8 W m-2) scenarios. The global mean temperature difference between the simulations with standard RCP aerosol emissions was less than 0.18 °C, whereas the difference between LOW and HIGH reached 0.86 °C in 2061. In LOW, the rate of warming peaked at 0.48 °C per decade in the 2030s, whereas in HIGH it was the lowest of all simulations and never exceeded 0.23 °C per decade. Using present-day population density and baseline mortality rates for all scenarios, PM2.5-induced premature mortality was 2 371 800 deaths per year in 2010 and 525 700 in 2100 with RCP4.5 aerosol emissions; in HIGH, the premature mortality reached its maximum value of 2 780 800 deaths per year in 2030, whereas in LOW the premature mortality at 2030 was below 299 900 deaths per year. Our results show potential trade-offs in aerosol mitigation with respect to climate change and public health as ambitious reduction of aerosol emissions considerably increased warming while decreasing mortality.

  3. Potential deaths averted in USA by replacing cigarettes with e-cigarettes.

    Science.gov (United States)

    Levy, David T; Borland, Ron; Lindblom, Eric N; Goniewicz, Maciej L; Meza, Rafael; Holford, Theodore R; Yuan, Zhe; Luo, Yuying; O'Connor, Richard J; Niaura, Raymond; Abrams, David B

    2018-01-01

    US tobacco control policies to reduce cigarette use have been effective, but their impact has been relatively slow. This study considers a strategy of switching cigarette smokers to e-cigarette use ('vaping') in the USA to accelerate tobacco control progress. A Status Quo Scenario, developed to project smoking rates and health outcomes in the absence of vaping, is compared with Substitution models, whereby cigarette use is largely replaced by vaping over a 10-year period. We test an Optimistic and a Pessimistic Scenario, differing in terms of the relative harms of e-cigarettes compared with cigarettes and the impact on overall initiation, cessation and switching. Projected mortality outcomes by age and sex under the Status Quo and E-Cigarette Substitution Scenarios are compared from 2016 to 2100 to determine public health impacts. Compared with the Status Quo, replacement of cigarette by e-cigarette use over a 10-year period yields 6.6 million fewer premature deaths with 86.7 million fewer life years lost in the Optimistic Scenario. Under the Pessimistic Scenario, 1.6 million premature deaths are averted with 20.8 million fewer life years lost. The largest gains are among younger cohorts, with a 0.5 gain in average life expectancy projected for the age 15 years cohort in 2016. The tobacco control community has been divided regarding the role of e-cigarettes in tobacco control. Our projections show that a strategy of replacing cigarette smoking with vaping would yield substantial life year gains, even under pessimistic assumptions regarding cessation, initiation and relative harm. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Health Promotion Education in India: Present Landscape and Future Vistas

    Science.gov (United States)

    Pati, Sanghamitra; Sharma, Kavya; Zodpey, Sanjay; Chauhan, Kavita; Dobe, Madhumita

    2012-01-01

    Health promotion is the process of enabling people to increase control over and to improve their health’. This stream of public health is emerging as a critical domain within the realm of disease prevention. Over the last two decades, the curative model of health care has begun a subtle shift towards a participatory model of health promotion emphasizing upon practice of healthy lifestyles and creating healthy communities. Health promotion encompasses five key strategies with health communication and education as its cornerstones. Present study is an attempt to explore the current situation of health promotion education in India with an aim to provide a background for capacity building in health promotion. A systematic predefined method was adopted to collect and compile information on existing academic programs pertaining to health promotion and health education/communication. Results of the study reveal that currently health promotion education in India is fragmented and not uniform across institutes. It is yet to be recognized as a critical domain of public health education. Mostly teaching of health promotion is limited to health education and communication. There is a need for designing programmes for short-term and long-term capacity building, with focus on innovative methods and approaches. Public health institutes and associations could play a proactive role in designing and imparting academic programs on health promotion. Enhancing alliances with various institutes involved in health promotion activities and networking among public health and medical institutes as well as health services delivery systems would be more productive. PMID:22980352

  5. The missing piece: Valuing averting behavior for children's ozone exposures

    Energy Technology Data Exchange (ETDEWEB)

    Mansfield, Carol; Reed Johnson, F.; Van Houtven, George [Research Triangle Institute, P.O. Box 12194, Research Triangle Park, NC 27709-2194 (United States)

    2006-08-15

    Individuals can reduce their exposure to air pollution by reducing the amount of time they spend outdoors. Reducing outdoor time is an example of an averting behavior that should be measured as part of willingness to pay (WTP) for improvements in air quality. In this paper, we estimate parents' WTP to prevent restrictions on a child's outdoor time from a stated-preference (SP) conjoint survey. We combine this WTP measure with an estimate of reductions in time spent outdoors on high-ozone days from an activity-diary study to estimate this averting behavior component of WTP for reductions in ozone pollution. (author)

  6. The future of global health education: training for equity in global health

    Directory of Open Access Journals (Sweden)

    Lisa V. Adams

    2016-11-01

    Full Text Available Abstract Background Among academic institutions in the United States, interest in global health has grown substantially: by the number of students seeking global health opportunities at all stages of training, and by the increase in institutional partnerships and newly established centers, institutes, and initiatives to house global health programs at undergraduate, public health and medical schools. Witnessing this remarkable growth should compel health educators to question whether the training and guidance that we provide to students today is appropriate, and whether it will be applicable in the next decade and beyond. Given that “global health” did not exist as an academic discipline in the United States 20 years ago, what can we expect it will look like 20 years from now and how can we prepare for that future? Discussion Most clinicians and trainees today recognize the importance of true partnership and capacity building in both directions for successful international collaborations. The challenge is in the execution of these practices. There are projects around the world where this is occurring and equitable partnerships have been established. Based on our experience and observations of the current landscape of academic global health, we share a perspective on principles of engagement, highlighting instances where partnerships have thrived, and examples of where we, as a global community, have fallen short. Conclusions As the world moves beyond the charity model of global health (and its colonial roots, it is evident that the issue underlying ethical global health practice is partnership and the pursuit of health equity. Thus, achieving equity in global health education and practice ought to be central to our mission as educators and advisors when preparing trainees for careers in this field. Seeking to eliminate health inequities wherever they are ingrained will reveal the injustices around the globe and in our own cities and

  7. Averting Current and Future Special Education Faculty Shortages: Policy Implications and Recommendations

    Science.gov (United States)

    West, Jane E.; Hardman, Michael L.

    2012-01-01

    The federal government plays an indispensable role in preparing special education personnel to become teacher educators in higher education. The 2011 Special Education Faculty Needs Assessment study documents a continued supply-demand imbalance of special education faculty. It also documents effectiveness and impact of the Office of Special…

  8. Health promotion education in India: present landscape and future vistas

    NARCIS (Netherlands)

    Pati, S.; Sharma, K.; Zodpey, S.; Chauhan, K.; Dobe, M.

    2012-01-01

    'Health promotion is the process of enabling people to increase control over and to improve their health'. This stream of public health is emerging as a critical domain within the realm of disease prevention. Over the last two decades, the curative model of health care has begun a subtle shift

  9. Oral health in Libya: addressing the future challenges

    African Journals Online (AJOL)

    2014-03-24

    Mar 24, 2014 ... Keywords: oral health; oral health research; oral health care; dental research; dental education; Libya ... Libyan Journal of Medicine 2014. © 2014 Syed Wali Peeran ..... Clinical examination for dental erosion .... International health conference, ... (MIH) in a group of school-aged children in Benghazi, Libya.

  10. Averting Regulatory Enforcement: Evidence from New Source Review

    Energy Technology Data Exchange (ETDEWEB)

    Keohane, N.O.; Mansur, E.T.; Voynov, A. [Yale University, New York, NY (USA)

    2009-09-15

    This paper explores firms' response to regulatory enforcement. New Source Review (NSR), a provision of the Clean Air Act, imposes stringent emissions limitations on significantly modified older power plants. In 1999, the Environmental Protection Agency (EPA) sued owners of 46 plants for NSR violations. We study how electricity companies respond to both the perceived threat of future action, and the action itself. A discrete choice model estimates plants likelihood of being named in lawsuits increases with large historic emissions and investments. On the eve of the lawsuits, emissions at plants with a one standard deviation greater probability of being sued fell approximately 10%.

  11. Future directions for Public Health Education reforms in India

    Directory of Open Access Journals (Sweden)

    Sanjay P Zodpey

    2014-09-01

    Full Text Available Health systems globally are experiencing a shortage of competent public health professionals. Public health education across developing countries is stretched by capacity generation and maintaining an adequate ‘standard’ and ‘quality’ of their graduate product. We analyzed the Indian public health education scenario using the institutional and instructional reforms framework advanced by the Lancet Commission report on Education of Health Professionals. The emergence of a new century necessitates a re-visit on the institutional and instructional challenges surrounding public health education. Currently, there is neither an accreditation council nor a formal structure or system of collaboration between academic stakeholders. Health systems have little say in health professional training with limited dialogue between health systems and public health education institutions. Despite a recognized shortfall of public health professionals, there are limited job opportunities for public health graduates within the health system and absence of a structured career pathway for them. Public health institutions need to evolve strategies to prevent faculty attrition. A structured development program in teaching-learning methods and pedagogy is the need of the hour.

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

    Directory of Open Access Journals (Sweden)

    Thielke S

    2011-06-01

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

  13. Tuberculosis deaths averted by implementation of the DOTS strategy in Kazakhstan.

    Science.gov (United States)

    Favorov, M; Belilovsky, E; Aitmagambetova, I; Ismailov, S; White, M E; Chorba, T

    2010-12-01

    Kazakhstan began implementing the DOTS strategy for tuberculosis (TB) in 1998. Data were analyzed 1) to determine if changes in TB mortality rate (MR) and case fatality rate (CFR) in Kazakhstan for 1998-2003 differed from those of Uzbekistan and four adjacent Russian Federation (RF) oblasts that had not yet implemented DOTS, and 2) to estimate the number of deaths averted in Kazakhstan as a result of DOTS. Observed MRs were calculated, and predicted MRs for Kazakhstan were approximated by linear regression based on average slope of MRs from 1998 through 2003 in adjacent non-DOTS-implementing territories. Deaths averted were calculated by comparing predicted MRs to actual MRs by converting rate differences to numbers of deaths. TB MRs in Kazakhstan decreased markedly, but remained stable or increased in the neighboring territories. CFRs decreased markedly in Kazakhstan and marginally in Uzbekistan, and increased in the neighboring RF oblasts. From 1998 to 2004, DOTS appears to have helped avert approximately 17,800 deaths in Kazakhstan. DOTS has contributed markedly to a decrease in TB mortality in Kazakhstan. In settings where mortality data are relatively complete, deaths averted can be another indicator of DOTS effectiveness.

  14. Student-Generated Protective Behaviors to Avert Severe Harm Due to High-Risk Alcohol Consumption

    Science.gov (United States)

    Smith, Sandi W.; LaPlante, Carolyn; Wibert, Wilma Novales; Mayer, Alex; Atkin, Charles K.; Klein, Katherine; Glazer, Edward; Martell, Dennis

    2011-01-01

    High-risk alcohol consumption is a significant problem on college campuses that many students see as a rite of passage in their development into adulthood. Developing effective prevention campaigns designed to lessen or avert the risks associated with alcohol consumption entails understanding how students perceive harmful consequences as well as…

  15. ICT and the future of health care: aspects of health promotion.

    Science.gov (United States)

    Haluza, Daniela; Jungwirth, David

    2015-01-01

    Increasingly, Information and Communication Technology (ICT) applications enter the daily lives of consumers. Availability of various multimedia interfaces offers the opportunity to develop and adjust ICT solutions to all aspects of society including health care. To address the challenges of the ongoing adaptive progress of ICT, decision makers profit from estimates of expectable merits and risks of future technological developments. The aim of the present study was to assess the prevailing opinions and expectations among Austrian stakeholders regarding ICT-assisted health promotion. In total, 73 experts (74% males) engaged in the Austrian health care sector participated in a biphasic online Delphi survey. Panellists were assigned to three groups representing medical professionals, patient advocates, and administrative personnel. In a scenario-based questionnaire, experts evaluated potential advantages and barriers as well as degree of innovation, desirability, and estimated date of implementation of six future ICT scenarios. Scenario-specific and consolidated overall opinions were ranked. Inter-group differences were assessed using ANOVA. Panellists expected the future ICT-supported health promotion strategies to especially improve the factors living standard (56%), quality of health care (53%), and patient's knowledge (44%). Nevertheless, monetary aspects (57%), acceptance by patient advocates (45%), and data security and privacy (27%) were considered as the three most substantial hampering factors for ICT applications. Although overall mean desirability of the scenarios was quite high (80%) amongst panellists, it was considerably lower in medical professionals compared to patient advocates and administrative personnel (p=0.006). This observation suggests a more precautious attitude of this specific interest group regarding technological innovations. The present Delphi survey identified issues relevant for successful implementation of ICT-based health care

  16. Mental Health Services in South Africa: Scaling up and future ...

    African Journals Online (AJOL)

    “No health without mental health” has become a rallying call for the World Health Organization and numerous service providers, training institutions, health researchers, and advocacy groups around the world. It is timely to consider the implications of this call for South Africa. We review key evidence regarding the burden ...

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

    Science.gov (United States)

    Thielke, Stephen; Thompson, Alexander; Stuart, Richard

    2011-01-01

    Over the last decade, research about health psychology in primary care has reiterated its contributions to mental and physical health promotion, and its role in addressing gaps in mental health service delivery. Recent meta-analyses have generated mixed results about the effectiveness and cost-effectiveness of health psychology interventions. There have been few studies of health psychology interventions in real-world treatment settings. Several key challenges exist: determining the degree of penetration of health psychology into primary care settings; clarifying the specific roles of health psychologists in integrated care; resolving reimbursement issues; and adapting to the increased prescription of psychotropic medications. Identifying and exploring these issues can help health psychologists and primary care providers to develop the most effective ways of applying psychological principles in primary care settings. In a changing health care landscape, health psychologists must continue to articulate the theories and techniques of health psychology and integrated care, to put their beliefs into practice, and to measure the outcomes of their work.

  18. Obstetrician-assessed maternal health at pregnancy predicts offspring future health.

    Directory of Open Access Journals (Sweden)

    Debbie A Lawlor

    2007-08-01

    Full Text Available We aimed to examine the association between obstetrician assessment of maternal physical health at the time of pregnancy and offspring cardiovascular disease risk.We examined this association in a birth cohort of 11,106 individuals, with 245,000 person years of follow-up. We were concerned that any associations might be explained by residual confounding, particularly by family socioeconomic position. In order to explore this we used multivariable regression models in which we adjusted for a range of indicators of socioeconomic position and we explored the specificity of the association. Specificity of association was explored by examining associations with other health related outcomes. Maternal physical health was associated with cardiovascular disease: adjusted (socioeconomic position, complications of pregnancy, birthweight and childhood growth at mean age 5 hazard ratio comparing those described as having poor or very poor health at the time of pregnancy to those with good or very good health was 1.55 (95%CI: 1.05, 2.28 for coronary heart disease, 1.91 (95%CI: 0.99, 3.67 for stroke and 1.57 (95%CI: 1.13, 2.18 for either coronary heart disease or stroke. However, this association was not specific. There were strong associations for other outcomes that are known to be related to socioeconomic position (3.61 (95%CI: 1.04, 12.55 for lung cancer and 1.28 (95%CI:1.03, 1.58 for unintentional injury, but not for breast cancer (1.10 (95%CI:0.48, 2.53.These findings demonstrate that a simple assessment of physical health (based on the appearance of eyes, skin, hair and teeth of mothers at the time of pregnancy is a strong indicator of the future health risk of their offspring for common conditions that are associated with poor socioeconomic position and unhealthy behaviours. They do not support a specific biological link between maternal health across her life course and future risk of cardiovascular disease in her offspring.

  19. Global trade and health: key linkages and future challenges.

    Science.gov (United States)

    Bettcher, D W; Yach, D; Guindon, G E

    2000-01-01

    Globalization of trade, marketing and investment has important implications for public health, both negative and positive. This article considers the implications of the single package of World Trade Organization (WTO) agreements for public health research and policy, focusing on three themes: commodities, intellectual property rights, and health services. The main aims of the analysis are as follows: to identify how trade issues are associated with the transnationalization of health risks and possible benefits; to identify key areas of research; and to suggest policy-relevant advice and interventions on trade and health issues. The next wave of international trade law will need to take more account of global public health issues. However, to become more engaged in global trade debates, the public health community must gain an understanding of the health effects of global trade agreements. It must also ensure that its own facts are correct, so that public health is not blindly used for political ends, such as justifying unwarranted economic protectionism. "Healthy trade" policies, based on firm empirical evidence and designed to improve health status, are an important step towards reaching a more sustainable form of trade liberalization.

  20. The Future of Home Health project: developing the framework for health care at home.

    Science.gov (United States)

    Lee, Teresa; Schiller, Jennifer

    2015-02-01

    In addition to providing high-quality care to vulnerable patient populations, home healthcare offers the least costly option for patients and the healthcare system, particularly in postacute care. As the baby boom generation ages, policymakers are expressing concerns about rising costs, variation in home healthcare service use, and program integrity. The Alliance for Home Health Quality and Innovation seeks to develop a research-based strategic framework for the future of home healthcare for older Americans and those with disabilities. This article describes the initiative and invites readers to provide comments and suggestions.

  1. Health Behaviour Change Support Systems: Past Research and Future Challenges

    OpenAIRE

    Mettler, Tobias

    2015-01-01

    The emergence of mobile devices and social technologies has opened up new possibilities for health promotion and disease prevention. By means of emotional stimuli, motivation, and persuasion health behaviour change support systems (HBCSS) aim at influencing users to improve their health and wellbeing. This article presents the results of a bibliometric analysis related to the existing HBCSS body of knowledge. A total of 51 research studies were analysed with a look at their topical and theore...

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

    OpenAIRE

    Thielke, Stephen; Thompson,; Stuart,

    2011-01-01

    Stephen Thielke1, Alexander Thompson2, Richard Stuart31Psychiatry and Behavioral Sciences, University of Washington, Geriatric Research, Education, and Clinical Center, Puget Sound VA Medical Center, Seattle, WA, USA; 2Group Health Cooperative, Seattle, WA, USA; 3Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USAAbstract: Over the last decade, research about health psychology in primary care has reiterated its contributions to mental and physical health promotion, ...

  3. Future orientation and health quality of life in primary care: vitality as a mediator.

    Science.gov (United States)

    Hirsch, Jameson K; Molnar, Danielle; Chang, Edward C; Sirois, Fuschia M

    2015-07-01

    Temporal perspective, including views about future goals, may influence motivational processes related to health. An adaptive sense of future orientation is linked to better health, but little research has examined potential underlying factors, such as vitality. In a sample of 101 primary care patients, we examined whether belief in the changeability of the future was related to mental and physical energization and, in turn, to health-related quality of life. Participants were working, uninsured primary care patients, who completed self-report measures of future orientation, vitality, and health-related quality of life. Mediation models, covarying age, sex, and race/ethnicity indicated that vitality significantly mediated the association between future orientation and the outcomes of general health, mental health, social functioning, bodily pain, and role limitations due to emotional and physical reasons. Vitality exerted an indirect-only effect on the relation between future orientation and physical functioning. Our findings suggest that adaptive beliefs about the future may promote, or allow access to, physical and mental energy and, in turn, may result in better mental and physical health functioning. Individual-level and public health interventions designed to promote future orientation and vitality may beneficially influence quality of life and well-being.

  4. Visionary leadership and the future of VA health system.

    Science.gov (United States)

    Bezold, C; Mayer, E; Dighe, A

    1997-01-01

    As the U.S. Department of Veterans Affairs (VA) makes the change over to Veterans Integrated Service Network (VISNs) the need for new and better leadership is warranted if VA wants to not only survive, but thrive in the emerging twenty-first century healthcare system. VA can prepare for the future and meet the challenges facing them by adopting a system of visionary leadership. The use of scenarios and vision techniques are explained as they relate to VA's efforts to move toward their new system of VISNs. The four scenarios provide snapshots of possible futures for the U.S. healthcare system as well as the possible future role and mission of VA--from VA disappearing to its becoming a premier virtual organization.

  5. Future of health technology assessment studies in gene and cell ...

    African Journals Online (AJOL)

    However, as should be noted, health care decisions need to be based on Health Technology Assessments (HTA) that should be based on objective criteria as efficacy, effectiveness, quality, safety, psychological, social, ethical, organisational and professional implications as well as cost effectiveness and further macro ...

  6. Expert paper for the Future Panel on Public Health Genomics

    NARCIS (Netherlands)

    Stemerding, D.; Krom, A.

    2013-01-01

    Developments in public health genomics (PHG) hold the promise to be beneficial for individuals and to promote public health. Central to this paper is the idea that given the range of uncertainties and ambiguities related to genome-based information and technologies (GBIT), the responsible

  7. Smart hospitals and m health-future ahead

    Directory of Open Access Journals (Sweden)

    Dev Prakash Sharma

    2015-01-01

    Full Text Available Electronic gadgets along with mobile devices & Apps are becoming integral part of the modern healthcare industry. PACS and RIS were just the building blocks in the era of m Health, which now thrives on enterprise viewers and technologies like mobile e- visit technology to name a few. With gradual increase in quality and availability ofthe technology the concept of traditional health center is getting outdated. Today in the technology driven society the patient wants at door health services with mobile key boards as means of communication with his healthcare providers.

  8. Development assistance for health: past trends, associations, and the future of international financial flows for health.

    Science.gov (United States)

    Dieleman, Joseph L; Schneider, Matthew T; Haakenstad, Annie; Singh, Lavanya; Sadat, Nafis; Birger, Maxwell; Reynolds, Alex; Templin, Tara; Hamavid, Hannah; Chapin, Abigail; Murray, Christopher J L

    2016-06-18

    Disbursements of development assistance for health (DAH) have risen substantially during the past several decades. More recently, the international community's attention has turned to other international challenges, introducing uncertainty about the future of disbursements for DAH. We collected audited budget statements, annual reports, and project-level records from the main international agencies that disbursed DAH from 1990 to the end of 2015. We standardised and combined records to provide a comprehensive set of annual disbursements. We tracked each dollar of DAH back to the source and forward to the recipient. We removed transfers between agencies to avoid double-counting and adjusted for inflation. We classified assistance into nine primary health focus areas: HIV/AIDS, tuberculosis, malaria, maternal health, newborn and child health, other infectious diseases, non-communicable diseases, Ebola, and sector-wide approaches and health system strengthening. For our statistical analysis, we grouped these health focus areas into two categories: MDG-related focus areas (HIV/AIDS, tuberculosis, malaria, child and newborn health, and maternal health) and non-MDG-related focus areas (other infectious diseases, non-communicable diseases, sector-wide approaches, and other). We used linear regression to test for structural shifts in disbursement patterns at the onset of the Millennium Development Goals (MDGs; ie, from 2000) and the global financial crisis (impact estimated to occur in 2010). We built on past trends and associations with an ensemble model to estimate DAH through the end of 2040. In 2015, US$36·4 billion of DAH was disbursed, marking the fifth consecutive year of little change in the amount of resources provided by global health development partners. Between 2000 and 2009, DAH increased at 11·3% per year, whereas between 2010 and 2015, annual growth was just 1·2%. In 2015, 29·7% of DAH was for HIV/AIDS, 17·9% was for child and newborn health, and 9·8

  9. Looking to the Future: Health Professions Education in Texas

    National Research Council Canada - National Science Library

    Rettig, Richard

    2000-01-01

    ...? How can underserved populations be better served? The broad scope of RAND's assignment-identifying for the Texas Higher Education Coordinating Board important issues in health professions education-was made more complicated by the fact that issues...

  10. Future of health technology assessment studies in gene and cell ...

    African Journals Online (AJOL)

    SERVER

    2007-07-18

    Jul 18, 2007 ... by such data to allow health and public policy decision makers to take evidence based decisions which .... North America and accounts for 25% of total medical ... such information to decision makers and the use of such.

  11. A Very Early Rehabilitation Trial after stroke (AVERT): a Phase III, multicentre, randomised controlled trial.

    Science.gov (United States)

    Langhorne, Peter; Wu, Olivia; Rodgers, Helen; Ashburn, Ann; Bernhardt, Julie

    2017-09-01

    outcome at 3 months cautioning against very early high-dose mobilisation. At 12 months, health-related QoL was similar regardless of group. Shorter, more frequent mobilisation early after stroke may be associated with a more favourable outcome. These results informed a new trial proposal [A Very Early Rehabilitation Trial - DOSE (AVERT-DOSE)] aiming to determine the optimal frequency and dose of EM. The trial is registered with the Australian New Zealand Clinical Trials Registry number ACTRN12606000185561, Current Controlled Trials ISRCTN98129255 and ISRCTN98129255. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 21, No. 54. See the NIHR Journals Library website for further project information. Funding was also received from the National Health and Medical Research Council Australia, Singapore Health, Chest Heart and Stroke Scotland, Northern Ireland Chest Heart and Stroke, and the Stroke Association. In addition, National Health and Medical Research Council fellowship funding was provided to Julie Bernhardt (1058635), who also received fellowship funding from the Australia Research Council (0991086) and the National Heart Foundation (G04M1571). The Florey Institute of Neuroscience and Mental Health, which hosted the trial, acknowledges the support received from the Victorian Government via the Operational Infrastructure Support Scheme.

  12. The mental health system in Brazil: Policies and future challenges

    Directory of Open Access Journals (Sweden)

    Razzouk Denise

    2008-09-01

    Full Text Available Abstract Background The aim of this paper is to assess the mental health system in Brazil in relation to the human resources and the services available to the population. Methods The World Health Organization Assessment Instrument for Mental Health Systems (WHO AIMS was recently applied in Brazil. This paper will analyse data on the following sections of the WHO-AIMS: a mental health services; and b human resources. In addition, two more national datasets will be used to complete the information provided by the WHO questionnaire: a the Executive Bureau of the Department of Health (Datasus; and b the National Register of Health Institutions (CNS. Results There are 6003 psychiatrists, 18,763 psychologists, 1985 social workers, 3119 nurses and 3589 occupational therapists working for the Unified Health System (SUS. At primary care level, there are 104,789 doctors, 184, 437 nurses and nurse technicians and 210,887 health agents. The number of psychiatrists is roughly 5 per 100,000 inhabitants in the Southeast region, and the Northeast region has less than 1 psychiatrist per 100,000 inhabitants. The number of psychiatric nurses is insufficient in all geographical areas, and psychologists outnumber other mental health professionals in all regions of the country. The rate of beds in psychiatric hospitals in the country is 27.17 beds per 100,000 inhabitants. The rate of patients in psychiatric hospitals is 119 per 100,000 inhabitants. The average length of stay in mental hospitals is 65.29 days. In June 2006, there were 848 Community Psychosocial Centers (CAPS registered in Brazil, a ratio of 0.9 CAPS per 200,000 inhabitants, unequally distributed in the different geographical areas: the Northeast and the North regions having lower figures than the South and Southeast regions. Conclusion The country has opted for innovative services and programs, such as the expansion of Psychosocial Community Centers and the Return Home program to deinstitutionalize

  13. Future of electronic health records: implications for decision support.

    Science.gov (United States)

    Rothman, Brian; Leonard, Joan C; Vigoda, Michael M

    2012-01-01

    The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data

  14. Using Systems Thinking to train future leaders in global health.

    Science.gov (United States)

    Paxton, Anne; Frost, Laura J

    2017-07-09

    Systems Thinking provides a useful set of concepts and tools that can be used to train students to be effective and innovative global health leaders in an ever-changing and often chaotic world. This paper describes an experiential, multi-disciplinary curriculum that uses Systems Thinking to frame and analyse global health policies and practices. The curriculum uses case studies and hands-on activities to deepen students' understanding of the following concepts: complex adaptive systems, dynamic complexity, inter-relationships, feedback loops, policy resistance, mental models, boundary critique, leverage points, and multi-disciplinary, multi-sectoral, and multi-stakeholder thinking and action. A sample of Systems Thinking tools for analysing global health policies and practices are also introduced.

  15. The ghost of public health journalism: past, present, and future.

    Science.gov (United States)

    Cooper, Glinda S; Brown, Rebecca C

    2010-03-01

    The news industry is undergoing shrinking newspaper circulations, cuts in science and health coverage, and expansion of Internet news sources. We examine the impact of these changes using a case study set in Libby, Montana. In 1999, a Seattle newspaper story focused attention on asbestos exposure and related diseases in this small town. In 2009, that newspaper became an online-only newspaper, just as coverage of a related criminal trial began. Later that year the U.S. Environmental Protection Agency issued a public health emergency. Online newspaper archives and a collaboration between the University of Montana's journalism and law schools contributed to coverage of these developments. Continued efforts to promote interest in and skills needed for high-quality public health and environmental reporting are needed.

  16. [The role of ergonomics in occupational health - past and future].

    Science.gov (United States)

    Izumi, Hiroyuki

    2013-10-01

    The aim of working condition and ergonomics is to control the task method and condition for the best productive activity with the highest efficiency and sustainability. The Principles of Scientific Management by Frederick Winslow Taylor and its criticism by Gito Teruoka, the 1st director of The Institute for Science of Labour, are introduced for a better understanding of work condition and ergonomics in this article. Occupational physician have a duty to control working method and condition to reduce the health hazards induced by job duty. Not only the technical knowledge of medicine, but also a fundamental knowledge of manufacturing is needed for the occupational physician. The development of tools for early detection of health hazards and workload evaluation, the introduction of work management systems with cooperation between occupational physicians and technical experts of manufacturing are needed for effective control of the workplace. The strengthening of the Industrial Safety and Health Law should help to drive these improvements.

  17. Gut-Bioreactor and Human Health in Future.

    Science.gov (United States)

    Purohit, Hemant J

    2018-03-01

    Gut-microbiome provides the complementary metabolic potential to the human system. To understand the active participation and the performance of the microbial community in human health, the concept of gut as a plug-flow reactor with the fed-batch mode of operation can provide better insight. The concept suggests the virtual compartmentalized gut with sequential stratification of the microbial community in response to a typical host genotype. It also provides the analysis plan for gut microbiome; and its relevance in developing health management options under the identified clinical conditions.

  18. Knowledge for Healthcare: the future of health librarianship.

    Science.gov (United States)

    Bryant, Sue Lacey; Stewart, David; Goswami, Louise

    2015-09-01

    Many people are still not receiving the right care. It is imperative for health care librarians to come together around a common vision to achieve Knowledge for Healthcare so that the right knowledge and evidence is used at the right time in the right place. The authors describe five workstreams within a modernisation programme: Service Transformation, Workforce Planning and Development, Quality and Impact, Resource Discovery and Optimising Investment. Communications, engagement and partnership working are central to success. The development framework sets out principles on which to base decisions, and design criteria for transforming services. © 2015 Health Libraries Group.

  19. A delphi study on health in future India.

    Science.gov (United States)

    Rohatgi, K; Rohatgi, P K

    1980-07-01

    A delphi study was conducted to identify or envision health scenarios in India by the year 2000. Questionnaires consisting of 48 questions on 5 areas (diagnosis and therapy; family planning; pharmaceuticals and drugs; biochemical and biomedical research; health services) were mailed to 250 experts in India. 36 responded. Results were compiled and mailed back to the respondents for changes and comments. 17 people responded. Results of the delphi study shows that policy decisions with respect to compulsory family planning as well as health education at secondary school level will precede further breakthroughs in birth control technology. Non operation reversible sterilization procedures, immunological birth control, Ayurvedic medicines for contraception and abortion, and selection of baby's sex are all possible by 2000 thereafter. Complete eradication of infectious diseases, malnutrition and associated diseases is considered unlikely before 2000, as are advances in biomedical research. Changes in health services (e.g., significant increases in hospital beds and doctors, cheap bulk drugs), particularly in rural areas, are imminent, leading to prolonging of life expectancy to 70 years. Genetic engineering may provide significant breakthroughs in the prevention of malignancies and cardiac disorders. The India delphi study is patterned after a similar delphi study conducted in the U.S. by Smith, Kline and French (SKF) Laboratories in 1968. The SKF study was able to predict some breakthroughs with basic research which have been realized.

  20. International Terrorism and Mental Health: Recent Research and Future Directions

    Science.gov (United States)

    Fischer, Peter; Ai, Amy L.

    2008-01-01

    International terrorism has become a major global concern. Several studies conducted in North America and Europe in the aftermath of terrorist attacks reveal that international terrorism represents a significant short-term and long-term threat to mental health. In the present article, the authors clarify the concept and categories of terrorism and…

  1. Occupational safety and health in India: now and the future.

    Science.gov (United States)

    Pingle, Shyam

    2012-01-01

    India, a growing economy and world's largest democracy, has population exceeding 1.2 billion. Out of this huge number, 63.6% form working age group. More than 90% work in the informal economy, mainly agriculture and services. Less than 10% work in the organized sector; mainly industry, mining and some services. New service industries like Information Technology (IT), Business Process Outsourcing (BPO) are increasing rapidly; so is the proportion of females in the workforce. The occupational safety and health (OSH) scenario in India is complex. Unprecedented growth and progress go hand in hand with challenges such as huge workforce in unorganized sector, availability of cheap labor, meager public spending on health, inadequate implementation of existing legislation, lack of reliable OSH data, shortage of OSH professionals, multiplicity of statutory controls, apathy of stakeholders and infrastructure problems. The national policy on OSH at workplace, adopted by the government in 2009, is yet to be implemented. Some of the major occupational risks are accidents, pneumoconiosis, musculoskeletal injuries, chronic obstructive lung diseases; pesticide poisoning and noise induced hearing loss. The three most important OSH needs are: 1. legislation to extend OSH coverage to all sectors of working life including the unorganized sector; 2. spreading the awareness about OSH among stakeholders; 3. development of OSH infrastructure and OSH professionals. Other issues include integration of occupational health with primary health care.

  2. special article child health: past, present and future challenges

    African Journals Online (AJOL)

    among other things at ... in the planning of the new extensions to Korle Bu ... one ward (ward M) housed all the paediatric pa- ... Health Care Delivery to children by the Women Medi- .... Street, London to try to learn some paediatrics. ... career. Times indeed have changed, but there will al- ways be personal challenges for ...

  3. Engaging trainees in shaping the future of health policy.

    Science.gov (United States)

    Atkinson, Stephen; Sachedina, Nabihah; King, Judith; Mak, Matthew; Morganstein, Louise; Mytton, Oliver T; Thomas, Justyn

    2011-04-01

    This paper presents an analysis of the views and ideas generated at a recent health policy discussion for doctors in training. This provides an illustration of the creativity and enthusiasm that trainees can bring to the policy sphere by providing unique insights and a fresh perspective.

  4. Inequalities in health--future threats to equity

    NARCIS (Netherlands)

    Gunning-Schepers, L. J.; Stronks, K.

    1999-01-01

    In discussions about equity there is a tendency to focus on the inequalities in health status that appear to be the result of the material and immaterial consequences of a lower income, professional or social status in society. If we look at publications such as the Black Report in the UK or

  5. Task Force on the Future of Military Health Care

    Science.gov (United States)

    2007-12-01

    Ibid. 17 32 C.F.R. §199.17(p)(5)(ii) (2005). 18 See http://mytoc.tma.osd.mil/AccessToCare/ TOC /ATC.htm. 19 File name “AccessToCareSummary_MHS.xls...on Healthy People’s leading health indicators: physical activity; overweight and obesity; tobacco use; substance abuse; responsible sexual behavior

  6. Futures

    DEFF Research Database (Denmark)

    Pedersen, Michael Haldrup

    2017-01-01

    Currently both design thinking and critical social science experience an increased interest in speculating in alternative future scenarios. This interest is not least related to the challenges issues of global sustainability present for politics, ethics and design. This paper explores the potenti......Currently both design thinking and critical social science experience an increased interest in speculating in alternative future scenarios. This interest is not least related to the challenges issues of global sustainability present for politics, ethics and design. This paper explores...... the potentials of speculative thinking in relation to design and social and cultural studies, arguing that both offer valuable insights for creating a speculative space for new emergent criticalities challenging current assumptions of the relations between power and design. It does so by tracing out discussions...... of ‘futurity’ and ‘futuring’ in design as well as social and cultural studies. Firstly, by discussing futurist and speculative approaches in design thinking; secondly by engaging with ideas of scenario thinking and utopianism in current social and cultural studies; and thirdly by showing how the articulation...

  7. Forging a future of better cardiovascular health: addressing childhood obesity.

    Science.gov (United States)

    Pratt, Charlotte A; Arteaga, Sonia; Loria, Catherine

    2014-02-04

    This paper describes ongoing National, Heart, Lung, and Blood Institute (NHLBI)-initiated childhood obesity research. It calls on clinicians, researchers, and cardiologists to work with other healthcare providers, community agencies, schools and caregivers to foster better cardiovascular health in children by intervening on multiple levels of influence on childhood obesity. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  8. Future Trends of Virtual, Augmented Reality, and Games for Health

    OpenAIRE

    Ma, Minhua; Jain, Lakhmi C; Anderson, Paul

    2014-01-01

    Serious game is now a multi-billion dollar industry and is still growing steadily in many sectors. As a major subset of serious games, designing and developing Virtual Reality (VR), Augmented Reality (AR), and serious games or adopting off-the-shelf games to support medical education, rehabilitation, or promote health has become a promising frontier in the healthcare sector since 2004, because games technology is inexpensive, widely available, fun and entertaining for people of all ages, with...

  9. A Golden Ticket to Future Occupational and Environmental Health Monitoring

    Science.gov (United States)

    2015-10-01

    a health risk assessment (HRA) of the exposure by considering multiple factors including: threat source, route of exposure ( inhalation , ingestion...contaminants for chemical and particulate inhalational exposures. Measurements of physical exposures are also monitored to include noise, temperature, and...hazards are. Some hazards are always present in very common Air Force 12 processes (i.e. jet fuel in a refueling process), while other hazards are

  10. Electronic Health Records: Then, Now, and in the Future

    Science.gov (United States)

    2016-01-01

    Summary Objectives Describe the state of Electronic Health Records (EHRs) in 1992 and their evolution by 2015 and where EHRs are expected to be in 25 years. Further to discuss the expectations for EHRs in 1992 and explore which of them were realized and what events accelerated or disrupted/derailed how EHRs evolved. Methods Literature search based on “Electronic Health Record”, “Medical Record”, and “Medical Chart” using Medline, Google, Wikipedia Medical, and Cochrane Libraries resulted in an initial review of 2,356 abstracts and other information in papers and books. Additional papers and books were identified through the review of references cited in the initial review. Results By 1992, hardware had become more affordable, powerful, and compact and the use of personal computers, local area networks, and the Internet provided faster and easier access to medical information. EHRs were initially developed and used at academic medical facilities but since most have been replaced by large vendor EHRs. While EHR use has increased and clinicians are being prepared to practice in an EHR-mediated world, technical issues have been overshadowed by procedural, professional, social, political, and especially ethical issues as well as the need for compliance with standards and information security. There have been enormous advancements that have taken place, but many of the early expectations for EHRs have not been realized and current EHRs still do not meet the needs of today’s rapidly changing healthcare environment. Conclusion The current use of EHRs initiated by new technology would have been hard to foresee. Current and new EHR technology will help to provide international standards for interoperable applications that use health, social, economic, behavioral, and environmental data to communicate, interpret, and act intelligently upon complex healthcare information to foster precision medicine and a learning health system. PMID:27199197

  11. Discounting future health benefits: the poverty of consistency arguments.

    Science.gov (United States)

    Nord, Erik

    2011-01-01

    In economic evaluation of health care, main stream practice is to discount benefits at the same rate as costs. But main papers in which this practice is advocated have missed a distinction between two quite different evaluation problems: (1) How much does the time of program occurrence matter for value and (2) how much do delays in health benefits from programs implemented at a given time matter? The papers have furthermore focused on logical and arithmetic arguments rather than on real value considerations. These 'consistency arguments' are at best trivial, at worst logically flawed. At the end of the day, there is a sensible argument for equal discounting of costs and benefits rooted in microeconomic theory of rational, utility maximising consumers' saving behaviour. But even this argument is problematic, first because the model is not clearly supported by empirical observations of individuals' time preferences for health, second because it relates only to evaluation in terms of overall individual utility. It does not provide grounds for claiming that decision makers with a wider societal perspective, which may include concerns for fair distribution, need to discount Copyright © 2010 John Wiley & Sons, Ltd. 2010 John Wiley & Sons, Ltd.

  12. Future Educators’ Gender Norms, Sexuality, and Reproductive Health

    Directory of Open Access Journals (Sweden)

    Leodoro J. Labrague

    2013-01-01

    Full Text Available This investigation explored gender-related norms, sexuality, and reproductive health among education students in a government university in Samar, Philippines. A descriptive-analytical design of study was adopted for this investigation and data were collected over a period of five months. Five hundred fifty (550 education students who were enrolled in the different year level completed the modified John Clelands’ Illustrative Questionnaire for Young People. Results indicated that 14.73% of the students reported having had early sexual experience where in 69.14 % had it unplanned. Among sexually active students, only 17.28% used contraception, with condoms and withdrawal as the most popular choices. Respondents were also found to have some misconceptions regarding HIV/AIDS and STI’s. Result also showed that dating was still acceptable, however, the idea of abortion and sexual coercion were considered wrong. No significant differences in the knowledge about HIV/AIDS and STI’s and gender norms were found across year level. Findings suggest a greater need for education, support and advocacy relative to sexuality so as to create a more positive school environment conducive for holistic growth and development of all students. Thus, school administrators should improve/enhance existing policies and programs relative to reproductive health among college students of the University such as health promotion activities, sexuality education, counseling and alike.

  13. Health Physics Innovations Developed During Cassini for Future Space Applications

    Science.gov (United States)

    Nickell, Rodney E.; Rutherford, Theresa M.; Marmaro, George M.

    1999-01-01

    The long history of space flight includes missions that used Space Nuclear Auxiliary Power devices, starting with the Transit 4A Spacecraft (1961), continuing through the Apollo, Pioneer, Viking, Voyager, Galileo, Ulysses, Mars Pathfinder, and most recently, Cassini (1997). All Major Radiological Source (MRS) missions were processed at Kennedy Space Center/Cape Canaveral Air Station (KSC/CCAS) Launch Site in full compliance with program and regulatory requirements. The cumulative experience gained supporting these past missions has led to significant innovations which will be useful for benchmarking future MRS mission ground processing. Innovations developed during ground support for the Cassini mission include official declaration of sealed-source classifications, utilization of a mobile analytical laboratory, employment of a computerized dosimetry record management system, and cross-utilization of personnel from related disciplines.

  14. Inequalities in health--future threats to equity.

    Science.gov (United States)

    Gunning-Schepers, L J; Stronks, K

    1999-01-01

    In discussions about equity there is a tendency to focus on the inequalities in health status that appear to be the result of the material and immaterial consequences of a lower income, professional or social status in society. If we look at publications such as the Black Report in the UK or Ongelijke gezondheid in The Netherlands, we have to accept that despite our universal access to healthcare and the existence in many Western countries of social security measures that preclude 'real' poverty, considerable differences in health continue to exist between socioeconomic groups. This is corroborated for many other European countries in the research carried out by a concerted action led by Mackenbach. These inequalities in health have been referred to in many countries as inequities, meaning that society finds them unjust and expects them to be 'avoidable' or amenable to policy interventions. However, the research on the causal networks underlying the occurrence and the avoidability of inequalities in health remains sparse and intervention studies seem to focus on policy measures that can be evaluated, but which will most likely have a limited impact on the inequalities measured at the population level. Thus the research community leaves policymakers with very little evidence on which to build policy initiatives that are nevertheless requested by many governments. The third element, which needs to be addressed in this context, is the ominous inequality in access to healthcare. Since the debate on equity in health has rightly been initiated in the context of a broader, more intersectoral approach to health policy, very little attention has been paid, so far, to the issue of universal access to quality healthcare services. This is because in the second half of this century most Western (European) countries have created a healthcare system with universal access, financed either through taxation or through social insurance schemes. It is these financing systems that will

  15. Quantifying Averted Disability-Adjusted Life Years as a Performance Indicator for Water Quality Interventions: A Review of Current Methodologies and Challenges

    Directory of Open Access Journals (Sweden)

    Darcy M. Anderson

    2018-06-01

    Full Text Available Sustainable access to safe drinking water protects against infectious disease and promotes overall health. Despite considerable progress toward increasing water access, safe water quality and reliable service delivery remain a challenge. Traditional financing strategies pay implementers based on inputs and activities, with minimal incentives for water quality monitoring and sustained service operation. Pay-for-performance offers an alternative financing strategy that delivers all or a portion of payment based on performance indicators of desired outputs or outcomes. A pay-for-performance approach in the water sector could quantify and incentivize health impact. Averted disability-adjusted life years (ADALYs have been used as a performance indicator to measure the burden of disease averted due to environmental health interventions. Water-related disease burden can be measured for application as an ADALYs performance indicator following either comparative risk assessment or quantitative microbial risk assessment. Comparative risk assessment models disease burden using water source type as a proxy indicator of microbial water quality, while quantitative microbial risk assessment models disease burden using concentrations of indicator pathogens. This paper compares these risk assessment methodologies, and summarizes the limitations of applying these approaches toward quantifying ADALYs as a performance indicator for water quality interventions.

  16. Future of keeping pet reptiles and amphibians: animal welfare and public health perspective.

    Science.gov (United States)

    Warwick, C; Jessop, M; Arena, P; Pliny, A; Nicholas, E; Lambiris, A

    2017-10-28

    In a review summary on page 450, Pasmans and others discuss the future of keeping reptiles and amphibians as pets. Here, Clifford Warwick and others discuss the animal welfare and public health implications of exotic pet business. British Veterinary Association.

  17. Sustainable workplaces of the future – European Research Challenges for occupational safety and health

    NARCIS (Netherlands)

    Anonymous

    2012-01-01

    Via a consultation process, the PEROSH members identified what occupational safety and health topics the European institutes specialised in, and what they see as the major trends and future challenges in the world of work and their impact on OSH. A second part of the consultation analysed future

  18. An Analysis of the Future Need for Certified Animal Health Technicians and Instructional Program Content.

    Science.gov (United States)

    Nevada State Council on Occupational Education, Carson City.

    A study examined the future need for certified animal health technicians (CAHT) in Nevada and the skills/knowledge that future CAHTs will need. Questionnaires were mailed to all of Nevada's 306 licensed veterinarians; 100 (32.68%) responded. The estimated numbers of CAHTs needed by the state's veterinarians in 1, 3, and 5 years were 62, 142, and…

  19. Contraceptive prevalence, reproductive health and our common future.

    Science.gov (United States)

    Diczfalusy, E

    1991-03-01

    The 1980s will go into history as a decade of lost opportunities to increase contraceptive prevalence and improve reproductive health worldwide. As the decade closes, 500 million couples still have no access to fertility regulation, there are 30-50 million induced abortions each year, 15 million infant and child deaths (30% of all deaths worldwide), an estimated 250 million new cases of sexually transmitted diseases and 60-80 million infertile couples. One of the major problems is that many policy makers are still unimpressed with the global demographic reality. World population was less than 300 million 1991 years ago. It took some 1500 years to double this number by the time of the voyages of Columbus to America. The first billion was reached at the beginning of the last century and the second in the lifetime of the author, in 1927. Then it took less than 50 years to double this number to 4 billion by 1976. Global population is 5.3 billion today. In view of such figures, it is understandable that, historically, it was this demographic concern that in the 1960s persuaded many governments to support family planning programmes. During the subsequent decades, it was gradually recognized by developing country governments that family planning lowers infant, child and maternal mortality and morbidity and reduces the number of illegal abortions and their health hazards. Today, 52 developing country governments support family planning programmes for the demographic rationale, but 65 for the reproductive health and human rights rationale. Where do we go from here? That will mainly depend on the number of years it will take to reach replacement level of fertility (around 2.1 children per couple) worldwide. If the level is reached in 2010 (the low projection of the United Nations), global population will stabilize by the end of the 21st century at 8 billion; if it is reached in 2035 (medium projection), population will stabilize around 10 billion; however, if it is reached

  20. [Pharmacogenetics in primary health care: implementation and future expectations].

    Science.gov (United States)

    Houwink, Elisa J F; Rigter, Tessel; Swen, Jesse J; Cornel, Martina C; Kienhuis, Anne; Rodenburg, Wendy; Weda, Marjolein

    2015-01-01

    Personalised medicine is a targeted approach to the prevention, diagnosis and treatment of disorders on the basis of the specific genetic profile of the patient. Pharmacogenetics research shows that differences in the genetic profile of patients explain the interindividual differences in efficacy and side effects of medicines. Although there are high expectations of personalised medicine and pharmacogenetics in healthcare, both are only used to a limited extent to date. Pharmacogenetics seems particularly important in diseases with a poor prognosis and treatments with potentially serious side effects. Pharmacogenetics testing is reimbursed in the case of serious side effects or unexpected ineffectiveness. 95% of patients in the Netherlands have at least one abnormality in the panel of genes for which guidance is available. The KNMP (Royal Dutch Pharmacists' Association) provides dosing advice based on genotype for 80 medicines, 27 of which are regularly prescribed in primary health care.

  1. Measuring the Burden of Surgical Disease Averted by Emergency and Essential Surgical Care in a District Hospital in Papua New Guinea.

    Science.gov (United States)

    Stokes, Matthew A R; Guest, Glenn D; Mamadi, Perista; Seta, Westin; Yaubihi, Noel; Karawiga, Grace; Naidi, Billy; Watters, David A K

    2017-03-01

    Timely access to emergency and essential surgical care (EESC) and anaesthesia in low- and middle-income countries (LMICs) prevents premature death, minimises lifelong disability and reduces their economic impact on families and communities. Papua New Guinea is one of the poorest countries in the Pacific region, and provides much of its surgical care at a district hospital level. We aimed to evaluate the surgical capacity of a district hospital in PNG and estimate the effectiveness of surgical interventions provided. We performed a prospective study to calculate the number of DALYs averted for 465 patients treated with surgical care over a 3-month period (Sep-Nov 2013) in Alotau Hospital, Milne Bay Province, PNG (pop 210,000). Data were also collected on infrastructure, workforce, interventions provided and equipment available using the World Health Organization's Integrated Management of Emergency and Essential Surgical Care Toolkit, a survey to assess EESC and surgical capacity. We also performed a retrospective one-year audit of surgical, obstetric and anaesthetic care to provide context with regards to annual disease burden treated and surgical activity. EESC was provided by 11 Surgeons/Anaesthetists/Obstetricians (SAO) providers, equating to 5.7 per 100,000 population (including 4 nurse anaesthetists). They performed 783/100,000 procedures annually. Over the 3-month prospective study period, 4954 DALYs were averted by 465 surgical interventions, 52 % of which were elective. This equates to 18,330 DALYs averted annually or, approximately 18 % of the published but estimated disease burden in the Province in the 2013 Global Burden of Disease Study. The overall peri-operative mortality rate was 1.29 %, with 0.41 % for elective procedures and 2.25 % for emergencies. Much of the burden of surgical disease in Papua New Guinea presenting to Alotau General Hospital serving Milne Bay Province can be effectively treated by a small team providing emergency and

  2. The impact of health information technology and e-health on the future demand for physician services.

    Science.gov (United States)

    Weiner, Jonathan P; Yeh, Susan; Blumenthal, David

    2013-11-01

    Arguably, few factors will change the future face of the American health care workforce as widely and dramatically as health information technology (IT) and electronic health (e-health) applications. We explore how such applications designed for providers and patients will affect the future demand for physicians. We performed what we believe to be the most comprehensive review of the literature to date, including previously published systematic reviews and relevant individual studies. We estimate that if health IT were fully implemented in 30 percent of community-based physicians' offices, the demand for physicians would be reduced by about 4-9 percent. Delegation of care to nurse practitioners and physician assistants supported by health IT could reduce the future demand for physicians by 4-7 percent. Similarly, IT-supported delegation from specialist physicians to generalists could reduce the demand for specialists by 2-5 percent. The use of health IT could also help address regional shortages of physicians by potentially enabling 12 percent of care to be delivered remotely or asynchronously. These estimated impacts could more than double if comprehensive health IT systems were adopted by 70 percent of US ambulatory care delivery settings. Future predictions of physician supply adequacy should take these likely changes into account.

  3. Work satisfaction and future career intentions of experienced nurses transitioning to primary health care employment.

    Science.gov (United States)

    Ashley, Christine; Peters, Kath; Brown, Angela; Halcomb, Elizabeth

    2018-02-12

    To explore registered nurses' reflections on transitioning from acute to primary health care employment, and future career intentions. Reforms in primary health care have resulted in increasing demands for a skilled primary health care nursing workforce. To meet shortfalls, acute care nurses are being recruited to primary health care employment, yet little is known about levels of satisfaction and future career intentions. A sequential mixed methods study consisting of a survey and semi-structured interviews with nurses who transition to primary health care. Most reported positive experiences, valuing work/life balance, role diversity and patient/family interactions. Limited orientation and support, loss of acute skills and inequitable remuneration were reported negatively. Many respondents indicated an intention to stay in primary health care (87.3%) and nursing (92.6%) for the foreseeable future, whilst others indicated they may leave primary health care as soon as convenient (29.6%). Our findings provide guidance to managers in seeking strategies to recruit and retain nurses in primary health care employment. To maximize recruitment and retention, managers must consider factors influencing job satisfaction amongst transitioning nurses, and the impact that nurses' past experiences may have on future career intentions in primary health care. © 2018 John Wiley & Sons Ltd.

  4. Future orientation: a construct with implications for adolescent health and wellbeing.

    Science.gov (United States)

    Johnson, Sarah R Lindstrom; Blum, Robert W; Cheng, Tina L

    2014-01-01

    Multidisciplinary research has supported a relationship between adolescent future orientation (the ability to set future goals and plans) and positive adolescent health and development outcomes. Many preventive strategies - for example, contracepting, exercising - are based on taking actions in the present to avoid unwanted or negative future consequences. However, research has been hampered by unclear and often divergent conceptualizations of the future orientation construct. The present paper aims to integrate previous conceptual and operational definitions into a conceptual framework that can inform programs and services for youth and efforts to evaluate future orientation as a target for intervention. Recommendations focus on furthering the study of the construct through measurement synthesis as well as studies of the normative development of future orientation. Also suggested is the need to pair environmental intervention strategies with individual level efforts to improve future orientation in order to maximize benefits.

  5. Educating the future public health workforce: do schools of public health teach students about the private sector?

    Science.gov (United States)

    Rutkow, Lainie; Traub, Arielle; Howard, Rachel; Frattaroli, Shannon

    2013-01-01

    Recent surveys indicate that approximately 40% of graduates from schools of public health are employed within the private sector or have an employer charged with regulating the private sector. These data suggest that schools of public health should provide curricular opportunities for their students--the future public health workforce--to learn about the relationship between the private sector and the public's health. To identify opportunities for graduate students in schools of public health to select course work that educates them about the relationship between the private sector and public health. We systematically identified and analyzed data gathered from publicly available course titles and descriptions on the Web sites of accredited schools of public health. Data were collected in the United States. The sample consisted of accredited schools of public health. Descriptions of the number and types of courses that schools of public health offer about the private sector and identification of how course descriptions frame the private sector relative to public health. We identified 104 unique courses with content about the private sector's relationship to public health. More than 75% of accredited schools of public health offered at least 1 such course. Nearly 25% of identified courses focused exclusively on the health insurance industry. Qualitative analysis of the data revealed 5 frames used to describe the private sector, including its role as a stakeholder in the policy process. Schools of public health face a curricular gap, with relatively few course offerings that teach students about the relationship between the private sector and the public's health. By developing new courses or revising existing ones, schools of public health can expose the future public health workforce to the varied ways public health professionals interact with the private sector, and potentially influence students' career paths.

  6. Negotiations between health and social goals over the lifespan: The role of future time perspective.

    Science.gov (United States)

    Li, Kin-Kit

    2017-02-01

    The interplay between health and social goals in relation to age and future time perspective was examined among 131 older and 131 younger adults via surveys and future time manipulations (limited, unchanged, and expansive). Being older was associated with weaker physical activity intentions and social activity intentions as mediated by a limited future time perspective. Physical activity intentions decreased in the limited condition and increased in the expansive condition, social activity intentions increased in all conditions, and preference toward health (over social) goals decreased in both the limited and expansive conditions. The results suggest that anticipated endings may become salient in all conditions and favor social goals, which are emotionally relevant.

  7. An examination of the factors affecting people's participation in future health examinations based on community health exam interventions.

    Science.gov (United States)

    Tu, Shih-Kai; Liao, Hung-En

    2014-01-01

    Community-based intervention health examinations were implemented at a health care facility to comply with the government's primary health care promotion policy. The theory of planned behavior model was applied to examine the effect that community-based health examinations had on people's health concepts regarding seeking future health examinations. The research participants were individuals who had received a health examination provided at two branches of a hospital in central Taiwan in 2012. The hospital's two branches held a total of 14 free community-based health examination sessions. The hospital provided health examination equipment and staff to perform health examinations during public holidays. We conducted an exploratory questionnaire survey to collect data and implemented cross-sectional research based on anonymous self-ratings to examine the public's intention to receive future community-based or hospital-based health examinations. Including of 807 valid questionnaires, accounting for 89.4% of the total number of questionnaires distributed. The correlation coefficients of the second-order structural model indicate that attitudes positively predict behavioral intentions (γ = .66, p intentions (γ = .66, p intentions (γ = -.71, p > .05). The results of the first-order structural model indicated that the second-order constructs had a high explanatory power for the first-order constructs. People's health concepts regarding health examinations and their desire to continue receiving health examinations must be considered when promoting health examinations in the community. Regarding hospital management and the government's implementation of primary health care, health examination services should address people's medical needs to increase coverage and participation rates and reduce the waste of medical resources.

  8. Future time perspective and positive health practices in young adults: an extension.

    Science.gov (United States)

    Mahon, N E; Yarcheski, T J; Yarcheski, A

    1997-06-01

    A sample of 69 young adults attending a public university responded to the Future Time Perspective Inventory, two subscales of the Time Experience Scales (Fast and Slow Tempo), and the Personal Lifestyle Questionnaire in classroom settings. A statistically significant correlation (.52) was found between scores for future time perspective and the ratings for the practice of positive health behaviors in young adults. This correlation was larger than those previously found for middle and late adolescents. Scores on subscales of individual health practices and future time perspective indicated statistically significant correlations for five (.25 to .56) of the six subscales. Scores on neither Fast nor Slow Tempo were related to ratings of positive health practices or ratings on subscales measuring positive health practices.

  9. Evaluation of severe accident safety system value based on averting financial risks

    International Nuclear Information System (INIS)

    Hatch, S.W.; Benjamin, A.S.; Bennett, P.R.

    1983-01-01

    The Severe Accident Risk Reduction Program is being performed to benchmark the risks from nuclear power plants and to assess the benefits and impacts of a set of severe accident safety features. This paper describes the program in general and presents some preliminary results. These results include estimates of the financial risks associated with the operation of six reference plants and the value of severe accident prevention and mitigation safety systems in averting these risks. The results represent initial calculations and will be iterated before being used to support NRC decisions

  10. Men's Sheds function and philosophy: towards a framework for future research and men's health promotion.

    Science.gov (United States)

    Wilson, Nathan J; Cordier, Reinie; Doma, Kenji; Misan, Gary; Vaz, Sharmila

    2015-08-01

    The Men's Shed movement supports a range of men's health promotion initiatives. This paper examines whether a Men's Shed typology could inform future research and enable more efficient and targeted health promotion activities through Men's Sheds. The International Men's Shed Survey consisted of a cross-sectional exploration of sheds, their members, and health and social activities. Survey data about shed 'function' and 'philosophy' were analysed using descriptive and inferential statistics. A framework of Men's Sheds based on function and philosophy demonstrated that most sheds serve a primary utility function, a secondary social function, but most importantly a primary social opportunity philosophy. Sheds with a primary health philosophy participated in fewer health promotion activities when compared with sheds without a primary health philosophy. In addition to the uniform health promotion resources distributed by the Men's Shed associations, specific health promotion activities, such as prostate education, are being initiated from an individual shed level. This framework can potentially be used to enable future research and health promotion activities to be more efficiently and effectively targeted. SO WHAT? Men experience poorer health and well being outcomes than women. This framework offers a novel approach to providing targeted health promotion activities to men in an environment where it is okay to talk about men's health.

  11. Forming a health culture of future teachers in Polish educational establishments

    Directory of Open Access Journals (Sweden)

    T.S. IERMAKOVA

    2014-10-01

    Full Text Available Aim: to study the experience of the structure and system of training of future teachers in Polish schools. Material: content analysis of domestic and foreign authors. Used data from the survey of students of Polish universities. Also were used survey results through polish service ANKIETKA. For comparison, a questionnaire survey 35 students of the Faculty of Physical Education (future teachers of physical training and 30 students - the future teachers of elementary school of Ukrainian university. Results: the study of Polish teachers consider health culture of a person as the ability to assess individual and community health needs using in everyday life hygiene and health regulations. There have been some differences among Ukrainian and Polish students in their health and health culture. Among the respondents, Polish students - the future teachers of physical culture, is dominated motives such as the improvement of the physical condition, strengthen self-esteem, as well as improved health. Polish students from other disciplines believe that the most important motive for the adoption of physical activity is a concern for the physical well-being and mental health. The majority of Ukrainian students (future teachers of physical culture believe an important part of building health culture of their direct participation in various sports clubs, as well as the ability to organize physical culture, sports and educational work with students outside the classroom. Ukrainian students (other specialty noted the need to improve health, enhance knowledge in specific subjects humanities and promoting healthy lifestyles. Conclusions: It is recommended to use the experience of preparing students of Polish schools in modern Ukrainian higher education.

  12. Research inventory of child health: A report on roadmaps for the future of child health research in Europe

    OpenAIRE

    Ottova, Veronika; Alexander, Denise; Rigby, Michael; Staines, Anthony; Hjern, Anders; Leonardi, Matilde; Blair, Mitch; Tamburlini, Giorgio; Gaspar de Matos, Margarida; Bourek, Ales; Köhler, Lennart; Gunnlaugsson, Geir; Tomé, Gina; Ramiro, Lucia; Santos, Teresa

    2013-01-01

    RICHE was the response to a call under HEALTH-2009-3.3-5, with the title of 'European child health research platform'. The call text asked us to “address the diversity and fragmentation in child health research in Europe in an inclusive multidisciplinary way, identifying existing research programmes in Member States, recent advances and identification of gaps to explore road maps for the future of child health research in Europe”. Project structure A consortium, with a final total of 23 pa...

  13. The future of health economics: The potential of behavioral and experimental economics

    Directory of Open Access Journals (Sweden)

    Fredrik Hansen

    2015-05-01

    Full Text Available Health care systems around the globe are facing great challenges. The demand for health care is increasing due to the continuous development of new medical technologies, changing demographics, increasing income levels, and greater expectations from patients. The possibilities and willingness to expand health care resources, however, are limited. Consequently, health care organizations are increasingly required to take economic restrictions into account, and there is an urgent need for improved efficiency. It is reasonable to ask whether the health economics field of today is prepared and equipped to help us meet these challenges. Our aim with this article is twofold: to introduce the fields of behavioral and experimental economics and to then identify and characterize health economics areas where these two fields have a promising potential. We also discuss the advantages of a pluralistic view in health economics research, and we anticipate a dynamic future for health economics.

  14. Estimated disability-adjusted life years averted by long-term provision of long acting contraceptive methods in a Brazilian clinic.

    Science.gov (United States)

    Bahamondes, Luis; Bottura, Bruna F; Bahamondes, M Valeria; Gonçalves, Mayara P; Correia, Vinicius M; Espejo-Arce, Ximena; Sousa, Maria H; Monteiro, Ilza; Fernandes, Arlete

    2014-10-10

    .3 ± 5.7 (range 12-47) years in the 1980s, to 31.9 ± 7.4 (range 16-50) years in 2010-2011. The most common contraceptive chosen at the first consultation was copper IUD (48.3, 74.5 and 64.7% in the 1980s, 1990s and 2000s, respectively). For an evaluation over 20 years, the cumulative pregnancy rates (SEM) were 0.4 (0.2), 2.8 (2.1), 4.0 (0.4) and 1.3 (0.4) for the LNG-IUS, the implants, copper IUD and DMPA, respectively and cumulative continuation rates (SEM) were 15.1 (3.7), 3.9 (1.4), 14.1 (0.6) and 7.3 (1.7) for the LNG-IUS, implants, copper IUD and DMPA, respectively (P methods and DMPA to DALY averted was 37-60 maternal deaths; between 315 and 424 child mortalities; combined maternal morbidity and mortality and child mortality of between 634 and 853, and 1056-1412 unsafe abortions averted. The main limitations are the number of women who never returned to the clinic (overall 14% among the four methods under evaluation); consequently the pregnancy rate could be different. Other limitations include the analysis of two kinds of copper IUD and two kinds of contraceptive implants as the same IUD or implant, and the low number of users of implants. In addition, the DALY calculation relies on a number of estimates, which may vary in different parts of the world. LARC methods and DMPA are highly effective and women who were well-counselled used these methods for a long time. The benefit of averting maternal morbidity and mortality, child mortality, and unsafe abortions is an example to health policy makers to implement more family planning programmes and to offer contraceptive methods, mainly LARC and DMPA, at no cost or at affordable cost for the underprivileged population. This study received partial financial support from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), grant # 2012/12810-4 and from the National Research Council (CNPq), grant #573747/2008-3. B.F.B., M.P.G., and V.M.C. were fellows from the scientific initiation programme from

  15. Data, Staff, and Money: Leadership Reflections on the Future of Public Health Informatics.

    Science.gov (United States)

    Leider, Jonathon P; Shah, Gulzar H; Williams, Karmen S; Gupta, Akrati; Castrucci, Brian C

    Health informatics can play a critical role in supporting local health departments' (LHDs') delivery of certain essential public health services and improving evidence base for decision support. However, LHDs' informatics capacities are below an optimum level. Efforts to build such capacities face ongoing challenges. Moreover, little is known about LHD leaders' desires for the future of public health informatics. Conduct a qualitative analysis of LHDs' future informatics plans, perceived barriers to accomplishing those plans, and potential impact of future advances in public health informatics on the work of the public health enterprise. This research presents findings from 49 in-depth key informant interviews with public health leaders and informatics professionals from LHDs, representing insights from across the United States. Interviewees were selected on the basis of the size of the population their LHD serves, as well as level of informatics capacity. Interviews were transcribed, verified, and double coded. Major barriers to doing more with informatics included staff capacity and training, financial constraints, dependency on state health agency, and small LHD size/lack of regionalization. When asked about the role of leadership in expanding informatics, interviewees said that leaders could make it a priority through (1) learning more about informatics and (2) creating appropriate budgets for integrated information systems. Local health department leaders said that they desired data that were timely and geographically specific. In addition, LHD leaders said that they desired greater access to clinical data, especially around chronic disease indicators. Local health department leadership desires to have timely or even real-time data. Local health departments have a great potential to benefit from informatics, particularly electronic health records in advancing their administrative practices and service delivery, but financial and human capital represents the

  16. Future human health research directions for the Canadian Northern Contaminants Program

    Science.gov (United States)

    Donaldson, Shawn G.; Curren, Meredith S.; Adlard, Bryan; Provost, Jonathan; Leech, Tara; Tikhonov, Constantine; Feeley, Mark; Tomlinson, Scott; Shearer, Russel

    2013-01-01

    Studies conducted in the mid-1980s and early 1990s demonstrated that persistent organic pollutants (POPs) and metals were reaching the Arctic ecosystem at unexpectedly high levels, many of which had no Arctic or Canadian sources. Epidemiological and toxicological studies in Canada and in other countries have found that these contaminants may pose a risk to human health. The objective of this paper is to provide the foundation for the discussion on future northern human health research under the Northern Contaminants Program (NCP) in Canada. This short discussion of human health priorities will help guide a path forward for future northern human health research in Canada to address on-going and new health concerns related to contaminants exposure in the Canadian Arctic. PMID:24282784

  17. The Impact of Future Emissions Changes on Air Pollution Concentrations and Related Human Health Effects

    Science.gov (United States)

    Mikolajczyk, U.; Suppan, P.; Williams, M.

    2015-12-01

    Quantification of potential health benefits of reductions in air pollution on the local scale is becoming increasingly important. The aim of this study is to conduct health impact assessment (HIA) by utilizing regionally and spatially specific data in order to assess the influence of future emission scenarios on human health. In the first stage of this investigation, a modeling study was carried out using the Weather Research and Forecasting (WRF) model coupled with Chemistry to estimate ambient concentrations of air pollutants for the baseline year 2009, and for the future emission scenarios in southern Germany. Anthropogenic emissions for the baseline year 2009 are derived from the emission inventory provided by the Netherlands Organization of Applied Scientific Research (TNO) (Denier van der Gon et al., 2010). For Germany, the TNO emissions were replaced by gridded emission data with a high spatial resolution of 1/64 x 1/64 degrees. Future air quality simulations are carried out under different emission scenarios, which reflect possible energy and climate measures in year 2030. The model set-up included a nesting approach, where three domains with horizontal resolution of 18 km, 6 km and 2 km were defined. The simulation results for the baseline year 2009 are used to quantify present-day health burdens. Concentration-response functions (CRFs) for PM2.5 and NO2 from the WHO Health risks of air Pollution in Europe (HRAPIE) project were applied to population-weighted mean concentrations to estimate relative risks and hence to determine numbers of attributable deaths and associated life-years lost. In the next step, future health impacts of projected concentrations were calculated taking into account different emissions scenarios. The health benefits that we assume with air pollution reductions can be used to provide options for future policy decisions to protect public health.

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

    Directory of Open Access Journals (Sweden)

    Subitha Lakshminarayanan

    2011-01-01

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

  19. Plastics, the environment and human health: current consensus and future trends

    OpenAIRE

    Thompson, Richard C.; Moore, Charles J.; vom Saal, Frederick S.; Swan, Shanna H.

    2009-01-01

    Plastics have transformed everyday life; usage is increasing and annual production is likely to exceed 300 million tonnes by 2010. In this concluding paper to the Theme Issue on Plastics, the Environment and Human Health, we synthesize current understanding of the benefits and concerns surrounding the use of plastics and look to future priorities, challenges and opportunities. It is evident that plastics bring many societal benefits and offer future technological and medical advances. However...

  20. Employers’ Perspectives on Future Roles and Skills Requirements for Australian Health Librarians

    Directory of Open Access Journals (Sweden)

    Cheryl Hamill

    2011-01-01

    Full Text Available Objective – This study, which comprises one stage of a larger project (ALIA/HLA Workforce and Education Research Project, aimed to discover employers’ views on how (or whether health librarians assist in achieving the mission-critical goals of their organizations; how health librarians contribute to the organization now and into the future; and what are the current and future skills requirements of health librarians.Methods – Each member of the project group approached between one and five individuals known to them to generate a convenience sample of 22 employers of health librarians. There were 15 semi-structured interviews conducted between October and November 2010 with employers in the hospital, academic, government, private, consumer health and not-for-profit sectors. The interview schedule was sent to each interviewee prior to the interview so that they had time to consider their responses. The researchers wrote up the interview notes using the interview schedule and submitted them to the principal researcher, who combined the data into one document. Content analysis of the data was used to identify major themes.Results – Employers expressed a clear sense of respect for the roles and responsibilities of library staff in their organizations. Areas of practice such as education and training, scientific research and clinical support were highlighted as critical for the future. Current areas of practice such as using technology and systems to manage information, providing information services to meet user needs and management of health information resources in a range of formats were identified as remaining highly relevant for the future. There was potential for health librarians to play a more active and strategic role in their organizations, and to repackage their traditional skill sets for anticipated future roles. Interpersonal skills and the role of health librarians as the interface between clinicians and information technology

  1. Future heat stress arising from climate change on Iran's population health

    Science.gov (United States)

    Modarres, Reza; Ghadami, Mohammad; Naderi, Sohrab; Naderi, Mohammad

    2018-04-01

    Climate change-induced extreme heat events are becoming a major issue in different parts of the world, especially in developing countries. The assessment of regional and temporal past and future change in heat waves is a crucial task for public health strategies and managements. The historical and future heat index (HI) time series are investigated for temporal change across Iran to study the impact of global warming on public health. The heat index is calculated, and the nonparametric trend assessment is carried out for historical time series (1981-2010). The future change in heat index is also projected for 2020-2049 and 2070-2099 periods. A rise in the historical heat index and extreme caution conditions for summer and spring seasons for major parts of Iran are notable for historical (1981-2010) series in this study. Using different climate change scenarios shows that heat index will exceed the critical threshold for human adaptability in the future in the country. The impact of climate change on heat index risk in Iran is significant in the future. To cope with this crucial situation, developing early warning systems and health care strategies to deal with population growth and remarkable socio-economic features in future is essential.

  2. The future of health insurance for children with special health care needs.

    Science.gov (United States)

    Newacheck, Paul W; Houtrow, Amy J; Romm, Diane L; Kuhlthau, Karen A; Bloom, Sheila R; Van Cleave, Jeanne M; Perrin, James M

    2009-05-01

    Because of their elevated need for services, health insurance is particularly important for children with special health care needs. In this article we assess how well the current system is meeting the insurance needs of children with special health care needs and how emerging trends in health insurance may affect their well-being. We begin with a review of the evidence on the impact of health insurance on the health care experiences of children with special health care needs based on the peer-reviewed literature. We then assess how well the current system meets the needs of these children by using data from 2 editions of the National Survey of Children With Special Health Care Needs. Finally, we present an analysis of recent developments and emerging trends in the health insurance marketplace that may affect this population. Although a high proportion of children with special health care needs have insurance at any point in time, nearly 40% are either uninsured at least part of the year or have coverage that is inadequate. Recent expansions in public coverage, although offset in part by a contraction in employer-based coverage, have led to modest but significant reductions in the number of uninsured children with special health care needs. Emerging insurance products, including consumer-directed health plans, may expose children with special health care needs and their families to greater financial risks. Health insurance coverage has the potential to secure access to needed care and improve the quality of life for these children while protecting their families from financially burdensome health care expenses. Continued vigilance and advocacy for children and youth with special health care needs are needed to ensure that these children have access to adequate coverage and that they fare well under health care reform.

  3. Future health physics prospects in high-level nuclear waste management

    International Nuclear Information System (INIS)

    Waite, D.A.; Mayberry, J.J.

    1986-01-01

    The objective of this presentation is to provide an overview of health physics activities anticipated to be required at a high-level nuclear waste repository and to project the numbers of health physics personnel expected to be required to carry out these activities. Health physics personnel receiving consideration in the projections include the health physics manager, shift supervisors, area supervisors, health physicists, and technologists. Phases of the repository addressed are construction, operation, retrieval, and decommissioning. Specific topics discussed in the process of developing the projections are: (a) the basic features of a geologic repository, (b) the staffing requirements of such a repository, (c) health physics involvement in repository operations, and (d) the anticipated schedule for operation of repositories in the United States. A quantitative assessment of future health physics prospects in high-level nuclear waste management is included

  4. The technology acceptance model: its past and its future in health care.

    Science.gov (United States)

    Holden, Richard J; Karsh, Ben-Tzion

    2010-02-01

    Increasing interest in end users' reactions to health information technology (IT) has elevated the importance of theories that predict and explain health IT acceptance and use. This paper reviews the application of one such theory, the Technology Acceptance Model (TAM), to health care. We reviewed 16 data sets analyzed in over 20 studies of clinicians using health IT for patient care. Studies differed greatly in samples and settings, health ITs studied, research models, relationships tested, and construct operationalization. Certain TAM relationships were consistently found to be significant, whereas others were inconsistent. Several key relationships were infrequently assessed. Findings show that TAM predicts a substantial portion of the use or acceptance of health IT, but that the theory may benefit from several additions and modifications. Aside from improved study quality, standardization, and theoretically motivated additions to the model, an important future direction for TAM is to adapt the model specifically to the health care context, using beliefs elicitation methods.

  5. How to create a health care organization that can succeed in an unpredictable future.

    Science.gov (United States)

    Olden, Peter C; Haynos, Jessika

    2013-01-01

    For those who manage organizations, it has been said that success does not come from predicting the future but instead comes from creating an organization that can succeed in an unpredictable future. Managers are responsible for creating such an organization. To do that, managers can apply management-related principles and methods. This article explains selected principles of organization structure, human resources, culture, decision making, and change management and how to apply them to health care organizations. If done well, that will help such organizations succeed in an unpredictable future.

  6. Roundtable discussion: what is the future role of the private sector in health?

    Science.gov (United States)

    Stallworthy, Guy; Boahene, Kwasi; Ohiri, Kelechi; Pamba, Allan; Knezovich, Jeffrey

    2014-06-24

    The role for the private sector in health remains subject to much debate, especially within the context of achieving universal health coverage.This roundtable discussion offers diverse perspectives from a range of stakeholders--a health funder, a representative from an implementing organization, a national-level policy-maker, and an expert working in a large multi-national company--on what the future may hold for the private sector in health. The first perspective comes from a health funder, who argues that the discussion about the future role of the private sector has been bogged down in language. He argues for a 'both/and' approach rather than an 'either/or' when it comes to talking about health service provision in low- and middle-income countries.The second perspective is offered by an implementer of health insurance in sub-Saharan Africa. The piece examines the comparative roles of public sector actors, private sector actors and funding agencies, suggesting that they must work together to mobilize domestic resources to fund and deliver health services in the longer term.Thirdly, a special advisor working in the federal government of Nigeria considers the situation in that country. He notes that the private sector plays a significant role in funding and delivering health services there, and that the government must engage the private sector or forever be left behind.Finally, a representative from a multi-national pharmaceutical corporation gives an overview of global shifts that are creating opportunities for the private sector in health markets. Overall, the roundtable discussants agree that the private sector will play an important role in future health systems. But we must agree a common language, work together, and identify key issues and gaps that might be more effectively filled by the private sector.

  7. Death, taxes, public opinion, and the Midas touch of Mary Tyler Moore: accounting for promises by politicians to help avert and control diabetes.

    Science.gov (United States)

    Rock, Melanie

    2003-06-01

    Anthropologists have begun to publish ethnographic accounts of policy-making, but few have studied medical or health matters, despite broad acceptance in anthropology that "biopower" permeates contemporary societies. This article presents some findings from an ethnographic study of how diabetes gained recognition as a pressing public health problem in Canada. It underlines the importance of statistics for constituting power within and across nation states. Statistics imbricate people and things distributed across vast distances, but they still need to be generated and invoked by individuals to engender effects--as illustrated in this article by the contributions of researchers, aboriginal leaders, and an American actress, Mary Tyler Moore--in this case, the development of Canadian government policies justified in the name of averting and controlling diabetes. To make sense of these findings, subtle differences between two concepts coined by Michel Foucault, "biopower" and "governmentality," seem significant.

  8. Occupational safety and health in the United kingdom: securing future workplace health and wellbeing.

    Science.gov (United States)

    Harrison, John

    2012-01-01

    The industrial revolution that took place in the United Kingdom (UK) between 1760 and 1830 lead to profound social change, with rapid urbanisation associated with squalid living conditions and epidemics of infectious diseases. The next 150 yr or so saw the introduction of many specific acts of health and safety legislation. In 1974 new overarching primary legislation was introduced that would produce a step change in the evolution of health and safety enforcement. In 2004, a new strategy was launched designed to promote a vision embedding health and safety as a cornerstone of a civilised society and to achieve a record of workplace health and safety that leads the world. Good progress in controlling many safety hazards and improving occupational hygiene has been made. There has been a fall in numbers of a wide range of injuries and diseases or illnesses since 2000. The challenge will be to maintain these favourable trends and prepare for new and emerging diseases at a time when resources are diminishing. The importance of occupational health within the UK health and safety strategy has been recognised over the last decade. Occupational health is developing a new paradigm which combines classical health risk management with assessment of workability, rehabilitation back to work and promotion of health and wellbeing. There is an increasing recognition that being in supported employment is good for health and reduces health inequalities.

  9. Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments

    OpenAIRE

    Bakker, David; Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

    2016-01-01

    Background The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp de...

  10. The Future of Public Health Informatics: Alternative Scenarios and Recommended Strategies

    Science.gov (United States)

    Edmunds, Margo; Thorpe, Lorna; Sepulveda, Martin; Bezold, Clem; Ross, David A.

    2014-01-01

    Background: In October 2013, the Public Health Informatics Institute (PHII) and Institute for Alternative Futures (IAF) convened a multidisciplinary group of experts to evaluate forces shaping public health informatics (PHI) in the United States, with the aim of identifying upcoming challenges and opportunities. The PHI workshop was funded by the Robert Wood Johnson Foundation as part of its larger strategic planning process for public health and primary care. Workshop Context: During the two-day workshop, nine experts from the public and private sectors analyzed and discussed the implications of four scenarios regarding the United States economy, health care system, information technology (IT) sector, and their potential impacts on public health in the next 10 years, by 2023. Workshop participants considered the potential role of the public health sector in addressing population health challenges in each scenario, and then identified specific informatics goals and strategies needed for the sector to succeed in this role. Recommendations and Conclusion: Participants developed recommendations for the public health informatics field and for public health overall in the coming decade. These included the need to rely more heavily on intersectoral collaborations across public and private sectors, to improve data infrastructure and workforce capacity at all levels of the public health enterprise, to expand the evidence base regarding effectiveness of informatics-based public health initiatives, and to communicate strategically with elected officials and other key stakeholders regarding the potential for informatics-based solutions to have an impact on population health. PMID:25848630

  11. The effect of future outdoor air pollution on human health and the contribution of climate change

    Science.gov (United States)

    Silva, R.; West, J. J.; Lamarque, J.; Shindell, D.; Collins, W.; Dalsoren, S. B.; Faluvegi, G. S.; Folberth, G.; Horowitz, L. W.; Nagashima, T.; Naik, V.; Rumbold, S.; Skeie, R.; Sudo, K.; Takemura, T.; Bergmann, D. J.; Cameron-Smith, P. J.; Cionni, I.; Doherty, R. M.; Eyring, V.; Josse, B.; MacKenzie, I. A.; Plummer, D.; Righi, M.; Stevenson, D. S.; Strode, S. A.; Szopa, S.; Zeng, G.

    2013-12-01

    At present, exposure to outdoor air pollution from ozone and fine particulate matter (PM2.5) causes over 2 million deaths per year, due to respiratory and cardiovascular diseases and lung cancer. Future ambient concentrations of ozone and PM2.5 will be affected by both air pollutant emissions and climate change. Here we estimate the potential impact of future outdoor air pollution on premature human mortality, and isolate the contribution of future climate change due to its effect on air quality. We use modeled present-day (2000) and future global ozone and PM2.5 concentrations from simulations with an ensemble of chemistry-climate models from the Atmospheric Chemistry and Climate Model Intercomparison Project (ACCMIP). Future air pollution was modeled for global greenhouse gas and air pollutant emissions in the four IPCC AR5 Representative Concentration Pathway (RCP) scenarios, for 2030, 2050 and 2100. All model outputs are regridded to a common 0.5°x0.5° horizontal resolution. Future premature mortality is estimated for each RCP scenario and year based on changes in concentrations of ozone and PM2.5 relative to 2000. Using a health impact function, changes in concentrations for each RCP scenario are combined with future population and cause-specific baseline mortality rates as projected by a single independent scenario in which the global incidence of cardiopulmonary diseases is expected to increase. The effect of climate change is isolated by considering the difference between air pollutant concentrations from simulations with 2000 emissions and a future year climate and simulations with 2000 emissions and climate. Uncertainties in the results reflect the uncertainty in the concentration-response function and that associated with variability among models. Few previous studies have quantified the effects of future climate change on global human health via changes in air quality, and this is the first such study to use an ensemble of global models.

  12. The need for public-health veterinarians as seen by future employers.

    Science.gov (United States)

    Maccabe, Andrew T; Matchett, Karin E; Hueston, William D

    2008-01-01

    Future employers of veterinarians working in public health see a fast-growing demand. Emerging zoonotic diseases, bio-security threats, and food-safety problems all require the expertise of veterinarians with a focus on complex, global problems that span both human and animal health. The Public Health Task Force of the Association of American Veterinary Medical Colleges convened a group of stakeholders representing various branches of the US federal government, state and local governments, and professional societies to discuss their needs for public-health veterinarians. This article discusses those needs, the broader societal needs that require veterinarians with public-health expertise, and the implications of these for educational programs to train DVMs in public-health issues.

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

    Science.gov (United States)

    Parrish, R. Gibson; Ross, David A.

    2013-01-01

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

  14. Thirty years of experience in health physics education at Purdue University and plans for the future

    International Nuclear Information System (INIS)

    Landolt, R.R.; Ziemer, P.L.

    1988-01-01

    One way of anticipating areas of emphasis which health physics education should stress in the future is to study the employment trends of graduates. This study has been carried out by evaluating employment trends in six categories : medical, university (academic and radiation safety), federal laboratories, regulatory agencies, nuclear power and waste management/remedial action

  15. Adolescents' expectations for the future predict health behaviors in early adulthood.

    Science.gov (United States)

    McDade, Thomas W; Chyu, Laura; Duncan, Greg J; Hoyt, Lindsay T; Doane, Leah D; Adam, Emma K

    2011-08-01

    Health-related behaviors in adolescence establish trajectories of risk for obesity and chronic degenerative diseases, and they represent an important pathway through which socio-economic environments shape patterns of morbidity and mortality. Most behaviors that promote health involve making choices that may not pay off until the future, but the factors that predict an individual's investment in future health are not known. In this paper we consider whether expectations for the future in two domains relevant to adolescents in the U.S.-perceived chances of living to middle age and perceived chances of attending college-are associated with an individual's engagement in behaviors that protect health in the long run. We focus on adolescence as an important life stage during which habits formed may shape trajectories of disease risk later in life. We use data from a large, nationally representative sample of American youth (the US National Longitudinal Study of Adolescent Health) to predict levels of physical activity, fast food consumption, and cigarette smoking in young adulthood in relation to perceived life chances in adolescence, controlling for baseline health behaviors and a wide range of potentially confounding factors. We found that adolescents who rated their chances of attending college more highly exercised more frequently and smoked fewer cigarettes in young adulthood. Adolescents with higher expectations of living to age 35 smoked fewer cigarettes as young adults. Parental education was a significant predictor of perceived life chances, as well as health behaviors, but for each outcome the effects of perceived life chances were independent of, and often stronger than, parental education. Perceived life chances in adolescence may therefore play an important role in establishing individual trajectories of health, and in contributing to social gradients in population health. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Professional values, technology and future health care: The view of health care professionals in The Netherlands

    NARCIS (Netherlands)

    M.E. Nieboer; A.M. van Hout; Joost van Hoof; Sil Aarts; Eveline Wouters

    2014-01-01

    Perceptions and values of care professionals are critical in successfully implementing technology in health care. The aim of this study was threefold: (1) to explore the main values of health care professionals, (2) to investigate the perceived influence of the technologies regarding these values,

  17. International conference. Mental health consequences of the Chernobyl disaster: current state and future prospects

    International Nuclear Information System (INIS)

    Nyagu, A.I.

    1995-01-01

    Proceedings of the International Conference on the mental health consequences of the Chernobyl disaster: current state and future prospects was introduced.The questions connected with: 1. Mental health disorders biological basis after ionizing radiation influence; 2. Psychiatric aspects of the Chernobyl disaster; 3. Social stress following contradictory information: ways for its overcoming; 4. Rehabilitation and prophylactic measures for mental and nervous disorders. Psycho social rehabilitation of survivors; 5. Psychosomatic effects and somato-neurological consequences of the Chernobyl disaster; 6. Psychosomatic health of children and adolescents survivors of the Chernobyl disaster; 7. Brain damage as result of prenatal irradiation

  18. How Anterior Cruciate Ligament Injury was averted during Knee Collapse in a NBA Point Guard.

    Science.gov (United States)

    Schilaty, Nathan D; Bates, Nathaniel A; Krych, Aaron J; Hewett, Timothy E

    2017-01-01

    Non-contact anterior cruciate ligament (ACL) injuries occur with rapid decelerations and pivoting. A recent injury to a high-level National Basketball Association (NBA) player demonstrated neuromuscular control and injury-sparing mechanisms that resulted in only minor ligament injury to the medial collateral ligament. We analyzed biomechanical mechanisms via publically available orthogonal 2-D video to demonstrate how this potential ACL injury was averted. Analysis of the knee injury mechanism demonstrated that the NBA player experienced low ground reaction force, high sagittal plane flexion, and maintenance of frontal plane stability with neuromuscular control. The outcome of these factors inhibited dynamic valgus collapse of the knee throughout the fall, avoiding ACL injury - a potentially career-altering injury. Many athletes, professional and recreational, will be subjected to similar mechanisms of injury and will have improved outcomes if they can successfully utilize preventive strategies of neuromuscular control to limit injury mechanisms.

  19. Future trends in health and health care: implications for social work practice in an aging society.

    Science.gov (United States)

    Spitzer, William J; Davidson, Kay W

    2013-01-01

    Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the "graying of America" promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education.

  20. Linking the oceans to public health: current efforts and future directions.

    Science.gov (United States)

    Kite-Powell, Hauke L; Fleming, Lora E; Backer, Lorraine C; Faustman, Elaine M; Hoagland, Porter; Tsuchiya, Ami; Younglove, Lisa R; Wilcox, Bruce A; Gast, Rebecca J

    2008-11-07

    We review the major linkages between the oceans and public health, focusing on exposures and potential health effects due to anthropogenic and natural factors including: harmful algal blooms, microbes, and chemical pollutants in the oceans; consumption of seafood; and flooding events. We summarize briefly the current state of knowledge about public health effects and their economic consequences; and we discuss priorities for future research.We find that:* There are numerous connections between the oceans, human activities, and human health that result in both positive and negative exposures and health effects (risks and benefits); and the study of these connections comprises a new interdisciplinary area, "oceans and human health."* The state of present knowledge about the linkages between oceans and public health varies. Some risks, such as the acute health effects caused by toxins associated with shellfish poisoning and red tide, are relatively well understood. Other risks, such as those posed by chronic exposure to many anthropogenic chemicals, pathogens, and naturally occurring toxins in coastal waters, are less well quantified. Even where there is a good understanding of the mechanism for health effects, good epidemiological data are often lacking. Solid data on economic and social consequences of these linkages are also lacking in most cases.* The design of management measures to address these risks must take into account the complexities of human response to warnings and other guidance, and the economic tradeoffs among different risks and benefits. Future research in oceans and human health to address public health risks associated with marine pathogens and toxins, and with marine dimensions of global change, should include epidemiological, behavioral, and economic components to ensure that resulting management measures incorporate effective economic and risk/benefit tradeoffs.

  1. Study on a model for future occupational health: proposal for an occupational health service model in Japan.

    Science.gov (United States)

    Higashi, Toshiaki

    2006-10-01

    The Study Model for Future Occupational Health (funded by a research grant from the Ministry of Health, Welfare and Labor) is a joint research project involving various organizations and agencies undertaken from 2002 to 2004. Society has undergone a dramatic transformation due to technological developments and internationalization. At the same time a low birth rate and an aging population have resulted in an increase in both the percentage of workers experiencing strong anxiety and stress in relation to their jobs and the working environment and the number of suicides. As a natural consequence, occupational health services are now expected to provide EAP, consulting and other functions that were formerly considered outside the realm of occupational health. In consideration of this background, the present study propose the following issues to provide a model for future occupational health services that meet the conditions presently confronted by each worker. 1. How to provide occupational health services and occupational physicians' services: 1) a basic time of 20 minutes of occupational health services per year should be allotted to each worker and to all workers; 2) the obligatory regulations should be revised to expand the obligation from businesses each with 50 or more employees under the present laws to businesses each with 30 or more employees. 2. Providers of occupational health services and occupational physicians' services: (1) reinforcement of outside occupational health agencies; (2) fostering occupational health consultant firms; (3) development of an institute of occupational safety and health; (4) support of activities by authorized occupational physicians in the field; (5) expanding of joint selection of occupational physicians including subsidy increase and the extension of a period of subsidy to five hears; (6) licensing of new entry into occupational health undertaking. 3. Introduction of new report system: (1) establishment of the obligation to

  2. Automation of Knowledge Work in Medicine and Health care: Future and Challenges

    Directory of Open Access Journals (Sweden)

    Farzan Majidfar

    2017-07-01

    Full Text Available Increment of computing speed, machine learning and human interface, have extended capabilities of artificial intelligence applications to an important stage. It is predicted that use of artificial intelligence (AI to automate knowledge-based occupations (occupations such as medicine, engineering and law may have an global enormous economic impact in the near future.Applications based on artificial intelligence are able to improve health and quality of life for millions in the coming years. Although clinical applications of computer science are slow moving to real-world labs, but there are promising signs that the pace of innovation will improve. In the near future AI based applications by automating knowledge-based work in the field of diagnosis and treatment, nursing and health care, robotic surgery and development of new drugs, will have a transformative effect on the health sector. Therefore many artificial intelligence systems should work closely with health providers and patients to gain their trust. The progress of how smart machines naturally will interact with healthcare professionals, patients and patients' families is very important, yet challenging.In this article, we review the future of  automation of knowledge enabled by AI work in medicine and healthcare in  seven categories including big medical data mining, computer Aided Diagnosis, online consultations, evidence based medicine, health assistance, precision medicine and drug creation. Also challenges of this issue including cultural, organizational, legal and social barriers are described.

  3. Biomarkers for monitoring intestinal health in poultry: present status and future perspectives.

    Science.gov (United States)

    Ducatelle, Richard; Goossens, Evy; De Meyer, Fien; Eeckhaut, Venessa; Antonissen, Gunther; Haesebrouck, Freddy; Van Immerseel, Filip

    2018-05-08

    Intestinal health is determined by host (immunity, mucosal barrier), nutritional, microbial and environmental factors. Deficiencies in intestinal health are associated with shifts in the composition of the intestinal microbiome (dysbiosis), leakage of the mucosal barrier and/or inflammation. Since the ban on growth promoting antimicrobials in animal feed, these dysbiosis-related problems have become a major issue, especially in intensive animal farming. The economical and animal welfare consequences are considerable. Consequently, there is a need for continuous monitoring of the intestinal health status, particularly in intensively reared animals, where the intestinal function is often pushed to the limit. In the current review, the recent advances in the field of intestinal health biomarkers, both in human and veterinary medicine are discussed, trying to identify present and future markers of intestinal health in poultry. The most promising new biomarkers will be stable molecules ending up in the feces and litter that can be quantified, preferably using rapid and simple pen-side tests. It is unlikely, however, that a single biomarker will be sufficient to follow up all aspects of intestinal health. Combinations of multiple biomarkers and/or metabarcoding, metagenomic, metatranscriptomic, metaproteomic and metabolomic approaches will be the way to go in the future. Candidate biomarkers currently are being investigated by many research groups, but the validation will be a major challenge, due to the complexity of intestinal health in the field.

  4. ICT and the future of healthcare: Aspects of pervasive health monitoring.

    Science.gov (United States)

    Haluza, Daniela; Jungwirth, David

    2018-01-01

    Along with the digital revolution, information and communication technology applications are currently transforming the delivery of health and social care services. This paper investigates prevailing opinions toward future technology-based healthcare solutions among Austrian healthcare professionals. During a biphasic online Delphi survey, panelists rated expected outcomes of two future scenarios describing pervasive health monitoring applications. Experts perceived that the scenarios were highly innovative, but only moderately desirable, and that their implementation could especially improve patients' knowledge, quality of healthcare, and living standard. Contrarily, monetary aspects, technical prerequisites, and data security were identified as key obstacles. We further compared the impact of professional affiliation. Clearly, opinions toward pervasive healthcare differed between the interest groups, medical professionals, patient advocates, and administrative personnel. These data suggest closer collaborations between stakeholder groups to harmonize differences in expectations regarding pervasive health monitoring.

  5. Determination and use of the monetary values of the averted person-sievert for use in radiation protection decisions in Hungary.

    Science.gov (United States)

    Eged, K; Kanyár, B; Kis, Z; Tatay, T; Ivády, A; Volent, G

    2001-02-01

    The monetary value of the averted dose is a key element in the implementation of the optimization principle both in radiation praxis and intervention. The main concept of this principle is to select options so as to maintain exposures at a reasonable level. The feature of this concept is to look for the minimal total cost, i.e., the sum of the costs of protection and health detriment. In its publications, ICRP emphasized the need for developing models which also take into account the "subjective" aspects of health detriment in the optimization process, such as the perception of risk by individuals and the need to put more emphasis on equity in the distribution of individual doses. This paper proposes a modified alpha-value model based on CEPN's model (Centre d'Etude sur L'Evaluation de la Protection dans le Domaine Nucleaire) to put more emphasis on recently published considerations about the smaller effects of the portion of collective dose derived from small doses. The parameters of the monetary value of unit collective dose averted, which is a key element of this type of model, can be estimated by means of approaches like human capital (HC) and willingness to pay (WTP) from the point of view of economic theories. The present study summarizes the results achieved by WTP among the radiation specialists mainly from the Paks Nuclear Power Plant, Hungary. The aim of the effort was to determine the value of a statistical life and the monetary value of a unit person-sievert associated with averted occupational exposure due to ionizing radiation. To apply the WTP method, a questionnaire has been prepared on the basis of the one introduced by CEPN in the late 1990's. The investigations show that the value of US$6,200 person-Sv(-1) seems to be acceptable for the alphabase-value for the occupational situation in Hungary in 1999. WTP assessments should be applied with caution since the economic level of the country, the workplace surveyed, and the computational methods

  6. Operators’ Improvisation in Complex Technological Systems: The Last Resort to Averting an Assured Disaster

    International Nuclear Information System (INIS)

    Meshkati, N.

    2016-01-01

    normal function” of tightly coupled technological systems is to operate on the boundary to loss of control. That is, people are involved in a dynamic and continuous interaction with failure and hazard (Rasmussen, 1989). Thus, “touching the boundary to loss of control is necessary (e.g., for dynamic “speed-accuracy” trade-offs)” (Rasmussen, Pejtersen, & Goodstein, 1994). This is a rapidly changing environment, and in order to survive it, the system should be able to respond in a safe and effective manner. Occasionally, it may require an improvised response from the operator(s), but it should certainly be coordinated and in concert with others’ activities and stay within the boundaries of acceptable work performance (Rasmussen, 1989). Otherwise, it would be just noise in the control of the system and could lead to errors. It must also be able to flexibly reconfigure and synchronize all of its system elements to address the threatening issues. The brining the four nuclear reactors at the Fukushima Daini plant to the cold shut down, after the Tōhoku earthquake, tsunami and station black out of March 11, 2011, was nothing short of a miracle. The heroic act of a dedicated group of human operators, who went out of their way and by encountering multiple sources of hazard and harm, taking personal risk, and by relying on their ingenuity, teamwork, and dedication despite all odds, brought all four reactors to cold shutdown and consequently averted the second assured nuclear disaster in Fukushima prefecture with serious implications for travelling fallouts to Tokyo and its subsequent evacuation. The Superintendent of the Fukushima Daini Nuclear Power Station, Mr. Naohiro Masuda, and his operators resorted to improvisation to save the day after experiencing station black out; and their improvised acts are too numerous to mention. Nevertheless, the most memorable noteworthy ones include, “flexibly applying EOPs” and “Temporary cable of 9 km length was laid by about 200

  7. Report of the Independent Expert Group on the Future of European Public Health Research

    DEFF Research Database (Denmark)

    Olsen, Jørn

    2013-01-01

    Directorate General has set up an independent expert group. Its task was to take stock of the impacts, challenges and limitations of EU-funded public health research under the current and previous research framework programmes, and to identify priorities for future research. The experts, who worked in two...... agendas and national policy agendas? How to improve the uptake of evidence generated from public health research in the development of public health policy? This report summarises the recommendations from Subgroup 2.......The next EU research and innovation framework programme 'Horizon 2020' will address a number of important societal challenges including health, demographic changes and well-being. To prepare the work in these areas, the Health Directorate of the European Commission's Research & Innovation...

  8. Perspective for Future Research Direction About Health Impact of Ambient Air Pollution in China.

    Science.gov (United States)

    Dong, Guang-Hui

    2017-01-01

    Air pollution has become one of the major risks to human health because of the progressive increase in the use of vehicles powered by fossil fuels. Although lots of works on the health impact of ambient air pollution have been done in China, the following recommendations for future research were identified in this chapter: (1) the synergistic effect of indoor air pollution with climate change; (2) develop new technologies to improve accurate assessment of air pollution exposure; (3) well-designed cohort study of sensitive populations including children, older people, and people with chronic health problems; (4) multi-omics technologies in the underlying mechanisms study; and (5) benefits evaluation of improvement of air quality. In conclusion, China is becoming a suitable study site, providing an ideal opportunity to evaluate the effects of environmental pollution, including air pollution, on human health, which might serve as an example for developing countries where health impacts of air pollution are as serious as in China.

  9. Social, economic, and political forces affecting the future of occupational health nursing.

    Science.gov (United States)

    Miller, M A

    1989-09-01

    1. By monitoring the major social, economic, and political forces affecting health care, one can predict how these forces may impact the role of occupational health nurses. 2. Nursing can and must chart its own course in the midst of these social, economic, and political changes. 3. Changes which have major implications for occupational health nurses are: health care needs, cost containment, multi-hospital chains, alternative approaches to health care, the workplace, ethical concerns, biomedical technology, nursing shortage, and oversupply of physicians. 4. Nursing implications can also be drawn in the areas of autonomy, political skills, and education. Active involvement and a desire to shape professional change and the future of nursing are keys.

  10. Charting the future course of rural health and remote health in Australia: Why we need theory.

    Science.gov (United States)

    Bourke, Lisa; Humphreys, John S; Wakerman, John; Taylor, Judy

    2010-04-01

    This paper argues that rural and remote health is in need of theoretical development. Based on the authors' discussions, reflections and critical analyses of literature, this paper proposes key reasons why rural and remote health warrants the development of theoretical frameworks. The paper cites five reasons why theory is needed: (i) theory provides an approach for how a topic is studied; (ii) theory articulates key assumptions in knowledge development; (iii) theory systematises knowledge, enabling it to be transferable; (iv) theory provides predictability; and (v) theory enables comprehensive understanding. This paper concludes with a call for theoretical development in both rural and remote health to expand its knowledge and be more relevant to improving health care for rural Australians.

  11. Good Health at Low Cost 25 years on: lessons for the future of health systems strengthening.

    Science.gov (United States)

    Balabanova, Dina; Mills, Anne; Conteh, Lesong; Akkazieva, Baktygul; Banteyerga, Hailom; Dash, Umakant; Gilson, Lucy; Harmer, Andrew; Ibraimova, Ainura; Islam, Ziaul; Kidanu, Aklilu; Koehlmoos, Tracey P; Limwattananon, Supon; Muraleedharan, V R; Murzalieva, Gulgun; Palafox, Benjamin; Panichkriangkrai, Warisa; Patcharanarumol, Walaiporn; Penn-Kekana, Loveday; Powell-Jackson, Timothy; Tangcharoensathien, Viroj; McKee, Martin

    2013-06-15

    In 1985, the Rockefeller Foundation published Good health at low cost to discuss why some countries or regions achieve better health and social outcomes than do others at a similar level of income and to show the role of political will and socially progressive policies. 25 years on, the Good Health at Low Cost project revisited these places but looked anew at Bangladesh, Ethiopia, Kyrgyzstan, Thailand, and the Indian state of Tamil Nadu, which have all either achieved substantial improvements in health or access to services or implemented innovative health policies relative to their neighbours. A series of comparative case studies (2009-11) looked at how and why each region accomplished these changes. Attributes of success included good governance and political commitment, effective bureaucracies that preserve institutional memory and can learn from experience, and the ability to innovate and adapt to resource limitations. Furthermore, the capacity to respond to population needs and build resilience into health systems in the face of political unrest, economic crises, and natural disasters was important. Transport infrastructure, female empowerment, and education also played a part. Health systems are complex and no simple recipe exists for success. Yet in the countries and regions studied, progress has been assisted by institutional stability, with continuity of reforms despite political and economic turmoil, learning lessons from experience, seizing windows of opportunity, and ensuring sensitivity to context. These experiences show that improvements in health can still be achieved in countries with relatively few resources, though strategic investment is necessary to address new challenges such as complex chronic diseases and growing population expectations. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. The evolution of human rights in World Health Organization policy and the future of human rights through global health governance.

    Science.gov (United States)

    Meier, B M; Onzivu, W

    2014-02-01

    The World Health Organization (WHO) was intended to serve at the forefront of efforts to realize human rights to advance global health, and yet this promise of a rights-based approach to health has long been threatened by political constraints in international relations, organizational resistance to legal discourses, and medical ambivalence toward human rights. Through legal research on international treaty obligations, historical research in the WHO organizational archives, and interview research with global health stakeholders, this research examines WHO's contributions to (and, in many cases, negligence of) the rights-based approach to health. Based upon such research, this article analyzes the evolving role of WHO in the development and implementation of human rights for global health, reviews the current state of human rights leadership in the WHO Secretariat, and looks to future institutions to reclaim the mantle of human rights as a normative framework for global health governance. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  13. Cost Averted With Timely Fecal Microbiota Transplantation in the Management of Recurrent Clostridium difficile Infection in Alberta, Canada.

    Science.gov (United States)

    Waye, Arianna; Atkins, Kerry; Kao, Dina

    2016-10-01

    Fecal microbiota transplantation (FMT) is highly effective in treating recurrent Clostridium difficile infection (RCDI). However, the ideal timing for offering FMT remains to be determined. Furthermore, the direct medical costs averted with timely FMT have not been examined. A retrospective review of the Edmonton FMT program database included patients who received FMT for RCDI (October 2012 to September 2014). They were divided into 2 groups: those who received FMT after 2 recurrences (the timely FMT group) and those who received FMT after at least 3 recurrences (the delayed FMT group). The primary outcome was the difference in direct medical costs related to hospital admissions and emergency room visits due to CDI between the 2 groups. The secondary outcomes were RCDI cure rate and duration of RCDI in each group. A total of 75 patients were included: 30 received timely FMT, whereas 45 received delayed FMT. The mean difference in hospital length of stay and emergency room visits related to CDI were 13.8 days shorter and 1.3 visits fewer with timely FMT, associated with a mean cost saving of $29,842 per patient. Sensitivity analysis was performed to examine the effect of outliers and comorbities on the differential costs, and it was found that the differences in average cost per patient were more pronounced in those with Charlson comorbidity index ≥3 compared with those with scores of 0 to 2. The cure rate was 94% (timely FMT group) and 93% (delayed FMT group). The mean duration of RCDI was 109 days (timely FMT group) and 281 days (delayed FMT group). Timely FMT can provide significant cost savings to health-care systems, especially for patients with multiple comorbidities.

  14. Oral Health Care in the Future: Expansion of the Scope of Dental Practice to Improve Health.

    Science.gov (United States)

    Lamster, Ira B; Myers-Wright, Noreen

    2017-09-01

    The health care environment in the U.S. is changing. The population is aging, the prevalence of non-communicable diseases (NCDs) is increasing, edentulism is decreasing, and periodontal infection/inflammation has been identified as a risk factor for NCDs. These trends offer an opportunity for oral health care providers to broaden the scope of traditional dental practice, specifically becoming more involved in the management of the general health of patients. This new practice paradigm will promote a closer integration with the larger health care system. This change is based on the realization that a healthy mouth is essential for a healthy life, including proper mastication, communication, esthetics, and comfort. Two types of primary care are proposed: screenings for medical conditions that are directly affected by oral disease (and may modify the provision of dental care), and a broader emphasis on prevention that focuses on lifestyle behaviors. Included in the former category are screenings for NCDs (e.g., the risk of cardiovascular disease and identification of patients with undiagnosed dysglycemia or poorly managed diabetes mellitus), as well as identification of infectious diseases, such as HIV or hepatitis C. Reducing the risk of disease can be accomplished by an emphasis on smoking cessation and dietary intake and the prevention of obesity. These activities will promote interprofessional health care education and practice. While change is always challenging, this new practice paradigm could improve both oral health and health outcomes of patients seen in the dental office. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  15. Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments.

    Science.gov (United States)

    Bakker, David; Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

    2016-03-01

    The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems.

  16. Present and Future Trends in Consumer Health Informatics and Patient-Generated Health Data.

    Science.gov (United States)

    Lai, A M; Hsueh, P-Y S; Choi, Y K; Austin, R R

    2017-08-01

    Objectives: Consumer Health Informatics (CHI) and the use of Patient-Generated Health Data (PGHD) are rapidly growing focus areas in healthcare. The objective of this paper is to briefly review the literature that has been published over the past few years and to provide a sense of where the field is going. Methods: We searched PubMed and the ACM Digital Library for articles published between 2014 and 2016 on the topics of CHI and PGHD. The results of the search were screened for relevance and categorized into a set of common themes. We discuss the major topics covered in these articles. Results: We retrieved 65 articles from our PubMed query and 32 articles from our ACM Digital Library query. After a review of titles, we were left with 47 articles to conduct our full article survey of the activities in CHI and PGHD. We have summarized these articles and placed them into major categories of activity. Within the domain of consumer health informatics, articles focused on mobile health and patient-generated health data comprise the majority of the articles published in recent years. Conclusions: Current evidence indicates that technological advancements and the widespread availability of affordable consumer-grade devices are fueling research into using PGHD for better care. As we observe a growing number of (pilot) developments using various mobile health technologies to collect PGHD, major gaps still exist in how to use the data by both patients and providers. Further research is needed to understand the impact of PGHD on clinical outcomes. Georg Thieme Verlag KG Stuttgart.

  17. Potential Impacts of Future Climate Change on Regional Air Quality and Public Health over China

    Science.gov (United States)

    Hong, C.; Zhang, Q.; Zhang, Y.; He, K.

    2017-12-01

    Future climate change would affect public health through changing air quality. Climate extremes and poor weather conditions are likely to occur at a higher frequency in China under a changing climate, but the air pollution-related health impacts due to future climate change remain unclear. Here the potential impacts of future climate change on regional air quality and public health over China is projected using a coupling of climate, air quality and epidemiological models. We present the first assessment of China's future air quality in a changing climate under the Representative Concentration Pathway 4.5 (RCP4.5) scenario using the dynamical downscaling technique. In RCP4.5 scenario, we estimate that climate change from 2006-2010 to 2046-2050 is likely to adversely affect air quality covering more than 86% of population and 55% of land area in China, causing an average increase of 3% in O3 and PM2.5 concentrations, which are found to be associated with the warmer climate and the more stable atmosphere. Our estimate of air pollution-related mortality due to climate change in 2050 is 26,000 people per year in China. Of which, the PM2.5-related mortality is 18,700 people per year, and the O3-related mortality is 7,300 people per year. The climate-induced air pollution and health impacts vary spatially. The climate impacts are even more pronounced on the urban areas where is densely populated and polluted. 90% of the health loss is concentrated in 20% of land areas in China. We use a simple statistical analysis method to quantify the contributions of climate extremes and find more intense climate extremes play an important role in climate-induced air pollution-related health impacts. Our results indicate that global climate change will likely alter the level of pollutant management required to meet future air quality targets as well as the efforts to protect public health in China.

  18. Effect of the Exclusion of Behavioral Health from Health Information Technology (HIT) Legislation on the Future of Integrated Health Care.

    Science.gov (United States)

    Cohen, Deborah

    2015-10-01

    Past research has shown abundant comorbidity between physical chronic health conditions and mental illness. The focal point of the conversation to reduce cost is better care coordination through the implementation of health information technology (HIT). At the policy level, the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act) was implemented as a way to increase the implementation of HIT. However, behavioral health providers have been largely excluded from obtaining access to the funds provided by the HITECH Act. Without further intervention, disjointed care coordination between physical and behavioral health providers will continue.

  19. Association of physical activity with future mental health in older, mid-life and younger women.

    Science.gov (United States)

    Griffiths, Amanda; Kouvonen, Anne; Pentti, Jaana; Oksanen, Tuula; Virtanen, Marianna; Salo, Paula; Väänänen, Ari; Kivimäki, Mika; Vahtera, Jussi

    2014-10-01

    Mental ill-health, particularly depression and anxiety, is a leading and increasing cause of disability worldwide, especially for women. We examined the prospective association between physical activity and symptoms of mental ill-health in younger, mid-life and older working women. Participants were 26 913 women from the ongoing cohort Finnish Public Sector Study with complete data at two phases, excluding those who screened positive for mental ill-health at baseline. Mental health was assessed using the 12-item General Health Questionnaire. Self-reported physical activity was expressed in metabolic equivalent task (MET) hours per week. Logistic regression models were used to analyse associations between physical activity levels and subsequent mental health. There was an inverse dose-response relationship between physical activity and future symptoms of mental ill-health. This association is consistent with a protective effect of physical activity and remained after adjustments for socio-demographic, work-related and lifestyle factors, health and body mass index. Furthermore, those mid-life and older women who reported increased physical activity by more than 2 MET hours per week demonstrated a reduced risk of later mental ill-health in comparison with those who did not increase physical activity. This protective effect of increased physical activity did not hold for younger women. This study adds to the evidence for the protective effect of physical activity for later mental health in women. It also suggests that increasing physical activity levels may be beneficial in terms of mental health among mid-life and older women. The alleviation of menopausal symptoms may partly explain age effects but further research is required. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association.

  20. Reporting intellectual capital in health care organizations: specifics, lessons learned, and future research perspectives.

    Science.gov (United States)

    Veltri, Stefania; Bronzetti, Giovanni; Sicoli, Graziella

    2011-01-01

    This article analyzes the concept of intellectual capital (IC) in the health sector sphere by studying the case of a major nonprofit research organization in this sector, which has for some time been publishing IC reports. In the last few years, health care organizations have been the object of great attention in the implementation and transfer of managerial models and tools; however, there is still a lack of attention paid to the strategic management of IC as a fundamental resource for supporting and enhancing performance improvement dynamics. The main aim of this article is to examine the IC reporting model used by the Center of Molecular Medicine (CMM), a Swedish health organization which is an outstanding benchmark in reporting its IC. We also consider the specifics of IC reporting for health organizations, the lessons learned by analyzing CMM's IC reporting, and future perspectives for research.

  1. Non-governmental organizations in international health: past successes, future challenges.

    Science.gov (United States)

    Gellert, G A

    1996-01-01

    Non-governmental organizations, or NGOs, are increasingly instrumental to the implementation of international health programs. Following an overview of current conditions in global health and the problems that could be targeted by NGOs, this article describes the activities and philosophies of several representative approaches in this sector. The attributes of NGOs that increase their potential effectiveness are discussed, including ability to reach areas of severe need, promotion of local involvement, low cost of operations, adaptiveness and innovation, independence, and sustainability. A summary is provided of major future challenges in international health that may be addressed by NGOs, with particular emphasis on tobacco-related disease, communicable diseases and the AIDS epidemic, maternal mortality and women's health, injury prevention and control, and the need to secure durable financial support.

  2. Health and Aging Policy Fellows Program: Shaping a Healthy Future for Older Americans.

    Science.gov (United States)

    Pincus, Harold Alan; Pike, Kathleen M; Spaeth-Rublee, Brigitta; Elinson, Lynn

    2017-09-01

    As the size of the elderly population increases, so do the challenges of and barriers to high-quality, affordable health care. The Health and Aging Policy Fellows (HAPF) Program is designed to provide health and aging professionals with the skills and experience to help lead the effort in reducing these barriers and shaping a healthy and productive future for older Americans. Since its inception in 2008, the program has affected not only the fellows who participate, but also the field of health and aging policy. Work needs to be done to sustain this program so that more fellows can participate and sound policies for the elderly population can continue to be shaped and improved. This report describes the HAPF Program, including its background (rationale, description, partners, progress, effect), lessons learned, challenges and solutions, and policy implications. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  3. Geochemical legacies and the future health of cities: A tale of two neurotoxins in urban soils

    Science.gov (United States)

    Fillipelli, Gabriel M.; Risch, Martin R.; Laidlaw, Mark A. S.; Nichols, Deborah E.; Crewe, Julie

    2015-01-01

    The past and future of cities are inextricably linked, a linkage that can be seen clearly in the long-term impacts of urban geochemical legacies. As loci of population as well as the means of employment and industry to support these populations, cities have a long history of co-locating contaminating practices and people, sometimes with negative implications for human health. Working at the intersection between environmental processes, communities, and human health is critical to grapple with environmental legacies and to support healthy, sustainable, and growing urban populations. An emerging area of environmental health research is to understand the impacts of chronic exposures and exposure mixtures—these impacts are poorly studied, yet may pose a significant threat to population health.

  4. A systematic review of microfinance and women's health literature: Directions for future research.

    Science.gov (United States)

    O'Malley, T L; Burke, J G

    2017-11-01

    While growing evidence suggests that microfinance is an effective approach for improved women's health, a significant gap remains in our understanding. The objective of this review is to synthesise the findings from published literature focused on microfinance and health issues particularly affecting women, including HIV/AIDS, reproductive health, mental health, and violence. Forty-one articles that examine the impact of microfinance participation on women's health were identified through a systematic search of electronic databases, coded using a structured abstraction form, and synthesised. Review results indicate that the impact of microfinance on women's health is an area in great need of research and publication attention. Varied quality and reporting in the identified articles restricted the ability to draw concrete conclusions regarding the relationship between microfinance participation and women's health, but led to the identification of current gaps in existing published research. Future research should work to address the recommendations provided in order to offer additional evidence to better understand the use of microfinance programming as a structural intervention to improve women's health.

  5. The past, present, and future of soils and human health studies

    Science.gov (United States)

    Brevik, E. C.; Sauer, T. J.

    2015-01-01

    The idea that human health is tied to the soil is not a new one. As far back as circa 1400 BC the Bible depicts Moses as understanding that fertile soil was essential to the well-being of his people. In 400 BC the Greek philosopher Hippocrates provided a list of things that should be considered in a proper medical evaluation, including the properties of the local ground. By the late 1700s and early 1800s, American farmers had recognized that soil properties had some connection to human health. In the modern world, we recognize that soils have a distinct influence on human health. We recognize that soils influence (1) food availability and quality (food security), (2) human contact with various chemicals, and (3) human contact with various pathogens. Soils and human health studies include investigations into nutrient supply through the food chain and routes of exposure to chemicals and pathogens. However, making strong, scientific connections between soils and human health can be difficult. There are multiple variables to consider in the soil environment, meaning traditional scientific studies that seek to isolate and manipulate a single variable often do not provide meaningful data. The complete study of soils and human health also involves many different specialties such as soil scientists, toxicologists, medical professionals, anthropologists, etc. These groups do not traditionally work together on research projects, and do not always effectively communicate with one another. Climate change and how it will affect the soil environment/ecosystem going into the future is another variable affecting the relationship between soils and health. Future successes in soils and human health research will require effectively addressing difficult issues such as these.

  6. European Health Claims for Small and Medium-Sized Companies – Utopian Dream or Future Reality?

    Directory of Open Access Journals (Sweden)

    Sonja Brandenburger

    2015-02-01

    Full Text Available Background: In December 2007, the European Regulation (EC 1924/2006 on nutrition and health claims came into force. The European Union wanted to regulate the use of health claims on products. An online survey was carried out to evaluate the situation, particularly of small and medium-sized companies, dealing with the new regulation. Methods: The online survey on health claims was conducted with 16 enterprises. To underline the findings a SWOT (Strength, Weaknesses, Opportunities, Threats analysis was made of the nutrition and health claims regulation regarding small and medium-sized companies in the European food and drink market. Results: The findings of this study indicated that the European Union did a step in the right direction. Most companies defined the decent competition, the simplified trade within the inner-European market, and the consumer protection as positive aspects. The biggest threat is seen in false investment conditioned by the limited research and development budgets, especially of small and medium-sized enterprises, and the cost intensive scientific evaluation to reach an authorized health claim. Conclusions: Overall, there are several strengths and opportunities speaking for SMEs and health claims in the near future. The most promising ones are the publishing of the new European Union Register of Nutrition and Health Claims and the learning effects that will occur. The biggest threat is, and will remain to be, false investment and the possible loss of a lot of money. Nevertheless, health claims for small and medium-sized enterprises will inevitably be the future to keep the European food and drink market competitive.

  7. Current and future climate- and air pollution-mediated impacts on human health.

    Science.gov (United States)

    Doherty, Ruth M; Heal, Mathew R; Wilkinson, Paul; Pattenden, Sam; Vieno, Massimo; Armstrong, Ben; Atkinson, Richard; Chalabi, Zaid; Kovats, Sari; Milojevic, Ai; Stevenson, David S

    2009-12-21

    We describe a project to quantify the burden of heat and ozone on mortality in the UK, both for the present-day and under future emission scenarios. Mortality burdens attributable to heat and ozone exposure are estimated by combination of climate-chemistry modelling and epidemiological risk assessment. Weather forecasting models (WRF) are used to simulate the driving meteorology for the EMEP4UK chemistry transport model at 5 km by 5 km horizontal resolution across the UK; the coupled WRF-EMEP4UK model is used to simulate daily surface temperature and ozone concentrations for the years 2003, 2005 and 2006, and for future emission scenarios. The outputs of these models are combined with evidence on the ozone-mortality and heat-mortality relationships derived from epidemiological analyses (time series regressions) of daily mortality in 15 UK conurbations, 1993-2003, to quantify present-day health burdens. During the August 2003 heatwave period, elevated ozone concentrations > 200 microg m-3 were measured at sites in London and elsewhere. This and other ozone photochemical episodes cause breaches of the UK air quality objective for ozone. Simulations performed with WRF-EMEP4UK reproduce the August 2003 heatwave temperatures and ozone concentrations. There remains day-to-day variability in the high ozone concentrations during the heatwave period, which on some days may be explained by ozone import from the European continent.Preliminary calculations using extended time series of spatially-resolved WRF-EMEP4UK model output suggest that in the summers (May to September) of 2003, 2005 & 2006 over 6000 deaths were attributable to ozone and around 5000 to heat in England and Wales. The regional variation in these deaths appears greater for heat-related than for ozone-related burdens.Changes in UK health burdens due to a range of future emission scenarios will be quantified. These future emissions scenarios span a range of possible futures from assuming current air quality

  8. Resource approach in providing health-saving process of future teachers training

    Directory of Open Access Journals (Sweden)

    Mykytiuk S.A.

    2012-12-01

    Full Text Available The mechanisms of realization of resource approach are exposed in organization of pedagogical education. There were defined the ways of providing health-saving teacher training, namely: assessment criteria of adjustment of social order and personal professional development needs, means of implementing the tasks of pedagogical education concept according to the resource approach. The methods of maintainance and strengthening of health of future teachers are specified in the process of professional preparation. It is marked that resource approach unites requirement to the competence of teacher, provides the account of age-dependent features of organism of student and periods of becoming of personality of student and teacher. Resource approach is given by possibility to take into account the specific of labour and level of knowledge, abilities and skills of every student. Resource approach harmonizes the actual aspects of complex of the modern scientific going near education of students and professional preparation of future teachers.

  9. New challenges of public health: bringing the future of personalised healthcare into focus.

    Science.gov (United States)

    Ricciardi, Walter; Boccia, Stefania

    2017-10-01

    The greater personalization of healthcare represents a driver of innovation for research, and for the healthcare systems and industries as a whole. Still policy-makers, healthcare professionals, citizens and private companies need to take some steps to realize the potential for such a radical shift. In this paper, we illustrate the challenges, the benefits and consequences that might accompany the implementation of personalized healthcare, and the steps that policy-makers and practitioners would need to take to realise its potential. Six main prerequisites for radical change in healthcare are presented, that include achieving better genetic literacy for professionals and for the public; engaging citizen in the discourse; improved governance, consent and trust in healthcare; feeding and harnessing the data-knowledge cycle for better health; adopting and adapting the Health Technology Assessment framework for the evaluation of the new technologies; and retaining humanity and community in health and care. Some of these concepts originate from a discussion on the future of health and healthcare, looking at least 15-20 years into the future, that we had at the end of 2016 at Ickworth with an international group of experts, under the aegis of the PHG Foundation. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  10. The future of Catholic health care: observations from an Orthodox Christian perspective.

    Science.gov (United States)

    Cozby, Dimitri

    1999-04-01

    The author reflects on the future of Catholic health care by looking at the essays in this volume by Dennis Brodeur, Clarke E. Cochran, and Christopher J. Kauffman. The author argues that (1) Roman Catholic teaching on the Trinity is defective, yielding an inadequate model of society, (2) Roman Catholic teaching on the Incarnation is defective, yielding an impoverished understanding of the "sacramental," and (3) the institutional orientation of Roman Catholicism combined with the lack of true sacramental vision makes it nearly impossible for Roman Catholic theory to criticize the current structure of health care financing.

  11. Automation of Knowledge Work in Medicine and Health care: Future and Challenges

    OpenAIRE

    Farzan Majidfar

    2017-01-01

    Increment of computing speed, machine learning and human interface, have extended capabilities of artificial intelligence applications to an important stage. It is predicted that use of artificial intelligence (AI) to automate knowledge-based occupations (occupations such as medicine, engineering and law) may have an global enormous economic impact in the near future.Applications based on artificial intelligence are able to improve health and quality of life for millions in the coming years. ...

  12. Positive beliefs and privacy concerns shape the future for the Personally Controlled Electronic Health Record.

    Science.gov (United States)

    Lehnbom, E C; Douglas, H E; Makeham, M A B

    2016-01-01

    The uptake of the Personally Controlled Electronic Health Record (PCEHR) has been slowly building momentum in Australia. The purpose of the PCEHR is to collect clinically important information from multiple healthcare providers to provide a secure electronic record to patients and their authorised healthcare providers that will ultimately enhance the efficiency and effectiveness of healthcare delivery. Reasons for the slow uptake of the PCEHR and future directions to improve its usefulness is discussed later. © 2016 Royal Australasian College of Physicians.

  13. Designing Smart Health Care Technology into the Home of the Future

    Energy Technology Data Exchange (ETDEWEB)

    Craft, R.L.; Warren, S.

    1999-04-20

    This editorial paper presents a vision for intelligent health care in the home of the future, focusing on technologies with the highest potential payoff given targeted government funding over the next ten years. A secure, plug-and-play information framework provides the starting point for identifying technologies that must be developed before home-based devices can know their context and assimilate information to support care decisions.

  14. ICT and the future of health care: aspects of doctor-patient communication.

    Science.gov (United States)

    Haluza, Daniela; Jungwirth, David

    2014-07-01

    The current digital revolution is particularly relevant for interactions of healthcare providers with patients and the community as a whole. The growing public acceptance and distribution of new communication tools such as smart mobile phones provide the prerequisite for information and communication technology (ICT) -assisted healthcare applications. The present study aimed at identifying specifications and perceptions of different interest groups regarding future demands of ICT-supported doctor-patient communication in Austria. German-speaking Austrian healthcare experts (n = 73; 74 percent males; mean age, 43.9 years; SD 9.4) representing medical professionals, patient advocates, and administrative personnel participated in a 2-round online Delphi process. Participants evaluated scenario-based benefits and obstacles for possible prospect introduction as well as degree of innovation, desirability, and estimated implementation dates of two medical care-related future set ups. Panelists expected the future ICT-supported doctor-patient dialogue to especially improve the three factors doctors-patient relationship, patients' knowledge, and quality of social health care. However, lack of acceptance by doctors, data security, and monetary aspects were considered as the three most relevant barriers for ICT implementation. Furthermore, inter-group comparison regarding desirability of future scenarios showed that medical professionals tended to be more skeptical about health-related technological innovations (p ICT-supported collaboration and communication between doctors and patients.

  15. Child and Adolescent Mental Health Care in Iran: Current Status and Future Directions.

    Science.gov (United States)

    Sharifi, Vandad; Mojtabai, Ramin; Shahrivar, Zahra; Alaghband-Rad, Javad; Zarafshan, Hadi; Wissow, Lawrence

    2016-11-01

    The need for mental health care among children and adolescents in Iran, as in other low and middle income countries (LAMIC) remains mostly unmet. In this paper, we sought to provide an overview of the extent of unmet need and mental health services in Iran. We also aimed to propose approaches to address this gap. We reviewed the published epidemiologic studies of child and adolescent mental and behavioral health problems in Iran. We also examined the current status of child mental health services and the gaps between current needs and available services based on published literature that included papers published in scientific journals, as well as governmental and other administrative reports. The contextual issues relevant to child mental health care were also explored, as well as the possibilities to introduce new or scale up promising services. Child and adolescent mental and behavioral health problems are highly prevalent in Iran. Different studies have estimated that 16.7% to 36.4% of children and adolescents suffer from one or more mental health problems. However, there is a serious scarcity of resources to meet this need. Available services are delivered by independent public organizations (e.g., Ministry of Health, Welfare Organization, and Ministry of Education) or private sector with inefficient communication and collaboration among them and no mandatory national mental health policy. Available specialized child and adolescent services are mostly confined to small inpatient units and university outpatient facilities in larger cities, and there is a scarce evidence for  the effectiveness of the available services. Expansion of primary care's role in timely detection and management of child and adolescent mental health problems, implementation of task-shifting and -sharing initiatives, as well as improved collaboration among responsible governmental and non-governmental sectors are some of the most promising future venues to improve mental health care for

  16. Beyond Antitrust: Health Care And Health Insurance Market Trends And The Future Of Competition.

    Science.gov (United States)

    Glied, Sherry A; Altman, Stuart H

    2017-09-01

    The United States relies on competition to balance costs and quality in the health care system. But concentration is increasing throughout the hospital, physician, and insurer markets. Midsize community hospitals face declining demand and growing competition from both larger hospitals and smaller freestanding diagnostic and surgical centers, leaving the midsize hospitals vulnerable to closure or merger with other facilities. Competition among insurers has been limited by the development of hospital systems that extend the bargaining power of "must-have" hospitals (those perceived to provide the best care for complex and less common conditions) across local health care markets. Government antitrust enforcement could play an important role in maintaining competition in both the hospital and insurer markets, but in many markets, the impact of that enforcement has been limited to date. Policy makers should consider supplementing antitrust activities with strategies that combine competition and regulation-for example, by regulating selected prices and structuring competition to cover entire insurance markets. Project HOPE—The People-to-People Health Foundation, Inc.

  17. Future Organization of Oral Health Services Delivery: From 2012 to 2042.

    Science.gov (United States)

    Brown, L Jackson

    2017-09-01

    The United States is currently experiencing a vortex of change in both general health and oral health care delivery, the ultimate outcome of which is still not well understood. The specific focus of this article is to examine the future organization of the oral health services delivery system (OHSDS) in the U.S., with special attention given to the role of large group dental practices (LGDPs) in that future. The article describes the various types of LGDPs and their ability to change the economic characteristics of the OHSDS. Large geographically distributed corporate group dental practices (LGDCGDPs) are the type that may expand their market share to the extent that they could change the economic characteristics of the OHSDS. A wide range of scenarios is used to project the expansion of LGDCGDPs into the future. The scenarios modeled are not intended as predictions but rather to present a range of possible OHSDS market structures that may emerge over the next 30 years. The implications of each scenario for the economic competition within the OHSDS are described. Possible implications of these trends for dental education are also discussed. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  18. The health professions and the performance of future health systems in low-income countries: support or obstacle?

    Science.gov (United States)

    Dussault, Gilles

    2008-05-01

    This paper discusses the present and future role of the health professions in health services delivery systems in low-income countries. Unlike richer countries, most low-income countries do not have a tradition of labour market regulation and the capacity of the professions themselves to regulate the provision of health services by their members tends to be weak. The paper looks at the impact of professional monopolies on the performance of health services delivery systems, e.g. equity of access, effectiveness of services, efficiency in the use of scarce resources, responsiveness to users' needs, including protection against the financial impact of utilising health services. It identifies issues which policy-makers face in relation to opening the health labour market while guaranteeing the safety and security of services provided by professionals. The suggestion is made that a "social contract", granting privileges of practice in exchange of a commitment to actively maintain and enhance the quality of their services, may be a viable course of action. This would require that the actors in the policy process collaborate in strengthening the capacity of regulatory agencies to perform their role.

  19. Football Players' Perceptions of Future Risk of Concussion and Concussion-Related Health Outcomes.

    Science.gov (United States)

    Baugh, Christine M; Kroshus, Emily; Kiernan, Patrick T; Mendel, David; Meehan, William P

    2017-02-15

    Concussion is increasingly recognized as a risk of participation in contact and collision sports. There have been few examinations of athletes' perceptions of their susceptibility to concussion or concussion-related health consequences. We examine college football players' perceptions of their risk of sustaining a concussion and concussion-related health consequences in their future, whether these perceptions change over time, and how concussion history is related to perceived future risk of concussion and concussion-related health consequences. A survey was administered to National Collegiate Athletic Association Division I Football Championship Series athletes on 10 teams in 2013 and to nine of those teams in 2014. Athletes answered questions assessing their perceptions of concussion and potential concussion-related health consequences. Approximately 40% of athletes believed there was a strong possibility that they would sustain a concussion in the future, while approximately one-in-four thought a concussion would make them miss a few games. About one-in-10 athletes predicted dementia, Alzheimer's disease, or chronic traumatic encephalopathy would develop from concussions. These beliefs were stronger among athletes who had sustained previous concussions. Across the two years studied, athletes' perceptions of the risk of concussion and missing a few games because of concussion decreased significantly. Overall, a substantial proportion of college football players believe they will have long-term health consequences as a result of sustaining sport-related concussions. The true incidence and prevalence of many of these outcomes are unknown. Further research is needed to determine whether athletes have an accurate perception of the risks of these outcomes developing.

  20. The Public Health Nutrition workforce and its future challenges: the US experience.

    Science.gov (United States)

    Haughton, Betsy; George, Alexa

    2008-08-01

    To describe the US public health nutrition workforce and its future social, biological and fiscal challenges. Literature review primarily for the four workforce surveys conducted since 1985 by the Association of State and Territorial Public Health Nutrition Directors. The United States. Nutrition personnel working in governmental health agencies. The 1985 and 1987 subjects were personnel in full-time budgeted positions employed in governmental health agencies providing predominantly population-based services. In 1994 and 1999 subjects were both full-time and part-time, employed in or funded by governmental health agencies, and provided both direct-care and population-based services. The workforce primarily focuses on direct-care services for pregnant and breast-feeding women, infants and children. The US Department of Agriculture funds 81.7 % of full-time equivalent positions, primarily through the WIC Program (Special Supplemental Nutrition Program for Women, Infants, and Children). Of those personnel working in WIC, 45 % have at least 10 years of experience compared to over 65 % of the non-WIC workforce. Continuing education needs of the WIC and non-WIC workforces differ. The workforce is increasingly more racially/ethnically diverse and with 18.2 % speaking Spanish as a second language. The future workforce will need to focus on increasing its diversity and cultural competence, and likely will need to address retirement within leadership positions. Little is known about the workforce's capacity to address the needs of the elderly, emergency preparedness and behavioural interventions. Fiscal challenges will require evidence-based practice demonstrating both costs and impact. Little is known about the broader public health nutrition workforce beyond governmental health agencies.

  1. Consumer Health Informatics: Past, Present, and Future of a Rapidly Evolving Domain.

    Science.gov (United States)

    Demiris, G

    2016-05-20

    Consumer Health Informatics (CHI) is a rapidly growing domain within the field of biomedical and health informatics. The objective of this paper is to reflect on the past twenty five years and showcase informatics concepts and applications that led to new models of care and patient empowerment, and to predict future trends and challenges for the next 25 years. We discuss concepts and systems based on a review and analysis of published literature in the consumer health informatics domain in the last 25 years. The field was introduced with the vision that one day patients will be in charge of their own health care using informatics tools and systems. Scientific literature in the field originally focused on ways to assess the quality and validity of available printed health information, only to grow significantly to cover diverse areas such as online communities, social media, and shared decision-making. Concepts such as home telehealth, mHealth, and the quantified-self movement, tools to address transparency of health care organizations, and personal health records and portals provided significant milestones in the field. Consumers are able to actively participate in the decision-making process and to engage in health care processes and decisions. However, challenges such as health literacy and the digital divide have hindered us from maximizing the potential of CHI tools with a significant portion of underserved populations unable to access and utilize them. At the same time, at a global scale consumer tools can increase access to care for underserved populations in developing countries. The field continues to grow and emerging movements such as precision medicine and the sharing economy will introduce new opportunities and challenges.

  2. Alternative Measures of Self-Rated Health for Predicting Mortality Among Older People: Is Past or Future Orientation More Important?

    Science.gov (United States)

    Ferraro, Kenneth F; Wilkinson, Lindsay R

    2015-10-01

    The purpose of this study was to compare the prognostic validity of alternative measures of health ratings, including those that tap temporal reflections, on adult mortality. The study uses a national sample of 1,266 Americans 50-74 years old in 1995, with vital status tracked through 2005, to compare the effect of 3 types of health ratings on mortality: conventional indicator of self-rated health (SRH), age comparison form of SRH, and health ratings that incorporate temporal dimensions. Logistic regression was used to estimate the odds of mortality associated with alternative health ratings while adjusting for health conditions, lifestyle factors, and status characteristics and resources. Self-rated health was a consistent predictor of mortality, but the respondent's expected health rating-10 years in the future-was an independent predictor. Future health expectations were more important than past (recalled change) in predicting mortality risk: People with more negative expectations of future health were less likely to survive. The findings reveal the importance of future time perspective for older people and suggest that it is more useful to query older people about their future health expectations than about how their health has changed. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Pregnancy Characteristics and Women's Future Cardiovascular Health: An Underused Opportunity to Improve Women's Health?

    Science.gov (United States)

    Rich-Edwards, Janet W.; Fraser, Abigail; Lawlor, Deborah A.; Catov, Janet M.

    2014-01-01

    Growing evidence indicates that women with a history of common pregnancy complications, including fetal growth restriction and preterm delivery (often combined as low birth weight), hypertensive disorders of pregnancy, and gestational diabetes, are at increased risk for cardiovascular disease later in life. The purpose of this paper was to review the associations of parity and these 4 pregnancy complications with cardiovascular morbidity and mortality; to review the role of cardiovascular risk factors before, during, and after pregnancy complications in explaining these associations; and to explore the implications of this emerging science for new research and policy. We systematically searched for relevant cohort and case-control studies in Medline through December 2012 and used citation searches for already published reviews to identify new studies. The findings of this review suggest consistent and often strong associations of pregnancy complications with latent and future cardiovascular disease. Many pregnancy complications appear to be preceded by subclinical vascular and metabolic dysfunction, suggesting that the complications may be useful markers of latent high-risk cardiovascular trajectories. With further replication research, these findings would support the utility of these prevalent pregnancy complications in identifying high-risk women for screening, prevention, and treatment of cardiovascular disease, the leading cause of morbidity and mortality among women. PMID:24025350

  4. Designing serious video games for health behavior change: current status and future directions.

    Science.gov (United States)

    Thompson, Debbe

    2012-07-01

    Serious video games for health are designed to entertain while changing a specific health behavior. This article identifies behavioral principles that can guide the development of serious video games focused on changing a variety of health behaviors, including those attempting to decrease risk of obesity and type 2 diabetes. Guidelines discussed include how to develop video games that provide a solid foundation for behavior change by enhancing a player's knowledge and skill, ways in which personal mastery experiences can be incorporated into a video game environment, using game characters and avatars to promote observational learning, creating personalized experiences through tailoring, and the importance of achieving a balance between "fun-ness" and "seriousness." The article concludes with suggestions for future research needed to inform this rapidly growing field. © 2012 Diabetes Technology Society.

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

    Science.gov (United States)

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

    2017-07-01

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

  6. Radon reference levels and priority areas considering optimisation and avertable lung cancers

    International Nuclear Information System (INIS)

    Bochicchio, F.; Venoso, G.; Antignani, S.; Carpentieri, C.

    2017-01-01

    Protection from radon exposure in workplaces and dwellings, as included in the latest relevant international regulations and recommendations, is based on the new concept of 'reference level' whose meaning is significantly different from that of previous 'action level' concept. In fact, whereas remedial actions had to be considered only for radon concentrations above the action level, actions to optimise radon exposure are requested with priority above reference level but optimisation should be applied also for radon concentrations below reference level. Similar considerations can be applied to the usually called 'Rn-prone' areas, which are here proposed to be regulated as 'priority' areas. The main implication of these new challenging concepts is a substantial increase of avertable lung cancer deaths, as it will be shown using Italian data. Some practical examples of possible policy actions fitting an approach based on these new concepts will also be given, which could be useful for the implementation of the Council Directive 2013/59/Euratom. (authors)

  7. Neural Temporal Dynamics of Social Exclusion Elicited by Averted Gaze: An Event-Related Potentials Study

    Directory of Open Access Journals (Sweden)

    Yue Leng

    2018-02-01

    Full Text Available Eye gaze plays a fundamental role in social communication. The averted eye gaze during social interaction, as the most common form of silent treatment, conveys a signal of social exclusion. In the present study, we examined the time course of brain response to social exclusion by using a modified version of Eye-gaze paradigm. The event-related potentials (ERPs data and the subjective rating data showed that the frontocentral P200 was positively correlated with negative mood of excluded events, whereas, the centroparietal late positive potential (LPP was positively correlated with the perceived ostracism intensity. Both the P200 and LPP were more positive-going for excluded events than for included events. These findings suggest that brain responses sensitive to social exclusion can be divided into the early affective processing stage, linking to the early pre-cognitive warning system; and the late higher-order processes stage, demanding attentional resources for elaborate stimuli evaluation and categorization generally not under specific situation.

  8. Combining Archetypes with Fast Health Interoperability Resources in Future-proof Health Information Systems.

    Science.gov (United States)

    Bosca, Diego; Moner, David; Maldonado, Jose Alberto; Robles, Montserrat

    2015-01-01

    Messaging standards, and specifically HL7 v2, are heavily used for the communication and interoperability of Health Information Systems. HL7 FHIR was created as an evolution of the messaging standards to achieve semantic interoperability. FHIR is somehow similar to other approaches like the dual model methodology as both are based on the precise modeling of clinical information. In this paper, we demonstrate how we can apply the dual model methodology to standards like FHIR. We show the usefulness of this approach for data transformation between FHIR and other specifications such as HL7 CDA, EN ISO 13606, and openEHR. We also discuss the advantages and disadvantages of defining archetypes over FHIR, and the consequences and outcomes of this approach. Finally, we exemplify this approach by creating a testing data server that supports both FHIR resources and archetypes.

  9. Meaningful Use of Electronic Health Records: Experiences From the Field and Future Opportunities.

    Science.gov (United States)

    Slight, Sarah Patricia; Berner, Eta S; Galanter, William; Huff, Stanley; Lambert, Bruce L; Lannon, Carole; Lehmann, Christoph U; McCourt, Brian J; McNamara, Michael; Menachemi, Nir; Payne, Thomas H; Spooner, S Andrew; Schiff, Gordon D; Wang, Tracy Y; Akincigil, Ayse; Crystal, Stephen; Fortmann, Stephen P; Bates, David W

    2015-09-18

    With the aim of improving health care processes through health information technology (HIT), the US government has promulgated requirements for "meaningful use" (MU) of electronic health records (EHRs) as a condition for providers receiving financial incentives for the adoption and use of these systems. Considerable uncertainty remains about the impact of these requirements on the effective application of EHR systems. The Agency for Healthcare Research and Quality (AHRQ)-sponsored Centers for Education and Research in Therapeutics (CERTs) critically examined the impact of the MU policy relating to the use of medications and jointly developed recommendations to help inform future HIT policy. We gathered perspectives from a wide range of stakeholders (N=35) who had experience with MU requirements, including academicians, practitioners, and policy makers from different health care organizations including and beyond the CERTs. Specific issues and recommendations were discussed and agreed on as a group. Stakeholders' knowledge and experiences from implementing MU requirements fell into 6 domains: (1) accuracy of medication lists and medication reconciliation, (2) problem list accuracy and the shift in HIT priorities, (3) accuracy of allergy lists and allergy-related standards development, (4) support of safer and effective prescribing for children, (5) considerations for rural communities, and (6) general issues with achieving MU. Standards are needed to better facilitate the exchange of data elements between health care settings. Several organizations felt that their preoccupation with fulfilling MU requirements stifled innovation. Greater emphasis should be placed on local HIT configurations that better address population health care needs. Although MU has stimulated adoption of EHRs, its effects on quality and safety remain uncertain. Stakeholders felt that MU requirements should be more flexible and recognize that integrated models may achieve information

  10. Health saving technologies in the training of future primary school teachers

    Directory of Open Access Journals (Sweden)

    N.D. Karapuzova

    2015-01-01

    Full Text Available Purpose : To reveal the features of the application of technology in the health-professional training of future primary school teachers and to characterize their practical implementation. Material : The study involved 137 students. Test was used to determine the likelihood of stress on G. Nemchin and J. Taylor. Results : It was found that the vast majority of respondents (67% have a low level of efficiency and high stress. That is, there is the possibility of negative effects of stress. Among the students of middle and low level of success of 76% the cause of this was called exhaustion. Defined as the implementation of technologies will aggregate pedagogically appropriate forms, methods and means of organization and management of the educational process. Proposed criteria indicators of training activities from the standpoint of health preservation. An experience of work on the implementation of health-technology in the practice of psycho-pedagogical faculty. Conclusions : The health-tech feature is the harmonious combination of training, educational and developing pedagogical influences. They are specified in the learning and cognitive, research, organizational and educational work of the students and the teaching practice in schools. They are aimed at both the development and improvement of the physical, spiritual, mental and social health factors of a young man, and on the formation of health-competence of students.

  11. Ability to Pay for Future National Health Financing Scheme among Malaysian Households.

    Science.gov (United States)

    Aizuddin, Azimatun Noor; Aljunid, Syed Mohamed

    Malaysia is no exception to the challenging health care financing phenomenon of globalization. The objective of the present study was to assess the ability to pay among Malaysian households as preparation for a future national health financing scheme. This was a cross-sectional study involving representative samples of 774 households in Peninsular Malaysia. A majority of households were found to have the ability to pay for their health care. Household expenditure on health care per month was between MYR1 and MYR2000 with a mean (standard deviation [SD]) of 73.54 (142.66), or in a percentage of per-month income between 0.05% and 50% with mean (SD) 2.74 (5.20). The final analysis indicated that ability to pay was significantly higher among younger and higher-income households. Sociodemographic and socioeconomic statuses are important eligibility factors to be considered in planning the proposed national health care financing scheme to shield the needed group from catastrophic health expenditures. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

  12. 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.

  13. Do processes for training future police officers improve their mental health?

    Directory of Open Access Journals (Sweden)

    Miguel Clemente

    2016-06-01

    Full Text Available The selection and training of future police officer candidates are two fundamental processes in achieving an effective police force. From a psychological point of view, police officer training should improve candidates' mental health, so that they can perform their police work more appropriately, benefiting not only themselves but society as a whole. This article attempts to determine whether the training given to candidates selected for training prior to being selected as officers improves their mental health. There is no precedent for research in this regard, since work in Psychology has focused on verifying that subjects do not have psychological pathologies rather than examining the effect of the training they are given. This study looks at a sample of 713 persons selected for a pre-police training program designed to allow them to subsequently join the Peruvian police force. The Derogatis SCL-90 test was used as a personality measure. The test was administered before they received training and after they had completed it (only data from subjects who passed the police entrance exam were considered. The results indicate that the training process produced no changes in personality variables that imply major psychological pathologies, but such changes did occur in variables associated with lower degree psychological pathologies. We can therefore say that there was a decline in mental health among future police officers, or an increase in their psychological pathologies. We will discuss these results and identify the limitations of the study with an eye toward further research. It is recommended that training systems be created that improve the mental health of future police officers.

  14. Future and potential spending on health 2015-40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries.

    Science.gov (United States)

    2017-05-20

    The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future spending can be beneficial for policy makers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending. We extracted GDP, government spending in 184 countries from 1980-2015, and health spend data from 1995-2014. We used a series of ensemble models to estimate future GDP, all-sector government spending, development assistance for health, and government, out-of-pocket, and prepaid private health spending through 2040. We used frontier analyses to identify patterns exhibited by the countries that dedicate the most funding to health, and used these frontiers to estimate potential health spending for each low-income or middle-income country. All estimates are inflation and purchasing power adjusted. We estimated that global spending on health will increase from US$9·21 trillion in 2014 to $24·24 trillion (uncertainty interval [UI] 20·47-29·72) in 2040. We expect per capita health spending to increase fastest in upper-middle-income countries, at 5·3% (UI 4·1-6·8) per year. This growth is driven by continued growth in GDP, government spending, and government health spending. Lower-middle income countries are expected to grow at 4·2% (3·8-4·9). High-income countries are expected to grow at 2·1% (UI 1·8-2·4) and low-income countries are expected to grow at 1·8% (1·0-2·8). Despite this growth, health spending per capita in low-income countries is expected to remain low, at $154 (UI 133-181) per capita in 2030 and $195 (157-258) per capita in 2040. Increases in national health spending

  15. Global health indicators and maternal health futures: The case of Intrauterine Growth Restriction.

    Science.gov (United States)

    Erikson, Susan L

    2015-01-01

    Public health indicators generally operate in the world as credible, apolitical and authoritative. But indicators are less stable than they appear. Clinical critiques of Intrauterine Growth Restriction (IUGR) criteria have been forthcoming for decades. This article, though, takes up the measuring and calculation gradients of IUGR in the ultrasound machine itself, including the software algorithms that identify IUGR. One hospital where research was conducted incorrectly predicted pathological birth outcomes 14 of 14 times. We are at a historical moment when the global use of prenatal diagnostic ultrasound for the express purpose of assessing IUGR is set to escalate. Medical imaging device corporations like Siemens, Toshiba, General Electric and Phillips are quite literally banking on it, and new forms of ultrasound technology and diagnostic software are increasingly available on smartphones, tablets and laptops. Clinical guidelines for IUGR--assumed to be authoritative and evidence-based--are evolving right along with the installation throughout the world of the technology capable of diagnosing it. Maternal malnutrition remains the single strongest predictive factor for IUGR, regardless of the technological investments currently amassing to identify the indicator, which is cause for a reassessment of priority spending and investment.

  16. Second and third year oral health and dental student perceptions of future professional work.

    Science.gov (United States)

    Tan, A S; Anderson, V R; Foster Page, L A

    2013-11-01

    To explore and compare the ways dental and oral health students characterise their future professional work (FPW) at the end of their second and third professional years. Questionnaires were given to a cohort group of 48 dental students and 31 oral health students at the end of their second and third professional years at the University of Otago. Students' characterisations of their FPW were identified using an inductive approach, and the emphasis on each characterisation was confirmed using a 'weighted' table. Dental student response rates were 92% (in 2010) and 85% (in 2011); and oral health student response rates were 100% (in 2011) and 97% (in 2011). Students characterised their FPW in ten broad ways: in reference to treatment-related concerns, patient-related concerns, oral health promotion, oral health education, disease prevention and monitoring, communication, teamwork, maintaining an ideal clinical environment, maintaining a sense of self and improving quality of life. In both years, dental students emphasised treatment-related concerns as central to their FPW and dealing with patient-related concerns as a primary source of difficulty. Oral health students emphasised oral health promotion, oral health education, disease prevention and monitoring and restorative tasks as central to their FPW and dealing with patient-related concerns as a primary source of difficulty. Students' broad perceptions of their FPW changed little as they progressed through their programmes; however, their responses suggested the need for greater attention within their programmes to patient management and teamwork. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Current and future funding sources for specialty mental health and substance abuse treatment providers.

    Science.gov (United States)

    Levit, Katharine R; Stranges, Elizabeth; Coffey, Rosanna M; Kassed, Cheryl; Mark, Tami L; Buck, Jeffrey A; Vandivort-Warren, Rita

    2013-06-01

    Goals were to describe funding for specialty behavioral health providers in 1986 and 2005 and examine how the recession, parity law, and Affordable Care Act (ACA) may affect future funding. Numerous public data sets and actuarial methods were used to estimate spending for services from specialty behavioral health providers (general hospital specialty units; specialty hospitals; psychiatrists; other behavioral health professionals; and specialty mental health and substance abuse treatment centers). Between 1986 and 2005, hospitals-which had received the largest share of behavioral health spending-declined in importance, and spending shares trended away from specialty hospitals that were largely funded by state and local governments. Hospitals' share of funding from private insurance decreased from 25% in 1986 to 12% in 2005, and the Medicaid share increased from 11% to 23%. Office-based specialty providers continued to be largely dependent on private insurance and out-of-pocket payments, with psychiatrists receiving increased Medicaid funding. Specialty centers received increased funding shares from Medicaid (from 11% to 29%), and shares from other state and local government sources fell (from 64% to 46%). With ACA's full implementation, spending on behavioral health will likely increase under private insurance and Medicaid. Parity in private plans will also push a larger share of payments for office-based professionals from out-of-pocket payments to private insurance. As ACA provides insurance for formerly uninsured individuals, funding by state behavioral health authorities of center-based treatment will likely refocus on recovery and support services. Federal Medicaid rules will increase in importance as more people needing behavioral health treatment become covered.

  18. Livestock Production in the UK in the 21st Century: A Perfect Storm Averted?

    Directory of Open Access Journals (Sweden)

    Madeleine L. Campbell

    2013-06-01

    Full Text Available There is a school of thought that future demand for meat and other farm animal products is unsustainable for several reasons, including greenhouse gas emissions, especially from ruminants; standards of farm animal health and welfare, especially when farm animals are kept intensively; efficiency of conversion by livestock of solar energy into (human food, particularly by pigs and poultry; water availability and usage for all types of agricultural production, including livestock; and human health and consumption of meat, eggs and milk. Demand for meat is forecast to rise as a result of global population growth and increasing affluence. These issues buttress an impending perfect storm of food shortages, scarce water and insufficient energy, which is likely to coincide with global population reaching about 9 billion people in 2030 (pace Beddington. This paper examines global demand for animal products, the narrative of ‘sustainable intensification’ and the implications of each for the future of farm animal welfare. In the UK, we suggest that, though non-ruminant farming may become unsustainable, ruminant agriculture will continue to prosper because cows, sheep and goats utilize grass and other herbage that cannot be consumed directly by humans, especially on land that is unsuitable for other purposes. However, the demand for meat and other livestock-based food is often for pork, eggs and chicken from grain-fed pigs and poultry. The consequences of such a perfect storm are beginning to be incorporated in long-term business planning by retailers and others. Nevertheless, marketing sustainable animal produce will require considerable innovation and flair in public and private policies if marketing messages are to be optimized and consumer behaviour modified.

  19. Motivational power of future time perspective: Meta-analyses in education, work, and health.

    Directory of Open Access Journals (Sweden)

    Lucija Andre

    Full Text Available Future time perspective (FTP may predict individual attitudes and behaviors. However, FTP research includes different FTP conceptualizations and outcomes which hinder generalizing its findings. To solve the inconsistencies in FTP research and generalize the magnitude of FTP as a driver of motivation and behavior, we conducted the first systematical synthesis of FTP relationships in three crucial life domains. Our meta-analyses of FTP studies in education (k = 28, work (k = 17, and health (k = 32 involved N = 31,558 participants, and used a conceptual model for grouping FTP constructs. To address different outcome types, we applied the Theory of Planned Behavior when coding the studies. FTP relationships with outcomes were small-to-medium, were generalizable across domains, and were strongest when the FTP construct included a mixture of cognition, behavioral intention, and affect and, in education, when the FTP measure was domain specific rather than general. There were cross-cultural differences in FTP-outcome relationships. The strength of the FTP-outcome types relationship varied for attitudes, perceived behavioral control, behavioral intention, and behaviors. The lowest effect sizes were found for FTP predicting actual behaviors in education, work, and health and between FTP and health attitudes. Theoretical implications of the findings and future research directions are discussed.

  20. [The concept mapping of representations of the future of health services in French in linguistic minority].

    Science.gov (United States)

    Bouchard, Louise

    2013-06-06

    In the context of institutional incompleteness affecting the official minority language communities, we examine how the Francophones in a minority context see the future of health services offered in French. The study is based on a participatory methodology: the concept mapping will serve to identify the conceptual universe of a given problem. From a master statement such as: "When I think about the future of health services in French, I think of ...", participants are invited to make as many statements as come to mind. These statements are then categorized individually and treated collectively through a multivariate analysis. The main themes emerging from the mapping exercise indicate the issues and challenges raised by the participants, namely the geographical context, specific needs, language rights, education and training, human resources, bilingualism and translation, the minority experience, active offer, the role of governmental bodies, community mobilization, collaboration and networking. The participatory approach that concept mapping allows is interesting in more than one way: its flexibility provides a space for both individual and collective reflection; it allows identification and structuring of the crucial dimensions of an issue; and the research outcomes are useful both to researchers and participants in guiding action and achieving goals. Social actors can therefore benefit from a collective dynamic to reflect on the foundations for the development and organization of health services in French.

  1. Motivational power of future time perspective: Meta-analyses in education, work, and health.

    Science.gov (United States)

    Andre, Lucija; van Vianen, Annelies E M; Peetsma, Thea T D; Oort, Frans J

    2018-01-01

    Future time perspective (FTP) may predict individual attitudes and behaviors. However, FTP research includes different FTP conceptualizations and outcomes which hinder generalizing its findings. To solve the inconsistencies in FTP research and generalize the magnitude of FTP as a driver of motivation and behavior, we conducted the first systematical synthesis of FTP relationships in three crucial life domains. Our meta-analyses of FTP studies in education (k = 28), work (k = 17), and health (k = 32) involved N = 31,558 participants, and used a conceptual model for grouping FTP constructs. To address different outcome types, we applied the Theory of Planned Behavior when coding the studies. FTP relationships with outcomes were small-to-medium, were generalizable across domains, and were strongest when the FTP construct included a mixture of cognition, behavioral intention, and affect and, in education, when the FTP measure was domain specific rather than general. There were cross-cultural differences in FTP-outcome relationships. The strength of the FTP-outcome types relationship varied for attitudes, perceived behavioral control, behavioral intention, and behaviors. The lowest effect sizes were found for FTP predicting actual behaviors in education, work, and health and between FTP and health attitudes. Theoretical implications of the findings and future research directions are discussed.

  2. Motivational power of future time perspective: Meta-analyses in education, work, and health

    Science.gov (United States)

    2018-01-01

    Future time perspective (FTP) may predict individual attitudes and behaviors. However, FTP research includes different FTP conceptualizations and outcomes which hinder generalizing its findings. To solve the inconsistencies in FTP research and generalize the magnitude of FTP as a driver of motivation and behavior, we conducted the first systematical synthesis of FTP relationships in three crucial life domains. Our meta-analyses of FTP studies in education (k = 28), work (k = 17), and health (k = 32) involved N = 31,558 participants, and used a conceptual model for grouping FTP constructs. To address different outcome types, we applied the Theory of Planned Behavior when coding the studies. FTP relationships with outcomes were small-to-medium, were generalizable across domains, and were strongest when the FTP construct included a mixture of cognition, behavioral intention, and affect and, in education, when the FTP measure was domain specific rather than general. There were cross-cultural differences in FTP-outcome relationships. The strength of the FTP-outcome types relationship varied for attitudes, perceived behavioral control, behavioral intention, and behaviors. The lowest effect sizes were found for FTP predicting actual behaviors in education, work, and health and between FTP and health attitudes. Theoretical implications of the findings and future research directions are discussed. PMID:29364917

  3. Occupational safety and health in Japan: current situations and the future.

    Science.gov (United States)

    Sakurai, Haruhiko

    2012-01-01

    The Industrial Safety and Health Law enacted in 1972 has contributed much to the progress of occupational safety and health (OSH) activities. Many indicators including death and illness statistics show continued improvement up to date. The establishment of OSH organization within enterprises and 5-yr administrative programs formulated by the Ministry of Health, Labour, and Welfare (MHLW) were important factors for satisfactory management. The past programs indicate that the weight of self regulation in comparison to legal control gradually increased since late 1990s. In spite of the past achievement, many hazards such as overwork, mental stress, chemical agents and others still remain to be prevented. The systematic risk assessment of unregulated chemicals by the MHLW proved to be an effective scheme for risk-based management and to deserve continued implementation. The size of human resources for OSH was estimated at 1.5 million. In view of the adverse effect on OSH by economic, social and political environment in the future, the importance of the efficiency of OSH management was indicated. Since the efficiency depends on the competence of OSH personnel and the level of scientific basis, it was concluded that the fundamental policy for the future should give high priority to education and research.

  4. The future is no longer what it used to be. Managing health telematics projects.

    Science.gov (United States)

    Demeester, M; Beuscart, R

    1997-09-01

    Future used to mean global progress and convergence of science and technology and society. Today, we observe the decoupling of the two poles of knowledge formation and application (i.e. science and technology, and culture and society, respectively) and also fierce confrontation between them. The key issue to reconcile the two poles is to re-invent the link between them. The new future lies in the development of mental and technical capacities for change and the creation of new forms of solidarity. We propose, as a general attitude, to reactivate and develop the four principles of efficacy-effectiveness-efficiency, hospitality, responsibility and pertinence. Translated into driving forces for the development of health care telematic projects, they amount to the acceptance of and capacity for enterprise-wide solutions, hospitality and capacity to acquire outside knowledge, self-managed, multi-functional team work spirit, reengineering mentality to achieve pertinent technico-cultural solutions.

  5. School-Based Mental Health Programs in the United States: Present Status and a Blueprint for the Future.

    Science.gov (United States)

    Pfeiffer, Steven I.; Reddy, Linda A.

    1998-01-01

    Provides overview of sociocultural and political factors in the United States that have influenced recent interest in school-based health and mental health programs. Describes four well-known programs and presents a new framework, the Tripartite Model of School-Based Mental Health Interventions, to stimulate thinking on future programs. Addresses…

  6. Can we help in changing the future of Italian health care?

    Directory of Open Access Journals (Sweden)

    Mario Di Napoli

    2011-04-01

    Full Text Available [The abstract of this article is not available. Here are the first sentences of the article. The full text is freely available upon registration]The retirement age of the baby boom generation is almost out-door. The proportion of ageing people will grow rapidly in the near future [1-3]. There will be fewer people to pay for the health and social care of the quickly aging population; furthermore, advancements in medical science will raise a new bar for quality in terms of the outcomes achieved in the treatment of illness [3]. An ageing population and the rising public expectations will produce an increase in costs and will impede timely access to care, thus jeopardising sustainability.The Italian National Health system is an example of a collapsing system: the ageing Italian workforce affects not only patient demographics but also the availability of clinicians. The upcoming wave of retiring health care professionals will occur in the exact moment when they will be more necessary. To overcome these challenges, our health care system will have to use its resources more effectively. Access and equity remain essential characteristics of our health care system, but are insufficient goals in terms of improving quality and achieving financial sustainability.

  7. Co-treatment with imipramine averted haloperidol-instigated tardive dyskinesia: Association with serotonin in brain regions.

    Science.gov (United States)

    Samad, Noreen; Yasmin, Farzana; Haleem, Darakhshan Jabeen

    2016-11-01

    Outcome of imipramine (IMI) treatment was scrutinized on progression of haloperidol instigated tardive dyskinesia (TD). 0.2 mg/kg/rat dosage of haloperidol provided orally to rats for 2 weeks enhanced vacuous chewing movements that escalated when the process proceeded for 5 weeks. Following 2 weeks co-injection 5 mg/kg dosage of IMI was diminished haloperidol-instigated VCMs and fully averted following five weeks. The potency of 8-OH-DPAT-instigated locomotor activity exhibited higher in saline+haloperidol treated rats while not observed in IMI+ haloperidol treated rats. 8-OH-DPAT-instigated low 5-hydroxytryptamine (5-HT; serotonin) metabolism was higher in saline+ haloperidol treated rats when compare to IMI+ haloperidol treated rats in both regions of brain (striatum and midbrain). It is recommended that IMI possibly competent in averting TD, in cases receiving treatment to antipsychotics.

  8. The future of school nursing: banishing band-AIDS to improve public health outcomes.

    Science.gov (United States)

    Fleming, Robin

    2012-08-01

    This article provides analysis and commentary on the cultural roots that promote the provision of minor first aid in schools by school nurses. Using the Institute of Medicine's Future of Nursing report as a lens, this article illustrates how the focus on provision of first aid by school nurses dilutes larger public health contributions that school nurses could make if they were able to work to the full extent of their education, training and licensure. The article concludes with recommendations designed to support fuller use of nurses' scope of practice in schools.

  9. [Health and disability in the elderly: old paradigms and future prospects].

    Science.gov (United States)

    Liotta, Giuseppe; Mancinelli, Sandro; Scarcella, Paola; Pompei, Daniela; Mastromattei, Antonio; Cutini, Rita; Marazzi, Maria Cristina; Buonomo, Ersilia; Palombi, Leonardo; Gilardi, Francesco

    2012-01-01

    The projections regarding the ageing of the Italian population are cause for great concern; however, the ageing scenario may actually be interpreted in a more optimistic way. Theories formulated in the 80s envisaging a decline of mortality, morbidity and disability in the elderly are now confirmed and prefigure an unexpected decrease in disability rates in the elderly population. The aim of this review is to attempt to explain the reasons for this by analyzing the role played by the various determinants of health, in particular social isolation, which are likely to play an important role in the future as well.

  10. Using genetic algorithms to optimise current and future health planning - the example of ambulance locations

    Directory of Open Access Journals (Sweden)

    Suzuki Hiroshi

    2010-01-01

    Full Text Available Abstract Background Ambulance response time is a crucial factor in patient survival. The number of emergency cases (EMS cases requiring an ambulance is increasing due to changes in population demographics. This is decreasing ambulance response times to the emergency scene. This paper predicts EMS cases for 5-year intervals from 2020, to 2050 by correlating current EMS cases with demographic factors at the level of the census area and predicted population changes. It then applies a modified grouping genetic algorithm to compare current and future optimal locations and numbers of ambulances. Sets of potential locations were evaluated in terms of the (current and predicted EMS case distances to those locations. Results Future EMS demands were predicted to increase by 2030 using the model (R2 = 0.71. The optimal locations of ambulances based on future EMS cases were compared with current locations and with optimal locations modelled on current EMS case data. Optimising the location of ambulance stations locations reduced the average response times by 57 seconds. Current and predicted future EMS demand at modelled locations were calculated and compared. Conclusions The reallocation of ambulances to optimal locations improved response times and could contribute to higher survival rates from life-threatening medical events. Modelling EMS case 'demand' over census areas allows the data to be correlated to population characteristics and optimal 'supply' locations to be identified. Comparing current and future optimal scenarios allows more nuanced planning decisions to be made. This is a generic methodology that could be used to provide evidence in support of public health planning and decision making.

  11. Immunobiotic Lactobacillus administered post-exposure averts the lethal sequelae of respiratory virus infection.

    Science.gov (United States)

    Percopo, Caroline M; Rice, Tyler A; Brenner, Todd A; Dyer, Kimberly D; Luo, Janice L; Kanakabandi, Kishore; Sturdevant, Daniel E; Porcella, Stephen F; Domachowske, Joseph B; Keicher, Jesse D; Rosenberg, Helene F

    2015-09-01

    We reported previously that priming of the respiratory tract with immunobiotic Lactobacillus prior to virus challenge protects mice against subsequent lethal infection with pneumonia virus of mice (PVM). We present here the results of gene microarray which document differential expression of proinflammatory mediators in response to PVM infection alone and those suppressed in response to Lactobacillus plantarum. We also demonstrate for the first time that intranasal inoculation with live or heat-inactivated L. plantarum or Lactobacillus reuteri promotes full survival from PVM infection when administered within 24h after virus challenge. Survival in response to L. plantarum administered after virus challenge is associated with suppression of proinflammatory cytokines, limited virus recovery, and diminished neutrophil recruitment to lung tissue and airways. Utilizing this post-virus challenge protocol, we found that protective responses elicited by L. plantarum at the respiratory tract were distinct from those at the gastrointestinal mucosa, as mice devoid of the anti-inflammatory cytokine, interleukin (IL)-10, exhibit survival and inflammatory responses that are indistinguishable from those of their wild-type counterparts. Finally, although L. plantarum interacts specifically with pattern recognition receptors TLR2 and NOD2, the respective gene-deleted mice were fully protected against lethal PVM infection by L. plantarum, as are mice devoid of type I interferon receptors. Taken together, L. plantarum is a versatile and flexible agent that is capable of averting the lethal sequelae of severe respiratory infection both prior to and post-virus challenge via complex and potentially redundant mechanisms. Published by Elsevier B.V.

  12. Use of Traditional and Genetically Modified Probiotics in Human Health: What Does the Future Hold?

    Science.gov (United States)

    Bermúdez-Humarán, Luis G; Langella, Philippe

    2017-09-01

    Probiotics are live, nonpathogenic microorganisms that confer benefits to human health when administered in adequate amounts. Among the frequent proposed health benefits attributed to probiotics, their ability to interact with the host immune system is now well demonstrated. Although history has revealed that probiotics were part of fermented foods in the past, clinicians have started to use them therapeutically in regular diets. Moreover, the use of genetically modified probiotics to deliver molecules of therapeutic interest is gaining importance as an extension of the probiotic concept. This chapter summarizes some of the recent findings and perspectives on the use of both traditional and genetically modified probiotics to treat human diseases as well as what the future may hold concerning the use of these probiotics in humans.

  13. Limited take-up of health coverage tax credits: a challenge to future tax credit design.

    Science.gov (United States)

    Dorn, Stan; Varon, Janet; Pervez, Fouad

    2005-10-01

    The Trade Act of 2002 created federal tax credits to subsidize health coverage for certain early retirees and workers displaced by international trade. Though small, this program offers the opportunity to learn how to design future tax credits for larger groups of uninsured. During September 2004, the most recent month for which there are data about all forms of Trade Act credits, roughly 22 percent of eligible individuals received credits. The authors find that health insurance tax credits are more likely to reach their target populations if such credits: 1) limit premium costs for the low-income uninsured and do not require full premium payments while applications are pending; 2) provide access to coverage that beneficiaries value, including care for preexisting conditions; 3) are combined with outreach that uses easily understandable, multilingual materials and proactive enrollment efforts; and 4) feature a simple application process involving one form filed with one agency.

  14. Assessing long-term QALYs gain from averting and reversing overweight and obesity in childhood.

    Science.gov (United States)

    Techakehakij, Win

    2016-10-01

    Interventions to tackle childhood obesity have been devised in response to the rising prevalence of childhood obesity. However, efficiency of these interventions remains a concern. Cost-utility analysis, representing health benefits in terms of quality-adjusted life years (QALYs), is a type of economic evaluation that has widely been recommended in assessing efficiency of health interventions. However, certain limitations in using QALYs remain specifically difficult in QALYs estimation. This study estimates the long-term QALYs gain from reversing childhood obesity in Thailand. An economic model was developed to estimate long-term QALYs of the youth aged 3-18 for the BMI status in childhood, which were categorized into three groups: normal weight, overweight, and obese. Long-term QALYs were estimated between ages 35 and 100, according to children's age, sex, and BMI status. Differences in QALYs between BMI status groups were calculated to represent the QALYs gain for youth from reversing obesity and overweight. The future outcomes were discounted at 3 % per annum in the base-case analysis; the discount rates of 0, 1.5, 3.5, and 5 % were also applied in the sensitivity analyses. QALYs gained from reversing childhood obesity increase with age, starting from 0.040 and 0.083 QALYs at age 3 to 0.590 and 0.553 QALYs at age 18 in boys and girls, respectively. Reversing overweight and obesity in girls produces more QALYs than in boys between ages 3 and 17. Efficiency is an important issue in allocating public healthcare resources to maximize social benefits. The results of this study facilitate long-term QALYs estimation with respect to BMI status in childhood, which could encourage more routine economic evaluation of child obesity interventions and maximize their health benefits.

  15. [Horizon scanning in preparation for future health threats: a pilot exercise conducted by the French Institute for Public Health Surveillance in 2014].

    Science.gov (United States)

    Eilstein, Daniel; Xerri, Bertrand; Viso, Anne-Catherine; Therre, Hélène; Gorza, Maud; Fuchs, Doriane; Pozuelos, Jérôme; Ioos, Sophie; Che, Didier; Bertrand, Edwige; El Yamani, Mounia; Empereur-Bissonnet, Pascal; Duport, Nicolas; Desenclos, Jean-Claude

    2016-01-01

    Background: Health surveillance is a reactive process, with no real hindsight for dealing with signals and alerts. It may fail to detect more radical changes with a major medium-term or long-term impact on public health. To increase proactivity, the French Institute for Public Health Surveillance has opted for a prospective monitoring approach.Methods: Several steps were necessary: 1) Identification of public health determinants. 2) Identification of key variables based on a combination of determinants. Variables were classified into three groups (health event trigger factors, dissemination factors and response factors) and were submitted to future development assumptions. 3) Identification, in each of the three groups, of micro-scenarios derived from variable trends. 4) Identification of macro-scenarios, each built from the three micro-scenarios for each of the three groups. 5) Identification of issues for the future of public health.Results: The exercise identified 22 key variables, 17 micro-scenarios and 5 macro-scenarios. The topics retained relate to issues on social and territorial health inequalities, health burden, individual and collective responsibilities in terms of health, ethical aspects, emerging phenomena, ‘Big data’, data mining, new health technologies, interlocking of analysis scales.Conclusions: The approach presented here guides the programming of activities of a health safety agency, particularly for monitoring and surveillance. By describing possible future scenarios, health surveillance can help decision-makers to influence the context towards one or more favourable futures.

  16. The physician assistant workforce in Indiana: preparing to meet future health care needs.

    Science.gov (United States)

    Snyder, Jennifer; Zorn, Jennifer; Gjerde, Tom; Burkhart, Jennifer; Rosebrock, Lori

    2011-12-01

    This study identifies baseline demographic and descriptive statistics for physician assistants (PAs) in Indiana from 1978 to 2010. Data were obtained from Indiana Professional Licensing Agency applications, the Indiana State Department of Health, and PA educational programs. Descriptive statistics were used to characterize the PA workforce as well as their supervising physicians. Most PAs working in Indiana were born and educated outside the state. Of those educated in Indiana, 77% obtained an initial license in Indiana; as of May 2010, 62% were still licensed in the state. In the past 8 years, Indiana had a 97% increase in active licensed PAs. Only 24% of PAs work in primary care; 92% work in metropolitan areas. For 40 years, PAs have increasingly worked in areas that are medically underserved or experiencing a shortage of health professionals. However, the overall numbers of PAs working in those areas remain low. More PAs in Indiana are practicing in medical specialties than in primary care. As health care policy and regulatory changes evolve, future studies will be needed to understand the impact on the health care workforce of Indiana PAs. This study will serve as a baseline for those studies.

  17. Preparing mental health nurses for the future workforce: an exploration of postgraduate education in Victoria, Australia.

    Science.gov (United States)

    Happell, Brenda; Gough, Karla

    2009-10-01

    Problems with recruitment and retention in the mental health nursing workforce have been consistently acknowledged in the Australian literature. An Australian workforce scoping study conducted in 1999 revealed a significant shortfall between the number of nurses completing postgraduate mental health nursing programmes and both current and future workforce demands. Despite this, there has been no systematic analysis of these programmes to explain why they are not meeting workforce expectations. The primary aim of the current study was to elicit information about the number of applicants, enrolments, and completions during the 5-year period, 2000-2004. This information was obtained through structured interviews with representatives from Victorian universities (n = 6) who offered postgraduate mental health nursing programmes. Supplementary information, such as approaches to course advertising and student demographics, was also collected. The findings showed an overall increase in the number of students applying to and completing these degrees, although changes in the level of programmes students undertook were evident during this period. Despite revealing important insights regarding postgraduate mental health nursing courses within Victorian universities, the lack of systematic and comprehensive data collection was identified as a problem that limits the extent to which university data can inform recruitment strategies.

  18. Optimization of Bone Health in Children before and after Renal Transplantation: Current Perspectives and Future Directions

    Science.gov (United States)

    Sgambat, Kristen; Moudgil, Asha

    2014-01-01

    The accrual of healthy bone during the critical period of childhood and adolescence sets the stage for lifelong skeletal health. However, in children with chronic kidney disease (CKD), disturbances in mineral metabolism and endocrine homeostasis begin early on, leading to alterations in bone turnover, mineralization, and volume, and impairing growth. Risk factors for CKD–mineral and bone disorder (CKD–MBD) include nutritional vitamin D deficiency, secondary hyperparathyroidism, increased fibroblast growth factor 23 (FGF-23), altered growth hormone and insulin-like growth factor-1 axis, delayed puberty, malnutrition, and metabolic acidosis. After kidney transplantation, nutritional vitamin D deficiency, persistent hyperparathyroidism, tertiary FGF-23 excess, hypophosphatemia, hypomagnesemia, immunosuppressive therapy, and alteration of sex hormones continue to impair bone health and growth. As function of the renal allograft declines over time, CKD–MBD associated changes are reactivated, further impairing bone health. Strategies to optimize bone health post-transplant include healthy diet, weight-bearing exercise, correction of vitamin D deficiency and acidosis, electrolyte abnormalities, steroid avoidance, and consideration of recombinant human growth hormone therapy. Other drug therapies have been used in adult transplant recipients, but there is insufficient evidence for use in the pediatric population at the present time. Future therapies to be explored include anti-FGF-23 antibodies, FGF-23 receptor blockers, and treatments targeting the colonic microbiota by reduction of generation of bacterial toxins and adsorption of toxic end products that affect bone mineralization. PMID:24605319

  19. Perspective on the energy future of the Northeast: health and environmental impacts of alternative energy futures for the Northeast

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, L.D.; Morris, S.C.; Calef, C.E.; Kaplan, E.; Shreeve, D.F.; Reisman, A.W.

    1976-01-01

    Attention was focused on five air pollutants: sulfur oxides, nitrogen oxides, particulates, unburned hydrocarbons, and carbon monoxide. Emission coefficients were based on data in the BNL Energy Model Data Base. Tables are presented to show emission factors for electricity generation, for industrial energy use, and for Transportation sector. Health effects of air pollution, health impacts of nuclear power plants, and environmental considerations are also discussed. (HLW)

  20. HEALTH CARE SPENDING GROWTH AND THE FUTURE OF U.S. TAX RATES

    Science.gov (United States)

    Baicker, Katherine; Skinner, Jonathan S.

    2011-01-01

    The fraction of GDP devoted to health care in the United States is the highest in the world and rising rapidly. Recent economic studies have highlighted the growing value of health improvements, but less attention has been paid to the efficiency costs of tax-financed spending to pay for such improvements. This paper uses a life cycle model of labor supply, saving, and longevity improvement to measure the balanced-budget impact of continued growth in the Medicare and Medicaid programs. The model predicts that top marginal tax rates could rise to 70 percent by 2060, depending on the progressivity of future tax changes. The deadweight loss of the tax system is greater when the financing is more progressive. If the share of taxes paid by high-income taxpayers remains the same, the efficiency cost of raising the revenue needed to finance the additional health spending is $1.48 per dollar of revenue collected, and GDP declines (relative to trend) by 11 percent. A proportional payroll tax has a lower efficiency cost (41 cents per dollar of revenue averaged over all tax hikes, a 5 percent drop in GDP) but more than doubles the share of the tax burden borne by lower income taxpayers. Empirical support for the model comes from analysis of OECD country data showing that countries facing higher tax burdens in 1979 experienced slower health care spending growth in subsequent decades. The rising burden imposed by the public financing of health care expenditures may therefore serve as a brake on health care spending growth. PMID:21608156

  1. Chile Confronts its Environmental Health Future After 25 Years of Accelerated Growth.

    Science.gov (United States)

    Pino, Paulina; Iglesias, Verónica; Garreaud, René; Cortés, Sandra; Canals, Mauricio; Folch, Walter; Burgos, Soledad; Levy, Karen; Naeher, Luke P; Steenland, Kyle

    2015-01-01

    Chile has recently been reclassified by the World Bank from an upper-middle-income country to a high-income country. There has been great progress in the last 20 to 30 years in relation to air and water pollution in Chile. Yet after 25 years of unrestrained growth, there remain clear challenges posed by air and water pollution, as well as climate change. The aim of this study was to review environmental health in Chile. In late 2013, a 3-day workshop on environmental health was held in Santiago, Chile, bringing together researchers and government policymakers. As a follow-up to that workshop, here we review the progress made in environmental health in the past 20 to 30 years and discuss the challenges of the future. We focus on air and water pollution and climate change, which we believe are among the most important areas of environmental health in Chile. Air pollution in some cities remains among the highest in the continent. Potable water is generally available, but weak state supervision has led to serious outbreaks of infectious disease and ongoing issues with arsenic exposure in some regions. Climate change modeling in Chile is quite sophisticated, and a number of the impacts of climate change can be reasonably predicted in terms of which areas of the country are most likely to be affected by increased temperature and decreased availability of water, as well as expansion of vector territory. Some health effects, including changes in vector-borne diseases and excess heat mortality, can be predicted. However, there has yet to be an integration of such research with government planning. Although great progress has been made, currently there are a number of problems. We suspect that the Chilean experience in environmental health may be of some use for other Latin American countries with rapid economic development. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  2. Designing Smart Health Care Technology into the Home of the Future

    Energy Technology Data Exchange (ETDEWEB)

    Warren, S.; Craft, R.L.; Bosma, J.T.

    1999-04-07

    The US health care industry is experiencing a substantial paradigm shift with regard to home care due to the convergence of several technology areas. Increasingly-capable telehealth systems and the internet are not only moving the point of care closer to the patient, but the patient can now assume a more active role in his or her own care. These technologies, coupled with (1) the migration of the health care industry to electronic patient records and (2) the emergence of a growing number of enabling health care technologies (e.g., novel biosensors, wearable devices, and intelligent software agents), demonstrate unprecedented potential for delivering highly automated, intelligent health care in the home. This editorial paper presents a vision for the implementation of intelligent health care technology in the home of the future, focusing on areas of research that have the highest potential payoff given targeted government funding over the next ten years. Here, intelligent health care technology means smart devices and systems that are aware of their context and can therefore assimilate information to support care decisions. A systems perspective is used to describe a framework under which devices can interact with one another in a plug-and-play manner. Within this infrastructure, traditionally passive sensors and devices will have read/write access to appropriate portions of an individual's electronic medical record. Through intelligent software agents, plug-and-play mechanisms, messaging standards, and user authentication tools, these smart home-based medical devices will be aware of their own capabilities, their relationship to the other devices in the home system, and the identity of the individual(s) from whom they acquire data. Information surety technology will be essential to maintain the confidentiality of patient-identifiable medical information and to protect the integrity of geographically dispersed electronic medical records with which each home

  3. Quantifying Future PM2.5 and Associated Health Effects Due to Changes in US Wildfires

    Science.gov (United States)

    Pierce, J. R.; Val Martin, M.; Ford, B.; Zelasky, S.; Heald, C. L.; Li, F.; Lawrence, D. M.; Fischer, E. V.

    2017-12-01

    Fine particulate matter (PM2.5) from landscape fires has been shown to adversely affect visibility, air quality and and health across the US. Fire activity is strongly related to climate and human activities. Predictions based on climate scenarios and future land cover projections that consider socioeconomic development suggest that fire activity will rise dramatically over the next decades. As PM2.5 is associated with increased mortality and morbidity rates, increases in emissions from landscape fires may alter the health burden on the US population. Here we present an analysis of the changes in future wildfire activity and consequences for PM2.5 and health over the US from 2000 to 2100. We employ the global Community Earth System Model (CESM) with the IPCC RCP projections. Within CESM, we use a process-based global fire parameterization to project future climate-driven and human-caused fire emissions. From these simulations, we determine the current and future impact on PM2.5 concentrations and visibility for different regions of the US, and we also calculate the mortality attributable to PM2.5 and wildfire-specific PM2.5 using existing concentration-response functions. Results show that although total PM2.5 concentrations in the US are projected to be similar in 2100 as in 2000, the dominant source of PM2.5 will change. Under the RCP8.5 climate projection and SSP3 population projection, non-fire emissions (mostly anthropogenic) are projected to decrease, but PM2.5 from CONUS and non-US wildfires is projected to increase from approximately 20% of all PM2.5 in 2000 to 80% of all PM2.5 in 2100. Furthermore, although the US population is expected to decline between 2000 and 2100, the mortality attributable to wildfire smoke is expected to increase from 25,000 deaths per year in 2000 to 75,000 deaths per year in 2100.

  4. Quantifying the health impacts of future changes in temperature in California.

    Science.gov (United States)

    Ostro, Bart; Rauch, Stephen; Green, Shelley

    2011-11-01

    Several epidemiological studies demonstrate associations between high summer temperatures and increased mortality. However, the quantitative implications of projected future increases in temperature have not been well characterized. This study quantifies the effects of projected future temperatures on both mortality and morbidity in California, including the potential effects of mitigation. We first estimated the association between temperature and mortality for populations close to weather stations throughout the state. These dose-response estimates for mortality were then combined with local measures of current and projected changes in population, and projected changes in temperature, using a baseline of average temperatures from 1961 to 1990, for the years 2025 and 2050. The latter were based on two greenhouse gas emissions scenarios (A2 and B1) developed for the Intergovernmental Panel on Climate Change. In addition, we assessed the impacts of future adaptation through use of air conditioners. Several sensitivity analyses were conducted to determine the likely range of estimates. These analyses indicate that for the high emissions scenario, the central estimate of annual premature mortality ranges from 2100 to 4300 for the year 2025 and from 6700 to 11,300 for 2050. The highest estimates are from the models that use age-specific dose-response functions, while the low estimates are from the models that adjust for ozone. Estimates using the low emissions scenario are roughly half of these estimates. Mitigation based on our estimates of the effects of 10% and 20% increase in air conditioner use would generate reductions of 16% and 33% in the years 2025 and 2050, respectively. Our estimates suggest significant public health impacts associated with future projected increases in temperature. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Quantifying the health impacts of future changes in temperature in California

    International Nuclear Information System (INIS)

    Ostro, Bart; Rauch, Stephen; Green, Shelley

    2011-01-01

    Background: Several epidemiological studies demonstrate associations between high summer temperatures and increased mortality. However, the quantitative implications of projected future increases in temperature have not been well characterized. Objective: This study quantifies the effects of projected future temperatures on both mortality and morbidity in California, including the potential effects of mitigation. Data and methods: We first estimated the association between temperature and mortality for populations close to weather stations throughout the state. These dose–response estimates for mortality were then combined with local measures of current and projected changes in population, and projected changes in temperature, using a baseline of average temperatures from 1961 to 1990, for the years 2025 and 2050. The latter were based on two greenhouse gas emissions scenarios (A2 and B1) developed for the Intergovernmental Panel on Climate Change. In addition, we assessed the impacts of future adaptation through use of air conditioners. Several sensitivity analyses were conducted to determine the likely range of estimates. Results: These analyses indicate that for the high emissions scenario, the central estimate of annual premature mortality ranges from 2100 to 4300 for the year 2025 and from 6700 to 11,300 for 2050. The highest estimates are from the models that use age-specific dose–response functions, while the low estimates are from the models that adjust for ozone. Estimates using the low emissions scenario are roughly half of these estimates. Mitigation based on our estimates of the effects of 10% and 20% increase in air conditioner use would generate reductions of 16% and 33% in the years 2025 and 2050, respectively. Conclusion: Our estimates suggest significant public health impacts associated with future projected increases in temperature.

  6. Quantifying the health impacts of future changes in temperature in California

    Energy Technology Data Exchange (ETDEWEB)

    Ostro, Bart, E-mail: Bostro@Creal.cat [Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA (United States); Centre for Research in Environmental Epidemiology, Barcelona (Spain); Rauch, Stephen; Green, Shelley [Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA (United States)

    2011-11-15

    Background: Several epidemiological studies demonstrate associations between high summer temperatures and increased mortality. However, the quantitative implications of projected future increases in temperature have not been well characterized. Objective: This study quantifies the effects of projected future temperatures on both mortality and morbidity in California, including the potential effects of mitigation. Data and methods: We first estimated the association between temperature and mortality for populations close to weather stations throughout the state. These dose-response estimates for mortality were then combined with local measures of current and projected changes in population, and projected changes in temperature, using a baseline of average temperatures from 1961 to 1990, for the years 2025 and 2050. The latter were based on two greenhouse gas emissions scenarios (A2 and B1) developed for the Intergovernmental Panel on Climate Change. In addition, we assessed the impacts of future adaptation through use of air conditioners. Several sensitivity analyses were conducted to determine the likely range of estimates. Results: These analyses indicate that for the high emissions scenario, the central estimate of annual premature mortality ranges from 2100 to 4300 for the year 2025 and from 6700 to 11,300 for 2050. The highest estimates are from the models that use age-specific dose-response functions, while the low estimates are from the models that adjust for ozone. Estimates using the low emissions scenario are roughly half of these estimates. Mitigation based on our estimates of the effects of 10% and 20% increase in air conditioner use would generate reductions of 16% and 33% in the years 2025 and 2050, respectively. Conclusion: Our estimates suggest significant public health impacts associated with future projected increases in temperature.

  7. Using risk-based corrective action (RBCA) to assess (theoretical) cancer deaths averted compared to the (real) cost of environmental remediation

    International Nuclear Information System (INIS)

    Miller, M.L.; Pomatto, C.B.; Hylko, J.M.

    2000-01-01

    Decades of processing uranium ore for use in the government's nuclear weapons and energy programs resulted in the accumulation of contaminated mill tailings, a sand-like by-product of ore precessing, at 24 sites located primarily in the Western United States. The uranium mill tailings were allowed to accumulate, often in unstabilized and unprotected conditions. About 5,314 vicinity properties identified to date used these tailings for constructing foundations and walls of private and public buildings, and under streets and utility corridors. In 1978, on the basis of existing health studies at the time, legislation was proposed that would authorize remedial action at 22 inactive sites. The cost of the program to the Federal Government was expected to be $180 million. With the completion of this project, we have the opportunity to compare theoretical benefits (i.e., risk averted) to actual costs of remediation. Approximately 1300 theoretical cancer deaths were estimated to have been prevented in the next 100 years by the Uranium Mill Tailings Remedial Action (UMTRA) Project at a cost of $1.45 billion to the Federal Government. The most favorable cost benefits were associated with the high-risk sites. These included Salt Lake City, Grand Junction, and the vicinity properties, of which $0.2, $0.4, and $1.2 million were estimated to have been spent per cancer death averted over the next 100 years, respectively. The medium-, to low-risk sites were the least cost effective. For example, the Slick Rock site netted the least benefit for the cost with a projected $18 billion spent per theoretical cancer death averted. The lower cost benefit is attributable to its remote, rural location and sparse population resulting in very few persons being exposed. Since resources required to sustain remediation activities are often subject to reduction over time, this subsequent evaluation using a process incorporating risk-based corrective action (RBCA) demonstrates how remediation

  8. The Anticipated Positive Psychosocial Impact of Present Web-Based E-Health Services and Future Mobile Health Applications: An Investigation among Older Swedes.

    Science.gov (United States)

    Wiklund Axelsson, S; Nyberg, L; Näslund, A; Melander Wikman, A

    2013-01-01

    This study investigates the anticipated psychosocial impact of present web-based e-health services and future mobile health applications among older Swedes. Random sample's of Swedish citizens aged 55 years old and older were given a survey containing two different e-health scenarios which respondents rated according to their anticipated psychosocial impact by means of the PIADS instrument. Results consistently demonstrated the positive anticipation of psychosocial impacts for both scenarios. The future mobile health applications scored more positively than the present web-based e-health services. An increase in age correlated positively to lower impact scores. These findings indicate that from a psychosocial perspective, web-based e-health services and mobile health applications are likely to positively impact quality of life. This knowledge can be helpful when tailoring and implementing e-health services that are directed to older people.

  9. Past speculations of the future: a review of the methods used for forecasting emerging health technologies.

    Science.gov (United States)

    Doos, Lucy; Packer, Claire; Ward, Derek; Simpson, Sue; Stevens, Andrew

    2016-03-10

    Forecasting can support rational decision-making around the introduction and use of emerging health technologies and prevent investment in technologies that have limited long-term potential. However, forecasting methods need to be credible. We performed a systematic search to identify the methods used in forecasting studies to predict future health technologies within a 3-20-year timeframe. Identification and retrospective assessment of such methods potentially offer a route to more reliable prediction. Systematic search of the literature to identify studies reported on methods of forecasting in healthcare. People are not needed in this study. The authors searched MEDLINE, EMBASE, PsychINFO and grey literature sources, and included articles published in English that reported their methods and a list of identified technologies. Studies reporting methods used to predict future health technologies within a 3-20-year timeframe with an identified list of individual healthcare technologies. Commercially sponsored reviews, long-term futurology studies (with over 20-year timeframes) and speculative editorials were excluded. 15 studies met our inclusion criteria. Our results showed that the majority of studies (13/15) consulted experts either alone or in combination with other methods such as literature searching. Only 2 studies used more complex forecasting tools such as scenario building. The methodological fundamentals of formal 3-20-year prediction are consistent but vary in details. Further research needs to be conducted to ascertain if the predictions made were accurate and whether accuracy varies by the methods used or by the types of technologies identified. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. [The national health service in the United Kingdom-past, present and future].

    Science.gov (United States)

    Nakanishi, N; Tatara, K

    1996-10-01

    possible to direct patient care, the government produced and made public its plans for the future structure of NHS management in 1993 and a simplified structure is expected to go into effect by 1996. The Labour Party's document on health and health services in Britain was made public in 1994. The plan rejects the use of competition in the NHS and promises to reverse recent developments, reasserting the importance of the original principles of the NHS. It is too early to reach a verdict on the British experiment. Given the direction of change in Labour's thinking and the fact that the current reforms by the Conservatives are becoming more and more firmly embedded, almost anything is possible.

  11. Intellectual disability health content within medical curriculum: an audit of what our future doctors are taught.

    Science.gov (United States)

    Trollor, Julian N; Ruffell, Beth; Tracy, Jane; Torr, Jennifer J; Durvasula, Seeta; Iacono, Teresa; Eagleson, Claire; Lennox, Nicolas

    2016-04-11

    of content. There is a mismatch between the considerable unmet health needs of people with intellectual disability and the inconsistent teaching within medical schools. Future doctors will be better equipped to support the health and wellbeing of people with intellectual disability if curricula are enhanced in this area.

  12. An overview of future EU health systems. An insight into governance, primary care, data collection and citizens' participation.

    Science.gov (United States)

    Quaglio, Gianluca; Figueras, Josep; Mantoan, Domenico; Dawood, Amr; Karapiperis, Theodoros; Costongs, Caroline; Bernal-Delgado, Enrique

    2018-03-26

    Health systems in the European Union (EU) are being questioned over their effectiveness and sustainability. In pursuing both goals, they have to conciliate coexisting, not always aligned, realities. This paper originated from a workshop entitled 'Health systems for the future' held at the European Parliament. Experts and decision makers were asked to discuss measures that may increase the effectiveness and sustainability of health systems, namely: (i) increasing citizens' participation; (ii) the importance of primary care in providing integrated services; (iii) improving the governance and (iv) fostering better data collection and information channels to support the decision making process. In the parliamentary debate, was discussed the concept that, in the near future, health systems' effectiveness and sustainability will very much depend on effective access to integrated services where primary care is pivotal, a clearer shift from care-oriented systems to health promotion and prevention, a profound commitment to good governance, particularly to stakeholders participation, and a systematic reuse of data meant to build health data-driven learning systems. Many health issues, such as future health systems in the EU, are potentially transformative and hence an intense political issue. It is policy-making leadership that will mostly determine how well EU health systems are prepared to face future challenges.

  13. Looking to the future of new media in health marketing: deriving propositions based on traditional theories.

    Science.gov (United States)

    Della, Lindsay J; Eroglu, Dogan; Bernhardt, Jay M; Edgerton, Erin; Nall, Janice

    2008-01-01

    Market trend data show that the media marketplace continues to rapidly evolve. Recent research shows that substantial portions of the U.S. media population are "new media" users. Today, more than ever before, media consumers are exposed to multiple media at the same point in time, encouraged to participate in media content generation, and challenged to learn, access, and use the new media that are continually entering the market. These media trends have strong implications for how consumers of health information access, process, and retain health-related knowledge. In this article we review traditional information processing models and theories of interpersonal and mass media access and consumption. We make several theory-based propositions for how traditional information processing and media consumption concepts will function as new media usage continues to increase. These propositions are supported by new media usage data from the Centers for Disease Control and Prevention's entry into the new media market (e.g., podcasting, virtual events, blogging, and webinars). Based on these propositions, we conclude by presenting both opportunities and challenges that public health communicators and marketers will face in the future.

  14. Zika virus disease knowledge among the future health-care providers of the United Arab Emirates.

    Science.gov (United States)

    Rabbani, Syed Arman; Mustafa, Farhan; Shouqair, Tasneem; Mohamad, Itaf; Tahsin, Nada

    2018-01-01

    Zika virus (ZIKV) disease has become a major public health concern. Although there are no reported cases of ZIKV disease in the United Arab Emirates (UAE), there is a potential risk of transmission due to large expatriate population and high influx of international travelers. This cross-sectional study was conducted to assess the knowledge of ZIKV disease among the students of a medical and health sciences university in the UAE. Their knowledge of ZIKV disease was assessed using a specially designed, pretested, and validated questionnaire. Of the 500 respondents included in the final analysis, 314 (62.8%) respondents presented with poor knowledge of ZIKV disease. The mean knowledge score of the study population was 10.48 ± 2.48 out of a maximum of 17. Gender, college and year of study, nationality and attendance in lecture/conference/workshop on Zika were significantly associated with the level of knowledge. The males possessed significantly ( P = 0.046) better knowledge as compared to the females. Students of medical college had significantly ( P = 0.005) better knowledge as compared to students of other colleges. The level of knowledge improved significantly ( P = 0.026) as the year of study progressed. There is a need for medical and paramedical students to update their knowledge of ZIKV disease as they are the future health-care providers who will be responsible for creating awareness about such outbreaks and their preventive measures.

  15. Zika virus disease knowledge among the future health-care providers of the United Arab Emirates

    Directory of Open Access Journals (Sweden)

    Syed Arman Rabbani

    2018-01-01

    Full Text Available Zika virus (ZIKV disease has become a major public health concern. Although there are no reported cases of ZIKV disease in the United Arab Emirates (UAE, there is a potential risk of transmission due to large expatriate population and high influx of international travelers. This cross-sectional study was conducted to assess the knowledge of ZIKV disease among the students of a medical and health sciences university in the UAE. Their knowledge of ZIKV disease was assessed using a specially designed, pretested, and validated questionnaire. Of the 500 respondents included in the final analysis, 314 (62.8% respondents presented with poor knowledge of ZIKV disease. The mean knowledge score of the study population was 10.48 ± 2.48 out of a maximum of 17. Gender, college and year of study, nationality and attendance in lecture/conference/workshop on Zika were significantly associated with the level of knowledge. The males possessed significantly (P = 0.046 better knowledge as compared to the females. Students of medical college had significantly (P = 0.005 better knowledge as compared to students of other colleges. The level of knowledge improved significantly (P = 0.026 as the year of study progressed. There is a need for medical and paramedical students to update their knowledge of ZIKV disease as they are the future health-care providers who will be responsible for creating awareness about such outbreaks and their preventive measures.

  16. Future Health and Economic Impact of Comprehensive Tobacco Control in DoD: A Microsimulation Approach.

    Science.gov (United States)

    Yang, Wenya; Zou, Quan; Tan, Eleonora; Watkins, Lachlan; Beronja, Kaleigh; Hogan, Paul F; Elenberg, Kimberly

    2018-01-01

    Tobacco use is a major concern to the Military Health System of the Department of Defense (DoD). The 2011 DoD Health Related Behavior Survey reported that 24.5% of active duty personnel are current smokers, which is higher than the national estimate of 20.6% for the civilian population. Overall, it is estimated that tobacco use costs the DoD $1.6 billion a year through related medical care, increased hospitalization, and lost days of work, among others. This study evaluated future health outcomes of Tricare Prime beneficiaries aged 18-64 yr (N = 3.2 million, including active duty and retired military members and their dependents) and the potential economic impact of initiatives that DoD may take to further its effort to transform the military into a tobacco-free environment. Our analysis simulated the future smoking status, risk of developing 25 smoking-related diseases, and associated medical costs for each individual using a Markov Chain Monte Carlo microsimulation model. Data sources included Tricare administrative data, national data such as Centers for Disease Control and Prevention mortality data and National Cancer Institute's cancer registry data, as well as relative risks of diseases obtained from a literature review. We found that the prevalence of active smoking among the Tricare Prime population will decrease from about 24% in 2015 to 18% in 2020 under a status quo scenario. However, if a comprehensive tobacco control initiative that includes a 5% price increase, a tighter clean air policy, and an intensified media campaign were to be implemented between 2016 and 2020, the prevalence of smoking could further decrease to 16%. The near 2 percentage points reduction in smoking prevalence represents an additional 81,240 quitters and translates to a total lifetime medical cost savings (in 2016 present value) of $968 million, with 39% ($382 million) attributable to Tricare savings. A comprehensive tobacco control policy within the DoD could significantly

  17. Concerns and future challenges of health literacy in the Nordic countries - From the point of view of health promotion practitioners and researchers.

    Science.gov (United States)

    Ringsberg, K C; Olander, E; Tillgren, P; Thualagant, N; Trollvik, A

    2018-02-01

    Health literacy is an essential social determinant for promoting and maintaining the health of a population. From a health promotion perspective, explore health literacy issues, concerns and future challenges among Nordic practitioners and researchers. Data were collected in a workshop at the 8 th Nordic Health Promotion Conference, and in a literature review, with articles from five databases. The search included title and abstract with the search terms health literacy* and health literacy as a MeSH term and all the Nordic countries. Qualitative and quantitative analysis were used. Twenty-five persons participated in the workshop. The discussions were summarized in six themes: concept of health literacy in national language; risk of victim blaming; measuring health literacy; content in school curricula on health literacy; new technologies for information and communication; communication and collaboration between different actors in support of health. Forty-three articles on health literacy were identified, mainly conducted within three fields: development, test and adaptation of instruments for measuring health literacy; measurement of health literacy among patients, or other defined target groups and on populations; and developing and evaluating methods/tools for the training of personnel groups or different target groups. There is a need for further studies providing a more in-depth understanding of the health literacy concept, knowledge on how to measure health literacy, ethical aspects, application in intersectoral collaboration as well as the adaptation to new technologies for information and communication in education supporting health literacy. As health literacy is an essential social health determinant, a concern and a future challenge must be, to make the health literacy concept familiar and visible in health promotion policies, research and practice such as health education.

  18. Health Promotion in Canada: perspectives & future prospects - doi:10.5020/18061230.2007.p3

    Directory of Open Access Journals (Sweden)

    Blake Poland

    2012-01-01

    Full Text Available Thank-you for the opportunity to be with you today in this fascinating panel on the state of health promotion in Brazil, Canada and around the world. It is a great pleasure to be here, and to share my thoughts and reflections with you, not as na expert here to tell you how it ‘should’ be, but as a colleague interested in dialogue around points of mutual concern. I feel we have much to learn from what has been happening here in Brazil, and the work of Paolo Freire and many contemporary colleagues who continue this tradition of critical pedagogy for health (like my colleague and friend here at UNIFOR, Dr. Francisco Cavalcante Jr.. So in this spirit of friendship, dialogue and mutual learning, I will be very frank with you about the lessons learned in Canada, including some of our failures and mistakes which I hope you can successfully avoid. Also, I offer my apologies for not being able to speak with you in your own language. I wish to thank my friends Nicolas Ayres and Francisco Cavalcante Jr. For their assistance with translation. In addition to a brief overview of the development of health promotion in Canada, I would like to share some reflections on the social, political and economic context in which the field has evolved, both in Canada and internationally. I Will address three (3 key tensions I see in the field at the moment (from a Canadian perspective, and reflect on our successes and our failures. I will close with a few thoughts on future prospects and some of the challenges that I see that lie ahead. I would like to emphasize that any brief history of health promotion in Canada, and any assessment of its strengths, contributions and failures is inherently ‘subjective’ and idiosyncratic. Rather than repeat the work of other analysts and commentators (see for example – cite PHAC/HC docs, I offer my observations based on over a decade of involvement in the field (including involvement in the Critical Social Science and Health

  19. Geochemical legacies and the future health of cities: A tale of two neurotoxins in urban soils

    Directory of Open Access Journals (Sweden)

    Gabriel M. Filippelli

    2015-07-01

    Full Text Available Abstract The past and future of cities are inextricably linked, a linkage that can be seen clearly in the long-term impacts of urban geochemical legacies. As loci of population as well as the means of employment and industry to support these populations, cities have a long history of co-locating contaminating practices and people, sometimes with negative implications for human health. Working at the intersection between environmental processes, communities, and human health is critical to grapple with environmental legacies and to support healthy, sustainable, and growing urban populations. An emerging area of environmental health research is to understand the impacts of chronic exposures and exposure mixtures—these impacts are poorly studied, yet may pose a significant threat to population health. Acute exposure to lead (Pb, a powerful neurotoxin to which children are particularly susceptible, has largely been eliminated in the U.S. and other countries through policy-based restrictions on leaded gasoline and lead-based paints. But the legacy of these sources remains in the form of surface soil Pb contamination, a common problem in cities and one that has only recently emerged as a widespread chronic exposure mechanism in cities. Some urban soils are also contaminated with another neurotoxin, mercury (Hg. The greatest human exposure to Hg is through fish consumption, so eating fish caught in urban areas presents risks for toxic Hg exposure. The potential double impact of chronic exposure to these two neurotoxins is pronounced in cities. Overall, there is a paradigmatic shift from reaction to and remediation of acute exposures towards a more nuanced understanding of the dynamic cycling of persistent environmental contaminants with resultant widespread and chronic exposure of inner-city dwellers, leading to chronic toxic illness and disability at substantial human and social cost.

  20. A model for mHealth skills training for clinicians: meeting the future now

    Science.gov (United States)

    Malvey, Donna M.; Neigel, Alexis R.

    2017-01-01

    We describe the current state of mHealth skills acquisition, education, and training available to clinical professionals in educational programs. We discuss how telemedicine experienced exponential growth due in large part to the ubiquity of the mobile phone. An outcome of this unprecedented growth has been the emergence of the need for technology skills training programs for clinicians that address extant curricula gaps. We propose a model to guide the development of future training programs that incorporate effective training strategies across five domains: (I) digital communication skills; (II) technology literacy and usage skills; (III) deploying telehealth products and services; (VI) regulatory and compliance issues; and (V) telehealth business case. These domains are discussed within the context of interprofessional teams and broader organizational factors. PMID:28736733

  1. Prognostics and Health Management of Wind Turbines -- Current Status and Future Opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Sheng, Shuangwen

    2017-04-28

    The global wind industry has seen tremendous growth during the past two decades. However, the industry is challenged by premature component failures, which lead to increased turbine downtime and subsequently, cost of energy for wind power. To mitigate the impacts from these failures, the wind industry has been exploring various areas for improvements ranging from product design, new materials or lubricants, to operation and maintenance (O&M) practices. Condition-based maintenance or prognostics and health management (PHM) has been explored as one enabling technology for improving O&M practices. This chapter provides a brief overview of wind turbine PHM with a focus on operational data mining and condition monitoring of drivetrains. Some future research and development opportunities in wind turbine PHM are also briefly discussed.

  2. The duality of health technology in chronic illness: how designers envision our future.

    Science.gov (United States)

    Lehoux, Pascale

    2008-06-01

    This essay critically explores the role of technological innovation in the constitution of chronic states and illness. Drawing on the co-construction of technology and society perspective, it focuses more specifically on the way in which innovation designers envisage the enhancement of the chronically ill and build certain kinds of socio-technical configuration to deal with chronic illness. Using the case of ;intelligent distance patient monitoring' as an illustration, the paper argues that technology creates as much as it solves the problem of chronic illness. Technology is recursively embedded in chronic illness and it generates dual effects: it constrains and sustains users' daily practices. Only by recognizing technology's duality and eventually transcending it will research and policy initiatives be able to deal creatively and responsibly with the design of our future health experiences.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-12-31

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

  4. Global and regional health effects of future food production under climate change: a modelling study.

    Science.gov (United States)

    Springmann, Marco; Mason-D'Croz, Daniel; Robinson, Sherman; Garnett, Tara; Godfray, H Charles J; Gollin, Douglas; Rayner, Mike; Ballon, Paola; Scarborough, Peter

    2016-05-07

    One of the most important consequences of climate change could be its effects on agriculture. Although much research has focused on questions of food security, less has been devoted to assessing the wider health impacts of future changes in agricultural production. In this modelling study, we estimate excess mortality attributable to agriculturally mediated changes in dietary and weight-related risk factors by cause of death for 155 world regions in the year 2050. For this modelling study, we linked a detailed agricultural modelling framework, the International Model for Policy Analysis of Agricultural Commodities and Trade (IMPACT), to a comparative risk assessment of changes in fruit and vegetable consumption, red meat consumption, and bodyweight for deaths from coronary heart disease, stroke, cancer, and an aggregate of other causes. We calculated the change in the number of deaths attributable to climate-related changes in weight and diets for the combination of four emissions pathways (a high emissions pathway, two medium emissions pathways, and a low emissions pathway) and three socioeconomic pathways (sustainable development, middle of the road, and more fragmented development), which each included six scenarios with variable climatic inputs. The model projects that by 2050, climate change will lead to per-person reductions of 3·2% (SD 0·4%) in global food availability, 4·0% (0·7%) in fruit and vegetable consumption, and 0·7% (0·1%) in red meat consumption. These changes will be associated with 529,000 climate-related deaths worldwide (95% CI 314,000-736,000), representing a 28% (95% CI 26-33) reduction in the number of deaths that would be avoided because of changes in dietary and weight-related risk factors between 2010 and 2050. Twice as many climate-related deaths were associated with reductions in fruit and vegetable consumption than with climate-related increases in the prevalence of underweight, and most climate-related deaths were projected to

  5. Willingness to treat drug dependence and depression: comparisons of future health professionals

    Directory of Open Access Journals (Sweden)

    Ríos-Bedoya CF

    2011-03-01

    treat nicotine and alcohol dependence-affected patients as compared to depression-affected patients. Personal history was not associated with the students' willingness to treat, but men were less willing to treat. Drawing strength from the randomized reinforcer experimental design nested within this survey approach, the study evidence suggests potential nonparticipation bias in standard surveys on this topic.Conclusion: These results indicate that future health professionals may prefer to treat depression as opposed to drug dependence conditions. For SBIRT success, curriculum change with educational interventions may be needed to increase willingness to treat patients with neuropsychiatric conditions such as drug dependence. Future research requires attention to a possible problem of nonparticipation bias in surveys of this type.Keywords: alcohol dependence, nicotine dependence, depression, health professionals, stigma 

  6. Trust and Credibility in Web-Based Health Information: A Review and Agenda for Future Research.

    Science.gov (United States)

    Sbaffi, Laura; Rowley, Jennifer

    2017-06-19

    Internet sources are becoming increasingly important in seeking health information, such that they may have a significant effect on health care decisions and outcomes. Hence, given the wide range of different sources of Web-based health information (WHI) from different organizations and individuals, it is important to understand how information seekers evaluate and select the sources that they use, and more specifically, how they assess their credibility and trustworthiness. The aim of this study was to review empirical studies on trust and credibility in the use of WHI. The article seeks to present a profile of the research conducted on trust and credibility in WHI seeking, to identify the factors that impact judgments of trustworthiness and credibility, and to explore the role of demographic factors affecting trust formation. On this basis, it aimed to identify the gaps in current knowledge and to propose an agenda for future research. A systematic literature review was conducted. Searches were conducted using a variety of combinations of the terms WHI, trust, credibility, and their variants in four multi-disciplinary and four health-oriented databases. Articles selected were published in English from 2000 onwards; this process generated 3827 unique records. After the application of the exclusion criteria, 73 were analyzed fully. Interest in this topic has persisted over the last 15 years, with articles being published in medicine, social science, and computer science and originating mostly from the United States and the United Kingdom. Documents in the final dataset fell into 3 categories: (1) those using trust or credibility as a dependent variable, (2) those using trust or credibility as an independent variable, and (3) studies of the demographic factors that influence the role of trust or credibility in WHI seeking. There is a consensus that website design, clear layout, interactive features, and the authority of the owner have a positive effect on trust or

  7. The future of mental health care: peer-to-peer support and social media.

    Science.gov (United States)

    Naslund, J A; Aschbrenner, K A; Marsch, L A; Bartels, S J

    2016-04-01

    about one's health condition. However, given the evidence to date, the benefits of online peer-to-peer support appear to outweigh the potential risks. Future research must explore these opportunities to support and empower people with serious mental illness through online peer networks while carefully considering potential risks that may arise from online peer-to-peer interactions. Efforts will also need to address methodological challenges in the form of evaluating interventions delivered through social media and collecting objective mental and physical health outcome measures online. A key challenge will be to determine whether skills learned from peers in online networks translate into tangible and meaningful improvements in recovery, employment, or mental and physical wellbeing in the offline world.

  8. The influence of banner advertisements on attention and memory: human faces with averted gaze can enhance advertising effectiveness.

    Science.gov (United States)

    Sajjacholapunt, Pitch; Ball, Linden J

    2014-01-01

    Research suggests that banner advertisements used in online marketing are often overlooked, especially when positioned horizontally on webpages. Such inattention invariably gives rise to an inability to remember advertising brands and messages, undermining the effectiveness of this marketing method. Recent interest has focused on whether human faces within banner advertisements can increase attention to the information they contain, since the gaze cues conveyed by faces can influence where observers look. We report an experiment that investigated the efficacy of faces located in banner advertisements to enhance the attentional processing and memorability of banner contents. We tracked participants' eye movements when they examined webpages containing either bottom-right vertical banners or bottom-center horizontal banners. We also manipulated facial information such that banners either contained no face, a face with mutual gaze or a face with averted gaze. We additionally assessed people's memories for brands and advertising messages. Results indicated that relative to other conditions, the condition involving faces with averted gaze increased attention to the banner overall, as well as to the advertising text and product. Memorability of the brand and advertising message was also enhanced. Conversely, in the condition involving faces with mutual gaze, the focus of attention was localized more on the face region rather than on the text or product, weakening any memory benefits for the brand and advertising message. This detrimental impact of mutual gaze on attention to advertised products was especially marked for vertical banners. These results demonstrate that the inclusion of human faces with averted gaze in banner advertisements provides a promising means for marketers to increase the attention paid to such adverts, thereby enhancing memory for advertising information.

  9. The influence of banner advertisements on attention and memory: Human faces with averted gaze can enhance advertising effectiveness

    Directory of Open Access Journals (Sweden)

    Pitch eSajjacholapunt

    2014-03-01

    Full Text Available Research suggests that banner advertisements used in online marketing are often overlooked, especially when positioned horizontally on webpages. Such inattention invariably gives rise to an inability to remember advertising brands and messages, undermining the effectiveness of this marketing method. Recent interest has focused on whether human faces within banner advertisements can increase attention to the information they contain, since the gaze cues conveyed by faces can influence where observers look. We report an experiment that investigated the efficacy of faces located in banner advertisements to enhance the attentional processing and memorability of banner contents. We tracked participants’ eye movements when they examined webpages containing either bottom-right vertical banners or bottom-centre horizontal banners. We also manipulated facial information such that banners either contained no face, a face with mutual gaze or a face with averted gaze. We additionally assessed people’s memories for brands and advertising messages. Results indicated that relative to other conditions, the condition involving faces with averted gaze increased attention to the banner overall, as well as to the advertising text and product. Memorability of the brand and advertising message was also enhanced. Conversely, in the condition involving faces with mutual gaze, the focus of attention was localised more on the face region rather than on the text or product, weakening any memory benefits for the brand and advertising message. This detrimental impact of mutual gaze on attention to advertised products was especially marked for vertical banners. These results demonstrate that the inclusion of human faces with averted gaze in banner advertisements provides a promising means for marketers to increase the attention paid to such adverts, thereby enhancing memory for advertising information.

  10. Incidence of medically attended influenza infection and cases averted by vaccination, 2011/12 and 2012/13 influenza seasons

    Science.gov (United States)

    Jackson, Michael L.; Jackson, Lisa A.; Kieke, Burney; McClure, David; Gaglani, Manjusha; Murthy, Kempapura; Malosh, Ryan; Monto, Arnold; Zimmerman, Richard K.; Foppa, Ivo M.; Flannery, Brendan; Thompson, Mark G.

    2018-01-01

    Background We estimated the burden of outpatient influenza and cases prevented by vaccination during the 2011/12 and 2012/13 influenza seasons using data from the United States Influenza Vaccine Effectiveness (US Flu VE) Network. Methods We defined source populations of persons who could seek care for acute respiratory illness (ARI) at each of the five US Flu VE Network sites. We identified all members of the source population who were tested for influenza during US Flu VE influenza surveillance. Each influenza-positive subject received a sampling weight based on the proportion of source population members who were tested for influenza, stratified by site, age, and other factors. We used the sampling weights to estimate the cumulative incidence of medically attended influenza in the source populations. We estimated cases averted by vaccination using estimates of cumulative incidence, vaccine coverage, and vaccine effectiveness. Results Cumulative incidence of medically attended influenza ranged from 0.8% to 2.8% across sites during 2011/12 and from 2.6% to 6.5% during the 2012/13 season. Stratified by age, incidence ranged from 1.2% among adults 50 years of age and older in 2011/12 to 10.9% among children 6 months to 8 years of age in 2012/13. Cases averted by vaccination ranged from 4 to 41 per 1,000 vaccinees, depending on the study site and year. Conclusions The incidence of medically attended influenza varies greatly by year and even by geographic region within the same year. The number of cases averted by vaccination varies greatly based on overall incidence and on vaccine coverage. PMID:26271827

  11. Review of Participatory Epidemiology Practices in Animal Health (1980-2015 and Future Practice Directions.

    Directory of Open Access Journals (Sweden)

    Alberto Allepuz

    Full Text Available In this study we combined an inventory of the major applications, geographic regions and diseases covered by participatory epidemiology (PE activities in the field of animal health since 1980, together with an email discussion forum with PE practitioners from different regions of the world. The inventory included the search of peer-reviewed papers, master and technical reports, conference proceedings, manuals, training materials and projects. The search resulted in a low number of PE activity results until the year 2000, followed by a considerable increase (especially from 2012. Most of the identified activities were implemented in Africa and Asia, and focused on surveillance, disease survey and prioritization, and disease control. Seventy-nine PE practitioners working predominantly in Africa, Asia and Europe (29, 22 and 18 respectively contributed to the email discussion forum. They proposed various modifications to the existing PE definition and discussed different issues related to the applicatoin of PE, its institutionalization for use in policy development, as well as the priorities for future development. The need to increase the number of PE trained people together with some methodological developments and the application of this methodology in developed countries, were some of the points highlighted during the forum. These factors stress the importance of further developing PE as a useful approach for engaging communities in addressing animal and related public health risks.

  12. Internet interventions for mental health and addictions: current findings and future directions.

    Science.gov (United States)

    Cunningham, John A; Gulliver, Amelia; Farrer, Lou; Bennett, Kylie; Carron-Arthur, Bradley

    2014-12-01

    Over the last several years, there has been a substantial increase in the number of publications reporting on Internet interventions for mental health and addictions. This paper provides a summary of the recent research on Internet interventions for the most common mental health and addictions concerns-depression, anxiety, alcohol and smoking. There is considerable evidence for the effectiveness of Internet-based interventions targeting depression, anxiety disorders, alcohol use and smoking. Small to moderate effect sizes have been reported for interventions targeting depression, anxiety and alcohol use, and smoking interventions have shown large effects. The addition of human support to depression and anxiety interventions has generally resulted in larger treatments effects, but this trend has not been observed in trials of interventions targeting alcohol use. There is some evidence that online interventions can be as effective as face-to-face therapies, at least for anxiety disorders. Despite a proliferation of research activity in this area, gaps in knowledge remain. Future research should focus on the development and evaluation of interventions for different platforms (e.g. smartphone applications), examining the long-term impacts of these interventions, determining active intervention components and identifying methods for enhancing tailoring and engagement. Careful consideration should be given to the ongoing technical and clinical expertise required to ensure that Internet interventions are delivered safely and professionally in a rapidly changing technology environment.

  13. Can We Avoid a Sick Fiscal Future? The Non-Sustainability of Health-Care Spending with an Aging Population

    Directory of Open Access Journals (Sweden)

    J.C. Herbert Emery

    2012-10-01

    Full Text Available Funding for Canadian public health care has long relied on a “pay-as-you-go” funding model: for the most part, government pays for health costs each year from taxes collected in that fiscal year with effectively nothing put aside for projected rising health-care costs in the future. But the future of Canadian public health care is going to get more expensive as the relatively large cohort of baby boomers reaches retirement age. As they exit the work force, and enter the ages at which Canadians use the health-care system more, a smaller population of younger workers is going to be left paying the growing health-care costs of older Canadians. If Canadians intend to preserve a publicly funded medicare system that offers a similar level of service in the future as it does today, under the pay-as-you-go model, eventually peak taxes for Canadians born after 1988 will end up twice as high as the peak taxes that the oldest baby boomers paid. The “payas-you-go” model has become like a Ponzi scheme, where those who got in early enough make out nicely, while those who arrive late stand to suffer a serious financial blow. This should concern both Canadians who value a comprehensive public health system as well as Canadians who value competitive tax rates: There is no reason to be certain that future taxpayers will blithely accept having their taxes substantially increased to finance health care for another, older generation that did not pay for a significant portion of its own health care. If the burden proves too high for the taxpaying public to accept, that could well jeopardize Canada’s health-care system as we know it. If Canadians intend to preserve their iconic public health system, and are unprepared to unjustly overburden future generations with the tax bill left by their parents and grandparents, provincial governments must make strong and rapid efforts to reform the health system. They must find more cost-efficient ways of managing

  14. The use of medical scribes in health care settings: a systematic review and future directions.

    Science.gov (United States)

    Shultz, Cameron G; Holmstrom, Heather L

    2015-01-01

    Electronic health records (EHRs) hold promise to improve productivity, quality, and outcomes; however, using EHRs can be cumbersome, disruptive to workflow, and off-putting to patients and clinicians. One proposed solution to this problem is the use of medical scribes. The purpose of this systematic review is to summarize the literature investigating the effect of medical scribes on health care productivity, quality, and outcomes. Implications for future research are discussed. A keyword search of the Cochrane Library, OvidSP Medline database, and Embase database from January 2000 through September 2014 was performed using the terms scribe or scribes in the title or abstract. To ensure no potentially eligible articles were missed, a second search was done using Google Scholar. English-language, peer-reviewed studies assessing the effect of medical scribes on health care productivity, quality, and outcomes were retained. Identified studies were assessed and the findings reported. Five studies were identified. Three studies assessed scribe use in an emergency department, 1 in a cardiology clinic, and 1 in a urology clinic. Two of 3 studies reported scribes had no effect on patient satisfaction; 2 of 2 reported improved clinician satisfaction; 2 of 3 reported an increase in the number of patients; 2 of 2 reported an increase in the number of relative value units per hour; 1 of 1 reported increased revenue; 3 of 4 reported improved time-related efficiencies; and 1 of 1 reported improved patient-clinician interactions. Available evidence suggests medical scribes may improve clinician satisfaction, productivity, time-related efficiencies, revenue, and patient-clinician interactions. Because the number of studies is small, and because each study suffered important limitations, confidence in the reliability of the evidence is significantly constrained. Given the nascent state of the science, methodologically rigorous and sufficiently powered studies are greatly needed.

  15. Private expenditure and the role of private health insurance in Greece: status quo and future trends.

    Science.gov (United States)

    Siskou, Olga; Kaitelidou, Daphne; Economou, Charalampos; Kostagiolas, Peter; Liaropoulos, Lycourgos

    2009-10-01

    The health care system in Greece is financed in almost equal proportions by public and private sources. Private expenditure, consists mostly of out-of-pocket and under-the-table payments. Such payments strongly suggest dissatisfaction with the public system, due to under financing during the last 25 years. This gap has been filled rapidly by the private sector. From this point of view, one might suggest that the flourishing development of private provision may lead in turn to a corresponding growth in private health insurance (PHI). This paper aims to examine the role of PHI in Greece, to identify the factors influencing its development, and to make some suggestions about future policies and trends. In the decade of 1985-1995 PHI show increasing activity, reflecting the intention of some citizens to seek health insurance solutions in the form of supplementary cover in order to ensure faster access, better quality of services, and increased consumer choice. The benefits include programs covering hospital expenses, cash benefits, outpatient care expenses, disability income insurance, as well as limited managed care programs. However, despite recent interest, PHI coverage remains low in Greece compared to other EU countries. Economic, social and cultural factors such as low average household income, high unemployment, obligatory and full coverage by social insurance, lead to reluctance to pay for second-tier insurance. Instead, there is a preference to pay a doctor or hospital directly even in the form of under-the-table payments (which are remarkably high in Greece), when the need arises. There are also factors endogenous to the PHI industry, related to market policies, low organisational capacity, cream skimming, and the absence of insurance products meeting consumer requirements, which explain the relatively low state of development of PHI in Greece.

  16. Patient Health Record Systems Scope and Functionalities: Literature Review and Future Directions.

    Science.gov (United States)

    Bouayad, Lina; Ialynytchev, Anna; Padmanabhan, Balaji

    2017-11-15

    A new generation of user-centric information systems is emerging in health care as patient health record (PHR) systems. These systems create a platform supporting the new vision of health services that empowers patients and enables patient-provider communication, with the goal of improving health outcomes and reducing costs. This evolution has generated new sets of data and capabilities, providing opportunities and challenges at the user, system, and industry levels. The objective of our study was to assess PHR data types and functionalities through a review of the literature to inform the health care informatics community, and to provide recommendations for PHR design, research, and practice. We conducted a review of the literature to assess PHR data types and functionalities. We searched PubMed, Embase, and MEDLINE databases from 1966 to 2015 for studies of PHRs, resulting in 1822 articles, from which we selected a total of 106 articles for a detailed review of PHR data content. We present several key findings related to the scope and functionalities in PHR systems. We also present a functional taxonomy and chronological analysis of PHR data types and functionalities, to improve understanding and provide insights for future directions. Functional taxonomy analysis of the extracted data revealed the presence of new PHR data sources such as tracking devices and data types such as time-series data. Chronological data analysis showed an evolution of PHR system functionalities over time, from simple data access to data modification and, more recently, automated assessment, prediction, and recommendation. Efforts are needed to improve (1) PHR data quality through patient-centered user interface design and standardized patient-generated data guidelines, (2) data integrity through consolidation of various types and sources, (3) PHR functionality through application of new data analytics methods, and (4) metrics to evaluate clinical outcomes associated with automated PHR

  17. Antioxidant activity of the giant jellyfish Nemopilema nomurai measured by the oxygen radical absorbance capacity and hydroxyl radical averting capacity methods.

    Science.gov (United States)

    Harada, Kazuki; Maeda, Toshimichi; Hasegawa, Yoshiro; Tokunaga, Takushi; Ogawa, Shinya; Fukuda, Kyoko; Nagatsuka, Norie; Nagao, Keiko; Ueno, Shunshiro

    2011-01-01

    The giant jellyfish Nemopilema nomurai (reaching sizes of up to 2 m diameter and 150 kg), which forms dense blooms, has caused extensive damage to fisheries by overloading trawl nets, while its toxic nematocysts cause dermatological symptoms. Giant jellyfish are currently discarded on the grounds of pest control. However, the giant jellyfish is considered to be edible and is part of Chinese cuisine. Therefore, we investigated whether any benefits for human health may be derived from consumption of the jellyfish in order to formulate medicated diets. Antioxidant activity of Nemopilema nomurai was measured using the oxygen radical absorbance capacity (ORAC) and hydroxyl radical averting capacity (HORAC) methods. Based on the results, the ORAC value of the giant jellyfish freeze-dried sample was 541 µmol trolox equivalent (TE)/100 g and the HORAC value was 3,687 µmol gallic acid equivalent (GAE)/100 g. On the other hand, the IC50 value of hydroxyl radical scavenging activity measured by using the electron spin resonance method was 3.3%. In conclusion, the results suggest that the freeze-dried powder of the giant jellyfish Nemopilema nomurai is a potentially beneficial food for humans.

  18. Health system costs by sex, age and proximity to death, and implications for estimation of future expenditure.

    Science.gov (United States)

    Blakely, Tony; Atkinson, June; Kvizhinadze, Giorgi; Nghiem, Nhung; McLeod, Heather; Wilson, Nick

    2014-05-02

    Health expenditure increases with age, but some of this increase is due to costs proximal to death. We used linked health datasets (HealthTracker) to determine health expenditure by proximity to death. We then determined the impact on future health expenditure projections of accounting for proximity to death in costs. 2007 to 2009 national health event data were linked for hospitalisations, inpatient procedures, outpatient events, pharmaceuticals, laboratory tests, and primary care consultations. Each event was assigned a cost. Health expenditure by sex, age and whether in last 6 or 12 months of life or not were calculated. Future health expenditure trends were then estimated for the Statistics New Zealand median projection population counts, with 2010-12 mortality rates reducing by 2% per annum into the future. A total of $8.1, $8.8 and $9.2 billion dollars (inflation-adjusted to 2011 NZ$) was allocated to individual health events in HealthTracker in 2007, 2008 and 2009, respectively. Citizen costs for people not within 6 months of death ranged from $498 per person-year (10-14 year old females) to $6900 per person-year (90-94 year old males). Per person-year costs in the last 6 months of life were 10-fold higher on average, being maximal at $30,000 or more among infants and the older elderly (80+ years). Similar patterns were apparent for costs within 12 months of death. For people hypothetically exposed to these 2007-09 health system costs over their full life, the cumulative costs for a person dying at age 70 years was $113,000, and doubled to $223,000 for a person dying at age 90. The proportion of cumulative health expenditure in the last year of life declined with increasing age of death: e.g. 24%, 13% and 10% for someone aged 40, 70 and 90 respectively. Projections of future health system expenditure were overestimated by 2.3% to 3.5% in 2041 when not accounting for proximity to death in costs. New Zealand is fortunate to have access to rich data on health

  19. Plastics, the environment and human health: current consensus and future trends

    Science.gov (United States)

    Thompson, Richard C.; Moore, Charles J.; vom Saal, Frederick S.; Swan, Shanna H.

    2009-01-01

    Plastics have transformed everyday life; usage is increasing and annual production is likely to exceed 300 million tonnes by 2010. In this concluding paper to the Theme Issue on Plastics, the Environment and Human Health, we synthesize current understanding of the benefits and concerns surrounding the use of plastics and look to future priorities, challenges and opportunities. It is evident that plastics bring many societal benefits and offer future technological and medical advances. However, concerns about usage and disposal are diverse and include accumulation of waste in landfills and in natural habitats, physical problems for wildlife resulting from ingestion or entanglement in plastic, the leaching of chemicals from plastic products and the potential for plastics to transfer chemicals to wildlife and humans. However, perhaps the most important overriding concern, which is implicit throughout this volume, is that our current usage is not sustainable. Around 4 per cent of world oil production is used as a feedstock to make plastics and a similar amount is used as energy in the process. Yet over a third of current production is used to make items of packaging, which are then rapidly discarded. Given our declining reserves of fossil fuels, and finite capacity for disposal of waste to landfill, this linear use of hydrocarbons, via packaging and other short-lived applications of plastic, is simply not sustainable. There are solutions, including material reduction, design for end-of-life recyclability, increased recycling capacity, development of bio-based feedstocks, strategies to reduce littering, the application of green chemistry life-cycle analyses and revised risk assessment approaches. Such measures will be most effective through the combined actions of the public, industry, scientists and policymakers. There is some urgency, as the quantity of plastics produced in the first 10 years of the current century is likely to approach the quantity produced in the

  20. Plastics, the environment and human health: current consensus and future trends.

    Science.gov (United States)

    Thompson, Richard C; Moore, Charles J; vom Saal, Frederick S; Swan, Shanna H

    2009-07-27

    Plastics have transformed everyday life; usage is increasing and annual production is likely to exceed 300 million tonnes by 2010. In this concluding paper to the Theme Issue on Plastics, the Environment and Human Health, we synthesize current understanding of the benefits and concerns surrounding the use of plastics and look to future priorities, challenges and opportunities. It is evident that plastics bring many societal benefits and offer future technological and medical advances. However, concerns about usage and disposal are diverse and include accumulation of waste in landfills and in natural habitats, physical problems for wildlife resulting from ingestion or entanglement in plastic, the leaching of chemicals from plastic products and the potential for plastics to transfer chemicals to wildlife and humans. However, perhaps the most important overriding concern, which is implicit throughout this volume, is that our current usage is not sustainable. Around 4 per cent of world oil production is used as a feedstock to make plastics and a similar amount is used as energy in the process. Yet over a third of current production is used to make items of packaging, which are then rapidly discarded. Given our declining reserves of fossil fuels, and finite capacity for disposal of waste to landfill, this linear use of hydrocarbons, via packaging and other short-lived applications of plastic, is simply not sustainable. There are solutions, including material reduction, design for end-of-life recyclability, increased recycling capacity, development of bio-based feedstocks, strategies to reduce littering, the application of green chemistry life-cycle analyses and revised risk assessment approaches. Such measures will be most effective through the combined actions of the public, industry, scientists and policymakers. There is some urgency, as the quantity of plastics produced in the first 10 years of the current century is likely to approach the quantity produced in the

  1. Sexual Health in Undergraduate Medical Education: Existing and Future Needs and Platforms.

    Science.gov (United States)

    Shindel, Alan W; Baazeem, Abdulaziz; Eardley, Ian; Coleman, Eli

    2016-07-01

    This article explores the evolution and current delivery of undergraduate medical education in human sexuality. To make recommendations regarding future educational needs, principles of curricular development, and how the International Society for Sexual Medicine (ISSM) should address the need to enhance and promote human sexuality education around the world. The existing literature was reviewed for sexuality education, curriculum development, learning strategies, educational formats, evaluation of programs, evaluation of students, and faculty development. The prevailing theme of most publications in this vein is that sexuality education in undergraduate medical education is currently not adequate to prepare students for future practice. We identified components of the principles of attitudes, knowledge, and skills that should be contained in a comprehensive curriculum for undergraduate medical education in human sexuality. Management of sexual dysfunction; lesbian, gay, bisexual, and transgender health care; sexuality across genders and lifespan; understanding of non-normative sexual practices; sexually transmitted infections and HIV, contraception; abortion; sexual coercion and violence; and legal aspects were identified as topics meriting particular attention. Curricula should be integrated throughout medical school and based on principles of adult learning. Methods of teaching should be multimodal and evaluations of student performance are critical. To realize much of what needs to be done, faculty development is critical. Thus, the ISSM can play a key role in the provision and dissemination of learning opportunities and materials, it can promote educational programs around the world, and it can articulate a universal curriculum with modules that can be adopted. The ISSM can create chapters, review documents, slide decks, small group and roleplay topics, and video-recorded materials and make all this material easily available. An expert consensus conference

  2. Averting Uncertainty: A Practical Guide to Physical Activity Research in Australian Schools

    Science.gov (United States)

    Rachele, Jerome N.; Cuddihy, Thomas F.; Washington, Tracy L.; McPhail, Steven M.

    2013-01-01

    Preventative health has become central to contemporary health care, identifying youth physical activity as a key factor in determining health and functioning. Schools offer a unique research setting due to distinctive methodological circumstances. However, school-based researchers face several obstacles in their endeavour to complete successful…

  3. Relationships between work-related factors and musculoskeletal health with current and future work ability among male workers.

    Science.gov (United States)

    Boschman, J S; Noor, A; Lundström, R; Nilsson, T; Sluiter, J K; Hagberg, M

    2017-08-01

    The purpose was to increase job-specific knowledge about individual and work-related factors and their relationship with current and future work ability (WA). We studied cross-sectional relationships between mental demands, physical exertion during work, grip strength, musculoskeletal pain in the upper extremities and WA and the relationships between these variables and WA 11 years later. We used a dataset of a prospective cohort study (1997-2008) among employees of an engineering plant (n = 157). The cohort was surveyed by means of tests and written questions on work demands, musculoskeletal health, WA score (WAS; 0-10), and mental and physical WA. Spearman correlation coefficients and logistic regression analysis were used. Among manual workers, we found weak correlations between grip strength and current and future physical WA. We did not find predictors for future poor WA among the manual workers. Among the office workers, we found that musculoskeletal pain was moderately and negatively related to current WAS and physical WA. More handgrip strength related to better future WAS and physical WA. Musculoskeletal pain (OR 1.67 p health and work ability depending on occupation. However, the present implies that predicting work ability in the far future based on health surveillance data is rather difficult. Testing the musculoskeletal system (grip strength) and asking workers' about their musculoskeletal health seems relevant when monitoring work ability.

  4. Endocrine regulation of fetal skeletal muscle growth: impact on future metabolic health

    Science.gov (United States)

    Brown, Laura D.

    2014-01-01

    Establishing sufficient skeletal muscle mass is essential for lifelong metabolic health. The intrauterine environment is a major determinant of the muscle mass that is present for the life course of an individual, because muscle fiber number is set at the time of birth. Thus, a compromised intrauterine environment from maternal nutrient restriction or placental insufficiency that restricts development of muscle fiber number can have permanent effects on the amount of muscle an individual will live with. Reduced muscle mass due to fewer muscle fibers persists even after compensatory or “catch up” postnatal growth occurs. Furthermore, muscle hypertrophy can only partially compensate for this limitation in fiber number. Compelling associations link low birth weight and decreased muscle mass to future insulin resistance, which can drive the development of the metabolic syndrome and type 2 diabetes, and risk for cardiovascular events later in life. There are gaps in knowledge about the origins of reduced muscle growth at the cellular level and how these patterns are set during fetal development. By understanding the nutrient and endocrine regulation of fetal skeletal muscle growth and development, we can direct research efforts towards improving muscle growth early in life in order to prevent the development of chronic metabolic disease later in life. PMID:24532817

  5. Emotion regulation and mental health: recent findings, current challenges, and future directions.

    Science.gov (United States)

    Berking, Matthias; Wupperman, Peggilee

    2012-03-01

    In recent years, deficits in emotion regulation have been studied as a putative maintaining factor and promising treatment target in a broad range of mental disorders. This article aims to provide an integrative review of the latest theoretical and empirical developments in this rapidly growing field of research. Deficits in emotion regulation appear to be relevant to the development, maintenance, and treatment of various forms of psychopathology. Increasing evidence demonstrates that deficits in the ability to adaptively cope with challenging emotions are related to depression, borderline personality disorder, substance-use disorders, eating disorders, somatoform disorders, and a variety of other psychopathological symptoms. Unfortunately, studies differ with regard to the conceptualization and assessment of emotion regulation, thus limiting the ability to compare findings across studies. Future research should systematically work to use comparable methods in order to clarify the following: which individuals have; what kinds of emotion regulation difficulties with; which types of emotions; and what interventions are most effective in alleviating these difficulties. Despite some yet to be resolved challenges, the concept of emotion regulation has a broad and significant heuristic value for research in mental health.

  6. Impacts of climate variability and future climate change on harmful algal blooms and human health

    Science.gov (United States)

    Moore, Stephanie K; Trainer, Vera L; Mantua, Nathan J; Parker, Micaela S; Laws, Edward A; Backer, Lorraine C; Fleming, Lora E

    2008-01-01

    Anthropogenically-derived increases in atmospheric greenhouse gas concentrations have been implicated in recent climate change, and are projected to substantially impact the climate on a global scale in the future. For marine and freshwater systems, increasing concentrations of greenhouse gases are expected to increase surface temperatures, lower pH, and cause changes to vertical mixing, upwelling, precipitation, and evaporation patterns. The potential consequences of these changes for harmful algal blooms (HABs) have received relatively little attention and are not well understood. Given the apparent increase in HABs around the world and the potential for greater problems as a result of climate change and ocean acidification, substantial research is needed to evaluate the direct and indirect associations between HABs, climate change, ocean acidification, and human health. This research will require a multidisciplinary approach utilizing expertise in climatology, oceanography, biology, epidemiology, and other disciplines. We review the interactions between selected patterns of large-scale climate variability and climate change, oceanic conditions, and harmful algae. PMID:19025675

  7. Air pollution in India and related adverse respiratory health effects: past, present, and future directions.

    Science.gov (United States)

    Khilnani, Gopi C; Tiwari, Pawan

    2018-03-01

    The review describes current status of air pollution in India, summarizes recent research on adverse health effects of ambient and household air pollution, and outlines the ongoing efforts and future actions required to improve air quality and reduce morbidity and mortality because of air pollution in India. Global burden of disease data analysis reveals more than one million premature deaths attributable to ambient air pollution in 2015 in India. More than one million additional deaths can be attributed to household air pollution. Particulate matter with diameter 2.5 μm or less has been causatively linked with most premature deaths. Acute respiratory tract infections, asthma, chronic obstructive pulmonary disease, exacerbations of preexisting obstructive airway disease and lung cancer are proven adverse respiratory effects of air pollution. Targeting air quality standards laid by WHO can significantly reduce morbidity and mortality because of air pollution in India. India is currently exposed to high levels of ambient and household air pollutants. Respiratory adverse effects of air pollution are significant contributors to morbidity and premature mortality in India. Substantial efforts are being made at legislative, administrative, and community levels to improve air quality. However, much more needs to be done to change the 'status quo' and attain the target air quality standards. VIDEO ABSTRACT: http://links.lww.com/COPM/A24.

  8. Penicillin allergy: optimizing diagnostic protocols, public health implications, and future research needs.

    Science.gov (United States)

    Macy, Eric

    2015-08-01

    Unverified penicillin allergy is being increasingly recognized as a public health concern. The ideal protocol for verifying true clinically significant IgE-mediated penicillin allergy needs to use only commercially available materials, be well tolerated and easy to perform in both the inpatient and outpatient settings, and minimize false-positive determinations. This review concentrates on articles published in 2013 and 2014 that present new data relating to the diagnosis and management of penicillin allergy. Penicillin allergy can be safely evaluated at this time, in patients with an appropriate clinical history of penicillin allergy, using only penicilloyl-poly-lysine and native penicillin G as skin test reagents, if an oral challenge with amoxicillin 250 mg, followed by 1 h of observation, is given to all skin test negative individuals. Millions of individuals falsely labeled with penicillin allergy need to be evaluated to safely allow them to use penicillin-class antibiotics and avoid morbidity associated with penicillin avoidance. Further research is needed to determine optimal protocol(s). There will still be a 1-2% rate of adverse reactions reported with all future therapeutic penicillin-class antibiotic use, even with optimal methods used to determine acute penicillin tolerance. Only a small minority of these new reactions will be IgE-mediated.

  9. The impact of future summer temperature on public health in Barcelona and Catalonia, Spain

    Science.gov (United States)

    Ostro, Bart; Barrera-Gómez, Jose; Ballester, Joan; Basagaña, Xavier; Sunyer, Jordi

    2012-11-01

    Several epidemiological studies have reported associations between increases in summer temperatures and risks of premature mortality. The quantitative implications of predicted future increases in summer temperature, however, have not been extensively characterized. We have quantified these effects for the four main cities in Catalonia, Spain (Barcelona, Tarragona, Lleida, Girona). We first used case-crossover analysis to estimate the association between temperature and mortality for each of these cities for the period 1983 to 2006. These exposure-response (ER) functions were then combined with local measures of current and projected changes in population, mortality and temperature for the years 2025 and 2050. Predicted daily mean temperatures were based on the A1B greenhouse gas emission, "business-as-usual" scenario simulations derived from the ENSEMBLES project. Several different ER functions were examined and significant associations between temperature and mortality were observed for all four cities. For these four cities, the age-specific piecewise linear model predicts 520 (95%CI 340, 720) additional annual deaths attributable to the change in temperature in 2025 relative to the average from the baseline period of 1960-1990. For 2050, the estimate increases to 1,610 deaths per year during the warm season. For Catalonia as a whole, the point estimates for those two years are 720 and 2,330 deaths per year, respectively, or about 2 and 3% of the warm season. In comparing these predicted impacts with current causes of mortality, they clearly represent significant burdens to public health in Catalonia.

  10. Impacts of climate variability and future climate change on harmful algal blooms and human health.

    Science.gov (United States)

    Moore, Stephanie K; Trainer, Vera L; Mantua, Nathan J; Parker, Micaela S; Laws, Edward A; Backer, Lorraine C; Fleming, Lora E

    2008-11-07

    Anthropogenically-derived increases in atmospheric greenhouse gas concentrations have been implicated in recent climate change, and are projected to substantially impact the climate on a global scale in the future. For marine and freshwater systems, increasing concentrations of greenhouse gases are expected to increase surface temperatures, lower pH, and cause changes to vertical mixing, upwelling, precipitation, and evaporation patterns. The potential consequences of these changes for harmful algal blooms (HABs) have received relatively little attention and are not well understood. Given the apparent increase in HABs around the world and the potential for greater problems as a result of climate change and ocean acidification, substantial research is needed to evaluate the direct and indirect associations between HABs, climate change, ocean acidification, and human health. This research will require a multidisciplinary approach utilizing expertise in climatology, oceanography, biology, epidemiology, and other disciplines. We review the interactions between selected patterns of large-scale climate variability and climate change, oceanic conditions, and harmful algae.

  11. Future Challenges in Managing Human Health and Performance Risks for Space Flight

    Science.gov (United States)

    Corbin, Barbara J.; Barratt, Michael

    2013-01-01

    The global economy forces many nations to consider their national investments and make difficult decisions regarding their investment in future exploration. To enable safe, reliable, and productive human space exploration, we must pool global resources to understand and mitigate human health & performance risks prior to embarking on human exploration of deep space destinations. Consensus on the largest risks to humans during exploration is required to develop an integrated approach to mitigating risks. International collaboration in human space flight research will focus research on characterizing the effects of spaceflight on humans and the development of countermeasures or systems. Sharing existing data internationally will facilitate high quality research and sufficient power to make sound recommendations. Efficient utilization of ISS and unique ground-based analog facilities allows greater progress. Finally, a means to share results of human research in time to influence decisions for follow-on research, system design, new countermeasures and medical practices should be developed. Although formidable barriers to overcome, International working groups are working to define the risks, establish international research opportunities, share data among partners, share flight hardware and unique analog facilities, and establish forums for timely exchange of results. Representatives from the ISS partnership research and medical communities developed a list of the top ten human health & performance risks and their impact on exploration missions. They also drafted a multilateral data sharing plan to establish guidelines and principles for sharing human spaceflight data. Other working groups are also developing methods to promote international research solicitations. Collaborative use of analog facilities and shared development of space flight research and medical hardware continues. Establishing a forum for exchange of results between researchers, aerospace physicians

  12. When worlds collide: medicine, business, the Affordable Care Act and the future of health care in the U.S.

    Science.gov (United States)

    Wicks, Andrew C; Keevil, Adrian A C

    2014-01-01

    The dialogue about the future of health care in the US has been impeded by flawed conceptions about medicine and business. The present paper re-examines some of the underlying assumptions about both medicine and business, and uses more nuanced readings of both terms to frame debates about the ACA and the emerging health care environment. © 2014 American Society of Law, Medicine & Ethics, Inc.

  13. Formative Research to Identify Perceptions of E-Cigarettes in College Students: Implications for Future Health Communication Campaigns

    Science.gov (United States)

    Case, Kathleen; Crook, Brittani; Lazard, Allison; Mackert, Michael

    2016-01-01

    Objective: This formative study examined perceptions of e-cigarettes in college students with the goal of informing future health communication campaigns. Differences between e-cigarette users and nonusers were also examined. Participants: Thirty undergraduate students were recruited from a large southwestern public university (15 users, 15…

  14. Damaging the Future: The Health Rights of Children and the Issue of Short-Termism; Issues Facing Australian Bioethicists.

    Science.gov (United States)

    Dalton-Brown, Sally

    2018-07-01

    This article considers recent ethical topics in Australia relating to the health rights of children in the contexts of (1) detention centers, (2) vaccination, and (3) procreative liberty, within a wider framework of discussion of the competing rights of society, parents, the child, and future generations.

  15. The importance of determining the air exchange rate in flats and buildings for calculations of the averted indoor inhalation doses arising from contaminated outdoor air

    International Nuclear Information System (INIS)

    Jilek, Karel; Thomas, J.; Bulanek, B.; Lenk, J.; Marikova, S.

    2015-01-01

    The indoor-outdoor air exchange rate is an important parameter when refining estimates of the averted inhaled doses to population in houses and buildings after an emergency event resulting in contamination of outdoor air with a radioactive material. The air exchange rates measured in 70 occupied houses and in 20 unoccupied houses using N 2 O as the tracer gas are presented, and the results of modelling the averted doses in the residential buildings for both gaseous and aerosol outdoor contaminants are demonstrated. (orig.)

  16. Caribbean Heat Threatens Health, Well-being and the Future of Humanity

    OpenAIRE

    Macpherson, Cheryl C.; Akpinar-Elci, Muge

    2015-01-01

    Climate change has substantial impacts on public health and safety, disease risks and the provision of health care, with the poor being particularly disadvantaged. Management of the associated health risks and changing health service requirements requires adequate responses at local levels. Health-care providers are central to these responses. While climate change raises ethical questions about its causes, impacts and social justice, medicine and bioethics typically focus on individual patien...

  17. Family members and health professionals' perspectives on future life planning of ageing people with Down syndrome: a qualitative study.

    Science.gov (United States)

    Covelli, Venusia; Raggi, Alberto; Paganelli, Chiara; Leonardi, Matilde

    2017-08-08

    To address the way in which primary caregivers of people over 45 with Down syndrome describe daily life activities and context and foresee their future. Thirteen family members and 15 health professionals participated to four focus groups. Meaningful concepts were identified and linked to the International Classification of Functioning, Disability and Health using established linking rules. A total of 258 relevant concepts were identified and linked to 75 categories of the classification: 38 were from activity and participation and 17 from environmental factors domains. The most commonly reported issues were mental functions (b117-intellectual functions and b152-emotional functions), community life activities (d910-community life and d920-recreation and leisure) and environmental factors (e310-support of immediate family, e355-support from health professionals and e555-associations and organizational services). Information on the daily life and health of ageing people with Down syndrome is important to plan social and health care interventions tailored to deal with problems that they may encounter in older age. Considering the interaction between health and environment and maintaining a continuity of daily routines were reported as the most relevant topics for managing daily lives of persons with Down syndrome in older ages. Implications for rehabilitation Pay more attention to the interaction between environmental factors and health condition in ageing people with Down syndrome. Information about the life contest are important in order to plan present and future social-health care interventions. Future planning for people with Down syndrome is a great concern for family members.

  18. [Global Public Health - Results of the Working Group 3 of the Forum Future Public Health, Berlin 2016].

    Science.gov (United States)

    Razum, Oliver; Zeeb, Hajo

    2017-11-01

    In the age of globalization, few health issues remain "local". For example, neither infectious diseases nor climate change stop at national borders, and hence cannot be controlled only within the nation state. The same applies to smoking and nutritional behaviors that affect health and are influenced by multinational companies and transnational policies. Therefore, public health needs to develop strategies and interventions that are not restricted to the nation state alone. This also applies to public health in Germany that needs a stronger global health perspective. © Georg Thieme Verlag KG Stuttgart · New York.

  19. A Bridge Back to the Future: Public Health Ethics, Bioethics, and Environmental Ethics.

    Science.gov (United States)

    Lee, Lisa M

    2017-09-01

    Contemporary biomedical ethics and environmental ethics share a common ancestry in Aldo Leopold's and Van Rensselaer Potter's initial broad visions of a connected biosphere. Over the past five decades, the two fields have become strangers. Public health ethics, a new subfield of bioethics, emerged from the belly of contemporary biomedical ethics and has evolved over the past 25 years. It has moved from its traditional concern with the tension between individual autonomy and community health to a wider focus on social justice and solidarity. Public health has a broad focus that includes individual, community, and environmental health. Public health ethics attends to these broad commitments reflected in the increasing concern with the connectedness of health of individuals to the health of populations, to the health of animals, to the health of the environment; it is well situated to reconnect all three "fields" of ethics to promote a healthier planet.

  20. City Leadership for Health and Well-being: Back to the Future

    OpenAIRE

    Tsouros, Agis

    2013-01-01

    The new European Health Policy Framework and Strategy: Health 2020 of the World Health Organization, draws upon the experience and insights of five phases, spanning 25 years, of the WHO European Healthy Cities Network (WHO-EHCN). Applying the 2020 health lens to Healthy Cities, equity in health and human-centered sustainable development are core values and cities have a profound influence on the wider determinants of health in the European population. “Making it Happen” relies on four action ...

  1. The health literacy demands of electronic personal health records (e-PHRs): An integrative review to inform future inclusive research.

    Science.gov (United States)

    Hemsley, Bronwyn; Rollo, Megan; Georgiou, Andrew; Balandin, Susan; Hill, Sophie

    2018-01-01

    To integrate the findings of research on electronic personal health records (e-PHRs) for an understanding of their health literacy demands on both patients and providers. We sought peer-reviewed primary research in English addressing the health literacy demands of e-PHRs that are online and allow patients any degree of control or input to the record. A synthesis of three theoretical models was used to frame the analysis of 24 studies. e-PHRs pose a wide range of health literacy demands on both patients and health service providers. Patient participation in e-PHRs relies not only on their level of education and computer literacy, and attitudes to sharing health information, but also upon their executive function, verbal expression, and understanding of spoken and written language. The multiple health literacy demands of e-PHRs must be considered when implementing population-wide initiatives for storing and sharing health information using these systems. The health literacy demands of e-PHRs are high and could potentially exclude many patients unless strategies are adopted to support their use of these systems. Developing strategies for all patients to meet or reduce the high health literacy demands of e-PHRs will be important in population-wide implementation. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Human and animal health risk assessments of chemicals in the food chain: Comparative aspects and future perspectives

    International Nuclear Information System (INIS)

    Dorne, J.L.C.M.; Fink-Gremmels, J.

    2013-01-01

    Chemicals from anthropogenic and natural origins enter animal feed, human food and water either as undesirable contaminants or as part of the components of a diet. Over the last five decades, considerable efforts and progress to develop methodologies to protect humans and animals against potential risks associated with exposure to such potentially toxic chemicals have been made. This special issue presents relevant methodological developments and examples of risk assessments of undesirable substances in the food chain integrating the animal health and the human health perspective and refers to recent Opinions of the Scientific Panel on Contaminants in the Food Chain (CONTAM) of the European Food Safety Authority (EFSA). This introductory review aims to give a comparative account of the risk assessment steps used in human health and animal health risk assessments for chemicals in the food chain and provides a critical view of the data gaps and future perspectives for this cross-disciplinary field. - Highlights: ► Principles of human and animal health risk assessment. ► Data gaps for each step of animal health risk assessment. ► Implications of animal risk assessment on human risk assessment. ► Future perspectives on chemical risk assessment

  3. Human and animal health risk assessments of chemicals in the food chain: Comparative aspects and future perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Dorne, J.L.C.M., E-mail: jean-lou.dorne@efsa.europa.eu [Emerging Risk Unit, Via Carlo Magno 1A, 43126 Parma (Italy); Fink-Gremmels, J. [Utrecht University, Faculty of Veterinary Medicine, Institute for Risk Assessment Sciences, Yalelaan 104, 3584 CM Utrecht (Netherlands)

    2013-08-01

    Chemicals from anthropogenic and natural origins enter animal feed, human food and water either as undesirable contaminants or as part of the components of a diet. Over the last five decades, considerable efforts and progress to develop methodologies to protect humans and animals against potential risks associated with exposure to such potentially toxic chemicals have been made. This special issue presents relevant methodological developments and examples of risk assessments of undesirable substances in the food chain integrating the animal health and the human health perspective and refers to recent Opinions of the Scientific Panel on Contaminants in the Food Chain (CONTAM) of the European Food Safety Authority (EFSA). This introductory review aims to give a comparative account of the risk assessment steps used in human health and animal health risk assessments for chemicals in the food chain and provides a critical view of the data gaps and future perspectives for this cross-disciplinary field. - Highlights: ► Principles of human and animal health risk assessment. ► Data gaps for each step of animal health risk assessment. ► Implications of animal risk assessment on human risk assessment. ► Future perspectives on chemical risk assessment.

  4. Social Media Technology and Public Health in Ontario: Findings from a Planning Meeting Exploring Current Practices and Future Research Directions.

    Science.gov (United States)

    Booth, Richard; McMurray, Josephine; Regan, Sandra; Kothari, Anita; Donelle, Lorie; McBride, Susan; Sobel, Annette; Hall, Jodi; Fraser, Robert; Foisey, Lyndsay

    2017-01-01

    In the province of Ontario, many of the public health units (PHUs) now possess and use social media as part of their daily health promotion and communication operations. To explore this topic, a planning meeting was held to generate deeper insights toward the use of these forms of technology for preventative services delivery. The planning meeting was held with 50 participants, comprising representatives from 20 of the 36 PHUs in Ontario, interested academics, students and government representatives. A nominal group technique (NGT) was used to build consensus related to future research needs, as related to public health and social media. Participants generated a range of insights around the use of social media, including the need for: leadership buy-in and resource allocation; social media policy and governance structure; performance measurement and evaluation; practices related to engagement with program recipients and addressing the lack of resources faced by many health units. Future research priorities were also generated, related to evaluating the cost-benefit of social media activities and understanding behaviour change implications. Further research is needed to evaluate the functionality, leadership and competency requirements and impact(s) of these new forms of health communication technology within public health service delivery. Copyright © 2017 Longwoods Publishing.

  5. In their own words: older male prisoners' health beliefs and concerns for the future.

    Science.gov (United States)

    Loeb, Susan J; Steffensmeier, Darrell; Myco, Priscilla M

    2007-01-01

    U.S. prisons are experiencing an exponential growth in inmates aged 50 years and older, a group with disproportionately high disease burden. The purpose of this study was to examine, in largely exploratory terms, the health beliefs and concerns of older male inmates and the health challenges they anticipate facing upon their return to the community. Results indicate that there is much to be gained from the assessments and insights of older prisoners with regard to health changes that occur during incarceration, health programs that they desire, the reasons for their confidence (or lack thereof) in health self-management, and fears about their health upon release. Geriatric nurses are well positioned to heed these important insights of inmates and translate them into steps for 1) preventing many of the health deteriorations experienced by older prisoners and 2) advocating for more seamless health care when incarcerated offenders transition back into the community.

  6. 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.

  7. The predictive validity of the HERO Scorecard in determining future health care cost and risk trends.

    Science.gov (United States)

    Goetzel, Ron Z; Henke, Rachel Mosher; Benevent, Richele; Tabrizi, Maryam J; Kent, Karen B; Smith, Kristyn J; Roemer, Enid Chung; Grossmeier, Jessica; Mason, Shawn T; Gold, Daniel B; Noeldner, Steven P; Anderson, David R

    2014-02-01

    To determine the ability of the Health Enhancement Research Organization (HERO) Scorecard to predict changes in health care expenditures. Individual employee health care insurance claims data for 33 organizations completing the HERO Scorecard from 2009 to 2011 were linked to employer responses to the Scorecard. Organizations were dichotomized into "high" versus "low" scoring groups and health care cost trends were compared. A secondary analysis examined the tool's ability to predict health risk trends. "High" scorers experienced significant reductions in inflation-adjusted health care costs (averaging an annual trend of -1.6% over 3 years) compared with "low" scorers whose cost trend remained stable. The risk analysis was inconclusive because of the small number of employers scoring "low." The HERO Scorecard predicts health care cost trends among employers. More research is needed to determine how well it predicts health risk trends for employees.

  8. Early food for future health: a randomized controlled trial evaluating the effect of an eHealth intervention aiming to promote healthy food habits from early childhood.

    Science.gov (United States)

    Helle, Christine; Hillesund, Elisabet Rudjord; Omholt, Mona Linge; Øverby, Nina Cecilie

    2017-09-20

    Childhood overweight and obesity is a global public health challenge. Primary prevention initiatives targeting parents have been called for to encourage a positive feeding environment and healthy eating habits that may lay a good foundation for future health. At the same time, there is a need for interventions which combine accessibility and scalability with cost effectiveness. Today's parents are extensive Internet-users, but only a few randomized controlled trials have investigated the use of Internet to promote healthy eating habits in early childhood. In Early Food for Future Health we have developed and will evaluate an Internet-based tool for parents of children between 6 and 12 months, aiming to increase knowledge about infant nutrition and foster protective feeding behavior. During springtime 2016, parents of children aged between 3 and 5 months were recruited through Norwegian child health centres and announcements on Facebook. After completing the baseline questionnaire, 718 parents were individually randomized to intervention- or control group. The intervention group received monthly emails with links to an age-appropriate web-site when their child was between 6 and 12 months. The control group received ordinary care from the child health centres. The data-collection is ongoing. All participants will be followed up at ages 12 and possibly 24 and 48 months, with questionnaires relating to eating behaviour and feeding practices, food variety and diet quality. Providing guidance and counseling to parents of infants is an important task for health authorities and the public child health services. Early Food for Future health is an intervention focusing on promoting early healthy food-habits which may prevent childhood overweight and obesity. If proven to be effective, Early Food for Future Health can be used by parents and public health nurses for supplementary guidance on feeding practices and diet. This study has the potential to provide greater

  9. Averting Dementia of the Alzheimer's Type in Women: Can Counselors Help?

    Science.gov (United States)

    Douthit, Kathryn Z.

    2007-01-01

    Alzheimer's disease (AD) is the most common cause of dementia in late life, taking its greatest toll on women over age 80. This article provides an overview of AD, including risk factors and counseling strategies targeting risk. Counseling strategies address stress, cardiovascular health, social integration, depression, and holistic wellness.

  10. Perception of violence against women among future health professionals in an industrial township

    Directory of Open Access Journals (Sweden)

    Siddharth Agrawal

    2010-01-01

    Full Text Available Background: There is a growing concern that medical education does not prepare the future health professional to effectively deal with violence against women. Against this background, the present study was undertaken. Aims: To elicit perception of violence against women among medical and nursing students, and study the association of these perceptions with certain demographic and social variables. Settings and Design: The study was conducted among students of a Medical College and a Nursing College both located at Pune, India. A cross-sectional descriptive study design was used to elicit the perceptions of the study subjects toward violence against women. Materials and Methods: A random sample of 125 medical and 125 nursing students was selected. Both quantitative and qualitative methods of data collection were employed. Qualitative data collection was done by focus group discussions with key persons such as dean and faculty of medical and nursing colleges. The syllabi of medical and nursing colleges were also reviewed for any topic related to domestic violence. Statistical analysis: The WHO/CDC Statistical and Epidemiology Software Package was used for data entry and statistical analysis. Various associations were explored by nonparametric tests (Mann-Whitney for ordinal data and by Chi-square and ODDS ratio (with 95% confidence intervals, for categorical data. Results: Overall 35.6% (95% CI 29.1%-42.6% of the study participants had witnessed/were aware of violence against women among their family/acquaintances. This awareness was significantly more among female respondents (OR=2.65, 95% CI 1.37-5.16, Chi Sq=9.81, df=1, P=0.001. Other socioeconomic variables such as urban/rural background, education, and income were not associated with perception about family violence. Majority (>80% agreed/strongly agreed that social agencies should do more to help battered women. Course content on violence against women was lacking in both medical and nursing

  11. Part A: Countermeasures to be taken after 1990 to ensure safe living conditions for the population affected by the Chernobyl accident in the USSR. A first evaluation of costs and doses averted

    International Nuclear Information System (INIS)

    Lochard, J.; Schneider, T.

    1992-01-01

    This part presents a first estimate of the cost and averted collective exposure of the potential relocation of the population from the affected territories of the BSSR, the RSFSR and the UKrSSR, to improve their living conditions following the Chernobyl accident. It is an input to the evaluation of the radiological consequences of the Chernobyl accident in the USSR. The general objective was to assess 'the concept which the USSR has evolved to enable the population to live safely in areas affected by radioactive contamination following the Chernobyl accident, and an evaluation of the effectiveness of the steps taken in these areas to safeguard the health of the population'. Specifically, this work aimed at evaluating protective measures from 1990 onwards

  12. Lay perceptions of current and future health, the causes of illness, and the nature of recovery: explaining health and illness in Malaysia.

    Science.gov (United States)

    Swami, Viren; Arteche, Adriane; Chamorro-Premuzic, Tomas; Maakip, Ismail; Stanistreet, Debbi; Furnham, Adrian

    2009-09-01

    This study examined beliefs about the causes and determinants of health, illness, and recovery in an opportunistic sample from Malaysia. In all, 371 women and 350 men completed the Health and Illness Scale, a 124-item scale that examined beliefs about current and future health, and beliefs about the causes of illness and recovery. Each of the four subscales of the Health Illness Scale were factor analysed to reveal the underlying structure. Results showed the emergence of a number of distinct factors in the case of each subscale, of which environmental, life-style, psychological, religious, and fate-related factors were fairly stable across subscales. Results also showed a number of differences in beliefs between religious groups, and that religiosity and sex were the strongest predictors of beliefs across the four subscales. The results are discussed in terms of the available cross-cultural literature on lay beliefs about health.

  13. The historical, present, and future role of veterinarians in One Health.

    Science.gov (United States)

    Gibbs, Samantha E J; Gibbs, E Paul J

    2013-01-01

    The renewed interest in the concept of One Health has occurred as a result of the increased emergence of zoonotic infectious diseases over the past decade. The subsequent impacts of these diseases on human, livestock, and wildlife health, as well as the economic effects, have given international health organizations and national governments a greater appreciation of the importance of collaborative efforts in solving health problems. The One Health concept is not new, but under its umbrella, a new generation of veterinarians, physicians, ecologists, biologists, and social scientists is shaping the concept in novel ways. This has led to increased support for One Health initiatives to control disease by international agencies, national governments, and nongovernmental organizations as well as a growing emphasis on One Health concepts in training the veterinary workforce. Veterinary schools are reorganizing veterinary education to better teach students the precepts of One Health. This chapter explores the evolution and application of the One Health concept from the perspective of the veterinarian. The veterinary profession is positioned to be a strong advocate and leader of One Health. Veterinarians have a long history of involvement with One Health activities, and this involvement has adjusted and shifted with the changing needs of society. A new area of work for veterinarians is ecosystem health, which is becoming more relevant as a result of the impact that the ever-increasing human population is having on the environment that supports them.

  14. Designing serious video games for health behavior change: Current status and future directions

    Science.gov (United States)

    Serious video games for health are designed to entertain while changing a specific health behavior. This article identifies behavioral principles that can guide the development of serious video games focused on changing a variety of health behaviors, including those attempting to decrease risk of o...

  15. USING RISK-BASED CORRECTIVE ACTION (RBCA) TO ASSESS (THEORETICAL) CANCER DEATHS AVERTED COMPARED TO THE (REAL) COST OF ENVIRONMENTAL REMEDIATION

    International Nuclear Information System (INIS)

    Miller, M. L.; Hylko, J. M.

    2002-01-01

    In 1978, on the basis of existing health studies at the time, the Uranium Mill Tailings Remedial Action (UMTRA) Project legislation was proposed that would authorize remedial action at inactive uranium processing sites and vicinity properties. The cost of the program to the Federal Government was expected to be $180 million. With the completion of this project, approximately 1300 theoretical cancer deaths were prevented in the next 100 years at a cost of $1.45 billion, based on the Fiscal Year 1998 Federal UMTRA budget. The individual site costs ranged from $0.2 million up to $18 billion spent per theoretical cancer death averted over the next 100 years. Resources required to sustain remediation activities such as this are subject to reduction over time, and are originally based on conservative assumptions that tend to overestimate risks to the general public. This evaluation used a process incorporating risk-based corrective action (RBCA); a three-tiered, decision-making process tailoring corrective action activities according to site-specific conditions and risks. If RBCA had been applied at the start of the UMTRA Project, and using a criterion of >1 excess cancer death prevented as justification to remediate the site, only 50% of the existing sites would have been remediated, yielding a cost savings of $303.6 million to the Federal Government and affected States, which share 10% of the cost. This cost savings equates to 21% of the overall project budget. In addition, only 22% of the vicinity properties had structural contamination contributing to elevated interior gamma exposure and radon levels. Focusing only on these particular properties could have saved an additional $269.3 million, yielding a total savings of $573 million; 40% of the overall project budget. As operational experience is acquired, including greater understanding of the radiological and nonradiological risks, decisions should be based on the RBCA process, rather than relying on conservative

  16. Effects of episodic future thinking on discounting: Personalized age-progressed pictures improve risky long-term health decisions.

    Science.gov (United States)

    Kaplan, Brent A; Reed, Derek D; Jarmolowicz, David P

    2016-03-01

    Many everyday choices are associated with both delayed and probabilistic outcomes. The temporal attention hypothesis suggests that individuals' decision making can be improved by focusing attention on temporally distal events and implies that environmental manipulations that bring temporally distal outcomes into focus may alter an individual's degree of discounting. One such manipulation, episodic future thinking, has shown to lower discount rates; however, several questions remain about the applicability of episodic future thinking to domains other than delay discounting. The present experiments examine the effects of a modified episodic-future-thinking procedure in which participants viewed age-progressed computer-generated images of themselves and answered questions related to their future, on probability discounting in the context of both a delayed health gain and loss. Results indicate that modified episodic future thinking effectively altered individuals' degree of discounting in the predicted directions and demonstrate the applicability of episodic future thinking to decision making of socially significant outcomes. © 2015 Society for the Experimental Analysis of Behavior.

  17. Global mHealth policy arena: status check and future directions.

    Science.gov (United States)

    Malvey, Donna M; Slovensky, Donna J

    2017-01-01

    In this review, we examine an important piece of the mHealth puzzle that has received scant attention-health policy. The question is whether health policy ultimately will serve to unite nations in advancing global mHealth or, as Mars and Scott suggested in 2010, keep nations isolated and ultimately making their policy decisions in "eHealth silos". Such a non-collaborative approach seriously hampers the potential for using mobile health technologies to deliver health care across borders, assuring individuals access to affordable, convenient, and quality healthcare in underserved regions. From a global perspective, mHealth policy review is difficult as some important policies may be subsumed in comprehensive planning and strategy documents. Political, environmental, economic, organizational, and technology disparities across nations represent a significant impediment to developing mHealth products and services that can be deployed globally. To date, there is modest evidence that such challenges are being addressed. Even though payers can encourage adoption of mHealth with financial incentives for use, it appears that payment or reimbursement tends to be a roadblock for almost all nations, whether they are emerging or developed. If payment for mHealth services is not guaranteed, business models will not be sustainable and providers will have fewer opportunities for scalability. Furthermore, because mHealth policies typically are subject to some type of government scrutiny and oversight, many product developers and entrepreneurs may turn elsewhere for their investments. Global resource scarcity also challenges optimal mHealth deployment, and governments seek to ensure improved population health outcomes as return on their mHealth investments. Unfortunately, such justification is difficult as evaluation methods simply have not kept pace with mHealth technology capability. Requisite measurement tools are sorely lacking when it comes to evaluating efficacy of mHealth

  18. Positive and negative affect in the future teacher: relationships with their academic achievement, mental health and satisfaction with life

    Directory of Open Access Journals (Sweden)

    Ruth Pinedo González

    2017-02-01

    Full Text Available Affects are composed of two key dimensions: the positive affect (PA and negative affect (NA. Both dimensions are related to psychological adjustment of the person and life satisfaction. This study is exploratory in nature and aims to make a first correlational analysis between different constructs: emotional disposition, academic achievement, mental health and life satisfaction in a sample of 143 student teachers. We have used the following scales adapted to the culture: The Positive and Negative Affect Schedule (PANAS, the Mental Health Inventory (MHI-5 and the Satisfaction With Life Scale (SWLS. Among the most interesting results it was found that positive affect was associated with academic achievement, mental health and life satisfaction. Positive and negative affects and satisfaction with life were formed as predictors of future teachers’ mental health. Extensive analysis and discussion of the results is included in the document.

  19. Psychosocial adjustment and mental health in former child soldiers--systematic review of the literature and recommendations for future research.

    Science.gov (United States)

    Betancourt, Theresa S; Borisova, Ivelina; Williams, Timothy P; Meyers-Ohki, Sarah E; Rubin-Smith, Julia E; Annan, Jeannie; Kohrt, Brandon A

    2013-01-01

    This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age reintegration in CAAFAG. Abduction, age of conscription, exposure to violence, gender, and community stigma were associated with increased internalizing and externalizing mental health problems. Family acceptance, social support, and educational/economic opportunities were associated with improved psychosocial adjustment. Research on the social reintegration and psychosocial adjustment of former child soldiers is nascent. A number of gaps in the available literature warrant future study. Recommendations to bolster the evidence base on psychosocial adjustment in former child soldiers and other war-affected youth include more studies comprising longitudinal study designs, and validated cross-cultural instruments for assessing mental health, as well as more integrated community-based approaches to study design and research monitoring. © 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.

  20. Human and animal health risk assessments of chemicals in the food chain: comparative aspects and future perspectives.

    Science.gov (United States)

    Dorne, J L C M; Fink-Gremmels, J

    2013-08-01

    Chemicals from anthropogenic and natural origins enter animal feed, human food and water either as undesirable contaminants or as part of the components of a diet. Over the last five decades, considerable efforts and progress to develop methodologies to protect humans and animals against potential risks associated with exposure to such potentially toxic chemicals have been made. This special issue presents relevant methodological developments and examples of risk assessments of undesirable substances in the food chain integrating the animal health and the human health perspective and refers to recent Opinions of the Scientific Panel on Contaminants in the Food Chain (CONTAM) of the European Food Safety Authority (EFSA). This introductory review aims to give a comparative account of the risk assessment steps used in human health and animal health risk assessments for chemicals in the food chain and provides a critical view of the data gaps and future perspectives for this cross-disciplinary field. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. The present and future roles of Traditional Health Practitioners within the formal healthcare sector of South Africa, as guided by the Traditional Health Practitioners Act No 22 (2007

    Directory of Open Access Journals (Sweden)

    Gabriel Louw

    2016-12-01

    Full Text Available Background The promulgation of the Traditional Health Practitioners Act No 22 (2007 was seen as the long awaited start-up of the traditional healing profession in South Africa. Act No 22 (2007 was strongly politically driven from the late 1960s onward. Many of these political motivators were based upon outdated cultural ideas, customs and traditions, rooted outside the modern day healthcare needs and demands of the particular population that traditional healing intends to serve. An in-depth needs and skills analysis, to test the viability and sustainability of the South African traditional healers as well as their positions and roles as health practitioners inside the formal healthcare sector, as guided and stipulated by the Traditional Health Practitioners Act No 22 (2007, was lacking in this early development and start-up process. This resulted in the traditional healers’ present and future roles as specific healthcare practitioners being both undefined and insufficiently formulated. In addition their existing education, training, skills and abilities to compete in the formal healthcare sector were ignored. Therefore, since the promulgation of the Act in 2007, there was limited professional-development for traditional healers, to improve their immediate professionalism and thus to promote effective role-playing and management in the formal healthcare sector. The South African traditional healing professional model is still in the foundational stage of its professional development; a stage which the other registered/regulated healthcare practitioners of the country surpassed long ago, making them well-equipped for role-playing and management as health professionals in the formal healthcare sector. The whole venture of the statutory recognition of the traditional health practitioners in 2007 as new healthcare professionals with the promulgation of the Traditional Health Practitioners Act No 22 (2007 seems to increasingly be a failure. There is

  2. Effectiveness and future prospects of telemedicine/remote health care management applications in Pakistan

    International Nuclear Information System (INIS)

    Iqbal, S.; Khan, N.

    2017-01-01

    Medical/Health care system is spraining in Pakistan because of innovative technology, activities and services as per their financial cost (position) which is increasing day by day. This research is intended for the assessment of Telemedicine/Remote Health Care Management practices (system), which encompasses usability, acceptance and impact in public/private hospitals. To improve the existing remote health care/telemedicine practices in Pakistan by using EM (Engineering Management) based approach. It has been widely and successfully implemented and is considered as a strategic and operational tool. In the 21st century due to the Technological advancements the mode of operation of service and business sector have been changed drastically. In the same way the health sectors activities also have been altered, new methods and techniques have also been devised for the treatment of the patients that were never even thought before. In the health sector Telemedicine/Remote Health Care Management is one of the development which was experienced lately. Telemedicine/Remote Health Careistaken exactly "medicine at a distance". Therefore, hypothetically, some procedures performed with medication which does not take place "face-to-face"and"in person"which can be considered as Telemedicine/Remote Health Care. In the industrialized world telemedicine is being used in full capacity to provide the health care services to remote and un-accessible areas. But Telemedicine/Remote Health Care Management is not very popular and admired in Pakistan; few applications are being functional presently. (author)

  3. Climate Change and Health on the U.S. Gulf Coast: Public Health Adaptation is Needed to Address Future Risks.

    Science.gov (United States)

    Petkova, Elisaveta P; Ebi, Kristie L; Culp, Derrin; Redlener, Irwin

    2015-08-11

    The impacts of climate change on human health have been documented globally and in the United States. Numerous studies project greater morbidity and mortality as a result of extreme weather events and other climate-sensitive hazards. Public health impacts on the U.S. Gulf Coast may be severe as the region is expected to experience increases in extreme temperatures, sea level rise, and possibly fewer but more intense hurricanes. Through myriad pathways, climate change is likely to make the Gulf Coast less hospitable and more dangerous for its residents, and may prompt substantial migration from and into the region. Public health impacts may be further exacerbated by the concentration of people and infrastructure, as well as the region's coastal geography. Vulnerable populations, including the very young, elderly, and socioeconomically disadvantaged may face particularly high threats to their health and well-being. This paper provides an overview of potential public health impacts of climate variability and change on the Gulf Coast, with a focus on the region's unique vulnerabilities, and outlines recommendations for improving the region's ability to minimize the impacts of climate-sensitive hazards. Public health adaptation aimed at improving individual, public health system, and infrastructure resilience is urgently needed to meet the challenges climate change may pose to the Gulf Coast in the coming decades.

  4. Climate Change and Health on the U.S. Gulf Coast: Public Health Adaptation is Needed to Address Future Risks

    Directory of Open Access Journals (Sweden)

    Elisaveta P. Petkova

    2015-08-01

    Full Text Available The impacts of climate change on human health have been documented globally and in the United States. Numerous studies project greater morbidity and mortality as a result of extreme weather events and other climate-sensitive hazards. Public health impacts on the U.S. Gulf Coast may be severe as the region is expected to experience increases in extreme temperatures, sea level rise, and possibly fewer but more intense hurricanes. Through myriad pathways, climate change is likely to make the Gulf Coast less hospitable and more dangerous for its residents, and may prompt substantial migration from and into the region. Public health impacts may be further exacerbated by the concentration of people and infrastructure, as well as the region’s coastal geography. Vulnerable populations, including the very young, elderly, and socioeconomically disadvantaged may face particularly high threats to their health and well-being. This paper provides an overview of potential public health impacts of climate variability and change on the Gulf Coast, with a focus on the region’s unique vulnerabilities, and outlines recommendations for improving the region’s ability to minimize the impacts of climate-sensitive hazards. Public health adaptation aimed at improving individual, public health system, and infrastructure resilience is urgently needed to meet the challenges climate change may pose to the Gulf Coast in the coming decades.

  5. Gene therapy: charting a future course--summary of a National Institutes of Health Workshop, April 12, 2013.

    Science.gov (United States)

    O'Reilly, Marina; Federoff, Howard J; Fong, Yuman; Kohn, Donald B; Patterson, Amy P; Ahmed, Nabil; Asokan, Aravind; Boye, Shannon E; Crystal, Ronald G; De Oliveira, Satiro; Gargiulo, Linda; Harper, Scott Q; Ikeda, Yasuhiro; Jambou, Robert; Montgomery, Maureen; Prograis, Lawrence; Rosenthal, Eugene; Sterman, Daniel H; Vandenberghe, Luk H; Zoloth, Laurie; Abedi, Mehrdad; Adair, Jennifer; Adusumilli, Prasad S; Goins, William F; Gray, Jhanelle; Monahan, Paul; Popplewell, Leslie; Sena-Esteves, Miguel; Tannous, Bakhos; Weber, Thomas; Wierda, William; Gopal-Srivastava, Rashmi; McDonald, Cheryl L; Rosenblum, Daniel; Corrigan-Curay, Jacqueline

    2014-06-01

    Recently, the gene therapy field has begun to experience clinical successes in a number of different diseases using various approaches and vectors. The workshop Gene Therapy: Charting a Future Course, sponsored by the National Institutes of Health (NIH) Office of Biotechnology Activities, brought together early and mid-career researchers to discuss the key scientific challenges and opportunities, ethical and communication issues, and NIH and foundation resources available to facilitate further clinical advances.

  6. Gene Therapy: Charting a Future Course—Summary of a National Institutes of Health Workshop, April 12, 2013

    Science.gov (United States)

    O'Reilly, Marina; Federoff, Howard J.; Fong, Yuman; Kohn, Donald B.; Patterson, Amy P.; Ahmed, Nabil; Asokan, Aravind; Boye, Shannon E.; Crystal, Ronald G.; De Oliveira, Satiro; Gargiulo, Linda; Harper, Scott Q.; Ikeda, Yasuhiro; Jambou, Robert; Montgomery, Maureen; Prograis, Lawrence; Rosenthal, Eugene; Sterman, Daniel H.; Vandenberghe, Luk H.; Zoloth, Laurie; Abedi, Mehrdad; Adair, Jennifer; Adusumilli, Prasad S.; Goins, William F.; Gray, Jhanelle; Monahan, Paul; Popplewell, Leslie; Sena-Esteves, Miguel; Tannous, Bakhos; Weber, Thomas; Wierda, William; Gopal-Srivastava, Rashmi; McDonald, Cheryl L.; Rosenblum, Daniel

    2014-01-01

    Abstract Recently, the gene therapy field has begun to experience clinical successes in a number of different diseases using various approaches and vectors. The workshop Gene Therapy: Charting a Future Course, sponsored by the National Institutes of Health (NIH) Office of Biotechnology Activities, brought together early and mid-career researchers to discuss the key scientific challenges and opportunities, ethical and communication issues, and NIH and foundation resources available to facilitate further clinical advances. PMID:24773122

  7. Labor Health Shortage and Future Prospects for the Medical Workforce in Morocco

    OpenAIRE

    Zouag, Nada; Driouchi, Ahmed; Achehboune, Amale

    2015-01-01

    Abstract This paper looks at the current situation of health deficits and shortages in Morocco with a focus on the roles of medical education and prospects for the health workforce for the period 2010-2030. The attained results from both trend description and simulations of patterns show major shortages relative to the needs. The existence of these trends appeals for further cooperation in the areas of health care through emphasis on medical education and research. These outcomes appear to be...

  8. Designing Serious Video Games for Health Behavior Change: Current Status and Future Directions

    OpenAIRE

    Thompson, Debbe

    2012-01-01

    Serious video games for health are designed to entertain while changing a specific health behavior. This article identifies behavioral principles that can guide the development of serious video games focused on changing a variety of health behaviors, including those attempting to decrease risk of obesity and type 2 diabetes. Guidelines discussed include how to develop video games that provide a solid foundation for behavior change by enhancing a player’s knowledge and skill, ways in which per...

  9. Integrating Environmental and Human Health Databases in the Great Lakes Basin: Themes, Challenges and Future Directions

    Directory of Open Access Journals (Sweden)

    Kate L. Bassil

    2015-03-01

    Full Text Available Many government, academic and research institutions collect environmental data that are relevant to understanding the relationship between environmental exposures and human health. Integrating these data with health outcome data presents new challenges that are important to consider to improve our effective use of environmental health information. Our objective was to identify the common themes related to the integration of environmental and health data, and suggest ways to address the challenges and make progress toward more effective use of data already collected, to further our understanding of environmental health associations in the Great Lakes region. Environmental and human health databases were identified and reviewed using literature searches and a series of one-on-one and group expert consultations. Databases identified were predominantly environmental stressors databases, with fewer found for health outcomes and human exposure. Nine themes or factors that impact integration were identified: data availability, accessibility, harmonization, stakeholder collaboration, policy and strategic alignment, resource adequacy, environmental health indicators, and data exchange networks. The use and cost effectiveness of data currently collected could be improved by strategic changes to data collection and access systems to provide better opportunities to identify and study environmental exposures that may impact human health.

  10. City leadership for health and well-being: back to the future.

    Science.gov (United States)

    Tsouros, Agis

    2013-10-01

    The new European Health Policy Framework and Strategy: Health 2020 of the World Health Organization, draws upon the experience and insights of five phases, spanning 25 years, of the WHO European Healthy Cities Network (WHO-EHCN). Applying the 2020 health lens to Healthy Cities, equity in health and human-centered sustainable development are core values and cities have a profound influence on the wider determinants of health in the European population. "Making it Happen" relies on four action elements applied and tested by municipalities and their formal and informal partners: political commitment, vision and strategy, institutional change, and networking. In turn, the renewed commitment by member states of the WHO Regional Committee to work with all spheres and tiers of government is a new dawn for city governance, encouraging cities to redouble their investment in health and health equity in all policies, even in a period of austerity. For phase VI, the WHO-EHCN is being positioned as a strategic vehicle for implementing Health 2020 at the local level. Healthy Cities' leadership is more relevant than ever.

  11. Perception of Health Risk and Averting Behavior: An Analysis of Household Water Consumption in Southwest Sri Lanka

    OpenAIRE

    Nauges, Céline; Van Den Berg, Caroline

    2009-01-01

    Using household data from surveys made in Sri Lanka, we provide original results regarding i) factors driving the perception of risk related to water consumption and ii) the role of perceived risk on household’s decision to treat water before drinking it. First, we find evidence that water aesthetic attributes (taste, smell, and color), household’s education and information about hygiene practices drive household’s assessment of safety risk. Second, we show that a higher perceived risk increa...

  12. Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health.

    Science.gov (United States)

    Stephenson, Judith; Heslehurst, Nicola; Hall, Jennifer; Schoenaker, Danielle A J M; Hutchinson, Jayne; Cade, Janet E; Poston, Lucilla; Barrett, Geraldine; Crozier, Sarah R; Barker, Mary; Kumaran, Kalyanaraman; Yajnik, Chittaranjan S; Baird, Janis; Mishra, Gita D

    2018-05-05

    A woman who is healthy at the time of conception is more likely to have a successful pregnancy and a healthy child. We reviewed published evidence and present new data from low-income, middle-income, and high-income countries on the timing and importance of preconception health for subsequent maternal and child health. We describe the extent to which pregnancy is planned, and whether planning is linked to preconception health behaviours. Observational studies show strong links between health before pregnancy and maternal and child health outcomes, with consequences that can extend across generations, but awareness of these links is not widespread. Poor nutrition and obesity are rife among women of reproductive age, and differences between high-income and low-income countries have become less distinct, with typical diets falling far short of nutritional recommendations in both settings and especially among adolescents. Several studies show that micronutrient supplementation starting in pregnancy can correct important maternal nutrient deficiencies, but effects on child health outcomes are disappointing. Other interventions to improve diet during pregnancy have had little effect on maternal and newborn health outcomes. Comparatively few interventions have been made for preconception diet and lifestyle. Improvements in the measurement of pregnancy planning have quantified the degree of pregnancy planning and suggest that it is more common than previously recognised. Planning for pregnancy is associated with a mixed pattern of health behaviours before conception. We propose novel definitions of the preconception period relating to embryo development and actions at individual or population level. A sharper focus on intervention before conception is needed to improve maternal and child health and reduce the growing burden of non-communicable diseases. Alongside continued efforts to reduce smoking, alcohol consumption, and obesity in the population, we call for heightened

  13. The future of health IT innovation and informatics: a report from AMIA's 2010 policy meeting

    Science.gov (United States)

    McGowan, Julie J; Cusack, Caitlin M

    2012-01-01

    While much attention has been paid to the short-term impact that widespread adoption of health information technology (health IT) will have on the healthcare system, there is a corresponding need to look at the long-term effects that extant policies may have on health IT system resilience, innovation, and related ethical, social/legal issues. The American Medical Informatics Association's 2010 Health Policy Conference was convened to further the national discourse on the issues surrounding these longer-term considerations. Conference participants self-selected into three broad categories: resilience in healthcare and health IT; ethical, legal, and social challenges; and innovation, adoption, and sustainability. The discussions about problem areas lead to findings focusing on the lack of encouragement for long-term IT innovation that may result from current health IT policies; the potential impact of uneven adoption of health IT based on the exclusions of the current financial incentives; the weaknesses of contingency and risk mitigation planning that threaten system resilience; and evolving standards developed in response to challenges relating to the security, integrity, and availability of electronic health information. This paper discusses these findings and also offers recommendations that address the interwoven topics of innovation, resilience, and adoption. The goal of this paper is to encourage public and private sector organizations that have a role in shaping health information policy to increase attention to developing a national strategy that assures that health IT innovation and resilience are not impeded by shorter-term efforts to implement current approaches emphasizing adoption and meaningful use of electronic health records. PMID:22037887

  14. Future Directions for Dissemination and Implementation Science: Aligning Ecological Theory and Public Health to Close the Research to Practice Gap.

    Science.gov (United States)

    Atkins, Marc S; Rusch, Dana; Mehta, Tara G; Lakind, Davielle

    2016-01-01

    Dissemination and implementation science (DI) has evolved as a major research model for children's mental health in response to a long-standing call to integrate science and practice and bridge the elusive research to practice gap. However, to address the complex and urgent needs of the most vulnerable children and families, future directions for DI require a new alignment of ecological theory and public health to provide effective, sustainable, and accessible mental health services. We present core principles of ecological theory to emphasize how contextual factors impact behavior and allow for the reciprocal impact individuals have on the settings they occupy, and an alignment of these principles with a public health model to ensure that services span the prevention to intervention continuum. We provide exemplars from our ongoing work in urban schools and a new direction for research to address the mental health needs of immigrant Latino families. Through these examples we illustrate how DI can expand its reach by embedding within natural settings to build on local capacity and indigenous resources, incorporating the local knowledge necessary to more substantively address long-standing mental health disparities. This paradigm shift for DI, away from an overemphasis on promoting program adoption, calls for fitting interventions within settings that matter most to children's healthy development and for utilizing and strengthening available community resources. In this way, we can meet the challenge of addressing our nation's mental health burden by supporting the needs and values of families and communities within their own unique social ecologies.

  15. Time orientation and eating behavior: Unhealthy eaters consider immediate consequences, while healthy eaters focus on future health.

    Science.gov (United States)

    Dassen, Fania C M; Houben, Katrijn; Jansen, Anita

    2015-08-01

    Time orientation could play an important role in eating behavior. The current study investigated whether eating behavior is associated with the Consideration of Future Consequences scale (CFC). Specifically, it was examined whether unhealthy eaters consider the future less and are more concerned with immediate gratification. A related measure of time orientation is delay discounting, a process by which a reinforcer becomes less valuable when considered later in time. Recent research argues that the relation between time orientation and health behaviors is measured best at a behavior-specific level. In the current study, we explored the relationships between CFC and discount rate - both general and food-specific - and their influence on healthy eating. Participants with ages 18 to 60 (N = 152; final sample N = 146) filled in an online questionnaire consisting of the CFC, a food-specific version of the CFC (CFC-food), the Monetary Choice Questionnaire (MCQ) and an adapted MCQ version with snack food as a reinforcer. Self-reported healthy eating was positively related to the future subscale (r = .48, p  .05). In order to predict behavior, measurements of time orientation should thus be tailored to the behavior of interest. Based on current results, shifting one's concern from the immediate consequences of eating to a more future-oriented perspective may present an interesting target for future interventions aimed at promoting healthy eating and reducing overweight. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Health Economics at the Crossroads of Centuries - From the Past to the Future.

    Science.gov (United States)

    Jakovljevic, Mihajlo Michael; Ogura, Seiritsu

    2016-01-01

    Health economics, as an interdisciplinary science, has experienced exceptionally bold evolution through the past eight decades. Generations of committed scholars have built up huge body of knowledge and developed a set of methodological tools to assist health-care authorities with resource allocation process. Following its conception at the US National Bureau of Economic Research and Ivy League US Universities, this science has spread across the Globe. It has adapted to a myriad of local conditions and needs of the national health systems with diverse historical legacies, medical services provision, and financing patterns. Challenge of financial sustainability facing modern day health systems remains primarily attributable to population aging, prosperity diseases, large scale migrations, rapid urbanization, and technological innovation in medicine. Despite promising developments in developing countries with emerging BRICS markets on the lead, rising out-of-pocket health spending continues to threaten affordability of medical care. Universal health coverage extension will likely remain serious challenge even for some of the most advanced OECD nations. These complex circumstances create strong drivers for inevitable further development of health economics. We believe that this interdisciplinary health science shall leave long-lasting blue print to be visible for decades to come.

  17. Mobile health in adults with congenital heart disease: Current use and future needs

    NARCIS (Netherlands)

    Schuuring, M.J.; A. Backx (Ad); Zwart, R.; Veelenturf, A.H.; D. Robbers-Visser (Daniëlle); M. Groenink (Maarten); A. Abu-Hanna (Ameen); N. Bruining (Nico); M.P. Schijven; B.J.M. Mulder (Barbara); B.J. Bouma (Berto)

    2016-01-01

    textabstractObjective Many adults with congenital heart disease (CHD) are affected lifelong by cardiac events, particularly arrhythmias and heart failure. Despite the care provided, the cardiac event rate remains high. Mobile health (mHealth) brings opportunities to enhance daily monitoring and

  18. Health Economics at the Crossroads of Centuries – From the Past to the Future

    Science.gov (United States)

    Jakovljevic, Mihajlo (Michael); Ogura, Seiritsu

    2016-01-01

    Health economics, as an interdisciplinary science, has experienced exceptionally bold evolution through the past eight decades. Generations of committed scholars have built up huge body of knowledge and developed a set of methodological tools to assist health-care authorities with resource allocation process. Following its conception at the US National Bureau of Economic Research and Ivy League US Universities, this science has spread across the Globe. It has adapted to a myriad of local conditions and needs of the national health systems with diverse historical legacies, medical services provision, and financing patterns. Challenge of financial sustainability facing modern day health systems remains primarily attributable to population aging, prosperity diseases, large scale migrations, rapid urbanization, and technological innovation in medicine. Despite promising developments in developing countries with emerging BRICS markets on the lead, rising out-of-pocket health spending continues to threaten affordability of medical care. Universal health coverage extension will likely remain serious challenge even for some of the most advanced OECD nations. These complex circumstances create strong drivers for inevitable further development of health economics. We believe that this interdisciplinary health science shall leave long-lasting blue print to be visible for decades to come. PMID:27376055

  19. Status and future of the forest health indicators program of the USA

    Science.gov (United States)

    Christopher William Woodall; Michael C. Amacher; William A. Bechtold; John W. Coulston; Sarah Jovan; Charles H. Perry; KaDonna C. Randolph; Beth K. Schulz; Gretchen C. Smith; Susan. Will-Wolf

    2011-01-01

    For two decades, the US Department of Agriculture, Forest Service, has been charged with implementing a nationwide field-based forest health monitoring effort. Given its extensive nature, the monitoring program has been gradually implemented across forest health indicators and inventoried states. Currently, the Forest Service's Forest Inventory and Analysis...

  20. Health services research and data linkages: issues, methods, and directions for the future.

    Science.gov (United States)

    Bradley, Cathy J; Penberthy, Lynne; Devers, Kelly J; Holden, Debra J

    2010-10-01

    Research on pressing health services and policy issues requires access to complete, accurate, and timely patient and organizational data. This paper describes how administrative and health records (including electronic medical records) can be linked for comparative effectiveness and health services research. We categorize the major agents (i.e., who owns and controls data and who carries out the data linkage) into three areas: (1) individual investigators; (2) government sponsored linked data bases; and (3) public-private partnerships that facilitate linkage of data owned by private organizations. We describe challenges that may be encountered in the linkage process, and the benefits of combining secondary databases with primary qualitative and quantitative sources. We use cancer care research to illustrate our points. To fill the gaps in the existing data infrastructure, additional steps are required to foster collaboration among institutions, researchers, and public and private components of the health care sector. Without such effort, independent researchers, governmental agencies, and nonprofit organizations are likely to continue building upon a fragmented and costly system with limited access. Discussion. Without the development and support for emerging information technologies across multiple health care settings, the potential for data collected for clinical and transactional purposes to benefit the research community and, ultimately, the patient population may go unrealized. The current environment is characterized by budget and technical challenges, but investments in data infrastructure are arguably cost-effective given the need to reform our health care system and to monitor the impact of health reform initiatives. © Health Research and Educational Trust.

  1. The Future of Counseling Psychology: Improving Quality of Life for Persons with Chronic Health Issues

    Science.gov (United States)

    Chwalisz, Kathleen

    2008-01-01

    The literature review and focus group findings that compose the Major Contribution illustrate how counseling psychologists can integrate expertise from various subdisciplines (vocational psychology, health psychology, multicultural psychology) to effectively address the needs of those living with HIV. Given changes in the nature of health problems…

  2. Nursing competence in adolescent health: anticipating the future needs of youth.

    Science.gov (United States)

    Bearinger, L H; Wildey, L; Gephart, J; Blum, R W

    1992-01-01

    The health problems of youth have dramatically shifted in the last 30 years from biological to social causes of morbidity and mortality. To assess the adequacy of nurses' knowledge and skills in adolescent health, a national survey of 445 nurses, including members of the American Public Health Association, the American School Health Association, and the National Association of Pediatric Nurse Associates and Practitioners, was undertaken in 1985. Results indicated that even among nurses who work with young people the most, areas of greatest knowledge and skill deficiencies included common social morbidities of adolescents. In addition to self-assessed inadequacies in knowledge and skills, nurses identified excessive time demands as a primary obstacle to the provision of health services to adolescents. To assure adequate preparation of nurses, it is recommended that accreditation criteria for baccalaureate and graduate programs specify essential adolescent health content for curricula compared to current accreditation criteria that generalizes "across the life span." Focusing on the enhancement of educational opportunities in adolescent health, nurses identified strategies for further education that would bridge the gap between the health needs of youth and nurse's self-perceived competencies in providing these services.

  3. [Cost-effectiveness in Dutch mental health care: future because of ROM?

    NARCIS (Netherlands)

    Agthoven, M. van; Kolk, A. van der; Knegtering, H.; Delespaul, P.A.; Arends, J.; Jeurissen, P.P.T.; Krabbe, P.F.M.; Huijsman, R.; Luijk, R.; Beurs, E. de; Hakkaart-van Roijen, L.; Bruggeman, R.

    2015-01-01

    BACKGROUND: The document reporting Dutch mental health care negotiations for 2014 - 2017 calls for a cost decrease based on cost-effectiveness. Thanks to rom, the Dutch mental health care seems well prepared for cost-effectiveness research.
    AIM: Evaluate how valid cost-effectiveness research

  4. eHealth Service Support in Future IPv6 Vehicular Networks

    Directory of Open Access Journals (Sweden)

    Véronique Vèque

    2013-06-01

    Full Text Available Recent vehicular networking activities include novel automotive applications, such as public vehicle to vehicle/infrastructure (V2X, large scale deployments, machine-to-machine (M2M integration scenarios, and more. The platform described in this paper focuses on the integration of eHealth in a V2I setting. This is to allow the use of Internet from a vehicular setting to disseminate health-related information. From an eHealth viewpoint, the use of remote healthcare solutions to record and transmit a patient’s vital signs is a special telemedicine application that helps hospital resident health professionals to optimally prepare the patient’s admittance. From the automotive perspective, this is a typical vehicle-to-infrastructure (V2I communication scenario. This proposal provides an IPv6 vehicular platform, which integrates eHealth devices and allows sending captured health-related data to a personal health record (PHR application server in the IPv6 Internet. The collected data is viewed remotely by a doctor and supports his diagnostic decision. In particular, our work introduces the integration of vehicular and eHealth testbeds, describes related work and presents a lightweight auto-configuration method based on a DHCPv6 extension to provide IPv6 connectivity with a few numbers of messages.

  5. Trump, Brexit, Right-wing Anti-globalisation, and An Uncertain Future for Public Health

    Science.gov (United States)

    Macgregor-Bowles, Isabelle; Bowles, Devin C.

    2017-01-01

    Global public health is intimately linked with political, economic and social determinants. The current global order has been built on the assumption that the globalisation agenda shared by political elites of the last several decades will continue. Individuals, businesses and countries have all made decisions, many of them linked to health, based on this assumption. The election of Donald Trump to the US presidency and the vote in Britain to exit the European Union exemplify a recent wave of right-wing anti-globalisation, which has risen in much of the West. The right-wing anti-globalisation movement will substantially affect global health through four pathways. Restrictions on trade will dampen economic growth and could diminish food security and the availability of medical supplies. Xenophobia will harm mental health through the lived experience of minorities, and will elevate the risk of economic and military conflict between countries. Increased defence expenditure in a time of limited government budgets will constrict funding available for healthcare and the social determinants of health. Mistrust of international treaties, including for climate change, will undermine the Paris Agreement and hasten greenhouse gas emissions. Without rapid mitigation, climate change could devastate population health globally through a range of mechanisms, including diminished food security and increased violent conflict. These would amplify many of the other health effects of right-wing anti-globalisation. By emphasising the shared humanity of all people, population health offers an antidote to the narrow focus of right-wing anti-globalisation. PMID:29546210

  6. Trump, Brexit, Right-wing Anti-globalisation, and An Uncertain Future for Public Health

    Directory of Open Access Journals (Sweden)

    2017-04-01

    Full Text Available Global public health is intimately linked with political, economic and social determinants. The current global order has been built on the assumption that the globalisation agenda shared by political elites of the last several decades will continue. Individuals, businesses and countries have all made decisions, many of them linked to health, based on this assumption. The election of Donald Trump to the US presidency and the vote in Britain to exit the European Union exemplify a recent wave of right-wing anti-globalisation, which has risen in much of the West. The right-wing anti-globalisation movement will substantially affect global health through four pathways. Restrictions on trade will dampen economic growth and could diminish food security and the availability of medical supplies. Xenophobia will harm mental health through the lived experience of minorities, and will elevate the risk of economic and military conflict between countries. Increased defence expenditure in a time of limited government budgets will constrict funding available for healthcare and the social determinants of health. Mistrust of international treaties, including for climate change, will undermine the Paris Agreement and hasten greenhouse gas emissions. Without rapid mitigation, climate change could devastate population health globally through a range of mechanisms, including diminished food security and increased violent conflict. These would amplify many of the other health effects of right-wing anti-globalisation. By emphasising the shared humanity of all people, population health offers an antidote to the narrow focus of right-wing anti-globalisation.

  7. Trump, Brexit, Right-wing Anti-globalisation, and An Uncertain Future for Public Health.

    Science.gov (United States)

    Macgregor-Bowles, Isabelle; Bowles, Devin C

    2017-01-01

    Global public health is intimately linked with political, economic and social determinants. The current global order has been built on the assumption that the globalisation agenda shared by political elites of the last several decades will continue. Individuals, businesses and countries have all made decisions, many of them linked to health, based on this assumption. The election of Donald Trump to the US presidency and the vote in Britain to exit the European Union exemplify a recent wave of right-wing anti-globalisation, which has risen in much of the West. The right-wing anti-globalisation movement will substantially affect global health through four pathways. Restrictions on trade will dampen economic growth and could diminish food security and the availability of medical supplies. Xenophobia will harm mental health through the lived experience of minorities, and will elevate the risk of economic and military conflict between countries. Increased defence expenditure in a time of limited government budgets will constrict funding available for healthcare and the social determinants of health. Mistrust of international treaties, including for climate change, will undermine the Paris Agreement and hasten greenhouse gas emissions. Without rapid mitigation, climate change could devastate population health globally through a range of mechanisms, including diminished food security and increased violent conflict. These would amplify many of the other health effects of right-wing anti-globalisation. By emphasising the shared humanity of all people, population health offers an antidote to the narrow focus of right-wing anti-globalisation.

  8. Defensive reactions to health-promoting information: an overview and implications for future research

    NARCIS (Netherlands)

    Riet, van 't J.P.; Ruiter, R.A.C.

    2013-01-01

    It is a common finding that recipients of threatening health-promoting information are motivated to dismiss or disregard the information, thus reacting defensively'. This article gives an overview of the literature on defensive reactions to health-promoting information. A distinction is made

  9. Near Misses in Financial Trading: Skills for Capturing and Averting Error.

    Science.gov (United States)

    Leaver, Meghan; Griffiths, Alex; Reader, Tom

    2018-05-01

    The aims of this study were (a) to determine whether near-miss incidents in financial trading contain information on the operator skills and systems that detect and prevent near misses and the patterns and trends revealed by these data and (b) to explore if particular operator skills and systems are found as important for avoiding particular types of error on the trading floor. In this study, we examine a cohort of near-miss incidents collected from a financial trading organization using the Financial Incident Analysis System and report on the nontechnical skills and systems that are used to detect and prevent error in this domain. One thousand near-miss incidents are analyzed using distribution, mean, chi-square, and associative analysis to describe the data; reliability is provided. Slips/lapses (52%) and human-computer interface problems (21%) often occur alone and are the main contributors to error causation, whereas the prevention of error is largely a result of teamwork (65%) and situation awareness (46%) skills. No matter the cause of error, situation awareness and teamwork skills are used most often to detect and prevent the error. Situation awareness and teamwork skills appear universally important as a "last line" of defense for capturing error, and data from incident-monitoring systems can be analyzed in a fashion more consistent with a "Safety-II" approach. This research provides data for ameliorating risk within financial trading organizations, with implications for future risk management programs and regulation.

  10. Physician leadership: a health-care system's investment in the future of quality care.

    Science.gov (United States)

    Orlando, Rocco; Haytaian, Marcia

    2012-08-01

    The current state of health care and its reform will require physician leaders to take on greater management responsibilities, which will require a set of organizational and leadership competencies that traditional medical education does not provide. Physician leaders can form a bridge between the clinical and administrative sides of a health-care organization, serving to further the organization's strategy for growth and success. Recognizing that the health-care industry is rapidly changing and physician leaders will play a key role in that transformation, Hartford HealthCare has established a Physician Leadership Development Institute that provides advanced leadership skills and management education to select physicians practicing within the health-care system.

  11. The Subjective Health Horizon Questionnaire (SHH-Q): Assessing Future Time Perspectives for Facets of an Active Lifestyle.

    Science.gov (United States)

    Düzel, Sandra; Voelkle, Manuel C; Düzel, Emrah; Gerstorf, Denis; Drewelies, Johanna; Steinhagen-Thiessen, Elisabeth; Demuth, Ilja; Lindenberger, Ulman

    2016-01-01

    A wider subjective time horizon is assumed to be positively associated with longevity and vitality. In particular, a lifestyle with exposure to novel and varied information is considered beneficial for healthy cognitive aging. At present, measures that specifically assess individuals' perceived temporal extension to engage in active lifestyles in the future are not available. We introduce and validate a new self-report measure, the Subjective Health Horizon Questionnaire (SHH-Q). The SHH-Q assesses individuals' future time perspectives in relation to four interrelated but distinct lifestyle dimensions: (1) novelty-oriented exploration (Novelty), (2) bodily fitness (Body), (3) work goals (Work), and (4) goals in life (Life Goals). The present study aims at: (a) validating the hypothesized factor structure of the SHH-Q, according to which the SHH-Q consists of four interrelated but distinct subscales, and (b) testing the hypothesis that the Novelty and Body subscales of the SHH-Q show positive and selective associations with markers of cognition and somatic health, respectively. Using structural equation modeling, we analyzed data from 1,371 healthy individuals (51% women) with a mean age of 70.1 years (SD = 3.6) who participated in the Berlin Aging Study II (BASE-II) and completed the SHH-Q. As predicted, the SHH-Q formed four correlated but distinct subscales: (1) Novelty, (2) Body, (3) Work, and (4) Life Goals. Greater self-reported future novelty orientation was associated with higher current memory performance, and greater future expectations regarding bodily fitness with better current metabolic status. The SHH-Q reliably assesses individual differences in four distinct dimensions of future time perspective. Two of these dimensions, Novelty and Body, show differential associations with cognitive status and somatic health. The SHH-Q may serve as a tool to assess how different facets of future time perspective relate to somatic health, cognition, motivation, and

  12. Delay Discounting as an Index of Sustainable Behavior: Devaluation of Future Air Quality and Implications for Public Health.

    Science.gov (United States)

    Berry, Meredith S; Nickerson, Norma P; Odum, Amy L

    2017-09-01

    Poor air quality and resulting annual deaths represent significant public health concerns. Recently, rapid delay discounting (the devaluation of future outcomes) of air quality has been considered a potential barrier for engaging in long term, sustainable behaviors that might help to reduce emissions (e.g., reducing private car use, societal support for clean air initiatives). Delay discounting has been shown to be predictive of real world behavior outside of laboratory settings, and therefore may offer an important framework beyond traditional variables thought to measure sustainable behavior such as importance of an environmental issue, or environmental attitudes/values, although more research is needed in this area. We examined relations between discounting of air quality, respiratory health, and monetary gains and losses. We also examined, relations between discounting and self-reported importance of air quality and respiratory health, and nature relatedness. Results showed rapid delay discounting of all outcomes across the time frames assessed, and significant positive correlations between delay discounting of air quality, respiratory health, and monetary outcomes. Steeper discounting of monetary outcomes relative to air quality and respiratory health outcomes was observed in the context of gains; however, no differences in discounting were observed across losses of monetary, air quality, and respiratory health. Replicating the sign effect, monetary outcomes were discounted more steeply than monetary losses. Importance of air quality, respiratory health and nature relatedness were significantly and positively correlated with one another, but not with degree of delay discounting of any outcome, demonstrating the need for more comprehensive measures that predict pro-environmental behaviors that might benefit individuals and public health over time. These results add to our understanding of decision-making, and demonstrate alarming rates of delay discounting of

  13. Impacts of climate variability and future climate change on harmful algal blooms and human health

    Science.gov (United States)

    Stephanie K. Moore; Vera L. Trainer; Nathan J. Mantua; Micaela S. Parker; Edward A. Laws; Lorraine C. Backer; Lora E. Fleming

    2008-01-01

    Anthropogenically-derived increases in atmospheric greenhouse gas concentrations have been implicated in recent climate change, and are projected to substantially impact the climate on a global scale in the future. For marine and freshwater systems, increasing concentrations of greenhouse gases are expected to increase surface temperatures, lower pH, and cause changes...

  14. Motivational power of future time perspective : Meta-analyses in education, work, and health

    NARCIS (Netherlands)

    Andre, L.; van Vianen, A.E.M.; Peetsma, T.T.D.; Oort, F.J.

    2018-01-01

    Future time perspective (FTP) may predict individual attitudes and behaviors. However, FTP research includes different FTP conceptualizations and outcomes which hinder generalizing its findings. To solve the inconsistencies in FTP research and generalize the magnitude of FTP as a driver of

  15. Formative research to identify perceptions of e-cigarettes in college students: Implications for future health communication campaigns

    Science.gov (United States)

    Case, Kathleen; Crook, Brittani; Lazard, Allison; Mackert, Michael

    2016-01-01

    Objective This formative study examined perceptions of e-cigarettes in college students with the goal of informing future health communication campaigns. Differences between e-cigarette users and nonusers were also examined. Participants: Thirty undergraduate students were recruited from a large southwestern public university (15 users, 15 nonusers). Methods Structured interviews were conducted and transcripts were coded for themes. Results Although users had more favorable attitudes toward e-cigarettes, both users and nonusers believed that e-cigarettes produce water vapor and reported that e-cigarettes were less harmful than conventional cigarettes. Potential health consequences and addiction concerns were the most common perceived threats for both users and nonusers. Both nonusers and users cited social stigma as a perceived disadvantage of e-cigarette use. Conclusions Ultimately, themes with particular relevance to future health communication campaigns included negative perceptions of e-cigarette users and social stigma, as well as harm perceptions and potential health consequences associated with e-cigarette use. PMID:26979833

  16. The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men.

    Science.gov (United States)

    Race, Kane; Lea, Toby; Murphy, Dean; Pienaar, Kiran

    2017-02-01

    There are complex historical connections between sexual minoritisation and desires to chemically alter bodily experience. For gay men, drug and alcohol use can be a creative or experimental response to social marginalisation - and not necessarily a problematic one in every instance. Numerous studies have found that infection with HIV and other sexually transmissible infections (STIs) is more likely among gay and men who have sex with men (MSM) who use recreational drugs than those who do not, but the causal nature of these relations is uncertain. Sexualised drug use is associated with a range of other problems, including dependence, mental health issues, accident and overdose. A growing body of work in the Alcohol and Other Drugs (AOD) field demonstrates the action of drugs and their purported effects to be a product of their relations with various other actors, contexts and practices. Given these contingencies, it is impossible to predict the future of drugs or their effect on the sexual health of gay and MSM with any degree of certainty. This article outlines some of the conditions most likely to mediate such futures in the medium term. Public funding for lesbian, gay, bisexual, transgender and queer drug issues should not remain restricted to questions of HIV prevention and sexual health. It should be expanded to equip sexual health and AOD service providers with the cultural and sexual literacy to mitigate stigma and allow them to respond constructively to drug problems among sexual and gender minorities as a matter of priority.

  17. Quantifying Health Utilities in Patients Undergoing Stereotactic Body Radiation Treatment for Liver Metastases for Use in Future Economic Evaluations.

    Science.gov (United States)

    Warren, B; Munoz-Schuffenegger, P; Chan, K K W; Chu, W; Helou, J; Erler, D; Chung, H

    2017-09-01

    Stereotactic body radiation therapy (SBRT) is increasingly used as an option for those with liver metastases. In order to facilitate future economic impact of health technologies, health utility scores may be used. The EuroQOL-5D-3L (EQ-5D) preference-based healthy utility instrument was used to evaluate the impact of treatment with SBRT on health utility scores. Between August 2013 and October 2014, 31 patients treated with 3-5 fractions of SBRT for liver metastases were enrolled in this study. The EQ-5D instrument was administered at baseline, during and up to 6 months post-SBRT. Mean EQ-5D score at baseline was 0.857, which remained stable across the entire study time period. Transient increases in difficulties with mobility (9.7% reported at baseline to 16.1% on the last day of treatment) and usual activities (3.2% reported at baseline to 34.5% on day two) were found during the course of treatment; these returned to baseline levels subsequently. The mean visual analogue score at baseline was 65.8 and remained unchanged throughout treatment and follow-up. The stability of health utility scores and problems reported by patients undergoing treatment indicate that SBRT for liver metastases does not impart a significant adverse effect on quality of life. These results may be used for future economic evaluation of SBRT. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  18. Behavioral intervention technologies: evidence review and recommendations for future research in mental health.

    Science.gov (United States)

    Mohr, David C; Burns, Michelle Nicole; Schueller, Stephen M; Clarke, Gregory; Klinkman, Michael

    2013-01-01

    A technical expert panel convened by the Agency for Healthcare Research and Quality and the National Institute of Mental Health was charged with reviewing the state of research on behavioral intervention technologies (BITs) in mental health and identifying the top research priorities. BITs refers to behavioral and psychological interventions that use information and communication technology features to address behavioral and mental health outcomes. This study on the findings of the technical expert panel. Videoconferencing and standard telephone technologies to deliver psychotherapy have been well validated. Web-based interventions have shown efficacy across a broad range of mental health outcomes. Social media such as online support groups have produced disappointing outcomes when used alone. Mobile technologies have received limited attention for mental health outcomes. Virtual reality has shown good efficacy for anxiety and pediatric disorders. Serious gaming has received little work in mental health. Research focused on understanding reach, adherence, barriers and cost is recommended. Improvements in the collection, storage, analysis and visualization of big data will be required. New theoretical models and evaluation strategies will be required. Finally, for BITs to have a public health impact, research on implementation and application to prevention is required. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. The photovoltaic industry on the path to a sustainable future--environmental and occupational health issues.

    Science.gov (United States)

    Bakhiyi, Bouchra; Labrèche, France; Zayed, Joseph

    2014-12-01

    As it supplies solar power, a priori considered harmless for the environment and human health compared with fossil fuels, the photovoltaic (PV) industry seems to contribute optimally to reduce greenhouse gas emissions and, overall, to sustainable development. However, considering the forecast for rapid growth, its use of potentially toxic substances and manufacturing processes presenting health and safety problems may jeopardize its benefits. This paper aims to establish a profile of the PV industry in order to determine current and emerging environmental and health concerns. A review of PV system life cycle assessments, in light of the current state of the industry and its developmental prospects, reveals information deficits concerning some sensitive life cycle indicators and environmental impacts, together with incomplete information on toxicological data and studies of workers' exposure to different chemical and physical hazards. Although solar panel installation is generally considered relatively safe, the occupational health concerns related to the growing number of hazardous materials handled in the PV industry warrants an all-inclusive occupational health and safety approach in order to achieve an optimal equilibrium with sustainability. To prevent eco-health problems from offsetting the benefits currently offered by the PV industry, manufacturers should cooperate actively with workers, researchers and government agencies toward improved and more transparent research, the adoption of specific and stricter regulations, the implementation of preventive risk management of occupational health and safety and, lastly, greater responsibilization toward PV systems from their design until their end of life. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Caribbean Heat Threatens Health, Well-being and the Future of Humanity.

    Science.gov (United States)

    Macpherson, Cheryl C; Akpinar-Elci, Muge

    2015-07-01

    Climate change has substantial impacts on public health and safety, disease risks and the provision of health care, with the poor being particularly disadvantaged. Management of the associated health risks and changing health service requirements requires adequate responses at local levels. Health-care providers are central to these responses. While climate change raises ethical questions about its causes, impacts and social justice, medicine and bioethics typically focus on individual patients and research participants rather than these broader issues. We broaden this focus by examining awareness among health-care providers in the Caribbean region, where geographic and socioeconomic features pose particular vulnerabilities to climate change. In focus groups, Caribbean providers described rises in mosquito-borne, flood-related, heat-related, respiratory and mental illnesses, and attributed these to local impacts of climate change. Their discussions showed that the significance of these impacts differs in different Caribbean nations, raising policy and social justice questions. Bioethics and public health ethics are situated to frame, inform and initiate public and policy dialog about values and scientific evidence associated with climate change. We urge readers to initiate such dialog within their own institutions about the context-dependent nature of the burdens of climate change, and values and policies that permit it to worsen.

  1. Health-Related Quality of Life of Future Physicians at a Medical School in the Philippines

    Directory of Open Access Journals (Sweden)

    John Anthony A. Domantay

    2014-07-01

    Full Text Available Medical students are trained to maintain the health of patients, but such training may have undesirable effects on medical students’ personal health. This study therefore aimed to assess the health-related quality of life (HRQOL of medical students and to determine the factors that are associated with the students’ HRQOL. The target population included all students enrolled at the Saint Louis University School of Medicine in Baguio City, Philippines, during school year 2012-2013. The measurements included the 36-Item Short Form Health Survey (SF-36 questionnaire for HRQOL, Beck Depression Inventory, abbreviated Maslach Burnout Inventory, Perceived Stress Scale, Holmes and Rahe Stress Scale, and self-report items for other exposure variables. A total of 527 medical students participated in the study. The mean scores in all of the eight domains of HRQOL ranged from 51.36 to 85.83. The highest mean scores were along the areas of physical functioning (85.83 and bodily pain (69.20, whereas the lowest mean scores were in the areas of vitality (51.72 and role limitations due to emotional problems (51.36. Depression, stress, and burnout were associated with lower scores in most of the domains of HRQOL. Medical students in our school are generally in a satisfactory state of functional health and well-being, but have a lower level of mental health as compared with physical health.

  2. What Could Be Future Scenarios?-Lessons from the History of Public Health Surveillance for the Future: --A keynote address presented at the 8th World Alliance for Risk Factor Surveillance (WARFS) Global Conference on October 30, 2013, Beijing, China.

    Science.gov (United States)

    Choi, Bernard C K

    2015-01-01

    This article provides insights into the future based on a review of the past and present of public health surveillance-the ongoing systematic collection, analysis, interpretation, and dissemination of health data for the planning, implementation, and evaluation of public health action. Public health surveillance dates back to the first recorded epidemic in 3180 BC in Egypt. A number of lessons and items of interest are summarised from a review of historical perspectives in the past 5,000 years and the current practice of surveillance. Some future scenarios are presented: exploring new frontiers; enhancing computer technology; improving epidemic investigations; improving data collection, analysis, dissemination and use; building on lessons from the past; building capacity; and enhancing global surveillance. It is concluded that learning from the past, reflecting on the present, and planning for the future can further enhance public health surveillance.

  3. Modelling the affordability and distributional implications of future health care financing options in South Africa.

    Science.gov (United States)

    McIntyre, Di; Ataguba, John E

    2012-03-01

    South Africa is considering introducing a universal health care system. A key concern for policy-makers and the general public is whether or not this reform is affordable. Modelling the resource and revenue generation requirements of alternative reform options is critical to inform decision-making. This paper considers three reform scenarios: universal coverage funded by increased allocations to health from general tax and additional dedicated taxes; an alternative reform option of extending private health insurance coverage to all formal sector workers and their dependents with the remainder using tax-funded services; and maintaining the status quo. Each scenario was modelled over a 15-year period using a spreadsheet model. Statistical analyses were also undertaken to evaluate the impact of options on the distribution of health care financing burden and benefits from using health services across socio-economic groups. Universal coverage would result in total health care spending levels equivalent to 8.6% of gross domestic product (GDP), which is comparable to current spending levels. It is lower than the status quo option (9.5% of GDP) and far lower than the option of expanding private insurance cover (over 13% of GDP). However, public funding of health services would have to increase substantially. Despite this, universal coverage would result in the most progressive financing system if the additional public funding requirements are generated through a surcharge on taxable income (but not if VAT is increased). The extended private insurance scheme option would be the least progressive and would impose a very high payment burden; total health care payments on average would be 10.7% of household consumption expenditure compared with the universal coverage (6.7%) and status quo (7.5%) options. The least pro-rich distribution of service benefits would be achieved under universal coverage. Universal coverage is affordable and would promote health system equity, but

  4. Preeclampsia and Future Cardiovascular Health: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Wu, Pensée; Haththotuwa, Randula; Kwok, Chun Shing; Babu, Aswin; Kotronias, Rafail A; Rushton, Claire; Zaman, Azfar; Fryer, Anthony A; Kadam, Umesh; Chew-Graham, Carolyn A; Mamas, Mamas A

    2017-02-01

    Preeclampsia is a pregnancy-specific disorder resulting in hypertension and multiorgan dysfunction. There is growing evidence that these effects persist after pregnancy. We aimed to systematically evaluate and quantify the evidence on the relationship between preeclampsia and the future risk of cardiovascular diseases. We studied the future risk of heart failure, coronary heart disease, composite cardiovascular disease, death because of coronary heart or cardiovascular disease, stroke, and stroke death after preeclampsia. A systematic search of MEDLINE and EMBASE was performed to identify relevant studies. We used random-effects meta-analysis to determine the risk. Twenty-two studies were identified with >6.4 million women including >258 000 women with preeclampsia. Meta-analysis of studies that adjusted for potential confounders demonstrated that preeclampsia was independently associated with an increased risk of future heart failure (risk ratio [RR], 4.19; 95% confidence interval [CI], 2.09-8.38), coronary heart disease (RR, 2.50; 95% CI, 1.43-4.37), cardiovascular disease death (RR, 2.21; 95% CI, 1.83-2.66), and stroke (RR, 1.81; 95% CI, 1.29-2.55). Sensitivity analyses showed that preeclampsia continued to be associated with an increased risk of future coronary heart disease, heart failure, and stroke after adjusting for age (RR, 3.89; 95% CI, 1.83-8.26), body mass index (RR, 3.16; 95% CI, 1.41-7.07), and diabetes mellitus (RR, 4.19; 95% CI, 2.09-8.38). Preeclampsia is associated with a 4-fold increase in future incident heart failure and a 2-fold increased risk in coronary heart disease, stroke, and death because of coronary heart or cardiovascular disease. Our study highlights the importance of lifelong monitoring of cardiovascular risk factors in women with a history of preeclampsia. © 2017 American Heart Association, Inc.

  5. Health and human rights education in U.S. schools of medicine and public health: current status and future challenges.

    Science.gov (United States)

    Cotter, L Emily; Chevrier, Jonathan; El-Nachef, Wael Noor; Radhakrishna, Rohan; Rahangdale, Lisa; Weiser, Sheri D; Iacopino, Vincent

    2009-01-01

    Despite increasing recognition of the importance of human rights in the protection and promotion of health, formal human rights education has been lacking in schools of medicine and public health. Our objectives were: 1) to determine the nature and extent of health and human rights (HHR) education among schools of medicine (SOMs) and public health (SPHs); 2) to identify perceived barriers to implementing HHR curricula; 3) to learn about deans' interests and attitudes toward HHR education, and; 4) to identify factors associated with offering HHR education. We conducted a cross-sectional survey among deans of all accredited allopathic SOMs and SPHs in the United States and Puerto Rico. Seventy-one percent of U.S. SOMs and SPHs responded. Thirty-seven percent of respondents indicated that their schools offered some form of HHR education. Main barriers to offering HHR education included competition for time, lack of qualified instructors and lack of funding. Among schools not offering HHR education, 35% of deans were interested in offering HHR education. Seventy-six percent of all deans believed that it was very important or important to offer HHR education. Multiple regression analysis revealed that deans' attitudes were the most important factor associated with offering any HHR education. Findings indicate that though a majority of deans of SOMs and SPHs believe that knowledge about human rights is important in health practice and support the inclusion of HHR studies in their schools, HHR education is lacking at most of their institutions. These results and the growing recognition of the critical interdependence between health and human rights indicate a need for SOMs and SPHs to work towards formal inclusion of HHR studies in their curricula, and that HHR competency requirements be considered to overcome barriers to its inclusion.

  6. Technology in Mental Health: Creating New Knowledge and Inventing the Future of Services.

    Science.gov (United States)

    Ben-Zeev, Dror

    2017-02-01

    The mental health services now in place are intrinsically linked with the technology that has been at our disposal for decades of research and practice. Advancements in Web, mobile, sensor, and informatics technology can do more than serve as tools to enhance existing models of care. Novel technologies can help us better understand the very nature of mental illness and revise our fundamental assumptions about the structure, boundaries, and modalities of mental health treatment. Recognizing the unprecedented opportunities new technology offers to improve the outcomes of people with mental illness, Psychiatric Services announces a new column on technology and mental health.

  7. The opportunity and strategy for quality and health-system improvement now and in the future.

    Science.gov (United States)

    Sherar, Michael; Maley, Oonagh

    2015-01-01

    Since 2004, Cancer Care Ontario (CCO) has played a leadership role in linking funding to quality of care, and in using evidence and administrative and clinical data to drive performance and quality improvement. This article describes how CCO has used its cancer and renal health system strategies to establish an environment of continuous health system improvement. The article also describes how CCO's Corporate Strategy is driving organizational improvement: evolving CCO's capacity and capability to drive quality and value across healthcare settings, and its ability to advance broader health system transformation in support of cancer and renal patients. Copyright © 2014 Longwoods Publishing.

  8. Assessment of the Future Health Burden Attributable to Undernutrition under the Latest Scenario Framework for Climate Change Research

    Science.gov (United States)

    Ishida, Hiroyuki; Kobayashi, Shota; Yoshikawa, Sayaka; Kanae, Shinjiro; Hasegawa, Tomoko; Fujimori, Shinichiro; Shin, Yonghee; Takahashi, Kiyoshi; Masui, Toshihiko; Tanaka, Akemi; Honda, Yasushi

    2014-05-01

    There are growing concerns that future food security will be negatively affected by various factors, such as changes in socioeconomic and climate conditions. The health burden attributable to childhood undernutrition is among the most severe problems related to food crisis in the world. This study assessed the health burden attributable to childhood underweight through 2050 focusing on disability-adjusted life years (DALYs), by considering the latest scenarios for climate change studies (Representative Concentration Pathways (RCPs) and Shared Socioeconomic Pathways (SSPs)) and conducting sensitivity analysis. We used three SSPs (SSP1, SSP2 and SSP3) as future population and gross domestic products (GDP), three RCPs (RCP2.6, RCP4.5 and RCP8.5) for a greenhouse gas emissions constraint, and 12 Global Circulation Models (12 GCMs) to estimate climate conditions. A regression model for estimating DALYs attributable to childhood underweight (DAtU) was developed using the relationship between DAtU and childhood stunting. A logarithmic relationship was proposed for the regression model. We combined a global computable general equilibrium model, a crop model (M-GAEZ), and two regression models to assess the future health burden. We found that i) world total DAtU decreases from 2005 by 23 ~ 60% in 2030 depending on the socioeconomic scenarios. DAtU decreases further by 2050 for SSP1 and SSP2 scenario, whereas it slightly increases for SSP3. Per capita DAtU also decreases in all regions under either scenario in 2050, but the decreases vary significantly by regions and scenarios. ii) the impact of climate change is relatively small in the framework of this study but, on the other hand, socioeconomic conditions have a great impact on the future health burden. The impact of changes in socioeconomic conditions on the health burden is greater in the regions where current health burden is high. iii) parameter uncertainty of the regression models is the second largest factor on

  9. Future time perspective and health behaviors: temporal framing of self-regulatory processes in physical exercise and dietary behaviors.

    Science.gov (United States)

    Gellert, Paul; Ziegelmann, Jochen P; Lippke, Sonia; Schwarzer, Ralf

    2012-04-01

    Limitations in perceived lifetime can undermine long-term goal striving. Planning is supposed to translate intentions into health behaviors and to operate as a compensatory strategy to overcome goal striving deficits associated with a limited time perspective. Two longitudinal studies were conducted examining the compensatory role of planning: an online survey on fruit and vegetable consumption (N = 909; 16-78 years; follow-up at 4 months) and a questionnaire study on physical exercise in older adults (N = 289; 60-95 years, over a half-year period). Intentions, planning, and behavior were measured in a behavior-specific, future time perspective in a generic manner. Planning mediated between intentions and both health behaviors. Time perspective operated as a moderator, indicating that in individuals with a more limited time perspective, a stronger effect of planning on health behaviors emerged. Planning as a self-regulatory strategy may compensate for a limited time perspective.

  10. Current and future health care professionals attitudes toward and knowledge of statistics: How confidence influences learning.

    Science.gov (United States)

    Baghi, Heibatollah; Kornides, Melanie L

    2013-01-01

    Health care professionals require some understanding of statistics to successfully implement evidence based practice. Developing competency in statistical reasoning is necessary for students training in health care administration, research, and clinical care. Recently, the interest in healthcare professional's attitudes toward statistics has increased substantially due to evidence that these attitudes can hinder professionalism developing an understanding of statistical concepts. In this study, we analyzed pre- and post-instruction attitudes towards and knowledge of statistics obtained from health science graduate students, including nurses and nurse practitioners, enrolled in an introductory graduate course in statistics (n = 165). Results show that the students already held generally positive attitudes toward statistics at the beginning of course. However, these attitudes-along with the students' statistical proficiency-improved after 10 weeks of instruction. The results have implications for curriculum design and delivery methods as well as for health professionals' effective use of statistics in critically evaluating and utilizing research in their practices.

  11. Validating health impact assessment: Prediction is difficult (especially about the future)

    International Nuclear Information System (INIS)

    Petticrew, Mark; Cummins, Steven; Sparks, Leigh; Findlay, Anne

    2007-01-01

    Health impact assessment (HIA) has been recommended as a means of estimating how policies, programmes and projects may impact on public health and on health inequalities. This paper considers the difference between predicting health impacts and measuring those impacts. It draws upon a case study of the building of a new hypermarket in a deprived area of Glasgow, which offered an opportunity to reflect on the issue of the predictive validity of HIA, and to consider the difference between potential and actual impacts. We found that the actual impacts of the new hypermarket on diet differed from that which would have been predicted based on previous studies. Furthermore, they challenge current received wisdom about the impact of food retail outlets in poorer areas. These results are relevant to the validity of HIA as a process and emphasise the importance of further research on the predictive validity of HIA, which should help improve its value to decision-makers

  12. Ethical aspects of future health care: globalisation of markets and differentiation of societies - ethical challenges.

    Science.gov (United States)

    Kluge, Eike-Henner W

    2008-01-01

    The shift in health care to an aggregate corporate and distributed model dominated by electronic methods of diagnosis, record-keeping and communication spanning jurisdictional boundaries raises technical, social and paradigmatic issues. The technical issues concern the material natures of the tools, devices, procedures and protocols; the social issues gravitate around abstract matters like individual rights and models of responsibility within a corporate setting and accountability in inter-jurisdictional contexts; the paradigmatic issues centre in the question of how the rights and duties of traditional and direct health care translate into the mediated context of the globally expanded corporate model of eHealth and telemedicine. The present discussion presents a brief overview of the issues and sketches some of their implications for the evolution of contemporary health care.

  13. The Space That Difference Makes: On Marginality, Social Justice and the Future of the Health Humanities.

    Science.gov (United States)

    Gutierrez, Kevin J; DasGupta, Sayantani

    2016-12-01

    Feminist theorist and educator, bell hooks, asserts that to seek true liberation one must choose marginality. One must choose to occupy the space outside the binary between colonizer-colonized, hegemonic center-periphery, and us-them in order to create a location of possibility. This essay will reveal the practice of social justice as the navigation of the space that difference makes and argue that choosing marginality provides a framework for health humanities work towards social justice in health care. The space of the launderette that is depicted in Hanif Kureishi's 1986 film, My Beautiful Laundrette, provides an example of choosing marginality and illustrates how difference structures both real and imagined spaces, which influences how individuals ultimately perceive one another. We will draw from the work of bell hooks; political geographer, Edward Soja; and Marxist philosopher, Henri Lefebvre, to demonstrate the importance of the health humanities' position at the margin to traditional health care education.

  14. Water resources management in a homogenizing world: Averting the Growth and Underinvestment trajectory

    Science.gov (United States)

    Mirchi, Ali; Watkins, David W.; Huckins, Casey J.; Madani, Kaveh; Hjorth, Peder

    2014-09-01

    Biotic homogenization, a de facto symptom of a global biodiversity crisis, underscores the urgency of reforming water resources management to focus on the health and viability of ecosystems. Global population and economic growth, coupled with inadequate investment in maintenance of ecological systems, threaten to degrade environmental integrity and ecosystem services that support the global socioeconomic system, indicative of a system governed by the Growth and Underinvestment (G&U) archetype. Water resources management is linked to biotic homogenization and degradation of system integrity through alteration of water systems, ecosystem dynamics, and composition of the biota. Consistent with the G&U archetype, water resources planning primarily treats ecological considerations as exogenous constraints rather than integral, dynamic, and responsive parts of the system. It is essential that the ecological considerations be made objectives of water resources development plans to facilitate the analysis of feedbacks and potential trade-offs between socioeconomic gains and ecological losses. We call for expediting a shift to ecosystem-based management of water resources, which requires a better understanding of the dynamics and links between water resources management actions, ecological side-effects, and associated long-term ramifications for sustainability. To address existing knowledge gaps, models that include dynamics and estimated thresholds for regime shifts or ecosystem degradation need to be developed. Policy levers for implementation of ecosystem-based water resources management include shifting away from growth-oriented supply management, better demand management, increased public awareness, and institutional reform that promotes adaptive and transdisciplinary management approaches.

  15. Health technology assessment and its role in the future development of the Indian healthcare sector

    OpenAIRE

    Hass, Bastian; Pooley, Jayne; Feuring, Martin; Suvarna, Viraj; Harrington, Adrian E.

    2012-01-01

    Public expenditure on healthcare in India is low by international comparison, and access to essential treatment pushes many uninsured citizens below the poverty line. In many countries, policymakers utilize health technology assessment (HTA) methodologies to direct investments in healthcare, to obtain the maximum benefit for the population as a whole. With rising incomes and a commitment from the Government of India to increase the proportion of gross domestic product spent on health, this is...

  16. The European Donor Health Care Project: fulfilling needs and challenges for the future

    Directory of Open Access Journals (Sweden)

    P.J.M. van den Burg

    2014-05-01

    Full Text Available The Donor Health Care project is a EU granted project to develop a learning programme for professionals working in the field of Donor Health Care. The innovation of this curriculum is the focus on all donors, irrespective of whether they donate blood, cells, tissues or organs. This article describes the background of the project and the current possibilities and limitations of European accreditation, distance learning and Master degrees.

  17. Exposure information in environmental health research: Current opportunities and future directions for particulate matter, ozone, and toxic air pollutants

    Energy Technology Data Exchange (ETDEWEB)

    McKone, Thomas E.; Ryan, P. Barry; Ozkaynak, Haluk

    2007-02-01

    Understanding and quantifying outdoor and indoor sources of human exposure are essential but often not adequately addressed in health-effects studies for air pollution. Air pollution epidemiology, risk assessment, health tracking and accountability assessments are examples of health-effects studies that require but often lack adequate exposure information. Recent advances in exposure modeling along with better information on time-activity and exposure factors data provide us with unique opportunities to improve the assignment of exposures for both future and ongoing studies linking air pollution to health impacts. In September 2006, scientists from the US Environmental Protection Agency (EPA) and the Centers for Disease Control and Prevention (CDC) along with scientists from the academic community and state health departments convened a symposium on air pollution exposure and health in order to identify, evaluate, and improve current approaches for linking air pollution exposures to disease. This manuscript presents the key issues, challenges and recommendations identified by the exposure working group, who used cases studies of particulate matter, ozone, and toxic air pollutant exposure to evaluate health-effects for air pollution. One of the over-arching lessons of this workshop is that obtaining better exposure information for these different health-effects studies requires both goal-setting for what is needed and mapping out the transition pathway from current capabilities to meeting these goals. Meeting our long-term goals requires definition of incremental steps that provide useful information for the interim and move us toward our long-term goals. Another over-arching theme among the three different pollutants and the different health study approaches is the need for integration among alternate exposure assessment approaches. For example, different groups may advocate exposure indicators, biomonitoring, mapping methods (GIS), modeling, environmental media

  18. Potential health benefits of simulated laughter: a narrative review of the literature and recommendations for future research.

    Science.gov (United States)

    Mora-Ripoll, Ramon

    2011-06-01

    Scientific research has shown that laughter may have both preventive and therapeutic values. Health-related benefits of laughter are mainly reported from spontaneous laughter interventional studies. While the human mind can make a distinction between simulated and spontaneous laughter, the human body cannot. Either way health-related outcomes are deemed to be produced. Simulated laughter is thus a relatively under-researched treatment modality with potential health benefits. The aim of this review was firstly to identify, critically evaluate and summarize the laughter literature; secondly to assess to which extent simulated laughter health-related benefits are currently sustained by empirical evidence; and lastly to provide recommendations and future directions for further research. A comprehensive laughter literature search was performed. A list of inclusion and exclusion criteria was identified. Thematic analysis was applied to summarize laughter health-related outcomes, relationships, and general robustness. Laughter has shown different physiological and psychological benefits. Adverse effects are very limited and laughter is practically lacking in counter-indications. Despite the limited number of publications, there is some evidence to suggest that simulated laughter has also some effects on certain aspects of health, though further well-designed research is warranted. Simulated laughter techniques can be easily implemented in traditional clinical settings for health and patient care. Their effective use for therapeutic purposes needs to be learned, practiced, and developed as any other medical strategy. Practical guidelines and further research are needed to help health care professionals (and others) implement laughter techniques in their health care portfolio. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. 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.

  20. Integrated (one-stop shop) youth health care: best available evidence and future directions.

    Science.gov (United States)

    Hetrick, Sarah E; Bailey, Alan P; Smith, Kirsten E; Malla, Ashok; Mathias, Steve; Singh, Swaran P; O'Reilly, Aileen; Verma, Swapna K; Benoit, Laelia; Fleming, Theresa M; Moro, Marie Rose; Rickwood, Debra J; Duffy, Joseph; Eriksen, Trissel; Illback, Robert; Fisher, Caroline A; McGorry, Patrick D

    2017-11-20

    Although mental health problems represent the largest burden of disease in young people, access to mental health care has been poor for this group. Integrated youth health care services have been proposed as an innovative solution. Integrated care joins up physical health, mental health and social care services, ideally in one location, so that a young person receives holistic care in a coordinated way. It can be implemented in a range of ways. A review of the available literature identified a range of studies reporting the results of evaluation research into integrated care services. The best available data indicate that many young people who may not otherwise have sought help are accessing these mental health services, and there are promising outcomes for most in terms of symptomatic and functional recovery. Where evaluated, young people report having benefited from and being highly satisfied with these services. Some young people, such as those with more severe presenting symptoms and those who received fewer treatment sessions, have failed to benefit, indicating a need for further integration with more specialist care. Efforts are underway to articulate the standards and core features to which integrated care services should adhere, as well as to further evaluate outcomes. This will guide the ongoing development of best practice models of service delivery.

  1. Children's school readiness: implications for eliminating future disparities in health and education.

    Science.gov (United States)

    Pagani, Linda S; Fitzpatrick, Caroline

    2014-02-01

    School-entry characteristics predict adult educational attainment, which forecasts dispositions toward disease prevention. Health and education risks can also be transmitted from one generation to the next. As such, school readiness forecasts a set of intertwined biopsychosocial trajectories that can influence the developmental antecedents to health and disease prevalence in society. To predict children's health behaviors and academic adjustment at the end of fourth grade from their kindergarten entry math, vocabulary, and attention skills. We use a subsample of 614 girls and 541 boys from the Quebec Longitudinal Study of Child Development (Canada). Children were individually assessed for cognitive skills and teachers rated their classroom attention skills at 65 months. Outcome measures include health behaviors, psychosocial, and academic outcomes at 122 months. Multiple regression analyses were used. Receptive vocabulary in kindergarten exclusively predicted fourth-grade dietary habits. Unstandardized coefficients predicted decreases in sweet snack intake (β = -.009, 95% confidence interval [CI] = -.011 to -.006) and dairy product intake (β = .009, 95% CI = .005 to .013). Conversely, higher kindergarten math skills predicted increases in activities requiring physical effort (β = .030, 95% CI = .011 to .056). Although vocabulary and attention skills were found important, kindergarten math skills were stronger and more consistent predictors of later academic outcomes. From a population-health perspective, the skills children bring to the kindergarten classroom might reduce a host of lifestyle risks from childhood through adulthood. Early promotion of such skills also offers possibilities for ultimately reducing later disparities in health and education.

  2. The past, present, and future of health development campaigns: reflexivity and the critical-cultural approach.

    Science.gov (United States)

    Dutta, Mohan Jyoti; de Souza, Rebecca

    2008-07-01

    In contemporary society, health issues have gained increasing urgency in both political and academic spheres. Looking back at the failure of the modernist development initiatives, there is the need to realize that we live in a time of increasing sociopolitical complexity. The present moment is perhaps best understood in terms of a complex tension and linkage between the past and present, global and local, modern and postmodern. The critical-cultural approach to health campaigns is an approach that, through the reflexive interrogation of modernist assumptions underlying health communication campaigns, attempts to foreground the tensions inherent in the practice of health campaigns. This essay discusses the manner in which the critical-cultural approach interrogates modernist assumptions and provides an alternative paradigm for approaching the theory and practice of health campaigns by suggesting the necessity for reflexivity. Specifically, we discuss how the perspective interrogates the role of the media in development, the significance of culture, the locus of health responsibility, the impact of structural conditions, and the politics of knowledge, providing examples of campaigns that illustrate this reflexivity.

  3. Mitigation measures to avert the impacts of plastics and microplastics in the marine environment (a review).

    Science.gov (United States)

    Ogunola, Oluniyi Solomon; Onada, Olawale Ahmed; Falaye, Augustine Eyiwunmi

    2018-04-01

    The increasing demand for and reliance on plastics as an everyday item, and rapid rise in their production and subsequent indiscriminate disposal, rise in human population and industrial growth, have made the material an important environmental concern and focus of interest of many research. Historically, plastic production has increased tremendously to over 250 million tonnes by 2009 with an annual increased rate of 9%. In 2015, the global consumption of plastic materials was reported to be > 300 million tonnes and is expected to surge exponentially. Because plastic polymers are ubiquitous, highly resistant to degradation, the influx of these persistent, complex materials is a risk to human and environmental health. Because microplastics are principally generated from the weathering or breakdown of larger plastics (macroplastics), it is noteworthy and expedient to discuss in detail, expatiate, and tackle this main source. Macro- and microplastic pollution has been reported on a global scale from the poles to the equator. The major problem of concern is that they strangulate and are ingested by a number of aquatic biota especially the filter feeders, such as molluscs, mussels, oysters, from where it enters the food chain and consequently could lead to physical and toxicological effects on aquatic organisms and human being as final consumers. To this end, in order to minimise the negative impacts posed by plastic pollution (macro- and microplastics), a plethora of strategies have been developed at various levels to reduce and manage the plastic wastes. The objective of this paper is to review some published literature on management measures of plastic wastes to curb occurrence and incidents of large- and microplastics pollution in the marine environments.

  4. Do Savings Mediate Changes in Adolescents' Future Orientation and Health-Related Outcomes? Findings From Randomized Experiment in Uganda.

    Science.gov (United States)

    Karimli, Leyla; Ssewamala, Fred M

    2015-10-01

    This present study tests the proposition that an economic strengthening intervention for families caring for AIDS-orphaned adolescents would positively affect adolescent future orientation and psychosocial outcomes through increased asset accumulation (in this case, by increasing family savings). Using longitudinal data from the cluster-randomized experiment, we ran generalized estimating equation models with robust standard errors clustering on individual observations. To examine whether family savings mediate the effect of the intervention on adolescents' future orientation and psychosocial outcomes, analyses were conducted in three steps: (1) testing the effect of intervention on mediator; (2) testing the effect of mediator on outcomes, controlling for the intervention; and (3) testing the significance of mediating effect using Sobel-Goodman method. Asymmetric confidence intervals for mediated effect were obtained through bootstrapping-to address the assumption of normal distribution. Results indicate that participation in a matched Child Savings Account (CSA) program improved adolescents' future orientation and psychosocial outcomes by reducing hopelessness, enhancing self-concept, and improving adolescents' confidence about their educational plans. However, the positive intervention effect on adolescent future orientation and psychosocial outcomes was not transmitted through saving. In other words, participation in the matched CSA program improved adolescent future orientation and psychosocial outcomes regardless of its impact on reported savings. Further research is necessary to understand exactly how participation in economic strengthening interventions, for example, those that employ matched CSAs, shape adolescent future orientation and psychosocial outcomes: what, if not savings, transmits the treatment effect and how? Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  5. A report card on the physician work force: Israeli health care market--past experience and future prospects.

    Science.gov (United States)

    Toker, Asaf; Shvarts, Shifra; Glick, Shimon; Reuveni, Haim

    2010-09-01

    The worldwide shortage of physicians is due not only to the lack of physicians, but also to complex social and economic factors that vary from country to country. To describe the results of physician workforce planning in a system with unintended policy, such as Israel, based on past experience and predicted future trends, between 1995 and 2020. A descriptive study of past (1995-2009) and future (through 2020) physician workforce trends in Israel. An actuarial equation was developed to project physician supply until 2020. In Israel a physician shortage is expected in the very near future. This finding is the result of global as well as local changes affecting the supply of physicians: change in immigration pattern, gender effect, population growth, and transparency of data on demand for physicians. These are universal factors affecting manpower planning in most industrial countries all over the world. We describe a health care market with an unintended physician workforce policy. Sharing decision makers' experience in similar health care systems will enable the development of better indices to analyze, by comparison, effective physician manpower planning processes, worldwide.

  6. A scenario analysis of the future residential requirements for people with mental health problems in Eindhoven.

    Science.gov (United States)

    Bierbooms, Joyce J P A; Bongers, Inge M B; van Oers, Hans A M

    2011-01-06

    Despite large-scale investments in mental health care in the community since the 1990 s, a trend towards reinstitutionalization has been visible since 2002. Since many mental health care providers regard this as an undesirable trend, the question arises: In the coming 5 years, what types of residence should be organized for people with mental health problems? The purpose of this article is to provide mental health care providers, public housing corporations, and local government with guidelines for planning organizational strategy concerning types of residence for people with mental health problems. A scenario analysis was performed in four steps: 1) an exploration of the external environment; 2) the identification of key uncertainties; 3) the development of scenarios; 4) the translation of scenarios into guidelines for planning organizational strategy. To explore the external environment a document study was performed, and 15 semi-structured interviews were conducted. During a workshop, a panel of experts identified two key uncertainties in the external environment, and formulated four scenarios. The study resulted in four scenarios: 1) Integrated and independent living in the community with professional care; 2) Responsible healthcare supported by society; 3) Differentiated provision within the walls of the institution; 4) Residence in large-scale institutions but unmet need for care. From the range of aspects within the different scenarios, the panel was able to work out concrete guidelines for planning organizational strategy. In the context of residence for people with mental health problems, the focus should be on investment in community care and their re-integration into society. A joint effort is needed to achieve this goal. This study shows that scenario analysis leads to useful guidelines for planning organizational strategy in mental health care.

  7. Stakeholder consultation insights on the future of genomics at the clinical-public health interface.

    Science.gov (United States)

    Modell, Stephen M; Kardia, Sharon L R; Citrin, Toby

    2014-05-01

    In summer 2011, the Centers for Disease Control and Prevention Office of Public Health Genomics conducted a stakeholder consultation, administered by the University of Michigan Center for Public Health and Community Genomics, and Genetic Alliance, to recommend priorities for public health genomics from 2012 through 2017. Sixty-two responses from health professionals, administrators, and members of the public were pooled with 2 sets of key informant interviews and 3 discussion groups. NVivo 9 and manual methods were used to organize themes. This review offers an interim analysis of progress with respect to the final recommendations, which demonstrated a strong interest in moving genomic discoveries toward implementation and comparative effectiveness (T3/T4) translational research. A translational research continuum exists with familial breast and ovarian cancer at one end and prostate cancer at the other. Cascade screening for inherited arrhythmia syndromes and hypercholesterolemia lags stakeholder recommendations in the United States but not in Europe; implementation of health service-based screening for Lynch syndrome, and integration into electronic health information systems, is on pace with the recommended timeline. A number of options exist to address deficits in the funding of translational research, particularly for oncogenomic gene expression profiling. The goal of personalized risk assessment necessitates both research progress (eg, in whole genome sequencing, as well as provider education in the differentiation of low- vs high-risk status. The public health approach supports an emphasis on genetic test validation while endorsing clinical translation research inclusion of an environmental and population-based perspective. Copyright © 2014 Mosby, Inc. All rights reserved.

  8. Program of rehabilitative exercise and education to avert vascular events after non-disabling stroke or transient ischemic attack (PREVENT Trial: a multi-centred, randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Thompson Kara

    2010-12-01

    Full Text Available Abstract Background Despite lack of outward signs, most individuals after non-disabling stroke (NDS and transient ischemic attack (TIA have significant cardiovascular and cerebrovascular disease and are at high risk of a major stroke, hospitalization for other vascular events, or death. Most have multiple modifiable risk factors (e.g., hypertension, physical inactivity, hyperlipidaemia, diabetes, tobacco consumption, psychological stress. In addition, accelerated rates of depression, cognitive decline, and poor quality of sleep have been reported following TIA, which correlate with poor functional outcomes and reduced quality of life. Thus, NSD and TIA are important warning signs that should not be overlooked. The challenge is not unlike that facing other 'silent' conditions - to identify a model of care that is effective in changing people's current behaviors in order to avert further morbidity. Methods/Design A single blind, randomized controlled trial will be conducted at two sites to compare the effectiveness of a program of rehabilitative exercise and education versus usual care in modifying vascular risk factors in adults after NDS/TIA. 250 adults within 90 days of being diagnosed with NDS/TIA will be randomly allocated to a 12-week program of exercise and education (PREVENT or to an outpatient clinic assessment and discussion of secondary prevention recommendations with return clinic visits as indicated (USUAL CARE. Primary outcome measures will include blood pressure, waist circumference, 12-hour fasting lipid profile, and 12-hour fasting glucose/hemoglobin A1c. Secondary measures will include exercise capacity, walking endurance, physical activity, cognitive function, depression, goal attainment and health-related quality of life. Outcome assessment will be conducted at baseline, post-intervention, and 6- and 12-month follow-ups. Direct health care costs incurred over one year by PREVENT versus USUAL CARE participants will also be

  9. [Big Data and Public Health - Results of the Working Group 1 of the Forum Future Public Health, Berlin 2016].

    Science.gov (United States)

    Moebus, Susanne; Kuhn, Joseph; Hoffmann, Wolfgang

    2017-11-01

    Big Data is a diffuse term, which can be described as an approach to linking gigantic and often unstructured data sets. Big Data is used in many corporate areas. For Public Health (PH), however, Big Data is not a well-developed topic. In this article, Big Data is explained according to the intention of use, information efficiency, prediction and clustering. Using the example of application in science, patient care, equal opportunities and smart cities, typical challenges and open questions of Big Data for PH are outlined. In addition to the inevitable use of Big Data, networking is necessary, especially with knowledge-carriers and decision-makers from politics and health care practice. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Occupational safety and health in Europe: lessons from the past, challenges and opportunities for the future.

    Science.gov (United States)

    Gagliardi, Diana; Marinaccio, Alessandro; Valenti, Antonio; Iavicoli, Sergio

    2012-01-01

    Europe has always played a key role in the field of Occupational Health and Safety (OHS) and can be considered the cradle of Occupational Health. The European policy framework has been set since the establishment of the European Union, but its strength lies in the enactment of the Framework Directive on Occupational Health and Safety (89/391/EC), which has had a strong positive impact on the assessment and management of occupational risk factors and has promoted the quick diffusion of common standards across Europe. Yet, some implementation issues still remain to be addressed, due to changes in the world of work, fragmentation, economic crisis and, more generally, to the impact of globalization. Therefore, actions need to be reviewed with respect to research plans and policy implementation so as to support the OHS social dimension fostering a broader concept of wellbeing at work.

  11. Transport and public health in China: the road to a healthy future

    Science.gov (United States)

    Jiang, Baoguo; Liang, Song; Peng, Zhong-Ren; Cong, Haozhe; Levy, Morgan; Cheng, Qu; Wang, Tianbing; Remais, Justin

    2017-01-01

    Transportation-related risk factors are a major source of morbidity and mortality in China, where expansion of road networks and surges in personal vehicle ownership are having profound effects on public health. Road traffic injuries and fatalities have increased alongside motorized transport in China, and accident injury risk is aggravated by inadequate emergency response systems and trauma care. National air quality standards and emission control technologies are having a positive effect, yet persistent air pollution is increasingly attributable to a growing and outdated vehicle fleet, and famously congested roads. Urban design favors motorized transport, and physical activity and its associated health benefits are hindered by poor urban infrastructure. Transport emissions of greenhouse gases contribute substantially to regional and global climate change, which compound public health risks from multiple factors. Despite these complex challenges, technological advances and innovations in planning and policy stand to make China a leader in sustainable, healthy transportation. PMID:29047445

  12. Information and communications technology for future health systems in developing countries.

    Science.gov (United States)

    Lucas, Henry

    2008-05-01

    There has been much discussion of the role that recent advances in information and communication technologies (ICTs) could play in improving health systems in developing countries, but limited independent analysis of existing applications. Combining a case study approach with a general discussion of the issues, this paper attempts to assess the potential benefits of a diverse range of ICT innovations and some of the constraints they will need to overcome. Four broad areas are considered: improvements in traditional health information systems; computer-aided diagnosis and treatment monitoring; a range of applications generically labelled 'telemedicine'; and the use of ICT to inform general populations on health and healthcare. The final section speculates on the possible medium-term impacts of ICT in terms of improving the performance of existing systems, allowing scope for radical innovations, or even changing basic assumptions about the provider-patient relationship.

  13. Digital mental health and intellectual disabilities: state of the evidence and future directions.

    Science.gov (United States)

    Sheehan, Rory; Hassiotis, Angela

    2017-11-01

    The use of digital technologies in the management of mental illness, and more generally in the promotion of well-being and mental health, has received much recent attention and is a focus of current health policy. We conducted a narrative review to explore the opportunities and risks of digital technologies in mental healthcare specifically for people with intellectual disability, a sometimes marginalised and socially excluded group. The scope of digital mental health is vast and the promise of cheaper and more effective interventions delivered digitally is attractive. People with intellectual disability experience high rates of mental illness and could benefit from the development of novel therapies, yet seem to have been relatively neglected in the discourse around digital mental health and are often excluded from the development and implementation of new interventions. People with intellectual disability encounter several barriers to fully embracing digital technology, which may be overcome with appropriate support and adaptations. A small, but growing, literature attests to the value of incorporating digital technologies into the lives of people with intellectual disability, not only for promoting health but also for enhancing educational, vocational and leisure opportunities. Clearly further evidence is needed to establish the safety and clinical efficacy of digital mental health interventions for people with and without intellectual disability. A digital inclusion strategy that explicitly addresses the needs of people with intellectual disability would ensure that all can share the benefits of the digital world. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. The Future LGBT Health Professional: Perspectives on Career and Personal Mentorship.

    Science.gov (United States)

    Sánchez, Nelson F; Callahan, Edward; Brewster, Cheryl; Poll-Hunter, Norma; Sánchez, John Paul

    2018-04-01

    Mentorship is a critical factor contributing to career success. There is limited research on the quality of mentoring relationships for LGBT health professionals. This study explores facilitators of, obstacles to, and strategies for successful mentorship for LGBT health professional trainees. We applied a convenience sampling strategy to collect quantitative and qualitative data among LGBT health professional trainees. The authors identified trends in data using bivariate analyses and Consensual Qualitative Research methods. Seventy-five LGBT trainees completed surveys and a subset of 23 survey respondents also participated in three focus groups. Among survey participants, 100% identified along the queer spectrum; 10.7% identified along the trans spectrum; 36.0% identified as a racial or ethnic minority; and 61.3% were in MD/DO-granting programs. Eighty-eight percent of trainees reported working with at least one mentor and 48.5% of trainees had at least one mentor of the same sexual orientation. Seventy-two percent of trainees endorsed the importance of having an LGBT-identified mentor for personal development. Qualitative data showed that trainees valued such a mentor for positive role modeling and shared understanding of experiences. Fifty-nine percent of trainees felt it was important to have an LGBT-identified mentor for career development. LGBT peer networking and LGBT-related professional advice were cited as unique benefits in the qualitative findings. LGBT health professional trainees have unique personal and career development needs that may benefit from LGBT mentorship. Academic health centers that facilitate LGBT mentorship could enhance LGBT health trainees' academic productivity and personal development.

  15. Positive future orientation as a mediator between traumatic events and mental health among children affected by HIV/AIDS in rural China.

    Science.gov (United States)

    Zhang, Jintao; Zhao, Guoxiang; Li, Xiaoming; Hong, Yan; Fang, Xiaoyi; Barnett, Douglas; Lin, Xiuyun; Zhao, Junfeng; Zhang, Liying

    2009-12-01

    The current study was designed to explore the effect of future orientation in mediating the relationship between traumatic events and mental health in children affected by HIV/AIDS in rural China. Cross-sectional data were collected from 1221 children affected by HIV/AIDS (755 AIDS orphans and 466 vulnerable children). Future orientation among children was measured using three indicators (future expectation, hopefulness toward the future, and perceived control over the future). Measures of mental health consisted of depression, loneliness, and self-esteem. Children's experience of any traumatic events was measured using a modified version of the Life Incidence of Traumatic Events-Student Form. Mediation analysis was conducted using structural equation modeling (SEM) methods. Among the children surveyed, most of the traumatic indicators were negatively associated with future expectation, hopefulness, perceived control, and self-esteem, and positively associated with depression and loneliness. The SEM of mediation analysis demonstrated an adequate fit. Future orientation fully mediated the relationship between traumatic events and mental health and accounted for 67.9% of the total effect of traumatic events on mental health. Results of this study support the positive effect of future expectation in mediating the relationship between traumatic events and mental health among children affected by HIV/AIDS in China. Future mental health promotion and intervention efforts targeting children affected by HIV/AIDS should include components that can mitigate the negative impact of traumatic events on their lives. These components may aim to develop children's positive future expectations, increase their hopefulness toward the future, and improve their perceived control over the future.

  16. The Future Impact of Healthcare Services Digitalization on Health Workforce: The Increasing Role of Medical Informatics.

    Science.gov (United States)

    Lapão, Luís Velez

    2016-01-01

    The digital revolution is gradually transforming our society. What about the effects of digitalization and Internet of Things in healthcare? Among researchers two ideas are dominating, opposing each other. These arguments will be explored and analyzed. A mix-method approach combining literature review with the results from a focus group on eHealth impact on employment is used. Several experts from the WHO and from Health Professional Associations contributed for this analysis. Depending on the type of service it will entail reductions or more need of healthcare workers, yet whatever the scenario medical informatics will play an increasing role.

  17. Air Quality and Health Impacts of Future Ethanol Production and Use in São Paulo State, Brazil

    Directory of Open Access Journals (Sweden)

    Noah Scovronick

    2016-07-01

    Full Text Available It is often argued that liquid biofuels are cleaner than fossil fuels, and therefore better for human health, however, the evidence on this issue is still unclear. Brazil’s high uptake of ethanol and role as a major producer makes it the most appropriate case study to assess the merits of different biofuel policies. Accordingly, we modeled the impact on air quality and health of two future fuel scenarios in São Paulo State: a business-as-usual scenario where ethanol production and use proceeds according to government predictions and a counterfactual scenario where ethanol is frozen at 2010 levels and future transport fuel demand is met with gasoline. The population-weighted exposure to fine particulate matter (PM2.5 and ozone was 3.0 μg/m3 and 0.3 ppb lower, respectively, in 2020 in the scenario emphasizing gasoline compared with the business-as-usual (ethanol scenario. The lower exposure to both pollutants in the gasoline scenario would result in the population living 1100 additional life-years in the first year, and if sustained, would increase to 40,000 life-years in year 20 and continue to rise. Without additional measures to limit emissions, increasing the use of ethanol in Brazil could lead to higher air pollution-related population health burdens when compared to policy that prioritizes gasoline.

  18. French Health Technology Assessment of Antineoplastic Drugs Indicated in the Treatment of Solid Tumours: Perspective for Future Trends.

    Science.gov (United States)

    Chouaid, Christos; Borget, Isabelle; Braun, Eric; Bazil, Marie-Laure; Schaetz, Dominique; Rémuzat, Cécile; Toumi, Mondher

    2016-08-01

    France is one of the European countries that spend the most on oncology drugs. To keep pharmaceutical expenditure under control, Health Authorities highly scrutinize market access of costly medicines. To assess current and future trends in French health technology assessment (HTA) of antineoplastic drugs indicated in the treatment of solid tumours. A review of the SMR and ASMR drivers of the Transparency Committee (CT) opinions issued for antineoplastic drugs indicated in the treatment of solid tumours and approved between 2009 and 2014 was performed to assess current trends in French health technology assessment (HTA), complemented by an expert board consultation to capture the critical issues on the future of antineoplastic drugs HTA. Thirty-one drugs indicated for the treatment of solid tumours were identified (77 % targeted therapies). Initial CT assessments were available for 26 drugs. Four key items in the CT assessment were identified: 1) Clinical trial methodology; 2) Acceptance of progression-free survival (PFS) as a valuable endpoint; 3) Transferability of clinical trials in clinical practice; 4) Unpredictability of CT decisions. Experts raised the important development of personalised medicines in oncology and key challenges for oncology products to generate information expected from HTA perspective. The French system remains committed to its values and philosophy (access of all innovations for everybody) which are threatened by the increasing launch of innovative therapies and budget constraint. Both HTA decision framework evolution and revision of the current pricing process should be considered in France to cope with these new challenges.

  19. Ethnic identity and mental health in American Indian youth: examining mediation pathways through self-esteem, and future optimism.

    Science.gov (United States)

    Smokowski, Paul R; Evans, Caroline B R; Cotter, Katie L; Webber, Kristina C

    2014-03-01

    Mental health functioning in American Indian youth is an understudied topic. Given the increased rates of depression and anxiety in this population, further research is needed. Using multiple group structural equation modeling, the current study illuminates the effect of ethnic identity on anxiety symptoms, depressive symptoms, and externalizing behavior in a group of Lumbee adolescents and a group of Caucasian, African American, and Latino/Hispanic adolescents. This study examined two possible pathways (i.e., future optimism and self-esteem) through which ethnic identity is associated with adolescent mental health. The sample (N = 4,714) is 28.53% American Indian (Lumbee) and 51.38% female. The study findings indicate that self-esteem significantly mediated the relationships between ethnic identity and anxiety symptoms, depressive symptoms, and externalizing behavior for all racial/ethnic groups (i.e., the total sample). Future optimism significantly mediated the relationship between ethnic identity and externalizing behavior for all racial/ethnic groups and was a significant mediator between ethnic identity and depressive symptoms for American Indian youth only. Fostering ethnic identity in all youth serves to enhance mental health functioning, but is especially important for American Indian youth due to the collective nature of their culture.

  20. Air Quality and Health Impacts of Future Ethanol Production and Use in São Paulo State, Brazil.

    Science.gov (United States)

    Scovronick, Noah; França, Daniela; Alonso, Marcelo; Almeida, Claudia; Longo, Karla; Freitas, Saulo; Rudorff, Bernardo; Wilkinson, Paul

    2016-07-11

    It is often argued that liquid biofuels are cleaner than fossil fuels, and therefore better for human health, however, the evidence on this issue is still unclear. Brazil's high uptake of ethanol and role as a major producer makes it the most appropriate case study to assess the merits of different biofuel policies. Accordingly, we modeled the impact on air quality and health of two future fuel scenarios in São Paulo State: a business-as-usual scenario where ethanol production and use proceeds according to government predictions and a counterfactual scenario where ethanol is frozen at 2010 levels and future transport fuel demand is met with gasoline. The population-weighted exposure to fine particulate matter (PM2.5) and ozone was 3.0 μg/m³ and 0.3 ppb lower, respectively, in 2020 in the scenario emphasizing gasoline compared with the business-as-usual (ethanol) scenario. The lower exposure to both pollutants in the gasoline scenario would result in the population living 1100 additional life-years in the first year, and if sustained, would increase to 40,000 life-years in year 20 and continue to rise. Without additional measures to limit emissions, increasing the use of ethanol in Brazil could lead to higher air pollution-related population health burdens when compared to policy that prioritizes gasoline.

  1. Future Extreme Heat Scenarios to Enable the Assessment of Climate Impacts on Public Health over the Coterminous U.S.

    Science.gov (United States)

    Quattrochi, Dale A.; Crosson, William L.; Al-Hamdan, Mohammad Z.; Estes, Maurice G., Jr.

    2013-01-01

    In the United States, extreme heat is the most deadly weather-related hazard. In the face of a warming climate and urbanization, which contributes to local-scale urban heat islands, it is very likely that extreme heat events (EHEs) will become more common and more severe in the U.S. This research seeks to provide historical and future measures of climate-driven extreme heat events to enable assessments of the impacts of heat on public health over the coterminous U.S. We use atmospheric temperature and humidity information from meteorological reanalysis and from Global Climate Models (GCMs) to provide data on past and future heat events. The focus of research is on providing assessments of the magnitude, frequency and geographic distribution of extreme heat in the U.S. to facilitate public health studies. In our approach, long-term climate change is captured with GCM outputs, and the temporal and spatial characteristics of short-term extremes are represented by the reanalysis data. Two future time horizons for 2040 and 2090 are compared to the recent past period of 1981- 2000. We characterize regional-scale temperature and humidity conditions using GCM outputs for two climate change scenarios (A2 and A1B) defined in the Special Report on Emissions Scenarios (SRES). For each future period, 20 years of multi-model GCM outputs are analyzed to develop a 'heat stress climatology' based on statistics of extreme heat indicators. Differences between the two future and the past period are used to define temperature and humidity changes on a monthly time scale and regional spatial scale. These changes are combined with the historical meteorological data, which is hourly and at a spatial scale (12 km), to create future climate realizations. From these realizations, we compute the daily heat stress measures and related spatially-specific climatological fields, such as the mean annual number of days above certain thresholds of maximum and minimum air temperatures, heat indices

  2. Oral Health-Related Quality of Life in the Elderly: A Review and Future Challenges in Thailand

    Directory of Open Access Journals (Sweden)

    Supawadee Naorungroj, DDS, Ph.D.

    2015-09-01

    Full Text Available Oral health related quality of life (OHRQoL is a multidimensional concept that measures perceptions of oral health and the consequences of oral conditions at individual and population levels. Poor oral conditions are associated with a deteriorating quality of life (QoL through functional and psychosocial impacts. As the elder population is growing worldwide and the prevalence of oral diseases among older adults remains high, more at- tention needs to be paid to oral health conditions as well as impacts on QoL. However, there are few population studies regarding OHRQoL in older Thai adults. Apparently, there are several challenges facing the assessment and improvement of the OHRQoL of this aging population. First, effort towards the standardization of instruments and validation of translated instruments is needed. Secondly, a multidisciplinary team, composed of health care providers, dental professionals, and policy makers has to be established. Finally, a holistic oral health care concept must be emphasized in dental educational programs and training. This review presents an overview of OHRQoL and its importance to the elderly and discusses future challenges to this group of the population in Thailand.

  3. Responding to health care reform by addressing the institute of medicine report on the future of nursing.

    Science.gov (United States)

    Ellerbe, Suellyn; Regen, Debra

    2012-01-01

    The current health care environment has heightened the importance of achieving positive patient outcomes and excellent customer satisfaction. To remain competitive, health care organizations must adapt quickly to changing regulatory requirements, quality improvement initiatives, and customer expectations. To ensure nursing practice at the Saint Clare's Health System in Northwest New Jersey is at the forefront of leading change, the nursing staff has embraced the Institute of Medicine report The Future of Nursing: Leading Change. The empowered nursing team has applied Benner's Novice to Expert model and McCauley's Careful Nursing Theory as the foundation for nursing practice. The ability to apply evidence-based nursing research and cultivate professional development at the bedside has resulted in retention of expert nurses at the bedside. Engaging the nursing team has resulted in increased patient satisfaction and improved clinical outcomes. Advanced practice nurses play an important role to mentor the nursing staff and promote an interdisciplinary, collaborative relationship between all health care disciplines and community support programs. Nurses are recognized for their accomplishments and encouraged to obtain specialty certification, advanced degrees, and earn state and national recognition through professional organizations. The professional nurses at the Saint Clare's Health System are prepared to work in whatever environment the new normal creates.

  4. Transdisciplinary assignments in graduate health education as a model for future collaboration.

    Science.gov (United States)

    Christie, Catherine; Smith, A Russell; Bednarzyk, Michele

    2007-01-01

    Transdisciplinary health care continues to be at the forefront of patient treatment in the medical arena, in part due to escalating health care costs, an increasing aging population, and the development of multiple chronic diseases. Gaining the knowledge, experience, and principles associated with transdisciplinary teamwork to successfully prepare for modern-day practice is therefore essential for individuals of various health care professions. This report describes an assignment developed and implemented to facilitate professional interaction between graduate physical therapy, nutrition, and nursing students. The objectives of this assignment were to determine through student evaluation the effects of a transdisciplinary experience on students' understanding of the role of another discipline and students' communication skills across disciplines. When evaluating the assignment, students most often remarked that they developed a greater understanding of the roles of the included disciplines and reported a significant increase in communication skills. However, some students did not concur that this assignment was effective due to the scheduling conflicts and lack of teamwork that can occur during a collaborative project. The students' reports of their experiences in completing the assignment provide valuable insights for implementing and/or updating a preparatory transdisciplinary education component in other settings. Additional research can focus on the challenges faced by the majority of the students venturing into actual health care or "real-world" settings for comparative studies.

  5. Health Promotion and Complementary Medicine: The Extent and Future of Professional Collaboration and Integration

    Science.gov (United States)

    Hill, Faith

    2006-01-01

    Purpose: To explore the professional interface between health promotion (HP) and complementary and alternative medicine. Design/methodology/approach: A discussion paper, based on qualitative research involving in-depth interviews with 52 participants from either side of the interface. Findings: The current interface is predominantly limited to…

  6. A brief history of soils and human health work and needs for the future

    Science.gov (United States)

    The idea that human health is tied to the soil is not a new one. As far back as circa 1400 B.C. the Bible depicts Moses as understanding that fertile soil was essential to the well-being of his people. In 400 B.C. the Greek philosopher Hippocrates provided a list of things that should be considered ...

  7. Training healthcare professionals for the future: internationalism and effective inclusion of global health training.

    Science.gov (United States)

    Eaton, Deborah Murdoch; Redmond, Anthony; Bax, Nigel

    2011-01-01

    There has been a continuing rise in recent years of the number of medical schools in the developed world offering 'global health' teaching to its students. Yet, the term itself is used in a number of contexts and as yet no clear consensus on what constitutes an appropriate or successful global health education programme has been reached. Approaches to sustainable internationalisation of medical curricula include the expansion of not only opportunities for training in specific global health topics, but also the development of broader generic graduate attributes including global citizenship and ethical, cultural and social responsibility. Key components for successful implementation of such an educational framework includes a breadth of educational approach to effect truly integrated and effective curricular internationalisation. That such programmes can offer benefits is appreciated by both faculty and students alike, but there is also a burgeoning concern about potential negative effects of socially and culturally insensitive programmes. We explore three potential pedagogic approaches to the subject; Model A: an 'additive' or contributory model of global health content (the commonest current approach), Model B: an 'integrated' approach and Model C: the more challenging 'transformative' approach requiring institutional as well as programme flexibility.

  8. The future of the public's health in the 21st century

    National Research Council Canada - National Science Library

    Committee on Assuring the Health of the Public in the 21st Century

    The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation’s public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report...

  9. Medical devices, electronic health records and assuring patient safety : Future challenges?

    NARCIS (Netherlands)

    Kalkman, Cor J.

    2015-01-01

    The patient safety movement was triggered by publications showing that modern health care is more unsafe than road travel and that more patients are killed annually by avoidable adverse events than by breast cancer [1]. As a result, an urgent need to improve patient safety has dominated

  10. The private health sector in South Africa - current trends and future ...

    African Journals Online (AJOL)

    The private health sector is experiencing a crisis of spiralling costs, with average annual cost increases of between 13% and 32% over the decade 1978 - 1988. This trend is partly explained by the high utilisation rates that result from the combination of the 'fee-for-service' system and the 'third-party' payment structure of the ...

  11. The compatibility of future doctors' career intentions with changing health care demands

    NARCIS (Netherlands)

    van Offenbeek, M.A.G.; Kiewiet, D.J.; Oosterhuis, M.

    Background: In the Netherlands the medical education system is in the process of being transformed to establish a more demand-oriented health care system. This transformation may entail the occupational restructuring of the medical profession. Meanwhile, on the supply side, the career intentions of

  12. The History and Future of Neoliberal Health Reform: Obamacare and Its Predecessors.

    Science.gov (United States)

    Waitzkin, Howard; Hellander, Ida

    2016-10-01

    The Colombian reform of 1994, through a strange historical sequence, became a model for health reform in Latin America, Europe, and the United States. Officially, the reform aimed to improve access for the uninsured and underinsured, in collaboration with the private, for-profit insurance industry. After several historical attempts at health reform adhering to the neoliberal pattern, favored by international financial institutions and multinational insurance corporations, the Affordable Care Act (ACA) similarly enhanced access by corporations to public-sector trust funds. An ideology favoring for-profit corporations in the marketplace justified these reforms through unproven claims about the efficiency of the private sector and enhanced quality of care under principles of competition and business management. The ACA maintains this historical continuity by dealing with health care as a commodity bought and sold in a marketplace, rather than a fundamental human right to be guaranteed according to principles of social solidarity. As the ACA heads toward probable failure, a space finally will open for a U.S. national health program that does not follow same historical patterns of the neoliberal model. © The Author(s) 2016.

  13. Predicting the role of veterinary medicine in future health and food safety challenges

    Science.gov (United States)

    Fejzić, N.; Šerić-Haračić, S.

    2017-09-01

    Animals have always been a source of food, materials, protection and wellbeing for humans; however, animal diseases, including zoonoses, have both direct and indirect negative effects on human health, economy and the society. Since its establishment, the veterinary profession has provided crucial input in eradicating disease, increasing animal production and reducing losses due to diseases. Currently, foodborne diseases and zoonoses have raised awareness in developed countries, which have excellent systems for disease surveillance and reporting both in humans and animal populations. Due to lack of modern, integrated surveillance and reporting, the burden of zoonoses and foodborne diseases in developing European countries is much harder to assess. Differences in countries’ animal health status (demonstrated through disease surveillance) have been a main pivot point for international trade of animals and animal products. However, rapid and dramatic evolvement of the health trends in the world changed the principles of animal disease surveillance. Approaches requiring lower cost (i.e. risk-based surveillance) are now proposed, not only due to less available public funding, but also because the costs are harder to justify to policy makers if a disease is exotic and/or rare. Therefore, the veterinary profession has faced insufficient interest of governments and funds for further research into many persistent endemic animal diseases and zoonoses. On the other hand, eradication of selected diseases in some areas while elsewhere they still persist, and the continuous emergence of new diseases, cannot guarantee permanent epidemiological stability. As food safety and security become more important, global trends and events have highlighted the biological, health and economic inseparability of the relationships between humans, animals as pets and/or food sources and wildlife within the social and ecological framework of living space that these species share. Veterinarians

  14. The Fukushima radiological emergency and challenges identified for future public health responses.

    Science.gov (United States)

    Miller, Charles W

    2012-05-01

    On 11 March 2011, northern Japan was rocked by first a magnitude 9.0 earthquake off the eastern coast and then an ensuing tsunami. The Fukushima Daiichi Nuclear Power Plant complex was hit by these twin disasters, and a cascade of events was initiated that led to radionuclide releases causing widespread radioactive contamination of residential areas, agricultural land, and coastal waters. Radioactive material from Japan was subsequently transmitted to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to be a concern for health effects, but the presence of this material in the environment was enough to create a public health emergency in the U.S. The radiation safety and public health communities in the U.S. are identifying challenges they faced in responding to this incident. This paper discusses three of those challenges: (1) The growing shortage of trained radiation subject matter experts in the field of environmental transport and dosimetry of radionuclides; (2) the need to begin expressing all radiation-related quantities in terms of the International System of Units; and (3) the need to define when a radiation dose is or is not one of "public health concern." This list represents only a small subset of the list of challenges being identified by public health agencies that responded to the Fukushima incident. However, these three challenges are fundamental to any radiological emergency response. Addressing them will have a significant positive impact on how the U.S. responds to the next radiological emergency.

  15. Human health impacts in the life cycle of future European electricity generation

    International Nuclear Information System (INIS)

    Treyer, Karin; Bauer, Christian; Simons, Andrew

    2014-01-01

    This paper presents Life Cycle Assessment (LCA) based quantification of the potential human health impacts (HHI) of base-load power generation technologies for the year 2030. Cumulative Greenhouse Gas (GHG) emissions per kWh electricity produced are shown in order to provide the basis for comparison with existing literature. Minimising negative impacts on human health is one of the key elements of policy making towards sustainable development: besides their direct impacts on quality of life, HHI also trigger other impacts, e.g. external costs in the health care system. These HHI are measured using the Life Cycle Impact Assessment (LCIA) methods “ReCiPe” with its three different perspectives and “IMPACT2002+”. Total HHI as well as the shares of the contributing damage categories vary largely between these perspectives and methods. Impacts due to climate change, human toxicity, and particulate matter formation are the main contributors to total HHI. Independently of the perspective chosen, the overall impacts on human health from nuclear power and renewables are substantially lower than those caused by coal power, while natural gas can have lower HHI than nuclear and some renewables. Fossil fuel combustion as well as coal, uranium and metal mining are the life cycle stages generating the highest HHI. - Highlights: • Life cycle human health impacts (HHI) due to electricity production are analysed. • Results are shown for the three ReCiPe perspectives and IMPACT2002+LCIA method. • Total HHI of nuclear and renewables are much below those of fossil technologies. • Climate change and human toxicity contribute most to total HHI. • Fossil fuel combustion and coal mining are the most polluting life cycle stages

  16. [Interdisciplinary healthcare centres--a way of organising healthcare in the future from a health insurer's perspective].

    Science.gov (United States)

    Hecke, Torsten L; Hoyer, Jens Martin

    2009-01-01

    The German healthcare system modernization act enables healthcare providers to fund interdisciplinary healthcare centres. The Techniker Krankenkasse (TK) is a statutory health sickness fund that has contracted with some of the interdisciplinary healthcare centres named ATRIO-MED to achieve high-quality medical care and healthcare management. A range of patient-centred services is described in the cooperation agreement; in addition to central medical patient records one of the core competencies includes integrated pathways for defined diagnosis. The concept of the interdisciplinary healthcare centre is highly accepted among patients. It will serve as a platform for future TK healthcare policies.

  17. Urban heat stress: novel survey suggests health and fitness as future avenue for research and adaptation strategies

    Science.gov (United States)

    Schuster, Christian; Honold, Jasmin; Lauf, Steffen; Lakes, Tobia

    2017-04-01

    Extreme heat has tremendous adverse effects on human health. Heat stress is expected to further increase due to urbanization, an aging population, and global warming. Previous research has identified correlations between extreme heat and mortality. However, the underlying physical, behavioral, environmental, and social risk factors remain largely unknown and comprehensive quantitative investigation on an individual level is lacking. We conducted a new cross-sectional household questionnaire survey to analyze individual heat impairment (self-assessed and reported symptoms) and a large set of potential risk factors in the city of Berlin, Germany. This unique dataset (n = 474) allows for the investigation of new relationships, especially between health/fitness and urban heat stress. Our analysis found previously undocumented associations, leading us to generate new hypotheses for future research: various health/fitness variables returned the strongest associations with individual heat stress. Our primary hypothesis is that age, the most commonly used risk factor, is outperformed by health/fitness as a dominant risk factor. Related variables seem to more accurately represent humans’ cardiovascular capacity to handle elevated temperature. Among them, active travel was associated with reduced heat stress. We observed statistical associations for heat exposure regarding the individual living space but not for the neighborhood environment. Heat stress research should further investigate individual risk factors of heat stress using quantitative methodologies. It should focus more on health and fitness and systematically explore their role in adaptation strategies. The potential of health and fitness to reduce urban heat stress risk means that encouraging active travel could be an effective adaptation strategy. Through reduced CO2 emissions from urban transport, societies could reap double rewards by addressing two root causes of urban heat stress: population health and

  18. Study design, objectives, hypotheses, main findings, health consequences for the population exposed, rationale of future research

    Energy Technology Data Exchange (ETDEWEB)

    Trnovec, T.; Kocan, A. [Slovak Medical Univ., Bratislava (Slovakia); Bencko, V. [Charles Univ., Prague (Czech Republic); Langer, P. [Institute of Experimental Endocrinology SAS, Bratislava (Slovakia); Berg, M. van den [Rijksuniversiteit Utrecht (Netherlands); Bergman, A. [Stockholm Univ. (Sweden); Hustak, M. [Air Force Military Hospital, Kosics (Slovakia)

    2004-09-15

    In Slovakia, the Chemko Chemical Company, based in Strazske, in the Michalovce district, produced PCBs between 1959 and 1984, in the amount of more than 21,000 tons of commercial mixtures (Delor 103, 104, 105, 106, Delotherm DK and DH, Hydelor 137). PCBs were used for similar industrial purposes as in the west. Improper disposal from the Chemko plant via release of effluent directly into the Laborec River resulted in long-term contamination of sediment. As a result eastern Slovakia, the Michalovce district in particular, is recognized as one of the areas all over the world most heavily polluted with PCBs. Historical studies show that blood and adipose PCB levels were higher in Czechoslovakia than elsewhere in the 1970's and 1980's. Current data indicate that persons who eat locally raised food - pork, beef, poultry, eggs - in this district have elevated serum concentrations of PCBs. Environmental exposure to organochlorines in the Michalovce district indicate association with higher rates of certain cancers, but an inverse association with risk of breast cancer. An increased prevalence of thyroid disorders in the polluted area was also reported. This ''experimental setting in nature'' has attracted international scientific teams and two projects in the area are ongoing: Evaluating Human Health Risk from Low-dose and Long-term PCB Exposure, 5{sup th} FP Project QLK4-2000-00488, 2001- 2004; PCBRISK (http://www.pcbrisk.sk/) and Early Childhood Development and PCB Exposures in Slovakia, NCI/NIH, R01-CA96525 University of California, Davis, USA. This paper is serving as an introduction to papers of a session reporting on various health outcomes associated with PCB exposure. The objectives of the PCBRISK project were targeted at an evaluation of the human health risks of low-dose and long-term exposure to a group of persistent organochlorine pollutants, including polychlorinated biphenyls (PCBs) and their metabolites, organochlorine

  19. Building Evidence for Health: Green Buildings, Current Science, and Future Challenges.

    Science.gov (United States)

    Cedeño-Laurent, J G; Williams, A; MacNaughton, P; Cao, X; Eitland, E; Spengler, J; Allen, J

    2018-04-01

    Civilizational challenges have questioned the status quo of energy and material consumption by humans. From the built environment perspective, a response to these challenges was the creation of green buildings. Although the revolutionary capacity of the green building movement has elevated the expectations of new commercial construction, its rate of implementation has secluded the majority of the population from its benefits. Beyond reductions in energy usage and increases in market value, the main strength of green buildings may be the procurement of healthier building environments. Further pursuing the right to healthy indoor environments could help the green building movement to attain its full potential as a transformational public health tool. On the basis of 40 years of research on indoor environmental quality, we present a summary of nine environment elements that are foundational to human health. We posit the role of green buildings as a critical research platform within a novel sustainability framework based on social-environmental capital assets.

  20. The EXODUS of public health. What history can tell us about the future.

    Science.gov (United States)

    Fairchild, Amy L; Rosner, David; Colgrove, James; Bayer, Ronald; Fried, Linda P

    2010-01-01

    We trace the shifting definitions of the American public health profession's mission as a social reform and science-based endeavor. Its authority coalesced in the late nineteenth and early twentieth centuries as public health identified itself with housing, sanitation, and labor reform efforts. The field ceded that authority to medicine and other professions as it jettisoned its social mission in favor of a science-based identity. Understanding the potential for achieving progressive social change as it moves forward will require careful consideration of the industrial, structural, and intellectual forces that oppose radical reform and the identification of constituencies with which professionals can align to bring science to bear on the most pressing challenges of the day.

  1. Shaping the future: ten years of the occupational health internship program.

    Science.gov (United States)

    Delp, Linda; Riley, Kevin; Jacobs, Sarah; Bush, Diane; Kirkland, Katherine; Denis, Ingrid; London, Matt; Harrison, Robert

    2013-01-01

    The Occupational Health Internship Program (OHIP) was initiated in 2003 to recruit a new, diverse generation of occupational safety and health (OSH) professionals and to advance OSH within union and community-based initiatives. It retains the principles of the original OCAW/Montefiore internship program while adapting to the changed landscape of the 21st-century workplace. Case studies of OHIP projects illustrate how students have contributed to key OSH policies-to regulate silica exposure among construction workers, apply principles of green chemistry with Vietnamese nail salon workers, and integrate OSH into "green" jobs in the recycling industry. They have supported innovative campaigns with immigrant workers in contingent jobs-from taxi drivers to warehouse workers. The students, in turn, have been inspired to enter the OSH arena as professionals and worker advocates with the potential to contribute new energy to an OSH movement.

  2. Future Challenges to Protecting Public Health from Drinking-Water Contaminants

    Science.gov (United States)

    Murphy, Eileen A.; Post, Gloria B.; Buckley, Brian T.; Lippincott, Robert L.; Robson, Mark G.

    2014-01-01

    Over the past several decades, human health protection for chemical contaminants in drinking water has been accomplished by development of chemical-specific standards. This approach alone is not feasible to address current issues of the occurrence of multiple contaminants in drinking water, some of which have little health effects information, and water scarcity. In this article, we describe the current chemical-specific paradigm for regulating chemicals in drinking water and discuss some potential additional approaches currently being explored to focus more on sustaining quality water for specific purposes. Also discussed are strategies being explored by the federal government to screen more efficiently the toxicity of large numbers of chemicals to prioritize further intensive testing. Water reuse and water treatment are described as sustainable measures for managing water resources for potable uses as well as other uses such as irrigation. PMID:22224887

  3. Health marketing information: an assessment of past and future utilization patterns.

    Science.gov (United States)

    McSurely, H B; Fullerton, S

    1995-01-01

    A sample of 108 members of the Academy of Health Services Marketing provided bibliographic citations of 629 sources of information which have been important to them in their jobs. The results indicate that the propensity to rely upon a source is dependent upon the topic of the information sought. The sources under scrutiny were consultants, books, journals, magazines, seminars, conferences, video tapes, and audio tapes. The topics considered included the variables of the marketing mix as well as market planning and marketing research. The discussion provides insight about where seekers of health care marketing knowledge go for specific kinds of information. It also suggests types of media that information-providers should consider for dissemination of their material.

  4. Future challenges to protecting public health from drinking-water contaminants.

    Science.gov (United States)

    Murphy, Eileen A; Post, Gloria B; Buckley, Brian T; Lippincott, Robert L; Robson, Mark G

    2012-04-01

    Over the past several decades, human health protection for chemical contaminants in drinking water has been accomplished by development of chemical-specific standards. This approach alone is not feasible to address current issues of the occurrence of multiple contaminants in drinking water, some of which have little health effects information, and water scarcity. In this article, we describe the current chemical-specific paradigm for regulating chemicals in drinking water and discuss some potential additional approaches currently being explored to focus more on sustaining quality water for specific purposes. Also discussed are strategies being explored by the federal government to screen more efficiently the toxicity of large numbers of chemicals to prioritize further intensive testing. Water reuse and water treatment are described as sustainable measures for managing water resources for potable uses as well as other uses such as irrigation.

  5. Health care administration in the year 2000: practitioners' views of future issues and job requirements.

    Science.gov (United States)

    Hudak, R P; Brooke, P P; Finstuen, K; Riley, P

    1993-01-01

    This research identifies the most important domains in health care administration (HCA) from now to the year 2000 and differentiates job skill, knowledge, and ability requirements necessary for successful management. Fellows of the American College of Healthcare Executives from about half of the United States responded to two iterations of a Delphi mail inquiry. Fellows identified 102 issues that were content-analyzed into nine domains by an HCA expert panel. Domains, in order of ranked importance, were cost/finance, leadership, professional staff interactions, health care delivery concepts, accessibility, ethics, quality/risk management, technology, and marketing. In the second Delphi iteration, Fellows reviewed domain results and rated job requirements on required job importance. Results indicated that while a business orientation is needed for organizational survival, an equal emphasis on person-oriented skills, knowledge, and abilities is required.

  6. Round Six Of Partners Investing In Nursing's Future: Implications For The Health Sector, Policy Makers, And Foundations.

    Science.gov (United States)

    Jellinek, Paul S; Reinhardt, Renee J; Ladden, Maryjoan D; Salmon, Marla E

    2015-07-01

    In its 2011 report on the future of nursing, the Institute of Medicine issued recommendations to position nursing to meet the challenges of twenty-first-century health care. Following release of the report, the Robert Wood Johnson Foundation funded eleven local and regional partnerships of nurses, foundations, and other stakeholders to begin implementing some of the recommendations in their regions. A qualitative evaluation of these partnerships found that although not all goals were met, most of the partnerships achieved meaningful gains. Partnership participants emphasized the value of engaging foundations and other stakeholders from outside nursing in the implementation process, the necessity of funding for implementation, the need for policy makers to address constraints that local and regional partnerships by themselves cannot address, and the unique leadership and convening role that local and regional foundations can play to help their regions respond to complex challenges for the nursing profession. Project HOPE—The People-to-People Health Foundation, Inc.

  7. Screening Assessment of Potential Human-Health Risk from Future Natural-Gas Drilling Near Project Rulison in Western Colorado

    International Nuclear Information System (INIS)

    Daniels, Jeffrey I.; Chapman, Jenny B.

    2012-01-01

    The Project Rulison underground nuclear test was conducted in 1969 at a depth of 8,400 ft in the Williams Fork Formation of the Piceance Basin, west-central Colorado (Figure 1). The U.S. Department of Energy Office of Legacy Management (LM) is the steward of the site. Their management is guided by data collected from past site investigations and current monitoring, and by the results of calculations of expected behavior of contaminants remaining in the deep subsurface. The purpose of this screening risk assessment is to evaluate possible health risks from current and future exposure to Rulison contaminants so the information can be factored into LM's stewardship decisions. For example, these risk assessment results can inform decisions regarding institutional controls at the site and appropriate monitoring of nearby natural-gas extraction activities. Specifically, the screening risk analysis can provide guidance for setting appropriate action levels for contaminant monitoring to ensure protection of human health.

  8. Screening Assessment of Potential Human-Health Risk from Future Natural-Gas Drilling Near Project Rulison in Western Colorado

    Energy Technology Data Exchange (ETDEWEB)

    Daniels Jeffrey I.,Chapman Jenny B.

    2012-01-01

    The Project Rulison underground nuclear test was conducted in 1969 at a depth of 8,400 ft in the Williams Fork Formation of the Piceance Basin, west-central Colorado (Figure 1). The U.S. Department of Energy Office of Legacy Management (LM) is the steward of the site. Their management is guided by data collected from past site investigations and current monitoring, and by the results of calculations of expected behavior of contaminants remaining in the deep subsurface. The purpose of this screening risk assessment is to evaluate possible health risks from current and future exposure to Rulison contaminants so the information can be factored into LM's stewardship decisions. For example, these risk assessment results can inform decisions regarding institutional controls at the site and appropriate monitoring of nearby natural-gas extraction activities. Specifically, the screening risk analysis can provide guidance for setting appropriate action levels for contaminant monitoring to ensure protection of human health.

  9. Toward a better understanding of the future of the solo medical practitioner in health care industry: a conceptual review.

    Science.gov (United States)

    Erdem, S A; Lacombe, B

    1998-01-01

    Even a brief conceptual review of the current developments in the health care industry indicates that the future of independent medical practitioners is rather challenging. It may be necessary for these parties to pursue proactive and aggressive marketing strategies to be able to compete with the managed care organizations. Accordingly, this paper outlines some of the current trends in health care marketing as they relate to the ongoing changes to which solo medical practitioners need to respond. It is hoped that the review of the issues raised in this paper can provide an initial basis for a better understanding of some of the challenges to come up with more comprehensive and effective strategy decisions.

  10. Integrated protection model: ISO 45001 as a future of safety and health standards

    Directory of Open Access Journals (Sweden)

    Živković Snežana

    2015-01-01

    Full Text Available Along with the increase in awareness of the importance of human resources and their contribution to the value of the organization, there is a growing awareness of the need for their management. The fact that modern society prescribes by the law that organizations must identify dangers and hazards, risk level that may arise, as well as their management and implementation of consistent measures to reduce their impact, shows the importance that is attributed to this issue. For the effective implementation of laws in the field of health and safety at work and other necessary protective measures, there has been a need for a systematic approach to management in this area. Systematic approach to management in the field of health and safety at work ensures the implementation of all measures necessary for the safe operation thus protecting both employees and organization. This systematic approach is reflected in the current standard OHSAS 18001, which aims to establish control over the risks that carry harmful potentials, and thus ensuring the continuity of operation of the organization. The focus of the scientific community which is actively working on improving the existing standards in the field of safety and health of employees is focused on the upcoming standard that will replace OHSAS 18001. The upcoming standard places a greater emphasis on the risk management and the ongoing assessment of risks and opportunities to prevent or reduce side effects. The innovations in this standard are reflected in the strengthening of the role of top management and top management as well as in the context of the 'organization' itself. ISO 45001 provides for active participation of management in all processes of health and safety at work and tends to reduce the usage of process of delegated responsibility to one manager, while, on the other hand, the organization looks at the broader, i.e., the requirements of the wider community are taken into account.

  11. [Environment and health in Gela (Sicily): present knowledge and prospects for future studies].

    Science.gov (United States)

    Musmeci, Loredana; Bianchi, Fabrizio; Carere, Mario; Cori, Liliana

    2009-01-01

    The study area includes the Municipalities of Gela, Niscemi and Butera located in the South of Sicily, Italy. In 1990 it was declared Area at High Risk of Environmental Crisis. In 2000 part of it was designated as Gela Reclamation Site of National Interest, RSNI. The site includes a private industrial area, public and marine areas, for a total of 51 km(2). Gela populationin 2008 was 77,145 (54,774 in 1961). Sea level:46 m. Total area: 276 km(2). Grid reference: 37 degrees 4' 0" N, 14 degrees 15' 0" E. Niscemi and Butera are located border to Gela. Populations are respectively 26,541 and 5,063. Sea level respectively: 332 m and 402 m. Close to the city of Gela, the industrial area, operating since 1962, includes chemical production plants, a power station and an oil refinery plant, one of the larger in Europe, refining 5 millions tons of crude per year. From the beginning the workforces decreased from 7,000 to the current 3,000 units. Over the years, these industrial activities have been a major source of environmental pollution. Extremely high levels of toxic, persistent and bio-accumulating chemical pollutants have been documented. Many relevant environmental and health data are available. Prior to the studies described in the present publication, their use in order to identify environmental pressures on health has been limited. Nevertheless, since several years different epidemiological studies have provided evidence of the occurrence of health outcomes significantly higher than in neighbouring areas and compared to regional data. In 2007 a Multidisciplinary Working Group has been established, to analyze the existing data on pollution-exposure-effect and to complete current knowledge on the cycle of pollutants, from migration in the environment to health impact. The present publication is a collection of contribution of this group of experts, supported by the following projects: Evaluation of environmental health impact and estimation of economic costs at of

  12. The Future of Whole-Genome Sequencing for Public Health and the Clinic

    OpenAIRE

    Allard, Marc W.

    2016-01-01

    An American Society for Microbiology (ASM) conference titled the Conference on Rapid Next-Generation Sequencing and Bioinformatic Pipelines for Enhanced Molecular Epidemiological Investigation of Pathogens provided a venue for discussing how technologies surrounding whole-genome sequencing (WGS) are advancing microbiology. Several applications in microbial taxonomy, microbial forensics, and genomics for public health pathogen surveillance were presented at the meeting and are reviewed. All of...

  13. Toxicology of metals and metalloids: Promising issues for future studies in environmental health and toxicology.

    Science.gov (United States)

    Barbosa, Fernando

    2017-01-01

    The function and behavior of chemical elements in ecosystems and in human health probably comprise one of the most studied issues and a theme of great interest and fascination in science. Hot topics are emerging on an annual basis in this field. Bearing this in mind, some promising themes to explore in the field of metals and metalloids in the environment and in toxicology are highlighted and briefly discussed herein.

  14. Educating for the future: adolescent girls' health and education in West Bengal, India.

    Science.gov (United States)

    Rees, Chris A; Long, Katelyn N; Gray, Bobbi; West, Joshua H; Chanani, Sheila; Spielberg, Freya; Crookston, Benjamin T

    2012-01-01

    Adolescent girls in India carry a disproportionate burden of health and social risks; girls that do not finish secondary education are more likely to have an earlier age of sexual initiation, engage in risky sexual behavior, and consequentially be at greater risk of dying from pregnancy-related causes. This paper presents a comparison of girls in school and girls not in school from 665 participants in rural West Bengal, India. The social cognitive theory (SCT), a comprehensive theoretical model, was used as a framework to describe the personal, behavioral, and environmental factors affecting the lives of these adolescent girls. There were significant differences between girls in and out of school in all three categories of the SCT; girls in school were more likely to have heard of sexually transmitted diseases or infections than girls not in school (p<0.0001). Girls in school were also more likely than girls not in school to boil water before drinking (p=0.0078), and girls in school lived in dwellings with 2.3 rooms on average, whereas girls not in school lived in dwellings with only 1.7 rooms (p<0.0001). Indian adolescent girls who are not in school are disadvantaged both economically and by their lack of health knowledge and proper health behaviors when compared with girls who are still in school. In addition, to programs to keep girls in school, efforts should also be made to provide informal education to girls not in school to improve their health knowledge and behaviors.

  15. Maternal, newborn and child health needs, opportunities and preferred futures in Arusha and Ngorongoro: hearing women's voices.

    Science.gov (United States)

    Petrucka, Pammla; Bassendowski, Sandra; Dietrich-Leurer, Marie; Spence-Gress, Cara; Athuman, Zenath; Buza, Joram

    2015-12-12

    With the approaching sunset on the Millennium Development Goals (MDGs), Tanzania continues with its final national push towards achievement of MDG #4 and MDG #5. The Mama Kwanza Socio-economic Health Initiative (MKSHI) was introduced in the hope of contributing to improving maternal, newborn, and child health in Arusha and Ngorongoro. The MKSHI project is a holistic, inter-sectoral approach to maternal, newborn, and child health which aligns with the Government of Tanzania's Vision 2025. At the project onset, a baseline assessment was conducted to launch ongoing benchmarking, monitoring, and evaluation of the project's impacts and implications. The aim of this baseline assessment was twofold. First it was to determine the state of maternal, newborn, and child health in the two project sites. Second it was to ensure that a baseline of key indicators was established as well as identification of unique indicators relevant to the populations of interest. The baseline study was a mixed methods approach to identify maternal, newborn, and child risk factors and indicators in the two target sites. This paper focuses on the qualitative methods and findings. The qualitative component included a series of five community dialogue meetings and thirty-seven individual/dyad interviews with women, providers, and stakeholders. Initially, community meetings were held as open dialogues on maternal, newborn, and child health issues, opportunities, and preferred futures. Individual/dyad interviews were held with women, providers, and stakeholders who held unique information or experiences. Both community dialogue and interview data was analysed for themes and guiding or critical comments. Three over-arching findings emerged: What took you so long to come? How do we know what you know? and How will it change for our daughters? Participant voices are vital in ensuring the achievement of local and global efforts and preferred futures for maternal, newborn, and child health services. This

  16. THE PRESENT AND FUTURE OF CLINICAL AND HEALTH PSYCHOLOGY IN SPAIN: AN ALTERNATIVE VIEW

    Directory of Open Access Journals (Sweden)

    José Antonio Carrobles

    2015-01-01

    Full Text Available In our country, there are currently two types of psychologist qualified to practise psychology in the health field: the Specialist Psychologist in Clinical Psychology (PEPC and the General Health Psychologist (PGS. These qualifications are legally regulated and their accreditation is obtained through two different programs of postgraduate training: the Residential Internship Program (PIR in the case of the PEPC; and the Master of General Health Psychology (MPGS in the case of the PGS. These programs are of different lengths (4 years for the PIR and 2 years for the MPGS and they are accessed after completion of the corresponding degree in Psychology. However, the objectives and the skills to be attained, as well as the content of the training programs, are actually very similar, in spite of the different linguistic denominations used to describe them. On the basis of the existing differences in the terminology and the duration of the programs, some Spanish associations (ANPIR, COP, AEPCP and AEN defend the position that there should be established between the two qualifications, in addition to a hierarchical structure, a clear boundary with respect to the functions that the two types of psychologist can perform (clinical and specialised versus health and general functions and of the sectors or contexts in which they can practise (public versus private. In our article, we refute these positions and the reasons on which they are based and we argue extensively in favour of an alternative proposal more in tune with the reality of the facts and with the European context professional accreditation in clinical psychology, in the sense of accepting the existence of the two independent qualifications of clinical psychologists (the PEPC and the PGS, with direct access to both from the degree in Psychology, and with equivalent competencies and professional functions, although with some limitations in the case of the PGS, mainly with respect to the

  17. The radioactive risk - the future of radionuclides in the environment and their impacts on health

    International Nuclear Information System (INIS)

    Amiard, Jean-Claude

    2013-01-01

    This document contains a brief presentation and the table of contents of a book in which the author proposes a large synthesis of present knowledge on main radioactive pollutants (uranium, transuranic elements, caesium, strontium, iodine, tritium, carbon radioactive isotopes, and so on), their behaviour and their future in the various physical components of the environment and living organisms (including mankind). He presents the fundamentals of nuclear physics and chemistry, as well as their applications in different fields (military, energy, medicine, industry, etc.). He also addresses the important ecological and genetic notions, and recalls the anthropogenic origins of radionuclides in the environment: principles of radio-ecology, main radioactive risks, main drawbacks of the use of nuclear energy (wastes and their management), and nuclear accidents and their impact

  18. The glymphatic system in CNS health and disease: past, present and future

    Science.gov (United States)

    Plog, Benjamin A.; Nedergaard, Maiken

    2018-01-01

    The central nervous system (CNS) is unique in being the only organ system lacking lymphatic vessels to assist in the removal of interstitial metabolic waste products. Recent work has led to the discovery of the glymphatic system, a glial-dependent perivascular network that subserves a pseudo-lymphatic function in the brain. Within the glymphatic pathway, cerebrospinal fluid (CSF) enters brain via periarterial spaces, passes into the interstitium via perivascular astrocytic aquaporin-4, and then drives the perivenous drainage of interstitial fluid (ISF) and its solute. Here we review the role of the glymphatic pathway in CNS physiology, factors known to regulate glymphatic flow, and pathologic processes where a breakdown of glymphatic CSF-ISF exchange has been implicated in disease initiation and progression. Important areas of future research, including manipulation of glymphatic activity aiming to improve waste clearance and therapeutic agent delivery, will also be discussed. PMID:29195051

  19. The Glymphatic System in Central Nervous System Health and Disease: Past, Present, and Future.

    Science.gov (United States)

    Plog, Benjamin A; Nedergaard, Maiken

    2018-01-24

    The central nervous system (CNS) is unique in being the only organ system lacking lymphatic vessels to assist in the removal of interstitial metabolic waste products. Recent work has led to the discovery of the glymphatic system, a glial-dependent perivascular network that subserves a pseudolymphatic function in the brain. Within the glymphatic pathway, cerebrospinal fluid (CSF) enters the brain via periarterial spaces, passes into the interstitium via perivascular astrocytic aquaporin-4, and then drives the perivenous drainage of interstitial fluid (ISF) and its solute. Here, we review the role of the glymphatic pathway in CNS physiology, the factors known to regulate glymphatic flow, and the pathologic processes in which a breakdown of glymphatic CSF-ISF exchange has been implicated in disease initiation and progression. Important areas of future research, including manipulation of glymphatic activity aiming to improve waste clearance and therapeutic agent delivery, are also discussed.

  20. Influence of model assumptions about HIV disease progression after initiating or stopping treatment on estimates of infections and deaths averted by scaling up antiretroviral therapy

    Science.gov (United States)

    Sucharitakul, Kanes; Boily, Marie-Claude; Dimitrov, Dobromir

    2018-01-01

    Background Many mathematical models have investigated the population-level impact of expanding antiretroviral therapy (ART), using different assumptions about HIV disease progression on ART and among ART dropouts. We evaluated the influence of these assumptions on model projections of the number of infections and deaths prevented by expanded ART. Methods A new dynamic model of HIV transmission among men who have sex with men (MSM) was developed, which incorporated each of four alternative assumptions about disease progression used in previous models: (A) ART slows disease progression; (B) ART halts disease progression; (C) ART reverses disease progression by increasing CD4 count; (D) ART reverses disease progression, but disease progresses rapidly once treatment is stopped. The model was independently calibrated to HIV prevalence and ART coverage data from the United States under each progression assumption in turn. New HIV infections and HIV-related deaths averted over 10 years were compared for fixed ART coverage increases. Results Little absolute difference (ART coverage (varied between 33% and 90%) if ART dropouts reinitiated ART at the same rate as ART-naïve MSM. Larger differences in the predicted fraction of HIV-related deaths averted were observed (up to 15pp). However, if ART dropouts could only reinitiate ART at CD4ART interruption did not affect the fraction of HIV infections averted with expanded ART, unless ART dropouts only re-initiated ART at low CD4 counts. Different disease progression assumptions had a larger influence on the fraction of HIV-related deaths averted with expanded ART. PMID:29554136