Health improvement and prevention study (HIPS - evaluation of an intervention to prevent vascular disease in general practice

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Davies Gawaine

2010-08-01

Full Text Available Abstract Background The Health Improvement and Prevention Study (HIPS study aims to evaluate the capacity of general practice to identify patients at high risk for developing vascular disease and to reduce their risk of vascular disease and diabetes through behavioural interventions delivered in general practice and by the local primary care organization. Methods/Design HIPS is a stratified randomized controlled trial involving 30 general practices in NSW, Australia. Practices are randomly allocated to an 'intervention' or 'control' group. General practitioners (GPs and practice nurses (PNs are offered training in lifestyle counselling and motivational interviewing as well as practice visits and patient educational resources. Patients enrolled in the trial present for a health check in which the GP and PN provide brief lifestyle counselling based on the 5As model (ask, assess, advise, assist, and arrange and refer high risk patients to a diet education and physical activity program. The program consists of two individual visits with a dietician or exercise physiologist and four group sessions, after which patients are followed up by the GP or PN. In each practice 160 eligible patients aged between 40 and 64 years are invited to participate in the study, with the expectation that 40 will be eligible and willing to participate. Evaluation data collection consists of (1 a practice questionnaire, (2 GP and PN questionnaires to assess preventive care attitudes and practices, (3 patient questionnaire to assess self-reported lifestyle behaviours and readiness to change, (4 physical assessment including weight, height, body mass index (BMI, waist circumference and blood pressure, (5 a fasting blood test for glucose and lipids, (6 a clinical record audit, and (7 qualitative data collection. All measures are collected at baseline and 12 months except the patient questionnaire which is also collected at 6 months. Study outcomes before and after the

Frontline health care can be improved by bringing research into the clinic

DEFF Research Database (Denmark)

Steinhausen, Kirsten; Berghmans, Stephane; Højgaard, Liselotte

2011-01-01

Progress in clinical research has played a huge role in the great improvements in frontline health care achieved over the last 50 years, both in general practice and in hospitals.......Progress in clinical research has played a huge role in the great improvements in frontline health care achieved over the last 50 years, both in general practice and in hospitals....

Linking oral health, general health, and quality of life

NARCIS (Netherlands)

Kieffer, J.M.; Hoogstraten, J.

2008-01-01

The aim of this work was to assess the association among oral health, general health, and quality of life (QoL). The Oral Health Impact Profile (OHIP-49) and the RAND-36 were distributed amongst 118 psychology freshmen. Additionally, two single items self-rated general health (SRGH) and self-rated

Promoting Mental Health and Preventing Mental Illness in General Practice.

Science.gov (United States)

Thomas, Steve; Jenkins, Rachel; Burch, Tony; Calamos Nasir, Laura; Fisher, Brian; Giotaki, Gina; Gnani, Shamini; Hertel, Lise; Marks, Marina; Mathers, Nigel; Millington-Sanders, Catherine; Morris, David; Ruprah-Shah, Baljeet; Stange, Kurt; Thomas, Paul; White, Robert; Wright, Fiona

2016-01-01

This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert 'Think Tank' convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your 'cluster' of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development.

Process mapping as a framework for performance improvement in emergency general surgery.

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DeGirolamo, Kristin; D'Souza, Karan; Hall, William; Joos, Emilie; Garraway, Naisan; Sing, Chad Kim; McLaughlin, Patrick; Hameed, Morad

2018-02-01

Emergency general surgery conditions are often thought of as being too acute for the development of standardized approaches to quality improvement. However, process mapping, a concept that has been applied extensively in manufacturing quality improvement, is now being used in health care. The objective of this study was to create process maps for small bowel obstruction in an effort to identify potential areas for quality improvement. We used the American College of Surgeons Emergency General Surgery Quality Improvement Program pilot database to identify patients who received nonoperative or operative management of small bowel obstruction between March 2015 and March 2016. This database, patient charts and electronic health records were used to create process maps from the time of presentation to discharge. Eighty-eight patients with small bowel obstruction (33 operative; 55 nonoperative) were identified. Patients who received surgery had a complication rate of 32%. The processes of care from the time of presentation to the time of follow-up were highly elaborate and variable in terms of duration; however, the sequences of care were found to be consistent. We used data visualization strategies to identify bottlenecks in care, and they showed substantial variability in terms of operating room access. Variability in the operative care of small bowel obstruction is high and represents an important improvement opportunity in general surgery. Process mapping can identify common themes, even in acute care, and suggest specific performance improvement measures.

The influence of resilience on mental health: The role of general well-being.

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Gao, Tingting; Ding, Xinna; Chai, Jingxin; Zhang, Zhao; Zhang, Han; Kong, Yixi; Mei, Songli

2017-06-01

Nurses are suffering from increasing stress, and nursing is recognized as one of the most stressful job. Their mental health problems are serious and worthy of attention. The purpose of this study was to explore the relationship between resilience and mental health and general well-being among nurses. A cross-sectional survey was conducted in 2014, using a self-reported questionnaire. Participants were asked to complete the measure of resilience, mental health, and general well-being. The method of randomly cluster sampling was used to select nurses as participants. A survey of 365 nurses was conducted to test the hypothesized model. This study showed that resilience, mental health, and general well-being correlated with each other. General well-being was an effective predictor of resilience and mental health, whereas it both can moderate and mediate the relationship. Strategies to increase nurses' general well-being could enhance their resilience and reduce mental health problems. It is important to improve the mental health of nurses and maintain the professional values that ensure career sustainability. © 2017 John Wiley & Sons Australia, Ltd.

Sleep and Mental Health in Undergraduate Students with Generally Healthy Sleep Habits.

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Milojevich, Helen M; Lukowski, Angela F

2016-01-01

Whereas previous research has indicated that sleep problems tend to co-occur with increased mental health issues in university students, relatively little is known about relations between sleep quality and mental health in university students with generally healthy sleep habits. Understanding relations between sleep and mental health in individuals with generally healthy sleep habits is important because (a) student sleep habits tend to worsen over time and (b) even time-limited experience of sleep problems may have significant implications for the onset of mental health problems. In the present research, 69 university students with generally healthy sleep habits completed questionnaires about sleep quality and mental health. Although participants did not report clinically concerning mental health issues as a group, global sleep quality was associated with mental health. Regression analyses revealed that nighttime sleep duration and the frequency of nighttime sleep disruptions were differentially related to total problems and clinically-relevant symptoms of psychological distress. These results indicate that understanding relations between sleep and mental health in university students with generally healthy sleep habits is important not only due to the large number of undergraduates who experience sleep problems and mental health issues over time but also due to the potential to intervene and improve mental health outcomes before they become clinically concerning.

Collaboration between general practitioners and mental health care professionals: a qualitative study.

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Fredheim, Terje; Danbolt, Lars J; Haavet, Ole R; Kjønsberg, Kari; Lien, Lars

2011-05-23

Collaboration between general practice and mental health care has been recognised as necessary to provide good quality healthcare services to people with mental health problems. Several studies indicate that collaboration often is poor, with the result that patient' needs for coordinated services are not sufficiently met, and that resources are inefficiently used. An increasing number of mental health care workers should improve mental health services, but may complicate collaboration and coordination between mental health workers and other professionals in the treatment chain. The aim of this qualitative study is to investigate strengths and weaknesses in today's collaboration, and to suggest improvements in the interaction between General Practitioners (GPs) and specialised mental health service. This paper presents a qualitative focus group study with data drawn from six groups and eight group sessions with 28 health professionals (10 GPs, 12 nurses, and 6 physicians doing post-doctoral training in psychiatry), all working in the same region and assumed to make professional contact with each other. GPs and mental health professionals shared each others expressions of strengths, weaknesses and suggestions for improvement in today's collaboration. Strengths in today's collaboration were related to common consultations between GPs and mental health professionals, and when GPs were able to receive advice about diagnostic treatment dilemmas. Weaknesses were related to the GPs' possibility to meet mental health professionals, and lack of mutual knowledge in mental health services. The results describe experiences and importance of interpersonal knowledge, mutual accessibility and familiarity with existing systems and resources. There is an agreement between GPs and mental health professionals that services will improve with shared knowledge about patients through systematic collaborative services, direct cell-phone lines to mental health professionals and allocated

Collaboration between general practitioners and mental health care professionals: a qualitative study

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Haavet Ole R

2011-05-01

Full Text Available Abstract Background Collaboration between general practice and mental health care has been recognised as necessary to provide good quality healthcare services to people with mental health problems. Several studies indicate that collaboration often is poor, with the result that patient' needs for coordinated services are not sufficiently met, and that resources are inefficiently used. An increasing number of mental health care workers should improve mental health services, but may complicate collaboration and coordination between mental health workers and other professionals in the treatment chain. The aim of this qualitative study is to investigate strengths and weaknesses in today's collaboration, and to suggest improvements in the interaction between General Practitioners (GPs and specialised mental health service. Methods This paper presents a qualitative focus group study with data drawn from six groups and eight group sessions with 28 health professionals (10 GPs, 12 nurses, and 6 physicians doing post-doctoral training in psychiatry, all working in the same region and assumed to make professional contact with each other. Results GPs and mental health professionals shared each others expressions of strengths, weaknesses and suggestions for improvement in today's collaboration. Strengths in today's collaboration were related to common consultations between GPs and mental health professionals, and when GPs were able to receive advice about diagnostic treatment dilemmas. Weaknesses were related to the GPs' possibility to meet mental health professionals, and lack of mutual knowledge in mental health services. The results describe experiences and importance of interpersonal knowledge, mutual accessibility and familiarity with existing systems and resources. There is an agreement between GPs and mental health professionals that services will improve with shared knowledge about patients through systematic collaborative services, direct cell

Relationship between general health of older health service users and their self-esteem in Isfahan in 2014.

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Molavi, Razieh; Alavi, Mousa; Keshvari, Mahrokh

2015-01-01

Self-esteem is known to be one of the most important markers of successful aging. Older people's self-esteem is influenced by several factors that particularly may be health related. Therefore, this study aimed to explore some important general health-related predictors of the older people's self-esteem. In this study, 200 people, aged 65 years and older, who referred to health care centers were selected through stratified random sampling method. Data were collected by using Rosenberg's self-esteem scale and the 28-item Goldberg's general health questionnaire. Data were analyzed by Pearson's coefficient tests and multiple regression analysis. Findings showed that the entered predictor variables accounted for 49% of the total variance (R(2)) of self-esteem in the model (P self-esteem. The results emphasized on the determinant role of both physical (somatic signs) and mental (anxiety/insomnia and depression) aspects of health in older patients' self-esteem. The significant general health-related predictors found in the present study emphasize on some of the significant points that should be considered in planning for improving older patients' self-esteem.

Protecting and improving health through the radiological sciences. A report to the Surgeon General

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NONE

1966-04-01

, the Committee in this report makes a number of recommendations to the Surgeon General and urges that he take appropriate steps for their early implementation. For convenience, these recommendations are summarized as follows: 1. The Public Health Service should take immediate steps to strengthen its programs in the radiological sciences by unifying their administrative direction. Such action is needed to assure an orderly development of the broad spectrum of radiological activities for which the Service is responsible and to give continuous attention to the balance of benefit and risk in all matters pertaining to the human application of ionizing radiation. 2. The Service should undertake the following training and research and development programs to upgrade the quality of the radiological services which have become such a critical part of medical and dental care and to improve radiation protection practices in the health professions: (a) a series of training programs: (i) to strengthen radiological instruction of medical students; (ii) to increase the number of academic radiologists in American medical schools; and (iii) to increase the number of practicing radiologists in the United States. (b) a series of training programs to provide increasing numbers of radiochemists, radiological engineers, radiobiologists, radiological physicists and radiological health specialists. (c) a series of training programs to provide increasing numbers of technologists in the several disciplines of the radiological sciences. (d) a series of applied research and development programs to increase the effectiveness and safety with which radiological procedures are employed in the health professions.

Protecting and improving health through the radiological sciences. A report to the Surgeon General

International Nuclear Information System (INIS)

1966-04-01

, the Committee in this report makes a number of recommendations to the Surgeon General and urges that he take appropriate steps for their early implementation. For convenience, these recommendations are summarized as follows: 1. The Public Health Service should take immediate steps to strengthen its programs in the radiological sciences by unifying their administrative direction. Such action is needed to assure an orderly development of the broad spectrum of radiological activities for which the Service is responsible and to give continuous attention to the balance of benefit and risk in all matters pertaining to the human application of ionizing radiation. 2. The Service should undertake the following training and research and development programs to upgrade the quality of the radiological services which have become such a critical part of medical and dental care and to improve radiation protection practices in the health professions: (a) a series of training programs: (i) to strengthen radiological instruction of medical students; (ii) to increase the number of academic radiologists in American medical schools; and (iii) to increase the number of practicing radiologists in the United States. (b) a series of training programs to provide increasing numbers of radiochemists, radiological engineers, radiobiologists, radiological physicists and radiological health specialists. (c) a series of training programs to provide increasing numbers of technologists in the several disciplines of the radiological sciences. (d) a series of applied research and development programs to increase the effectiveness and safety with which radiological procedures are employed in the health professions

Determining the Relation between General Health and Educational Progress among Paramedical Faculty’s Students of Tehran Medical University

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Hossein Dargahi

2016-12-01

Full Text Available Considering the fact that students studying various fields of Study will have the responsibility to create, maintain and improve society’s level of health, they should be cared for with precision so they can perform and play their role as an educated and expert work force. this is due to the fact that getting accepted in university is a very sensitive period in lives of efficient workforce and active youth in each country, therefore, present study determines the relation between general health and educational progress among paramedical faculty’s Students of Tehran Medical University. Method: present research has a descriptive-analytic nature and was executed in a time period during winter of 2016. the target society included all students of paramedical faculty and required data was gathered by an adults’ health function literacy questionnaire and general health was also gathered by means of general health questionnaire. in order to present descriptive results of percentage and median and to study and analyses quantitative data, parametric statistical tests was used for normal data and in case there were not normal, unparametric tests were applied. Findings: Results of present study showed that there is a positive significant relation between general health and educational progress (r=01 / 0 p <،28 / 0. Still, no significant relation was observed between general health and health literacy (r= 0.038, p=0.569. Conclusion: In studying general health aspects with health literacy and educational health motivation, all aspects of general health (physical aspect, anxiety aspect, social function aspect, depression aspect showed a direct and significant relation with educational progress but presented no significant relation with health literacy. Still, we could observe a positive effect on educational progress and health literacy by trying to improve any of general health factors. In other words, we could use organizational capitals to improve

Surgeon General's Family Health History Initiative

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... Source Code The Surgeon General's Family Health History Initiative To help focus attention on the importance of ... health campaign, called the Surgeon General's Family History Initiative, to encourage all American families to learn more ...

Improving employee productivity through improved health.

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Mitchell, Rebecca J; Ozminkowski, Ronald J; Serxner, Seth

2013-10-01

The objective of this study was to estimate productivity-related savings associated with employee participation in health promotion programs. Propensity score weighting and multiple regression techniques were used to estimate savings. These techniques were adjusted for demographic and health status differences between participants who engaged in one or more telephonic health management programs and nonparticipants who were eligible for but did not engage in these programs. Employees who participated in a program and successfully improved their health care or lifestyle showed significant improvements in lost work time. These employees saved an average of $353 per person per year. This reflects about 10.3 hours in additional productive time annually, compared with similar, but nonparticipating employees. Participating in health promotion programs can help improve productivity levels among employees and save money for their employers.

Proposed nurse-led initiatives in improving physical health of people with serious mental illness: a survey of nurses in mental health.

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Happell, Brenda; Platania-Phung, Chris; Scott, David

2014-04-01

To identify nurse perceptions on the potential value of general and specific nursing approaches to improving physical health outcomes of people with serious mental illness. People diagnosed with serious mental illnesses experience heightened rates of physical illnesses and can be supported better via healthcare system prevention and management. Nurses working in mental health are a critical part of a system-wide approach to improving physical health care, but there is little known on their views on specific approaches within Australia (e.g. screening for risks, stigma reduction). A national, cross-sectional and nonrandom survey study delivered online. Members of the Australian College of Mental Health Nurses (n = 643), representing nurses employed in mental healthcare services across Australia (71·6% from public mental health services). Participants were asked to rate the potential of nine nurse-based strategies for improving physical health (options: 'yes', 'no', 'not sure') and the potential value of 10 nursing and general strategies for improving physical health (rating from 'negative value' to 'significant value'). There was a high endorsement of all nine nurse-based strategies for physical health (e.g. lifestyle programmes, screening, linking services), although there was less support for reducing antipsychotics or advocating for fewer side effects. Participants mainly viewed all strategies as of moderate to significant value, with the most promising value attached to colocation of primary and mental care services, lifestyle programmes and improving primary care services (reduce stigma, train GPs). Australian nurses working in mental health services view a range of nurse-based strategies for improving physical healthcare services and standards as important. Nurses collectively need to work with consumers, health agencies and the general public to further define how to organise and implement physical health integration strategies, towards more comprehensive

Crosstalk between oral and general health status in e-smokers.

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Tatullo, Marco; Gentile, Stefano; Paduano, Francesco; Santacroce, Luigi; Marrelli, Massimo

2016-12-01

Electronic cigarette (e-cigarette) simulates the act of tobacco smoking by vaporizing a mixture of propylene glycol, nicotine, and flavoring agents. e-cigarette has been proposed as a product able to aid to stop smoking. The aim of the study is to verify the clinical variations of periodontal health induced by e-cigarettes use and, moreover, to investigate about the awareness of the e-smokers about their health variations and about their hypothetical need to turn back to smoke combustible cigarettes.This clinical observational pilot study involved 110 out of 350 smokers, who switched to e-cigarette. Patients were subjected to oral examinations. A questionnaire to self-assess the variations of some parameters of general health, and to self-assess the need to smoke combustible cigarettes, was distributed to such subjects involved in the study.At the end of the study, we registered a progressive improvement in the periodontal indexes, as well as in the general health perception. Finally, many patients reported an interesting reduction in the need to smoke.In the light of this pilot study, the e-cigarette can be considered as a valuable alternative to tobacco cigarettes, but with a positive impact on periodontal and general health status.

The Coronary Health Improvement Projects Impact on Lowering Eating, Sleep, Stress, and Depressive Disorders

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Merrill, Ray M.; Aldana, Stephen G.; Greenlaw, Roger L.; Diehl, Hans A.

2008-01-01

Background: The Coronary Health Improvement Project (CHIP) is designed to lower cardiovascular risk factors among a group of generally healthy individuals through health education. Purpose: This study will evaluate the efficacy of the CHIP intervention at improving eating, sleep, stress, and depressive disorders. Methods: A health education…

Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care

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Percival, Nikki; O’Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

2016-01-01

Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470

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

Directory of Open Access Journals (Sweden)

Nikki ePercival

2016-03-01

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

Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care.

Science.gov (United States)

Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

2016-01-01

Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers.

Evaluating the implementation of a quality improvement process in General Practice using a realist evaluation framework.

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Moule, Pam; Clompus, Susan; Fieldhouse, Jon; Ellis-Jones, Julie; Barker, Jacqueline

2018-05-25

Underuse of anticoagulants in atrial fibrillation is known to increase the risk of stroke and is an international problem. The National Institute for Health Care and Excellence guidance CG180 seeks to reduce atrial fibrillation related strokes through prescriptions of Non-vitamin K antagonist Oral Anticoagulants. A quality improvement programme was established by the West of England Academic Health Science Network (West of England AHSN) to implement this guidance into General Practice. A realist evaluation identified whether the quality improvement programme worked, determining how and in what circumstances. Six General Practices in 1 region, became the case study sites. Quality improvement team, doctor, and pharmacist meetings within each of the General Practices were recorded at 3 stages: initial planning, review, and final. Additionally, 15 interviews conducted with the practice leads explored experiences of the quality improvement process. Observation and interview data were analysed and compared against the initial programme theory. The quality improvement resources available were used variably, with the training being valued by all. The initial programme theories were refined. In particular, local workload pressures and individual General Practitioner experiences and pre-conceived ideas were acknowledged. Where key motivators were in place, such as prior experience, the programme achieved optimal outcomes and secured a lasting quality improvement legacy. The employment of a quality improvement programme can deliver practice change and improvement legacy outcomes when particular mechanisms are employed and in contexts where there is a commitment to improve service. © 2018 John Wiley & Sons, Ltd.

Association between overuse of mobile phones on quality of sleep and general health among occupational health and safety students.

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Eyvazlou, Meysam; Zarei, Esmaeil; Rahimi, Azin; Abazari, Malek

2016-01-01

Concerns about health problems due to the increasing use of mobile phones are growing. Excessive use of mobile phones can affect the quality of sleep as one of the important issues in the health literature and general health of people. Therefore, this study investigated the relationship between the excessive use of mobile phones and general health and quality of sleep on 450 Occupational Health and Safety (OH&S) students in five universities of medical sciences in the North East of Iran in 2014. To achieve this objective, special questionnaires that included Cell Phone Overuse Scale, Pittsburgh's Sleep Quality Index (PSQI) and General Health Questionnaire (GHQ) were used, respectively. In addition to descriptive statistical methods, independent t-test, Pearson correlation, analysis of variance (ANOVA) and multiple regression tests were performed. The results revealed that half of the students had a poor level of sleep quality and most of them were considered unhealthy. The Pearson correlation co-efficient indicated a significant association between the excessive use of mobile phones and the total score of general health and the quality of sleep. In addition, the results of the multiple regression showed that the excessive use of mobile phones has a significant relationship between each of the four subscales of general health and the quality of sleep. Furthermore, the results of the multivariate regression indicated that the quality of sleep has a simultaneous effect on each of the four scales of the general health. Overall, a simultaneous study of the effects of the mobile phones on the quality of sleep and the general health could be considered as a trigger to employ some intervention programs to improve their general health status, quality of sleep and consequently educational performance.

Oral health, general health, and quality of life in older people

DEFF Research Database (Denmark)

Kandelman, Daniel; Petersen, Poul Erik; Ueda, Hiroshi

2008-01-01

The purpose of this report is to review the interrelationship between poor oral health conditions of older people and general health. The impact of poor oral health on quality of life (QOL) is analyzed, and the implications for public health intervention and oral health care are discussed. Findings...... from the current research may lead to the following conclusions: The available scientific evidence is particularly strong for a direct relationship between diabetes and periodontal disease; the direct relationship between periodontal disease and cardiovascular disease is less convincing. General...... and associated oral health conditions have a direct influence on elder people's QOL and lifestyle. The growing number of elderly people challenges health authorities in most countries. The evidence on oral health-general health relationships is particularly important to WHO in its effort to strengthen integrated...

Work related stress, burnout, job satisfaction and general health of nurses: A follow-up study.

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Khamisa, Natasha; Peltzer, Karl; Ilic, Dragan; Oldenburg, Brian

2016-12-01

Nurses experience high levels of work related stress and burnout as well as low job satisfaction and poor general health owing to the nature of their work. This paper seeks to provide a better understanding of the nature of relationships between work related stress, burnout, job satisfaction and general health of nurses over one year. This study involved a longitudinal design. Two hundred and seventy seven nurses from four hospitals completed a follow up survey consisting of five questionnaires. Data were collected between 2013 and 2014. The data were analysed using generalized estimation equation analysis. Lack of support was associated with burnout, patient care was associated with job satisfaction and staff issues were associated with general health of nurses. Burnout is more strongly related to job satisfaction than general health. The findings of this study could inform evidence based policy and practice through interventions aimed at improving job satisfaction and reducing the impact of burnout on general health of nurses. © 2016 John Wiley & Sons Australia, Ltd.

A Qualitative Study Exploring Facilitators for Improved Health Behaviors and Health Behavior Programs: Mental Health Service Users’ Perspectives

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Candida Graham

2014-01-01

Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.

Going for gold: the health promoting general practice.

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Watson, Michael

2008-01-01

The World Health Organization's Ottawa Charter for Health Promotion has been influential in guiding the development of 'settings' based health promotion. Over the past decade, settings such as schools have flourished and there has been a considerable amount of academic literature produced, including theoretical papers, descriptive studies and evaluations. However, despite its central importance, the health-promoting general practice has received little attention. This paper discusses: the significance of this setting for health promotion; how a health promoting general practice can be created; effective health promotion approaches; the nursing contribution; and some challenges that need to be resolved. In order to become a health promoting general practice, the staff must undertake a commitment to fulfil the following conditions: create a healthy working environment; integrate health promotion into practice activities; and establish alliances with other relevant institutions and groups within the community. The health promoting general practice is the gold standard for health promotion. Settings that have developed have had the support of local, national and European networks. Similar assistance and advocacy will be needed in general practice. This paper recommends that a series of rigorously evaluated, high-quality pilot sites need to be established to identify and address potential difficulties, and to ensure that this innovative approach yields tangible health benefits for local communities. It also suggests that government support is critical to the future development of health promoting general practices. This will be needed both directly and in relation to the capacity and resourcing of public health in general.

Practical recommendations for improvement of the physical health care of patients with severe mental illness

NARCIS (Netherlands)

van Hasselt, F. M.; Oud, M. J. T.; Loonen, A. J. M.

ObjectiveHealth care for the physical health of patients with severe mental illness (SMI) needs to be improved. Therefore, we aimed to develop policy recommendations to improve this physical health care in the Netherlands based on consensus (general agreement) between the major stakeholders. MethodA

Global policy for improvement of oral health in the 21st century--implications to oral health research of World Health Assembly 2007, World Health Organization

DEFF Research Database (Denmark)

Petersen, Poul Erik

2009-01-01

The World Health Organization (WHO) Global Oral Health Programme has worked hard over the past 5 years to increase the awareness of oral health worldwide as oral health is important component of general health and quality of life. Meanwhile, oral disease is still a major public health problem...... in high income countries and the burden of oral disease is growing in many low- and middle income countries. In the World Oral Health Report 2003, the WHO Global Oral Health Programme formulated the policies and necessary actions to the continuous improvement of oral health. The strategy is that oral...... disease prevention and the promotion of oral health needs to be integrated with chronic disease prevention and general health promotion as the risks to health are linked. The World Health Assembly (WHA) and the Executive Board (EB) are supreme governance bodies of WHO and for the first time in 25 years...

Improving equity in health care financing in China during the progression towards Universal Health Coverage.

Science.gov (United States)

Chen, Mingsheng; Palmer, Andrew J; Si, Lei

2017-12-29

China is reforming the way it finances health care as it moves towards Universal Health Coverage (UHC) after the failure of market-oriented mechanisms for health care. Improving financing equity is a major policy goal of health care system during the progression towards universal coverage. We used progressivity analysis and dominance test to evaluate the financing channels of general taxation, pubic health insurance, and out-of-pocket (OOP) payments. In 2012 a survey of 8854 individuals in 3008 households recorded the socioeconomic and demographic status, and health care payments of those households. The overall Kakwani index (KI) of China's health care financing system is 0.0444. For general tax KI was -0.0241 (95% confidence interval (CI): -0.0315 to -0.0166). The indices for public health schemes (Urban Employee Basic Medical Insurance, Urban Resident's Basic Medical Insurance, New Rural Cooperative Medical Scheme) were respectively 0.1301 (95% CI: 0.1008 to 0.1594), -0.1737 (95% CI: -0.2166 to -0.1308), and -0.5598 (95% CI: -0.5830 to -0.5365); and for OOP payments KI was 0.0896 (95%CI: 0.0345 to 0.1447). OOP payments are still the dominant part of China's health care finance system. China's health care financing system is not really equitable. Reducing the proportion of indirect taxes would considerably improve health care financing equity. The flat-rate contribution mechanism is not recommended for use in public health insurance schemes, and more attention should be given to optimizing benefit packages during China's progression towards UHC.

Educational inequalities in general and mental health: differential contribution of physical activity, smoking, alcohol consumption and diet.

Science.gov (United States)

Kurtze, Nanna; Eikemo, Terje A; Kamphuis, Carlijn B M

2013-04-01

Behavioural, material and psychosocial risk factors may explain educational inequalities in general health. To what extent these risk factors have similar or different contributions to educational inequalities in mental health is unknown. Data were derived from the Norwegian Survey of Level of Living from 2005, comprising 5791 respondents aged ≥ 25 years. The study objectives were addressed by means of a series of logistic regression analyses in which we examined: (i) educational inequalities in self-reported general and mental health; (ii) the associations between behavioural, material and psychosocial risk factors and general and mental health, controlled for sex, age and education; and (iii) the contribution of risk factors to the observed health gradients. The lower educated were more likely to be in poor health [odds ratio (OR): 3.46 (95% confidence interval, CI: 2.84-4.21)] and to be in poor mental health [OR: 1.41 (95% CI: 1.12-1.78)] than the highest educated. The joint contribution of behavioural, material and psychosocial risk factors explained all the variations of mental health inequalities, whereas these were able to explain ~40% of the inequalities in general health. Both behavioural and material risk factors contributed substantially to the explanation of general and mental health inequalities, whereas the psychosocial risk factor (i.e. having close persons to communicate with) only seemed to make a larger difference for the explanation of mental health inequalities. Policies and interventions to reduce health inequalities should have a broad focus. Combined strategies should be applied to improve physical activity, decrease smoking and improve material and psychosocial conditions among lower educated groups, to achieve the true potential of reducing inequalities in both general and mental health.

Mental Health of General Practitioners in Emergency Wards

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Sepehrmanesh Z.1 PhD,

2015-01-01

Full Text Available Aims General practitioners have an essential role in patient care and are exposed to high levels of job stress. General practitioners’ mental health has effects on their functional abilities and medical managements.This study was carried out to evaluate the mental health of general practitioners in emergency wards in KashanUniversity of Medical Sciences, Iran. Materials & Methods In this cross-sectional study, all of General practitioners in emergency wards (n=87 were studied. The survey instruments includedtwo questionnaires: 1-demographic variables and 2- General Health Questionnaire (GHQ-28. Data were analyzed using SPSS 16 software and Chi square, Fisher exactand Mann-Whitney statistical tests. Findings The mean age of general practitioners was 36.11±5.67 years; 89.7% of them were married; 60.3% were male. 41% of the total general practitioners had mental health problems. The mean score of GHQ was 22.56±9.24. There were significant relationships between mental health and each age, employment situation, and number of children (p0.05. Conclusion The majority of employed general practitioners in emergency rooms do not have proper mental health statuses.

Relationship between general health of older health service users and their self-esteem in Isfahan in 2014

Directory of Open Access Journals (Sweden)

Razieh Molavi

2015-01-01

Full Text Available Background: Self-esteem is known to be one of the most important markers of successful aging. Older people's self-esteem is influenced by several factors that particularly may be health related. Therefore, this study aimed to explore some important general health-related predictors of the older people's self-esteem. Materials and Methods: In this study, 200 people, aged 65 years and older, who referred to health care centers were selected through stratified random sampling method. Data were collected by using Rosenberg's self-esteem scale and the 28-item Goldberg's general health questionnaire. Data were analyzed by Pearson's coefficient tests and multiple regression analysis. Results: Findings showed that the entered predictor variables accounted for 49% of the total variance (R2 of self-esteem in the model (P < 0.001, F4,195 = 46.717. Three out of the four predictor variables including somatic signs, anxiety/insomnia, and depression, significantly predicted the self-esteem. The results emphasized on the determinant role of both physical (somatic signs and mental (anxiety/insomnia and depression aspects of health in older patients' self-esteem. Conclusions: The significant general health-related predictors found in the present study emphasize on some of the significant points that should be considered in planning for improving older patients' self-esteem.

Accredited Health Department Partnerships to Improve Health: An Analysis of Community Health Assessments and Improvement Plans.

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Kronstadt, Jessica; Chime, Chinecherem; Bhattacharya, Bulbul; Pettenati, Nicole

The Public Health Accreditation Board (PHAB) Standards & Measures require the development and updating of collaborative community health assessments (CHAs) and community health improvement plans (CHIPs). The goal of this study was to analyze the CHAs and CHIPs of PHAB-accredited health departments to identify the types of partners engaged, as well as the objectives selected to measure progress toward improving community health. The study team extracted and coded data from documents from 158 CHA/CHIP processes submitted as part of the accreditation process. Extracted data included population size, health department type, data sources, and types of partner organizations. Health outcome objectives were categorized by Healthy People 2020 Leading Health Indicator (LHI), as well as by the 7 broad areas in the PHAB reaccreditation framework for population health outcomes reporting. Participants included health departments accredited between 2013 and 2016 that submitted CHAs and CHIPs to PHAB, including 138 CHAs/CHIPs from local health departments and 20 from state health departments. All the CHAs/CHIPs documented collaboration with a broad array of partners, with hospitals and health care cited most frequently (99.0%). Other common partners included nonprofit service organizations, education, business, and faith-based organizations. Small health departments more frequently listed many partner types, including law enforcement and education, compared with large health departments. The majority of documents (88.6%) explicitly reference Healthy People 2020 goals, with most addressing the LHIs nutrition/obesity/physical activity and access to health services. The most common broad areas from PHAB's reaccreditation framework were preventive health care and individual behavior. This study demonstrates the range of partners accredited health departments engage with to collaborate on improving their communities' health as well as the objectives used to measure community health

Does competition improve health care quality?

Science.gov (United States)

Scanlon, Dennis P; Swaminathan, Shailender; Lee, Woolton; Chernew, Michael

2008-12-01

To identify the effect of competition on health maintenance organizations' (HMOs) quality measures. Longitudinal analysis of a 5-year panel of the Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Health Plans Survey(R) (CAHPS) data (calendar years 1998-2002). All plans submitting data to the National Committee for Quality Assurance (NCQA) were included regardless of their decision to allow NCQA to disclose their results publicly. NCQA, Interstudy, the Area Resource File, and the Bureau of Labor Statistics. Fixed-effects models were estimated that relate HMO competition to HMO quality controlling for an unmeasured, time-invariant plan, and market traits. Results are compared with estimates from models reliant on cross-sectional variation. Estimates suggest that plan quality does not improve with increased levels of HMO competition (as measured by either the Herfindahl index or the number of HMOs). Similarly, increased HMO penetration is generally not associated with improved quality. Cross-sectional models tend to suggest an inverse relationship between competition and quality. The strategies that promote competition among HMOs in the current market setting may not lead to improved HMO quality. It is possible that price competition dominates, with purchasers and consumers preferring lower premiums at the expense of improved quality, as measured by HEDIS and CAHPS. It is also possible that the fragmentation associated with competition hinders quality improvement.

Work Related Stress, Burnout, Job Satisfaction and General Health of Nurses

Directory of Open Access Journals (Sweden)

Natasha Khamisa

2015-01-01

Full Text Available Gaps in research focusing on work related stress, burnout, job satisfaction and general health of nurses is evident within developing contexts like South Africa. This study identified the relationship between work related stress, burnout, job satisfaction and general health of nurses. A total of 1200 nurses from four hospitals were invited to participate in this cross-sectional study (75% response rate. Participants completed five questionnaires and multiple linear regression analysis was used to determine significant relationships between variables. Staff issues are best associated with burnout as well as job satisfaction. Burnout explained the highest amount of variance in mental health of nurses. These are known to compromise productivity and performance, as well as affect the quality of patient care. Issues, such as security risks in the workplace, affect job satisfaction and health of nurses. Although this is more salient to developing contexts it is important in developing strategies and intervention programs towards improving nurse and patient related outcomes.

Work Related Stress, Burnout, Job Satisfaction and General Health of Nurses

Science.gov (United States)

Khamisa, Natasha; Oldenburg, Brian; Peltzer, Karl; Ilic, Dragan

2015-01-01

Gaps in research focusing on work related stress, burnout, job satisfaction and general health of nurses is evident within developing contexts like South Africa. This study identified the relationship between work related stress, burnout, job satisfaction and general health of nurses. A total of 1200 nurses from four hospitals were invited to participate in this cross-sectional study (75% response rate). Participants completed five questionnaires and multiple linear regression analysis was used to determine significant relationships between variables. Staff issues are best associated with burnout as well as job satisfaction. Burnout explained the highest amount of variance in mental health of nurses. These are known to compromise productivity and performance, as well as affect the quality of patient care. Issues, such as security risks in the workplace, affect job satisfaction and health of nurses. Although this is more salient to developing contexts it is important in developing strategies and intervention programs towards improving nurse and patient related outcomes. PMID:25588157

Work related stress, burnout, job satisfaction and general health of nurses.

Science.gov (United States)

Khamisa, Natasha; Oldenburg, Brian; Peltzer, Karl; Ilic, Dragan

2015-01-12

Gaps in research focusing on work related stress, burnout, job satisfaction and general health of nurses is evident within developing contexts like South Africa. This study identified the relationship between work related stress, burnout, job satisfaction and general health of nurses. A total of 1200 nurses from four hospitals were invited to participate in this cross-sectional study (75% response rate). Participants completed five questionnaires and multiple linear regression analysis was used to determine significant relationships between variables. Staff issues are best associated with burnout as well as job satisfaction. Burnout explained the highest amount of variance in mental health of nurses. These are known to compromise productivity and performance, as well as affect the quality of patient care. Issues, such as security risks in the workplace, affect job satisfaction and health of nurses. Although this is more salient to developing contexts it is important in developing strategies and intervention programs towards improving nurse and patient related outcomes.

Venous thromboprophylaxis in general surgery ward admissions: strategies for improvement.

Science.gov (United States)

Galante, Mariana; Languasco, Agustín; Gotta, Daniel; Bell, Soledad; Lancelotti, Tomás; Knaze, Viktoria; Saubidet, Cristián Lopez; Grand, Beatriz; Milberg, Matías

2012-12-01

To estimate the adherence to institutional venous thromboprophylaxis clinical practice guidelines (CPGs) in general surgery patients and to assess the effectiveness of a multi-strategy improvement intervention. A prospective before-after study. Two teaching hospitals located in the city of Buenos Aires, Argentina. Prescriptions belonging to patients admitted to the general surgery wards were evaluated. A multi-strategy intervention that included (i) simplification of institutional CPGs for venous thromboprophylaxis using a single drug at a single dose, based on the American College of Chest Physicians recommendations, (ii) distribution of pocket cards with an algorithm for the implementation of new recommendations to both, physicians and nurses, working in the general surgery units, (iii) educational talks, (iv) paper-based reminders and (v) audit and feedback. The adherence of the venous thromboprophylaxis prescription to the institutional recommendations. The prescriptions of 100 admitted patients before and 90 after the intervention were included in the analysis. The initial rate of adherence was 31%. After the intervention this rate rose to 71.1% (P< 0.001). The major improvement observed was the reduction in omitted prophylaxis in patients at risk of venous thromboembolism from 45 to 13.3% (P< 0.001). In the adjusted model, prescribing compliance with CPGs was five times more likely during the second stage than during the first stage (OR = 5.60, 95% CI = 2.92-10.74). Simple and economical interventions such as those described in this study can improve general surgeons compliance with the institutional and international guidelines, thus assuring patient safety and quality of health care.

The utah beacon experience: integrating quality improvement, health information technology, and practice facilitation to improve diabetes outcomes in small health care facilities.

Science.gov (United States)

Tennison, Janet; Rajeev, Deepthi; Woolsey, Sarah; Black, Jeff; Oostema, Steven J; North, Christie

2014-01-01

The Utah Improving Care through Connectivity and Collaboration (IC3) Beacon community (2010-2013) was spearheaded by HealthInsight, a nonprofit, community-based organization. One of the main objectives of IC(3) was to improve health care provided to patients with diabetes in three Utah counties, collaborating with 21 independent smaller clinics and two large health care enterprises. This paper will focus on the use of health information technology (HIT) and practice facilitation to develop and implement new care processes to improve clinic workflow and ultimately improve patients' diabetes outcomes at 21 participating smaller, independent clinics. Early in the project, we learned that most of the 21 clinics did not have the resources needed to successfully implement quality improvement (QI) initiatives. IC(3) helped clinics effectively use data generated from their electronic health records (EHRs) to design and implement interventions to improve patients' diabetes outcomes. This close coupling of HIT, expert practice facilitation, and Learning Collaboratives was found to be especially valuable in clinics with limited resources. Through this process we learned that (1) an extensive readiness assessment improved clinic retention, (2) clinic champions were important for a successful collaboration, and (3) current EHR systems have limited functionality to assist in QI initiatives. In general, smaller, independent clinics lack knowledge and experience with QI and have limited HIT experience to improve patient care using electronic clinical data. Additionally, future projects like IC(3) Beacon will be instrumental in changing clinic culture so that QI is integrated into routine workflow. Our efforts led to significant changes in how practice staff optimized their EHRs to manage and improve diabetes care, while establishing the framework for sustainability. Some of the IC(3) Beacon practices are currently smoothly transitioning to new models of care such as Patient

Universal health coverage in Latin American countries: how to improve solidarity-based schemes.

Science.gov (United States)

Titelman, Daniel; Cetrángolo, Oscar; Acosta, Olga Lucía

2015-04-04

In this Health Policy we examine the association between the financing structure of health systems and universal health coverage. Latin American health systems encompass a wide range of financial sources, which translate into different solidarity-based schemes that combine contributory (payroll taxes) and non-contributory (general taxes) sources of financing. To move towards universal health coverage, solidarity-based schemes must heavily rely on countries' capacity to increase public expenditure in health. Improvement of solidarity-based schemes will need the expansion of mandatory universal insurance systems and strengthening of the public sector including increased fiscal expenditure. These actions demand a new model to integrate different sources of health-sector financing, including general tax revenue, social security contributions, and private expenditure. The extent of integration achieved among these sources will be the main determinant of solidarity and universal health coverage. The basic challenges for improvement of universal health coverage are not only to spend more on health, but also to reduce the proportion of out-of-pocket spending, which will need increased fiscal resources. Copyright © 2015 Elsevier Ltd. All rights reserved.

Participative mental health consumer research for improving physical health care: An integrative review.

Science.gov (United States)

Happell, Brenda; Ewart, Stephanie B; Platania-Phung, Chris; Stanton, Robert

2016-10-01

People with mental illness have a significantly lower life expectancy and higher rates of chronic physical illnesses than the general population. Health care system reform to improve access and quality is greatly needed to address this inequity. The inclusion of consumers of mental health services as co-investigators in research is likely to enhance service reform. In light of this, the current paper reviews mental health consumer focussed research conducted to date, addressing the neglect of physical health in mental health care and initiatives with the aim of improving physical health care. The international literature on physical healthcare in the context of mental health services was searched for articles, including mental health consumers in research roles, via Medline, CINAHL and Google Scholar, in October 2015. Four studies where mental health consumers participated as researchers were identified. Three studies involved qualitative research on barriers and facilitators to physical health care access, and a fourth study on developing technologies for more effective communication between GPs and patients. This review found that participatory mental health consumer research in physical health care reform has only become visible in the academic literature in 2015. Heightened consideration of mental health consumer participation in research is required by health care providers and researchers. Mental health nurses can provide leadership in increasing mental health consumer research on integrated care directed towards reducing the health gap between people with and without mental illness. © 2016 Australian College of Mental Health Nurses Inc.

Prioritizing quality improvement in general surgery.

Science.gov (United States)

Schilling, Peter L; Dimick, Justin B; Birkmeyer, John D

2008-11-01

Despite growing interest in quality improvement, uncertainty remains about which procedures offer the most room for improvement in general surgery. In this context, we sought to describe the relative contribution of different procedures to overall morbidity, mortality, and excess length of stay in general surgery. Using data from the American College of Surgeons' National Surgery Quality Improvement Program (ACS-NSQIP), we identified all patients undergoing a general surgery procedure in 2005 and 2006 (n=129,233). Patients were placed in 36 distinct procedure groups based on Current Procedural Terminology codes. We first examined procedure groups according to their relative contribution to overall morbidity and mortality. We then assessed procedure groups according to their contribution to overall excess length of stay. Ten procedure groups alone accounted for 62% of complications and 54% of excess hospital days. Colectomy accounted for the greatest share of adverse events, followed by small intestine resection, inpatient cholecystectomy, and ventral hernia repair. In contrast, several common procedures contributed little to overall morbidity and mortality. For example, outpatient cholecystectomy, breast procedures, thyroidectomy, parathyroidectomy, and outpatient inguinal hernia repair together accounted for 34% of procedures, but only 6% of complications (and only 4% of major complications). These same procedures accounted for surgery. Focusing quality improvement efforts on these procedures may be an effective strategy for improving patient care and reducing cost.

Web-Based Interventions to Improve Mental Health, General Caregiving Outcomes, and General Health for Informal Caregivers of Adults With Chronic Conditions Living in the Community: Rapid Evidence Review.

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Ploeg, Jenny; Markle-Reid, Maureen; Valaitis, Ruta; McAiney, Carrie; Duggleby, Wendy; Bartholomew, Amy; Sherifali, Diana

2017-07-28

Most adults with chronic conditions live at home and rely on informal caregivers to provide support. Caregiving can result in negative impacts such as poor mental and physical health. eHealth interventions may offer effective and accessible ways to provide education and support to informal caregivers. However, we know little about the impact of Web-based interventions for informal caregivers of community-dwelling adults with chronic conditions. The purpose of this rapid evidence review was to assess the impact of Web-based interventions on mental health, general caregiving outcomes, and general health for informal caregivers of persons with chronic conditions living in the community. A rapid evidence review of the current literature was employed to address the study purpose. EMBASE, MEDLINE, PsychInfo, CINAHL, Cochrane, and Ageline were searched covering all studies published from January 1995 to July 2016. Papers were included if they (1) included a Web-based modality to deliver an intervention; (2) included informal, unpaid adult caregivers of community-living adults with a chronic condition; (3) were either a randomized controlled trial (RCT) or controlled clinical trial (CCT); and (4) reported on any caregiver outcome as a result of use or exposure to the intervention. A total of 20 papers (17 studies) were included in this review. Study findings were mixed with both statistically significant and nonsignificant findings on various caregiver outcomes. Of the 17 included studies, 10 had at least one significant outcome. The most commonly assessed outcome was mental health, which included depressive symptoms, stress or distress, and anxiety. Twelve papers examined the impact of interventions on the outcome of depressive symptoms; 4 found a significant decrease in depressive symptoms. Eight studies examined the outcome of stress or distress; 4 of these found a significant reduction in stress or distress as a result of the intervention. Three studies examined the

Improving hearing health for farming families.

Science.gov (United States)

Lower, Tony; Fragar, Lyn; Depcynzksi, Julie; Challinor, Kathy; Mills, Jan; Williams, Warwick

2010-01-01

Occupational noise injury and hearing loss are common features of agricultural workforces internationally. Farmsafe Australia has identified hearing health as one of its 4 key priority goals and targets. Currently, approximately 60-70% of Australian farmers have measurable hearing loss, compared with 27% of those in the general Australian community. This article describes the findings of a community based demonstration project to address hearing health issues conducted in the Australian state of New South Wales. This program sought to implement local demonstration projects in 3 communities to identify what works well in hearing health promotion with farmers and what could be applied more broadly throughout Australia. Local advisory groups were established in each community to guide project development and implementation. Project implementation focused on 3 major aspects: (1) increasing awareness of priority noise injury prevention and hearing health practices; (2) improving access to hearing health services; and (3) networking services in local communities. Area-specific training was undertaken for stakeholders to maximize local information links. Service utilization data were monitored and analysed. There was variability among sites; however in general there was an increased awareness of hearing health issues by farming families and expanded opportunities for farmers to access screening services. Utilization rates of hearing services also increased markedly in one community. Local hearing health networks were strengthened by linkages to key stakeholders outside the health sector. Previously unidentified methods of promoting hearing health (eg using agricultural retail outlets that supply hearing protection equipment and are accepted by farmers as an information source) were identified and utilized. Hearing health promotion with farmers in local communities can be enhanced through utilization and strengthening of local networks. Integration of hearing health

Health information systems to improve health care: A telemedicine case study

Directory of Open Access Journals (Sweden)

Liezel Cilliers

2013-03-01

Full Text Available Background: E-health has been identified as an integral part of the future of South African public healthcare. Telemedicine was first introduced in South Africa in 1997 and since then the cost of running the Telemedicine projects has increased substantially. Despite these efforts to introduce the system, only 34% of the Telemedicine sites in South Africa are functional at present. Objectives: Literature has suggested that one of the barriers to the successful implementation of health information systems is the user acceptance by health care workers of systems such as Telemedicine. This study investigated the user acceptance of Telemedicine in the public health care system in the Eastern Cape Province, making use of the Unified Theory of the Use and Acceptance of Technology. Method: The study employed a quantitative survey approach. A questionnaire was developed making use of existing literature and was distributed to various clinics around the province where Telemedicine has been implemented. Statistics were produced making use of Statistical Package for the Social Sciences (SPSS. Results: In general, the health care workers did understand the value and benefit of health information systems to improve the effectiveness and efficiency of the health care system. The barriers to the effective implementation of a health information system include the lack of knowledge and the lack of awareness regarding the Telemedicine system. This in turn means that the user is apprehensive when making use of the system thus contributing to less frequent usage. Conclusion: Health care workers do acknowledge that information systems can help to increase the effectiveness of the health care system. In general, the acceptance of Telemedicine in the Eastern Cape Department of Health is positive, but in order to integrate it into standard work practices, more must be done with regards to the promotion and education of telemedicine.

What makes British general practitioners take part in a quality improvement scheme?

Science.gov (United States)

Spooner, A; Chapple, A; Roland, M

2001-07-01

To understand the reasons for the apparent success of a quality improvement scheme designed to produce widespread changes in chronic disease management in primary care. Purposeful sample of 36 primary care staff, managers and specialists. Qualitative analysis of 27 interviews in East Kent Health Authority area, where, over a three-year period, more than three-quarters of general practitioners (GPs) and enrolled in a quality improvement programme which required them to meet challenging chronic disease management targets (PRImary Care Clinical Effectiveness--PRICCE). Major changes in clinical practice appeared to have taken place as a result of participation in PRICCE. The scheme was significantly dependent on leadership from the health authority and on local professional support. Factors that motivated GPs to take part in the project included: a desire to improve patient care; financial incentives; maintenance of professional autonomy in how to reach the targets; maintenance of professional pride; and peer pressure. Good teamworking was essential to successful completion of the project and often improved as a result of taking part. The scheme included a combination of interventions known to be effective in producing professional behavioural change. When managerial vision is aligned to professional values, and combined with a range of interventions known to influence professional behaviour including financial incentives, substantial changes in clinical practice can result. Lessons are drawn for future quality improvement programmes in the National Health Service.

Actions on social determinants and interventions in primary health to improve mother and child health and health equity in Morocco.

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Boutayeb, Wiam; Lamlili, Mohamed; Maamri, Abdellatif; Ben El Mostafa, Souad; Boutayeb, Abdesslam

2016-02-02

Over the last two decades, Moroccan authorities launched a number of actions and strategies to enhance access to health services and improve health outcomes for the whole population in general and for mother and child in particular. The Ministry of Health launched the action plans 2008-2012 and 2012-2016 and created the maternal mortality surveillance system. The Moroccan government opted for national health coverage through a mandatory health insurance and a scheme of health assistance to the poorest households. Other initiatives were devoted indirectly to health by acting on social determinants of health and poverty reduction. In this paper, we present results of an evaluation of interventions and programmes and their impact on health inequity in Morocco. We used data provided by national surveys over the last decades, information released on the website of the Ministry of Health, documentation published by the Moroccan government and international reports and studies related to Morocco and published by international bodies like the World Health Organisation, United Nations Development Programme, United Nations Population Fund, UNICEF, UNESCO and the World Bank. A short review of scientific publications was also carried out in order to select papers published on health equity, social determinants, health system and interventions in primary health in Morocco. Inferential and descriptive statistics (including principal component analysis) were carried out using software SPSS version 18. The findings indicate that substantial achievements were obtained in terms of access to health care and health outcomes for the whole Moroccan population in general and for mothers and children in particular. However, achievements are unfairly distributed between advantaged and less advantaged regions, literate and illiterate women, rural and urban areas, and rich and poor segments of the Moroccan population. Studies have shown that it is difficult to trace the effect of a primary

THE MAIN GENERAL HEALTH INDICATORS OF PRETERM NEWBORNS

OpenAIRE

Елена Николаевна Никулина; Светлана Ивановна Елгина; Юлия Александровна Липкова; Сергей Викторович Липков

2017-01-01

Objective – to determine the main health indicators in preterm newborns. Materials and Methods: Premature newborns and full-term newborns (160 and 1408, respectively) were investigated with clinical, instrumental, and statistical methods. Anthropometric parameters, somatic health, vulvar anatomy were considered to be the main criteria for general health. Results: The indicators of general health (physical development, somatic health, vulvar anatomy) in premature and full-term newborns...

Decimated Input Ensembles for Improved Generalization

Science.gov (United States)

Tumer, Kagan; Oza, Nikunj C.; Norvig, Peter (Technical Monitor)

1999-01-01

Recently, many researchers have demonstrated that using classifier ensembles (e.g., averaging the outputs of multiple classifiers before reaching a classification decision) leads to improved performance for many difficult generalization problems. However, in many domains there are serious impediments to such "turnkey" classification accuracy improvements. Most notable among these is the deleterious effect of highly correlated classifiers on the ensemble performance. One particular solution to this problem is generating "new" training sets by sampling the original one. However, with finite number of patterns, this causes a reduction in the training patterns each classifier sees, often resulting in considerably worsened generalization performance (particularly for high dimensional data domains) for each individual classifier. Generally, this drop in the accuracy of the individual classifier performance more than offsets any potential gains due to combining, unless diversity among classifiers is actively promoted. In this work, we introduce a method that: (1) reduces the correlation among the classifiers; (2) reduces the dimensionality of the data, thus lessening the impact of the 'curse of dimensionality'; and (3) improves the classification performance of the ensemble.

Psychological distress, optimism and general health in breast cancer survivors: a data linkage study using the Scottish Health Survey.

Science.gov (United States)

Leung, Janni; Atherton, Iain; Kyle, Richard G; Hubbard, Gill; McLaughlin, Deirdre

2016-04-01

The aim of this study is to examine the association between optimism and psychological distress in women with breast cancer after taking into account their self-rated general health. Data were aggregated from the Scottish Health Survey (2008 to 2011) to derive a nationally representative sample of 12,255 women (11,960 cancer-free controls, and 295 breast cancer cases identified from linked cancer registry data). The explanatory variables were optimism and general health, and the outcome variable was symptoms of psychological distress. Logistic regression analyses were conducted, with optimism entered in step 1 and general health entered in step 2. In an unadjusted model, higher levels of optimism were associated with lower odds of psychological distress in both the control group (OR = 0. 57, 95 % CI = 0.51-0.60) and breast cancer group (OR = 0. 64, 95 % CI = 0.47-0.88). However, in a model adjusting for general health, optimism was associated with lower odds of psychological distress only in the control group (OR = 0.50, 95 % CI = 0.44-0.57), but not significantly in the breast cancer group (OR = 1.15, 95 % CI = 0.32-4.11). In the breast cancer group, poor general health was a stronger associate of psychological distress (OR = 4. 98, 95 % CI = 1.32-18.75). Results were consistent after adjusting for age, years since breast cancer diagnosis, survey year, socioeconomic status, education, marital status, body mass index, smoking status, and alcohol consumption. This research confirms the value of multicomponent supportive care interventions for women with breast cancer. Specifically, it suggests that following breast cancer diagnosis, health care professionals need to provide advice and signpost to services that assist women to maintain or improve both their psychological and general health.

Workplace health improvement: perspectives of environmental health officers.

Science.gov (United States)

Reynolds, J; Wills, J

2012-01-01

Environmental health practice in the field of occupational health and safety is traditionally concerned with protecting health relating to the workplace. However, little is currently known about environmental health officers' (EHOs) perceptions of their role in workplace health improvement, a pertinent topic in light of the recent government agenda for improving the health of the workforce in the UK. To explore how EHOs perceive workplace health improvement and its relevance to their professional role. A qualitative methodology was employed, using a case-study design with thematic analysis of 15 transcripts of in-depth telephone interviews with EHOs working in London, UK. EHOs view themselves primarily as enforcement officers, with legislation guiding their understandings of workplace health. Many interpret work-related ill health in terms of safety and physical injury and do not feel competent in assessing broader psychosocial elements of ill health. However, a few EHOs welcomed the opportunity to promote health in the workplace, recognizing the importance of prevention. This study indicates a gap between the contemporary EHO role framed by professional bodies as holistic and contributing to public health goals and the role perceived by EHOs 'on the ground'. A more traditional, protective and enforcement-based approach persists among EHOs in this sample, and few feel they have skills to address determinants beyond physical hazards to health. Yet, a minority of EHOs adopted a more health-promoting approach, suggesting that the potential contribution of EHOs to the workplace health improvement agenda should be explored further.

Implementing the Mental Health Act 2007 in British general practice: Lessons from Ireland.

Science.gov (United States)

Jabbar, Faraz; Doherty, Anne M; Aziz, Muniba; Kelly, Brendan D

2011-01-01

Changes in mental health legislation (e.g. Mental Health Act 2007 in England and Wales, Mental Health Act 2001 in Ireland) have generally improved adherence to international human rights standards, but also present challenges to primary care providers. When mental health legislation was substantially reformed in Ireland, 62.9% of general practitioners (GPs) felt the new legislation was not user-friendly. Majorities of GPs who felt the legislation affected their practice reported increased workloads (85%) and various other difficulties (53%). GPs who had received training about the legislation were more likely to find it user-friendly (43% versus 30.9%), and informal training (e.g. from colleagues) was just as likely as formal training to be associated with a GP finding it user-friendly. With similar changes to mental health legislation being introduced in England and Wales, it is significant that informal training is just as good as formal training in helping GPs work with new mental health legislation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Does general practitioner gatekeeping curb health care expenditure?

NARCIS (Netherlands)

Delnoij, D.; Merode, G. van; Paulus, A.; Groenewegen, P.

2000-01-01

Objectives: It is generally assumed that health care systems in which specialist and hospital care is only accessible after referral by a general practitioner (GP) have lower total health care costs. In this study, the following questions were addressed: do health care systems with GPs acting as

Efficacy of training optimism on general health

Directory of Open Access Journals (Sweden)

Mojgan Behrad

2012-09-01

Full Text Available Background: The purpose of this study was to investigate the relation of optimism with mental health and the affectivity of optimism training on mental health and its components on Yazd University students. Materials and Methods: Fifty new students of the 2008-2009 academic years were randomly selected. The General Health Questionnaire (GHQ-28 and the optimism scale were completed by them. Thirty persons of these students, who had the highest psychological problems based on the general health questionnaire, were divided into two case and control groups through random assignment. The case group was trained for one month, in two 90-minute sessions per week. Pre-tests and follow-up tests were performed in both groups.Results: The results of Pearson correlation coefficients showed that optimism had a negative and significant relationship with mental health, anxiety, social function, and depression scores (p0.005. Multivariate analysis of covariance showed that optimism training had significant impact on mental health and its components in the case group, compared with the control group (p< 0.0001.Conclusion: In general, the findings of this research suggest the relationship between optimism and mental health and the effectiveness of optimism training on mental health. This method can be used to treat and prevent mental health problems.

Improving Service Coordination and Reducing Mental Health Disparities Through Adoption of Electronic Health Records.

Science.gov (United States)

McGregor, Brian; Mack, Dominic; Wrenn, Glenda; Shim, Ruth S; Holden, Kisha; Satcher, David

2015-09-01

Despite widespread support for removing barriers to the use of electronic health records (EHRs) in behavioral health care, adoption of EHRs in behavioral health settings lags behind adoption in other areas of health care. The authors discuss barriers to use of EHRs among behavioral health care practitioners, suggest solutions to overcome these barriers, and describe the potential benefits of EHRs to reduce behavioral health care disparities. Thoughtful and comprehensive strategies will be needed to design EHR systems that address concerns about policy, practice, costs, and stigma and that protect patients' privacy and confidentiality. However, these goals must not detract from continuing to challenge the notion that behavioral health and general medical health should be treated as separate and distinct. Ultimately, utilization of EHRs among behavioral health care providers will improve the coordination of services and overall patient care, which is essential to reducing mental health disparities.

Transgender Noninclusive Healthcare and Delaying Care Because of Fear: Connections to General Health and Mental Health Among Transgender Adults

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Seelman, Kristie L.; Colón-Diaz, Matthew J.P.; LeCroix, Rebecca H.; Xavier-Brier, Marik; Kattari, Leonardo

2017-01-01

Abstract Purpose: There are many barriers to reliable healthcare for transgender people that often contribute to delaying or avoiding needed medical care. Yet, few studies have examined whether noninclusive healthcare and delaying needed medical care because of fear of discrimination are associated with poorer health among transgender adults. This study aims to address these gaps in the knowledge base. Methods: This study analyzed secondary data from a statewide survey of 417 transgender adults in the Rocky Mountain region of the United States. Independent variables included noninclusive healthcare from a primary care provider (PCP) and delay of needed medical care because of fear of discrimination. Dependent variables assessed general health and mental health. Results: Transgender individuals who delayed healthcare because of fear of discrimination had worse general health in the past month than those who did not delay or delayed care for other reasons (B=−0.26, pdiscrimination, having a noninclusive PCP was not significantly associated with either general health or mental health. Conclusion: This study suggests a significant association between delaying healthcare because of fear of discrimination and worse general and mental health among transgender adults. These relationships remain significant even when controlling for provider noninclusivity, suggesting that fear of discrimination and consequent delay of care are at the forefront of health challenges for transgender adults. The lack of statistical significance for noninclusive healthcare may be related to the measurement approach used; future research is needed to develop an improved tool for measuring transgender noninclusive healthcare. PMID:28861545

Change in self-rated general health is associated with perceived illness burden

DEFF Research Database (Denmark)

Nielsen, Anni Brit Sternhagen; Jensen, Per; Gannik, Dorte Effersøe

2015-01-01

Background: iabetic patients’ lifestyle adaptations to improve glycaemic control are not always followed by improvements in self-rated general health (SRH). The perceived impact of diabetes on patients’ daily lives may influence changes in their SRH. This paper examines the association of illness...... diabetes-related symptoms, and cardiovascular disease were related to lower SRH ratings. On average SRH improved by 0.46 (95% CI: 0.37; 0.55) during the first year after diagnosis without inclusion of covariates. Mental and practical illness burden was the only factor associated with change in SRH...

General practice integration in Australia. Primary health services provider and consumer perceptions of barriers and solutions.

Science.gov (United States)

Appleby, N J; Dunt, D; Southern, D M; Young, D

1999-08-01

To identify practical examples of barriers and possible solutions to improve general practice integration with other health service providers. Twelve focus groups, including one conducted by teleconference, were held across Australia with GPs and non GP primary health service providers between May and September, 1996. Focus groups were embedded within concept mapping sessions, which were used to conceptually explore the meaning of integration in general practice. Data coding, organising and analysis were based on the techniques documented by Huberman and Miles. Barriers to integration were perceived to be principally due to the role and territory disputes between the different levels of government and their services, the manner in which the GP's role is currently defined, and the system of GP remuneration. Suggestions on ways to improve integration involved two types of strategies. The first involves initiatives implemented 'top down' through major government reform to service structures, including the expansion of the role of divisions of general practice, and structural changes to the GP remuneration systems. The second type of strategy suggested involves initiatives implemented from the 'bottom up' involving services such as hospitals (e.g. additional GP liaison positions) and the use of information technology to link services and share appropriate patient data. The findings support the need for further research and evaluation of initiatives aimed at achieving general practice integration at a systems level. There is little evidence to suggest which types of initiatives improve integration. However, general practice has been placed in the centre of the health care debate and is likely to remain central to the success of such initiatives. Clarification of the future role and authority of general practice will therefore be required if such integrative strategies are to be successful at a wider health system level.

Exercise adherence, cardiopulmonary fitness and anthropometric changes improve exercise self-efficacy and health-related quality of life.

Science.gov (United States)

Imayama, Ikuyo; Alfano, Catherine M; Mason, Caitlin E; Wang, Chiachi; Xiao, Liren; Duggan, Catherine; Campbell, Kristin L; Foster-Schubert, Karen E; Wang, Ching-Yun; McTiernan, Anne

2013-07-01

Regular exercise increases exercise self-efficacy and health-related quality of life (HRQOL); however, the mechanisms are unknown. We examined the associations of exercise adherence and physiological improvements with changes in exercise self-efficacy and HRQOL. Middle-aged adults (N = 202) were randomized to 12 months aerobic exercise (360 minutes/week) or control. Weight, waist circumference, percent body fat, cardiopulmonary fitness, HRQOL (SF-36), and exercise self-efficacy were assessed at baseline and 12 months. Adherence was measured in minutes/day from activity logs. Exercise adherence was associated with reduced bodily pain, improved general health and vitality, and reduced role-emotional scores (P(trend) ≤ 0.05). Increased fitness was associated with improved physical functioning, bodily pain and general health scores (P(trend) ≤ 0.04). Reduced weight and percent body fat were associated with improved physical functioning, general health, and bodily pain scores (P(trend) exercise adherence, increased cardiopulmonary fitness and reduced weight, waist circumference and percent body fat were associated with increased exercise self-efficacy (P(trend) exercise programs to induce changes in cardiopulmonary fitness and body composition may lead to greater improvements in HRQOL and self-efficacy that could promote exercise maintenance.

Forging Multidisciplinary Collaboration to Improve Mental/Behavioral Health.

Science.gov (United States)

Vaughn, Wanda M; Bunde, Paula K; Remick-Erickson, Kara; Rebeck, Shelby; Denny, Darla

2017-09-01

Five Johnson and Johnson fellows validated the lack of communication regarding students with mental/behavioral health issues and took a leadership position within their school district to address the problem. An open-ended survey revealed inconsistent and fragmented support given to students with mental/behavioral health concerns. A multidisciplinary task force was formed consisting of stakeholders including district and nondistrict community members. The procedure for district staff to address students' behavioral/mental health concerns was adapted by representatives from all stakeholders and was distributed district wide and uploaded to the district's staff website for general access. Training of district employees in Youth Mental Health First Aid has provided the foundation for communicating and implementing a standardized approach for identifying, responding, and referring students with mental/behavioral health concerns. Open dialog, better communication and understanding of disciplines, and more initiatives aimed at improving the mental health of all students has resulted from the collaboration started with this initiative.

Quality improvement and emerging global health priorities

Science.gov (United States)

Mensah Abrampah, Nana; Syed, Shamsuzzoha Babar; Hirschhorn, Lisa R; Nambiar, Bejoy; Iqbal, Usman; Garcia-Elorrio, Ezequiel; Chattu, Vijay Kumar; Devnani, Mahesh; Kelley, Edward

2018-01-01

Abstract Quality improvement approaches can strengthen action on a range of global health priorities. Quality improvement efforts are uniquely placed to reorient care delivery systems towards integrated people-centred health services and strengthen health systems to achieve Universal Health Coverage (UHC). This article makes the case for addressing shortfalls of previous agendas by articulating the critical role of quality improvement in the Sustainable Development Goal era. Quality improvement can stimulate convergence between health security and health systems; address global health security priorities through participatory quality improvement approaches; and improve health outcomes at all levels of the health system. Entry points for action include the linkage with antimicrobial resistance and the contentious issue of the health of migrants. The work required includes focussed attention on the continuum of national quality policy formulation, implementation and learning; alongside strengthening the measurement-improvement linkage. Quality improvement plays a key role in strengthening health systems to achieve UHC. PMID:29873793

Role of Video Games in Improving Health-Related Outcomes

Science.gov (United States)

Primack, Brian A.; Carroll, Mary V.; McNamara, Megan; Klem, Mary Lou; King, Brandy; Rich, Michael O.; Chan, Chun W.; Nayak, Smita

2012-01-01

Context Video games represent a multibillion-dollar industry in the U.S. Although video gaming has been associated with many negative health consequences, it may also be useful for therapeutic purposes. The goal of this study was to determine whether video games may be useful in improving health outcomes. Evidence acquisition Literature searches were performed in February 2010 in six databases: the Center on Media and Child Health Database of Research, MEDLINE, CINAHL, PsycINFO, EMBASE, and the Cochrane Central Register of Controlled Trials. Reference lists were hand-searched to identify additional studies. Only RCTs that tested the effect of video games on a positive, clinically relevant health consequence were included. Study selection criteria were strictly defined and applied by two researchers working independently. Study background information (e.g., location, funding source), sample data (e.g., number of study participants, demographics), intervention and control details, outcomes data, and quality measures were abstracted independently by two researchers. Evidence synthesis Of 1452 articles retrieved using the current search strategy, 38 met all criteria for inclusion. Eligible studies used video games to provide physical therapy, psychological therapy, improved disease self-management, health education, distraction from discomfort, increased physical activity, and skills training for clinicians. Among the 38 studies, a total of 195 health outcomes were examined. Video games improved 69% of psychological therapy outcomes, 59% of physical therapy outcomes, 50% of physical activity outcomes, 46% of clinician skills outcomes, 42% of health education outcomes, 42% of pain distraction outcomes, and 37% of disease self-management outcomes. Study quality was generally poor; for example, two thirds (66%) of studies had follow-up periods of video games to improve health outcomes, particularly in the areas of psychological therapy and physical therapy. RCTs with

Preconception health and care (PHC)-a strategy for improved maternal and child health.

Science.gov (United States)

Berglund, Anna; Lindmark, Gunilla

2016-06-20

Maternal health status before pregnancy is a decisive factor for pregnancy outcomes and for risk for maternal and infant complications. Still, maternity care does not start until the pregnancy is established and in most low-income settings not until more than half of the pregnancy has passed, which often is too late to impact outcomes. In Western societies preconception care (PCC) is widely recognized as a way to optimize women's health through biomedical and behavioural changes prior to conception with the aim of improving pregnancy outcomes. But the content of PCC is inconsistent and limited to single interventions or preconception counselling to women with chronic illnesses. It has been suggested that PCC should be extended to preconception health and care (PHC), including interventions prior to pregnancy in order to optimize women's health in general, and thereby subsequent pregnancy outcomes, the well-being of the family, and the health of the future child. With this definition, almost every activity that can improve the health of girls and women can be included in the concept. In the World Health Report of 2005 a longitudinal approach to women's wellness and reproductive health was highlighted, and the World Health Organization has proposed a more comprehensive maternal and child health care, also including psychosocial issues and intimate partner violence. The present article gives an overview of the recent literature and discusses contents and delivery of PCC/PHC in Western as well as low-income countries. The article puts special emphasis on why violence against women is an issue for PHC.

Communication and mental health in general practice: physicians' self-perceived learning needs and self-efficacy

OpenAIRE

Stensrud, Tonje L; Mjaaland, Trond A; Finset, Arnstein

2012-01-01

Background General practitioners (GPs) often see patients presenting with mental health problems, but their training regarding mental health treatment varies. GPs' communication skills are of particular importance in these consultations, and communication skills training of GPs has been found to improve patients' mental health. To tailor a communication skills training by basing it on GPs' learning needs and self-efficacy, thereby maximising learning, we conducted a questionnaire study.

Teaching Emotional Intelligence to Intensive Care Unit Nurses and their General Health: A Randomized Clinical Trial

Directory of Open Access Journals (Sweden)

F Sharif

2013-07-01

Full Text Available Background: Emotion and how people manage it is an important part of personality that would immensely affect their health. Investigations showed that emotional intelligence is significantly related to and can predict psychological health. Objective: To determine the effect of teaching emotional intelligence to intensive care unit nurses on their general health. Methods: This randomized clinical trial (registered as IRCT201208022812N9 was conducted on 52 of 200 in intensive care unit nurses affiliated to Shiraz University of Medical Sciences. They were recruited through purposeful convenience sampling and then randomly categorized into two groups. The intervention group members were trained in emotional intelligence. Bar-on emotional intelligence and Goldberg's general health questionnaires were administered to each participant before, immediately after, and one month after the intervention. Results: While the mean score of general health for the intervention group decreased from 25.4 before the intervention, to 18.1 immediately after the intervention and to 14.6 one month later, for the control group, it increased from 22.0, to 24.2 and to 26.5, respectively (p<0.001. Conclusion: Teaching emotional intelligence improved the general health of intensive care unit nurses.

eHealth Technologies as an intervention to improve adherence to topical antipsoriatics: a systematic review.

Science.gov (United States)

Svendsen, Mathias Tiedemann; Andersen, Flemming; Andersen, Klaus Ejner

2018-03-01

Topical antipsoriatics are recommended first-line treatment of psoriasis, but rates of adherence are low. Patient support by use of electronic health (eHealth) services is suggested to improve medical adherence. To review randomised controlled trials (RCTs) testing eHealth interventions designed to improve adherence to topical antipsoriatics and to review applications for smartphones (apps) incorporating the word psoriasis. Literature review: Medline, Embase, Cochrane, PsycINFO and Web of Science were searched using search terms for eHealth, psoriasis and topical antipsoriatics. General analysis of apps: The operating systems (OS) for smartphones, iOS, Google Play, Microsoft Store, Symbian OS and Blackberry OS were searched for apps containing the word psoriasis. Literature review: Only one RCT was included, reporting on psoriasis patients' Internet reporting their status of psoriasis over a 12-month period. The rate of adherence was measured by Medication Event Monitoring System (MEMS ® ). An improvement in medical adherence and reduction of severity of psoriasis were reported. General analysis of apps: A total 184 apps contained the word psoriasis. There is a critical need for high-quality RCTs testing if the ubiquitous eHealth technologies, for example, some of the numerous apps, can improve psoriasis patients' rates of adherence to topical antipsoriatics.

A Longitudinal Study of Health Improvement in the Atlanta CHDWB Wellness Cohort.

Science.gov (United States)

Tabassum, Rubina; Cunningham, Lynn; Stephens, Emily Hope; Sturdivant, Katelyn; Martin, Gregory S; Brigham, Kenneth L; Gibson, Greg

2014-12-22

The Center for Health Discovery and Wellbeing (CHDWB) is an academic program designed to evaluate the efficacy of clinical self-knowledge and health partner counseling for development and maintenance of healthy behaviors. This paper reports on the change in health profiles for over 90 traits, measured in 382 participants over three visits in the 12 months following enrolment. Significant changes in the desired direction of improved health are observed for many traits related to cardiovascular health, including BMI, blood pressure, cholesterol, and arterial stiffness, as well as for summary measures of physical and mental health. The changes are most notable for individuals in the upper quartile of baseline risk, many of whom showed a positive correlated response across clinical categories. By contrast, individuals who start with more healthy profiles do not generally show significant improvements and only a modest impact of targeting specific health attributes was observed. Overall, the CHDWB model shows promise as an effective intervention particularly for individuals at high risk for cardiovascular disease.

Health-Improving Rehabilitation Program of Pysical Education at Higher School

Directory of Open Access Journals (Sweden)

V. M. Naskalov

2013-01-01

Full Text Available The research is aimed to explore the efficiency of innovative technologies and increase the health-improving effect as a result of physical training in ecologically unfavorable conditions. A health-improving rehabilitation program, containing a set of modern means of physical rehabilitation and recreation in combination with physical exercises, was worked out to carry out the pedagogical experiment. The program includes the hydromassage, stretching exercises with biomechanical stimulation and exercises for developing weightlifting abilities. Apart from this, the interval hypoxic training was used in ‘artificially created’ favorable ecological conditions for detoxication. The students at Polotsk State University took part in the experiment. Among the assessment criteria applied by the author, there are generally acknowledged methods identifying the development of physical qualities, external respiration functions, body fat and other components composition. The experiment revealed that the innovative program had enhanced the health-improving effect compared to the traditional training programs, which was expressed by the statistically valid increase of the students’ speed- strength characteristics, flexibility, external respiration functions as well as the body fat decrease. Therefore, in order to increase a health-improving effect of physical training, the author recommends considering the specific ecological and hygienic conditions of a particular region to create the corresponding programs for group and individual health protection and recovery. The research findings can be used in physical education process at universities situated in the regions with unfavorable ecological conditions. 

The Relationship between General Health and Internet Addiction

Directory of Open Access Journals (Sweden)

Nastiezaie Nasser

2009-03-01

Full Text Available Background: Internet is a neutral tool on its own. However, excessive use of internet poses the risk of being addicted to it. This study was performed to investigate the association between general health and internet addiction.Materials and Methods: In this descriptive study a total number of 375 students (189 female and 186 male were randomly selected from Sistan and Baluchestan University between 2007 to 2008. Using the internet addiction test (IAT, the students were divided into two groups: ordinary users and addicted users of internet. The general health questionnaire (GHQ was used to compare these two groups. The SPSS software and t test were used to analyze the data and P<0.01 was significant.Results: The general health of internet-addicted users in comparison with ordinary users was at a higher risk (P<0.01. But the difference between two groups in general health and disorders of social function were not statistically significant. Conclusion: Depression and anxiety were common in internet addicted users and it was correlated to the amount of time that they were allocating to it.

[A proposal to improve nursing fee differentiation policy for general hospitals using profitability-analysis in the national health insurance].

Science.gov (United States)

Kim, Sungjae; Kim, Jinhyun

2012-06-01

The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy. A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance. The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades. Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.

A learning collaborative of CMHCs and CHCs to support integration of behavioral health and general medical care.

Science.gov (United States)

Vannoy, Steven D; Mauer, Barbara; Kern, John; Girn, Kamaljeet; Ingoglia, Charles; Campbell, Jeannie; Galbreath, Laura; Unützer, Jürgen

2011-07-01

Integration of general medical and mental health services is a growing priority for safety-net providers. The authors describe a project that established a one-year learning collaborative focused on integration of services between community health centers (CHCs) and community mental health centers (CMHCs). Specific targets were treatment for general medical and psychiatric symptoms related to depression, bipolar disorder, alcohol use disorders, and metabolic syndrome. This observational study used mixed methods. Quantitative measures included 15 patient-level health indicators, practice self-assessment of resources and support for chronic disease self-management, and participant satisfaction. Sixteen CHC-CMHC pairs were selected for the learning collaborative series. One pair dropped out because of personnel turnover. All teams increased capacity on one or more patient health indicators. CHCs scored higher than CMHCs on support for chronic disease self-management. Participation in the learning collaborative increased self-assessment scores for CHCs and CMHCs. Participant satisfaction was high. Observations by faculty indicate that quality improvement challenges included tracking patient-level outcomes, workforce issues, and cross-agency communication. Even though numerous systemic barriers were encountered, the findings support existing literature indicating that the learning collaborative is a viable quality improvement approach for enhancing integration of general medical and mental health services between CHCs and CMHCs. Real-world implementation of evidence-based guidelines presents challenges often absent in research. Technical resources and support, a stable workforce with adequate training, and adequate opportunities for collaborator communications are particular challenges for integrating behavioral and general medical services across CHCs and CMHCs.

Cell phone–based health education messaging improves health ...

African Journals Online (AJOL)

SMS), provides new and innovative opportunities for disease prevention and health education. Objective: To explore the use of cell phone–based health education SMS to improve the health literacy of community residents in China. Methods: ...

Health education programs may be as effective as exercise intervention on improving health-related quality of life among Japanese people over 65 years.

Science.gov (United States)

Tamari, Kotaro; Kawamura, Kenji; Sato, Mitsuya; Harada, Kazuhiro

2012-09-01

The current study was aimed to examine the short-term effects of a 3-month health education program on health-related quality of life using the Short-Form 36. Twenty-five Japanese older people aged 65 and older in the health education program were compared with two historical control groups (n = 25 each) undertaking group and resistance exercise interventions and matched by age, sex and body mass index. A series of split-design two-way analyses of variance were conducted for data analysis. Significant improvements were observed in general health and vitality subscales of the Short-Form 36 in the educational program group. Multivariate analyses, adjusted for several confounding factors, revealed that the effects of the three programs were comparable. The findings suggest that a structured 3-month educational program may be as effective as exercise interventions in improving general health and vitality in a community-dwelling Japanese older population. © 2011 The Authors. Australasian Journal on Ageing © 2011 ACOTA.

Who plans for health improvement? SEA, HIA and the separation of spatial planning and health planning

International Nuclear Information System (INIS)

Bond, Alan; Cave, Ben; Ballantyne, Rob

2013-01-01

This study examines whether there is active planning for health improvement in the English spatial planning system and how this varies across two regions using a combination of telephone surveys and focus group interviews in 2005 and 2010. The spatial planning profession was found to be ill-equipped to consider the health and well-being implications of its actions, whilst health professionals are rarely engaged and have limited understanding and aspirations when it comes to influencing spatial planning. Strategic Environmental Assessment was not considered to be successful in integrating health into spatial plans, given it was the responsibility of planners lacking the capacity to do so. For their part, health professionals have insufficient knowledge and understanding of planning and how to engage with it to be able to plan for health gains rather than simply respond to health impacts. HIA practice is patchy and generally undertaken by health professionals outside the statutory planning framework. Thus, whilst appropriate assessment tools exist, they currently lack a coherent context within which they can function effectively and the implementation of the Kiev protocol requiring the engagement of health professionals in SEA is not to likely improve the consideration of health in planning while there continues to be separation of functions between professions and lack of understanding of the other profession. -- Highlights: ► Health professionals have limited aspirations for health improvement through the planning system. ► Spatial planners are ill-equipped to understand the health and well-being implications of their activities. ► SEA and HIA currently do not embed health consideration in planning decisions. ► The separation of health and planning functions is problematic for the effective conduct of SEA and/or HIA

Who plans for health improvement? SEA, HIA and the separation of spatial planning and health planning

Energy Technology Data Exchange (ETDEWEB)

Bond, Alan, E-mail: alan.bond@uea.ac.uk [InteREAM (Interdisciplinary Research in Environmental Assessment and Management), School of Environmental Sciences, University of East Anglia, Norwich, NR4 7TJ (United Kingdom); Cave, Ben, E-mail: ben.cave@bcahealth.co.uk [Ben Cave Associates Ltd., Leeds (United Kingdom); Ballantyne, Rob, E-mail: robdballantyne@gmail.com [Planning and Health Consultant, Oxfordshire (United Kingdom)

2013-09-15

This study examines whether there is active planning for health improvement in the English spatial planning system and how this varies across two regions using a combination of telephone surveys and focus group interviews in 2005 and 2010. The spatial planning profession was found to be ill-equipped to consider the health and well-being implications of its actions, whilst health professionals are rarely engaged and have limited understanding and aspirations when it comes to influencing spatial planning. Strategic Environmental Assessment was not considered to be successful in integrating health into spatial plans, given it was the responsibility of planners lacking the capacity to do so. For their part, health professionals have insufficient knowledge and understanding of planning and how to engage with it to be able to plan for health gains rather than simply respond to health impacts. HIA practice is patchy and generally undertaken by health professionals outside the statutory planning framework. Thus, whilst appropriate assessment tools exist, they currently lack a coherent context within which they can function effectively and the implementation of the Kiev protocol requiring the engagement of health professionals in SEA is not to likely improve the consideration of health in planning while there continues to be separation of functions between professions and lack of understanding of the other profession. -- Highlights: ► Health professionals have limited aspirations for health improvement through the planning system. ► Spatial planners are ill-equipped to understand the health and well-being implications of their activities. ► SEA and HIA currently do not embed health consideration in planning decisions. ► The separation of health and planning functions is problematic for the effective conduct of SEA and/or HIA.

Mental health in Asia: social improvements and challenges.

Science.gov (United States)

Tseng, W S; Ebata, K; Kim, K I; Krahl, W; Kua, E H; Lu, Q; Shen, Y; Tan, E S; Yang, M J

2001-01-01

Remarkable improvements in economic conditions and a considerable upgrade in the quality of life have been observed in many parts of Asia during the past several decades. At the same time, many mental health challenges face the people of Asia. Various social mental health indexes are reviewed here, with available data from China, Japan, Korea, Singapore, Malaysia, and other Asian societies. The data are compared with data from the United States, Australia in the Pacific Rim, and some other Western countries to examine patterns of similarity or difference between East and West in the process of modernization. Common trends in mental health issues associated with rapid sociocultural change observed in different Asian societies are discussed, as well as the relative shortage of mental health personnel available in many Asian societies. It is emphasized that, in addition to expanding psychiatric services, there is an even more urgent need to promote mental health knowledge and concern through education in the general population. Mental health needs to be cultivated and maintained by social forces and cultural strengths. It is stressed that there is a challenge for Asian people to advance mental health beyond economic development in the 21st century.

Desire for autonomy in health care decisions: a general population survey.

Science.gov (United States)

Cullati, Stéphane; Courvoisier, Delphine S; Charvet-Bérard, Agathe I; Perneger, Thomas V

2011-04-01

To examine factors associated with desire for autonomy in health care decisions in the general population. Mailed survey of 2348 residents of Geneva, Switzerland. Participants answered questions on a scale measuring their desire for autonomy in health care decisions. The scale was scored between 0 (lowest desire for autonomy) and 100 (highest desire for autonomy). On average the respondents favoured shared or active involvement in medical decisions (mean score 62.0, SD 20.9), but attitudes varied considerably. In the multivariate model, factors associated with a higher desire for autonomy included female gender, younger age, higher education, living alone, reporting an excellent global health and - a new observation compared to previous studies - having made several medical decisions in the past 6 months. The attitudes of the general public appear to be consistent with the model of shared decision making. However, people vary considerably in their desire for autonomy. An explicit assessment of each individual's desire for autonomy may improve the decision-making process. Such an assessment should be repeated regularly, as familiarity with medical decisions may increase the desire for autonomy. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

The relationship between job satisfaction and general health in workers and workplace accidents in medium-scale industries

Directory of Open Access Journals (Sweden)

Mohammad Khandan

2015-09-01

Full Text Available Background & objective: Job satisfaction and high levels of general health in workers can lead to their better performance, the reduction of workplace accidents and ultimately the improved productivity of the organization. The present study was therefore conducted to assess the relationship between these variables and the incidence of workplace accidents in medium-scale industries in 2014-15. Methods: : The entire population of workers in three medium-scale industries (n=163 entered the study. Data collection was conducted using Goldberg’s General Health Questionnaire, the Minnesota Satisfaction Questionnaire and a demographic questionnaire containing items on age, gender and the number of workplace accidents. The data obtained were then analyzed in SPSS-20 using the multiple-linear and the Poisson regression models. Results: The general health scores obtained by the participants ranged from 4 to 68 and had a mean and standard deviation of 25.87±13.085. The job satisfaction scores obtained ranged from 31 to 100 and had a mean and standard deviation of 63.45±11.462. The Poisson regression model showed that the level of education, age, physical symptoms and anxiety and insomnia had a significant relationship with the rate of accidents (P<0.05. The model also showed a significant relationship between job satisfaction and general health ( =-0.417 and P =0.001. Conclusion: The general health of the study participants can be said to be unacceptable and their job satisfaction to be medium. Devising plans for controlling and improving psychological and psycho-social factors such as job satisfaction is essential for workplace decision-makers, particularly in small and medium-scale industries. These plans can facilitate the achievement of higher health and safety levels in workers.

Risk assessment - a research program aimed at health risks from air pollution in the general environment

International Nuclear Information System (INIS)

Lindahl-Kiessling, K.; Ahlborg, U.; Bylin, G.; Ehrenberg, L.; Hemminki, K.; Lindell, B.; Nilsson, Robert; Bostroem, C.E.; Swarn, U.

1991-01-01

The paper presents a new research program for assessment of health risks caused by air pollutants. It is important to develop general methods for quantitative risk assessments and to improve the scientific base materials. (KAE)

Size acceptance and intuitive eating improve health for obese, female chronic dieters.

Science.gov (United States)

Bacon, Linda; Stern, Judith S; Van Loan, Marta D; Keim, Nancy L

2005-06-01

Examine a model that encourages health at every size as opposed to weight loss. The health at every size concept supports homeostatic regulation and eating intuitively (ie, in response to internal cues of hunger, satiety, and appetite). Six-month, randomized clinical trial; 2-year follow-up. White, obese, female chronic dieters, aged 30 to 45 years (N=78). Free-living, general community. Six months of weekly group intervention (health at every size program or diet program), followed by 6 months of monthly aftercare group support. Anthropometry (weight, body mass index), metabolic fitness (blood pressure, blood lipids), energy expenditure, eating behavior (restraint, eating disorder pathology), and psychology (self-esteem, depression, body image). Attrition, attendance, and participant evaluations of treatment helpfulness were also monitored. Analysis of variance. Cognitive restraint decreased in the health at every size group and increased in the diet group, indicating that both groups implemented their programs. Attrition (6 months) was high in the diet group (41%), compared with 8% in the health at every size group. Fifty percent of both groups returned for 2-year evaluation. Health at every size group members maintained weight, improved in all outcome variables, and sustained improvements. Diet group participants lost weight and showed initial improvement in many variables at 1 year; weight was regained and little improvement was sustained. The health at every size approach enabled participants to maintain long-term behavior change; the diet approach did not. Encouraging size acceptance, reduction in dieting behavior, and heightened awareness and response to body signals resulted in improved health risk indicators for obese women.

Socioeconomic gradients in general and oral health of primary school children in Shiraz, Iran.

Science.gov (United States)

Golkari, Ali; Sabokseir, Aira; Sheiham, Aubrey; Watt, Richard G

2016-01-01

Health status is largely determined by socio-economic status. The general health of individuals at higher social hierarchy is better than people in lower levels. Likewise, people with higher socio-economic status have better oral health than lower socio-economic groups. There has not been much work regarding the influence of socio-economic status on the health conditions of children in developing countries, particularly in Iran. The aim of this study was to compare the oral and general health conditions of primary school children of three different socio-economic areas in the city of Shiraz, Iran. This cross-sectional study was conducted on 335, 8- to 11-year-old primary schoolchildren in Shiraz. The children were selected by a three-stage cluster sampling method from three socio-economically different areas. Tools and methods used by the United Kingdom's Medical Research Council were used to obtain anthropometric variables as indicators of general health. The Decay, Missing, Filled Teeth (DMFT) Index for permanent teeth, dmft Index for primary teeth, the Modified Developmental Defects of Enamel (DDE) Index, the Gingival Index (GI) and the Debris Index-Simplified (DI-S) were used for oral health assessment.  Height (Poral health status of the primary schoolchildren of Shiraz. The influence of socio-economic status on health condition means children have different life chances based on their socio-economic conditions. These findings emphasize the significance of interventions for tackling socio-economic inequalities in order to improve the health status of children in lower socio-economic areas.

Measuring general animal health status: Development of an animal health barometer.

Science.gov (United States)

Depoorter, Pieter; Van Huffel, Xavier; Diricks, Herman; Imberechts, Hein; Dewulf, Jeroen; Berkvens, Dirk; Uyttendaele, Mieke

2015-03-01

The development of an animal health barometer, an instrument to measure the general health of the Belgian livestock population on a yearly basis and to monitor its evolution over time, is described. The elaboration of a set of 13 animal health indicators (AHIs) as the basis for the animal health barometer is discussed. These indicators were weighted by experts - including scientists, policy makers and agro-industrial representatives - to determine their relative weight in the barometer. The result of the barometer is expressed as a comparison with a previous year. Based on the results of the 13 AHIs, it is concluded that general animal health in Belgium shows a positive evolution since 2008. The animal health barometer provides a composite view of the status of livestock health in Belgium and is a tool to communicate in an intelligible, comprehensible manner on aspects of animal health to consumers and professional stakeholders in the animal production and food chain. Together with the food safety barometer (Baert et al., 2011. Food Res. Int. 44, 940) and the plant health barometer (Wilmart et al., 2014. Eur. J. Plant Pathol. doi: 10.1007/s10658-014-0547-x), the animal health barometer is one of the three instruments to provide a holistic view on the overall status of the safety of the food chain in Belgium. Copyright © 2014 Elsevier B.V. All rights reserved.

MELATONIN: POTENTIAL UTILITY FOR IMPROVING PUBLIC HEALTH

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Russel J REITER; Fatih GULTEKIN; Luis J FLORES; Ma Pilar TERRON; Dun-Xian TAN

2006-04-01

Full Text Available This review summarizes the beneficial actions of melatonin in various experimental conditions/diseases and identifies where the use of melatonin may be helpful in improving public health. The nightly use of melatonin supplements by humans often improves their sleep and helps correct the circadian dyssynchronization associated with “jet lag”. Additionally, melatonin has been found effective in curtailing the growth of a variety of experimental cancers. Mechanistically, this is achieved by melatonin’s ability to limit fatty acid uptake, especially linoleic acid, by tumor cells. Fatty acids are growth factors for many tumors. Additionally, melatonin inhibits the elevated telomerase activity of tumor cells thus making them more fragile and vulnerable to chemotherapies. Melatonin also may inhibit angiogenesis in tumors by suppressing endothelin-1 production and the indole interferes with the stimulatory action of steroids on hormone-responsive tumors. As an ubiquitously-acting antioxidant, melatonin reduces cardiac damage during ischemia/reperfusion (I/R injury (heart attack and during I/R to the brain (stroke. Melatonin also limits the toxicity of amyloid  peptide and of neurofibrillary tangles, two of the cardinal signs of Alzheimer’s disease. Collectively, these data suggest supplementation with melatonin, whose endogenous levels decrease with age, may improve the quality of life in the aged and, as a consequence, be beneficial for public health generally. [TAF Prev Med Bull 2006; 5(2.000: 131-158

Reducing Health Disparities and Improving Health Equity in Saint Lucia

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Kisha Holden

2015-12-01

Full Text Available St. Lucia is an island nation in the Eastern Caribbean, with a population of 179,000 people, where chronic health conditions, such as hypertension and diabetes, are significant. The purpose of this pilot study is to create a model for community health education, tracking, and monitoring of these health conditions, research training, and policy interventions in St. Lucia, which may apply to other Caribbean populations, including those in the U.S. This paper reports on phase one of the study, which utilized a mixed method analytic approach. Adult clients at risk for, or diagnosed with, diabetes (n = 157, and health care providers/clinic administrators (n = 42, were recruited from five healthcare facilities in St. Lucia to assess their views on health status, health services, and improving health equity. Preliminary content analyses indicated that patients and providers acknowledge the relatively high prevalence of diabetes and other chronic illnesses, recognize the impact that socioeconomic status has on health outcomes, and desire improved access to healthcare and improvements to healthcare infrastructures. These findings could inform strategies, such as community education and workforce development, which may help improve health outcomes among St. Lucians with chronic health conditions, and inform similar efforts among other selected populations.

Reducing Health Disparities and Improving Health Equity in Saint Lucia.

Science.gov (United States)

Holden, Kisha; Charles, Lisa; King, Stephen; McGregor, Brian; Satcher, David; Belton, Allyson

2015-12-22

St. Lucia is an island nation in the Eastern Caribbean, with a population of 179,000 people, where chronic health conditions, such as hypertension and diabetes, are significant. The purpose of this pilot study is to create a model for community health education, tracking, and monitoring of these health conditions, research training, and policy interventions in St. Lucia, which may apply to other Caribbean populations, including those in the U.S. This paper reports on phase one of the study, which utilized a mixed method analytic approach. Adult clients at risk for, or diagnosed with, diabetes (n = 157), and health care providers/clinic administrators (n = 42), were recruited from five healthcare facilities in St. Lucia to assess their views on health status, health services, and improving health equity. Preliminary content analyses indicated that patients and providers acknowledge the relatively high prevalence of diabetes and other chronic illnesses, recognize the impact that socioeconomic status has on health outcomes, and desire improved access to healthcare and improvements to healthcare infrastructures. These findings could inform strategies, such as community education and workforce development, which may help improve health outcomes among St. Lucians with chronic health conditions, and inform similar efforts among other selected populations.

Comparison of yoga and aerobic trainings for improving mental health of divorced women

Directory of Open Access Journals (Sweden)

Afrooz Mousavi

2017-11-01

Full Text Available Exercise is an acceptable method for improving and maintaining the physical and emotional health. The aim of the present study was to compare the effectiveness of yoga training program and aerobic exercise on the mental health of divorced women. Two experimental groups and one control group were employed in this quasi-experimental study. The number of 30 divorced women was randomly divided into three groups. The experimental groups involved in yoga (n=10 and aerobics training (n=10 and received 16 exercise sessions for two months. The control group (n=10 received no training. General health questionnaire-28 was employed to evaluate the mental health of participants. Covariance analysis was used as the statistical method. The obtained results indicated that the intervention improved significantly the mental health indices in the intervention groups of yoga and aerobics. In comparison of the effectiveness of yoga and aerobics exercises, the results showed that there is not significant difference between the effectiveness of yoga and aerobics. Therefore, the two methods of exercise are effective on improving the mental health

Housing improvements for health and associated socio-economic outcomes.

Science.gov (United States)

Thomson, Hilary; Thomas, Sian; Sellstrom, Eva; Petticrew, Mark

2013-02-28

identified. These were studies of warmth improvements (n = 7) and rehousing (n = 5). Three qualitative studies were excluded from the synthesis due to lack of clarity of methods. Six of the included qualitative studies also reported quantitative data which was included in the review.Very little quantitative synthesis was possible as the data were not amenable to meta-analysis. This was largely due to extreme heterogeneity both methodologically as well as because of variations in the intervention, samples, context, and outcome; these variations remained even following grouping of interventions and outcomes. In addition, few studies reported data that were amenable to calculation of standardized effect sizes. The data were synthesised narratively.Data from studies of warmth and energy efficiency interventions suggested that improvements in general health, respiratory health, and mental health are possible. Studies which targeted those with inadequate warmth and existing chronic respiratory disease were most likely to report health improvement. Impacts following housing-led neighbourhood renewal were less clear; these interventions targeted areas rather than individual households in most need. Two poorer quality LMIC studies reported unclear or small health improvements. One better quality study of rehousing from slums (pre-1960) reported some improvement in mental health. There were few reports of adverse health impacts following housing improvement. A small number of studies gathered data on social and socio-economic impacts associated with housing improvement. Warmth improvements were associated with increased usable space, increased privacy, and improved social relationships; absences from work or school due to illness were also reduced.Very few studies reported differential impacts relevant to equity issues, and what data were reported were not amenable to synthesis. Housing investment which improves thermal comfort in the home can lead to health improvements, especially

Improving the quality of the evidence base of health informatics.

Science.gov (United States)

Talmon, Jan

2008-11-06

Evaluation of health informatics technology has had attention from quite a few researchers in health informatics in the last few decades. In the early nineties of the past century several working groups and research projects have discussed evaluation methods and methodologies. Despite these activities, evaluation of health informatics has not received the recognition it deserves. In this presentation we will reiterate the arguments put forward in the Declaration of Innsbruck to consider evaluation an essential element of the evidence base of health informatics. Not only are evaluation studies essential, it is also required that such studies are properly reported. A joint effort of the IMIA, EFMI and AMIA working groups on evaluation has resulted in a guideline for reporting the results of evaluation studies of health informatics applications (STARE-HI). STARE-HI is currently endorsed by EFMI. The general assembly of IMIA has adopted STARE-HI as an official IMIA document. Endorsement from AMIA is being sought. A pilot study in which STARE-HI was applied to assess the quality of current reporting clearly indicates that there is quite some room for improvement. Application of guidelines such as STARE-HI would contribute to a further improvement of the evidence base of health informatics and would open the road for high quality reviews and meta-analyses.

The waiting room: vector for health education? The general practitioner's point of view.

Science.gov (United States)

Gignon, Maxine; Idris, Hadjila; Manaouil, Cecile; Ganry, Oliver

2012-09-18

General practitioners (GPs) play a central role in disseminating information and most health policies are tending to develop this pivotal role of GPs in dissemination of health-related information to the public. The objective of this study was to evaluate use of the waiting room by GPs as a vector for health promotion. A cross-sectional study was conducted on a representative sample of GPs using semi-structured, face-to-face interviews. A structured grid was used to describe the documents. Quantitative and qualitative analysis was performed. Sixty GPs participated in the study. They stated that a waiting room had to be pleasant, but agreed that it was a useful vector for providing health information. The GPs stated that they distributed documents designed to improve patient care by encouraging screening, providing health education information and addressing delicate subjects more easily. However, some physicians believed that this information can sometimes make patients more anxious. A large number of documents were often available, covering a variety of topics. General practitioners intentionally use their waiting rooms to disseminate a broad range of health-related information, but without developing a clearly defined strategy. It would be interesting to correlate the topics addressed by waiting room documents with prevention practices introduced during the visit.

Structuring diabetes care in general practices: many improvements, remaining challenges.

LENUS (Irish Health Repository)

Jennings, S

2009-08-07

BACKGROUND: For people with type 2 diabetes to enjoy improved longevity and quality of life, care needs to be organised in a systematic way. AIM: To test if processes and intermediate outcomes for patients with type 2 diabetes changed with the move to structured care in general practice shared with secondary care. METHODS: An audit of process and intermediate outcomes for patients with type 2 diabetes before and after the change to structured care in 10 Dublin general practices shared with secondary care four years on. RESULTS: Structured diabetes care in general practice has led to more dedicated clinics improved processes of care and increased access to multidisciplinary expertise. Improvement in blood pressure control, the use of aspirin and the use of lipid lowering agents indicate a significant decrease in absolute risk of vascular events for this population. CONCLUSIONS: Structured care in general practice improves intermediate outcomes for people with type 2 diabetes. Further improvements need to be made to reach international targets.

A Longitudinal Study of Health Improvement in the Atlanta CHDWB Wellness Cohort

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Rubina Tabassum

2014-12-01

Full Text Available The Center for Health Discovery and Wellbeing (CHDWB is an academic program designed to evaluate the efficacy of clinical self-knowledge and health partner counseling for development and maintenance of healthy behaviors. This paper reports on the change in health profiles for over 90 traits, measured in 382 participants over three visits in the 12 months following enrolment. Significant changes in the desired direction of improved health are observed for many traits related to cardiovascular health, including BMI, blood pressure, cholesterol, and arterial stiffness, as well as for summary measures of physical and mental health. The changes are most notable for individuals in the upper quartile of baseline risk, many of whom showed a positive correlated response across clinical categories. By contrast, individuals who start with more healthy profiles do not generally show significant improvements and only a modest impact of targeting specific health attributes was observed. Overall, the CHDWB model shows promise as an effective intervention particularly for individuals at high risk for cardiovascular disease.

Employee Health Behaviors, Self-Reported Health Status, and Association With Absenteeism: Comparison With the General Population.

Science.gov (United States)

Yun, Young Ho; Sim, Jin Ah; Park, Eun-Gee; Park, June Dong; Noh, Dong-Young

2016-09-01

To perform a comparison between health behaviors and health status of employees with those of the general population, to evaluate the association between employee health behaviors, health status, and absenteeism. Cross-sectional study enrolled 2433 employees from 16 Korean companies in 2014, and recruited 1000 general population randomly in 2012. The distribution of employee health behaviors, health status, and association with absenteeism were assessed. Employees had significantly worse health status and low rates of health behaviors maintenance compared with the general population. Multiple logistic regression model revealed that regular exercise, smoking cessation, work life balance, proactive living, religious practice, and good physical health status were associated with lower absenteeism. Maintaining health behaviors and having good health status were associated with less absenteeism. This study suggests investment of multidimensional health approach in workplace health and wellness (WHW) programs.

Effects of Horticultural Ttherapy on Self-Esteem and General Health Status in Elderly Nursing Home Residents

Directory of Open Access Journals (Sweden)

Zahra Dehmani

2015-01-01

Full Text Available Objectives: The present study investigated the effectiveness of horticultural therapy on increasing of self esteem and general health in seniors. Methods & Materials: The study design was semi experimental. The study population was all of seniors that lived in nursing home residents of Tehran in 1392 that 24 of them were selected by convenience sampling method. Then, we assigned them in control (12 people and experimental (12 people groups. For gathering data we used Cooper Smith self-esteem inventory and General Health Questionnaires (GHQ. The entry criteria were obtaining low score in self esteem inventory and obtaining high score in General Health Questionnaire. Also exit criteria were relinquishment of any of subjects to continue of research process. The experimental group was exposed to 13 sessions of gardening instruction and all equipment of gardening provided by researcher for all of groups’ members. Then, both groups completed mentioned tools twice at the end of gardening therapy: at the post test and follow up stage (3 month later. Data analysis was performed by using of variance with repeated measures. Results: results showed that there is a significant difference between mean scores of general health and self esteem in post test and follow up stages compared to pre test stage. In other words, gardening therapy for increasing of self esteem and general health in seniors has been successful. Conclusion: Horticultural therapy can improves general health and self esteem of seniors who living in nursing homes. Also as a non-drug treatment and low cost for other groups of patients is recommended.

Self-reported oral and general health in relation to socioeconomic position.

Science.gov (United States)

Hakeberg, Magnus; Wide Boman, Ulla

2017-07-26

During the past two decades, several scientific publications from different countries have shown how oral health in the population varies with social determinants. The aim of the present study was to explore the relationship between self-reported oral and general health in relation to different measures of socioeconomic position. Data were collected from a randomly selected sample of the adult population in Sweden (n = 3500, mean age 53.4 years, 53.1% women). The response rate was 49.7%. Subjects were interviewed by telephone, using a questionnaire including items on self-reported oral and general health, socioeconomic position and lifestyle. A significant gradient was found for both oral and general health: the lower the socioeconomic position, the poorer the health. Socioeconomic position and, above all, economic measures were strongly associated with general health (OR 3.95) and with oral health (OR 1.76) if having an income below SEK 200,000 per year. Similar results were found in multivariate analyses controlling for age, gender and lifestyle variables. For adults, there are clear socioeconomic gradients in self-reported oral and general health, irrespective of different socioeconomic measures. Action is needed to ensure greater equity of oral and general health.

Quality improvement in practice: improving diabetes care and patient outcomes in Aboriginal Community Controlled Health Services.

Science.gov (United States)

Stoneman, Alice; Atkinson, David; Davey, Maureen; Marley, Julia V

2014-10-07

Management of chronic disease, including diabetes, is a central focus of most Aboriginal Community Controlled Health Services (ACCHSs) in Australia. We have previously demonstrated that diabetes monitoring and outcomes can be improved and maintained over a 10-year period at Derby Aboriginal Health Service (DAHS). While continuous quality improvement (CQI) has been shown to improve service delivery rates and clinical outcome measures, the process of interpreting audit results and developing strategies for improvement is less well described. This paper describes the evaluation of care of patients with type 2 diabetes mellitus (T2DM) and features of effective CQI in ACCHSs in the remote Kimberley region of north Western Australia. Retrospective audit of records for Aboriginal and Torres Strait Islander primary care patients aged ≥15 years with a confirmed diagnosis of T2DM at four Kimberley ACCHSs from 1 July 2011 to 30 June 2012. Interviews with health service staff and focus group discussions with patients post audit. diabetes care related activities, clinical outcome measures and factors influencing good diabetes related care and effective CQI. A total of 348 patients from the four ACCHSs were included in the study. Clinical care activities were generally high across three of the four health services (at least 71% of patients had cholesterol recorded, 89% blood pressure, 84% HbA1c). Patients from DAHS had lower median cholesterol levels (4.4 mmol/L) and the highest proportion of patients meeting clinical targets for HbA1c (31% v 16% ACCHS-3; P = 0.02). Features that facilitated good care included clearly defined staff roles for diabetes management, support and involvement of Aboriginal Health Workers, efficient recall systems, and well-coordinated allied health services. Effective CQI features included seamless and timely data collection, local ownership of the process, openness to admitting deficiencies and willingness to embrace change. Well

General Practitioners' Perspective on eHealth and Lifestyle Change: Qualitative Interview Study.

Science.gov (United States)

Brandt, Carl Joakim; Søgaard, Gabrielle Isidora; Clemensen, Jane; Sndergaard, Jens; Nielsen, Jesper Bo

2018-04-17

Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior for their patients and themselves. A total of 10 (5 female and 5 male) GPs were recruited by purposive sampling, aged 38 to 69 years (mean 51 years), of which 4 had an urban uptake of patients and 6 a rural uptake. All of them worked in the region of Southern Denmark where GPs typically work alone or in partnership with 1 to 4 colleagues and all use electronic patient health records for prescription, referral, and asynchronous electronic consultations. We performed qualitative, semistructured, individual in-depth interviews with the GPs in their own office about how they used eHealth and mHealth devices to help patients challenged with lifestyle issues and themselves. We also interviewed how they treated lifestyle-challenged patients in general and how they imagined eHealth could be used in the future. All GPs had smartphones or tablets, and everyone communicated on a daily basis with patients about disease and medicine via their electronic health record and the internet. We identified 3 themes concerning the use of eHealth: (1) how eHealth is used for patients; (2) general practitioners' own experience with improving lifestyle and eHealth support; and (3) relevant coaching techniques for transformation into eHealth. GPs used eHealth frequently for themselves but only infrequently for their patients. GPs are familiar with behavioral change techniques and are ready to use them in eHealth if they are used to

Evaluation of two communication strategies to improve udder health management.

Science.gov (United States)

Jansen, J; Renes, R J; Lam, T J G M

2010-02-01

Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers' udder health management, tools such as instruction cards, treatment plans, checklists and software were developed following an argument-based comprehensive "central route." These tools were used during on-farm study group meetings for farmers organized by veterinarians and also during individual veterinarian-farmer interactions. The second strategy aimed at adopting a single management practice to increase the use of milking gloves during milking. This approach followed a straightforward "peripheral" route that used implicit persuasion techniques. Results of an online survey of 374 Dutch dairy farmers showed that most farmers were able and willing to use the educational management tools to increase udder health on their farms. They evaluated the tools positively regardless of the mastitis problems on their farms. This seems to indicate that the central route of communication is most effective when farmers are motivated to work on udder health in general. Results of repeated random telephone surveys before, during, and after the campaign on the use of milking gloves showed that the use of gloves increased from 20.9 to 42.0% of the respondents. Respondents' opinions about milking gloves also changed favorably, indicating that a relatively short peripheral campaign on a single action can have a sustained effect on farmers' behavior. Both communication strategies seem to be potentially successful in disseminating knowledge to a specific target group of farmers and in changing that group's behavior. However, to reach as many farmers as possible, the strategies should be combined. When optimizing these strategies, both the farmers' motivation to work on udder health and the aim of the campaign should be considered

Improving communication in general practice when mental health issues appear: piloting a set of six evidence-based skills.

Science.gov (United States)

Stensrud, Tonje Lauritzen; Gulbrandsen, Pål; Mjaaland, Trond Arne; Skretting, Sidsel; Finset, Arnstein

2014-04-01

To test a communication skills training program teaching general practitioners (GPs) a set of six evidence-based mental health related skills. A training program was developed and tested in a pilot test-retest study with 21 GPs. Consultations were videotaped and actors used as patients. A coding scheme was created to assess the effect of training on GP behavior. Relevant utterances were categorized as examples of each of the six specified skills. The GPs' self-perceived learning needs and self-efficacy were measured with questionnaires. The mean number of GP utterances related to the six skills increased from 13.3 (SD 6.2) utterances before to 23.6 (SD 7.2) utterances after training; an increase of 77.4% (PSkills exploring emotions, cognitions and resources, and the skill Promote coping, increased significantly. Self-perceived learning needs and self-efficacy did not change significantly. The results from this pilot test are encouraging. GPs enhanced their use on four out of six mental health related communication skills significantly, and the effects were medium to large. This training approach appears to be an efficacious approach to mental health related communication skills training in general practice. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes.

Science.gov (United States)

McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

2018-01-01

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10-20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

Acceptability to general practitioners of national health insurance ...

African Journals Online (AJOL)

D. Mch1tyre. Objective. To determine general practitioners' attitudes to national health insurance (NHI) and to capitation as a ... GPs who approved the introduction of NHI varied depending ... Health Economics Unit, Department of Community Health, University .... in Table I. They were then asked a series of closed questions.

Leadership for health improvement--implementation and evaluation.

Science.gov (United States)

Carr, Susan M; Carr, Sue; Lhussier, Monique; Reynolds, Joanna; Hunter, David J; Hannaway, Catherine

2009-01-01

The purpose of this paper is to present a co-authored reflection on the health improvement leadership development programme and the key evaluation messages derived from piloting in an English National Health Service region. It highlights the specific attributes of this approach to health improvement leadership development and clarifies health improvement development issues. Appreciative inquiry and soft systems methodology are combined in an evaluation approach designed to capture individual as well as organisation learning and how it impacts on leadership in specific contexts. The evaluation exposes the health improvement leadership needs of a multi-organisation cohort, offers some explanations for successful achievement of learning needs while also exposing of the challenges and paradoxes faced in this endeavour. There are limited reported templates of how to develop leadership for health improvement. This paper details a whole systems approach, acknowledging the impact of context on leadership and an approach to evaluating such complex initiatives.

Improving global health: counting reasons why.

Science.gov (United States)

Selgelid, Michael J

2008-08-01

This paper examines cumulative ethical and self-interested reasons why wealthy developed nations should be motivated to do more to improve health care in developing countries. Egalitarian and human rights reasons why wealthy nations should do more to improve global health are that doing so would (1) promote equality of opportunity (2) improve the situation of the worst-off, (3) promote respect of the human right to have one's most basic needs met, and (4) reduce undeserved inequalities in well-being. Utilitarian reasons for improving global health are that this would (5) promote the greater good of humankind, and (6) achieve enormous benefits while requiring only small sacrifices. Libertarian reasons are that this would (7) amend historical injustices and (8) meet the obligation to amend injustices that developed world countries have contributed to. Self-interested reasons why wealthy nations should do more to improve global health are that doing so would (9) reduce the threat of infectious diseases to developed countries, (10) promote developed countries' economic interests, and (11) promote global security. All of these reasons count, and together they add up to make an overwhelmingly powerful case for change. Those opposed to wealthy government funding of developing world health improvement would most likely appeal, implicitly or explicitly to the idea that coercive taxation for redistributive purposes would violate the right of an individual to keep his hard-earned income. The idea that this reason not to improve global health should outweigh the combination of rights and values embodied in the eleven reasons enumerated above, however is implausibly extreme, morally repugnant and perhaps imprudent.

Gender and communication style in general practice: differences between women's health care and regular health care.

NARCIS (Netherlands)

Brink-Muinen, A. van den; Bensing, J.M.; Kerssens, J.J.

1998-01-01

Objectives: differences were investigated between general practitioners providing women's health care (4 women) and general practitioners providing regular health care (8 women and 8 men). Expectations were formulated on the basis of the principles of women's health care and literature about gender

Differences in health-related quality of life between older nursing home residents without cognitive impairment and the general population of Norway.

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Drageset, Jorunn; Natvig, Gerd Karin; Eide, Geir Egil; Clipp, Elizabeth C; Bondevik, Margareth; Nortvedt, Monica W; Nygaard, Harald A

2008-05-01

To advance the understanding of health-related quality of life among older nursing home residents by assessing their health-related quality of life and comparing this with norms from the general population. The study used a two-group cross-sectional comparative design. The samples comprised 227 nursing home residents aged 65-102 years with at least six months' residence and a representative population sample of 1137 Norwegian citizens aged 65-102 years. All nursing home residents had a Clinical Dementia Rating Scale score > or =0.5 and were capable of conversing. The respondents provided demographic information and were surveyed using the SF-36 Health Survey. We used univariate and multivariate linear models to identify possible differences in health-related quality of life between the nursing home residents and the general population, controlled for age, sex, marital status and education. After adjustment for age, group, sex, marital status and education, the nursing home residents scored significantly higher on bodily pain and on physical and emotional role limitation and significantly lower on the other SF-36 subscales, except social functioning, with the largest differences for physical functioning (mean nursing home 23.2 and mean general population 62.9). The general population scores on all subscales generally increased with increasing education but not among the nursing home residents. The mean SF-36 scale scores differed markedly between the nursing home residents and the general population, with the nursing home residents generally scoring lower. The association with background variables known to be related to health-related quality of life differed between the groups. Healthcare professionals should increase attention to health-related quality of life among nursing home residents, periodically assess health-related quality of life and consider interventions that may improve health-related quality of life in older institutionalised populations. This study

Performance of general health workers in leprosy control activities at public health facilities in Amhara and Oromia States, Ethiopia.

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Abeje, Tadiye; Negera, Edessa; Kebede, Eshetu; Hailu, Tsegaye; Hassen, Ismaile; Lema, Tsehainesh; Yamuah, Lawrence; Shiguti, Birru; Fenta, Melkamu; Negasa, Megersa; Beyene, Demissew; Bobosha, Kidist; Aseffa, Abraham

2016-04-07

towards leprosy was positive for the majority of the respondents. The result showed that 519 (86.3%) had poor knowledge. Overall 155 (25.8%) of the respondents had positive attitude towards leprosy while 205 (34.1%) had intermediate (mixed) attitude and 241 (40.1%) had negative attitude to the disease. Among 83 respondents assessed for diagnosis of leprosy only 15(18.0%) diagnosed leprosy correctly. Variation in knowledge and attitude indicated a significant difference (p leprosy control activities are integrated to the general health services in the country, the knowledge and skills of leprosy diagnosis, treatment and management by health workers was unsatisfactory. Hence, attention should be given to develop training strategies that can improve health worker knowledge and promote better leprosy management at public health facilities. This could be achieved through pre-service and in-service training and giving adequate emphasis to leprosy related practical work and continuous follow- up.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

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Janya McCalman

2018-03-01

Full Text Available Continuous quality improvement (CQI processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

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McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

2018-01-01

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally. PMID:29623271

The relationship between general health and coping style with the perceived stress in primigravida healthy pregnant women: using the PATH model.

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Shamsaei, Farshid; Maleki, Azam; Shobeiri, Fatemeh; Soltani, Farzaneh; Ahmadi, Fazlollah; Roshanaei, Ghodratollah

2018-02-05

The aim of this study was to analyze relationships among general health, coping style, and perceived stress in healthy primigravida pregnant women. A cross-sectional study was conducted at public health clinics in Hamadan city, Iran between July and December 2015. In total, 380 pregnant women were selected through stratified random sampling. Data were collected using the Revised Prenatal Coping Inventory and General Health Questionnaire. Perceived stress was assessed through an interview comprised of open-ended questions. The final PATH model fit well; general health (β = 0.02) as well as anxiety and sleep disorders (β = 0.03) were slightly directly associated with perceived stress, and only planning-preparation was related to perceived stress through general health (β = 0.09). The findings enhance the knowledge gained from previous perinatal stress research. General health status was directly related to stress, and coping style was indirectly related to stress. Coping styles may mediate the relationship between general health status and perceived stress, suggesting that midwives should attempt to improve the general health of women to reduce stress and its consequences during pregnancy by teaching patients appropriate coping styles. Further studies on the effect of coping style interventions on stress are warranted.

Coaching interprofessional health care improvement teams: the coachee, the coach and the leader perspectives.

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Godfrey, Marjorie M; Andersson-Gare, Boel; Nelson, Eugene C; Nilsson, Mats; Ahlstrom, Gerd

2014-05-01

To investigate health care improvement team coaching activities from the perspectives of coachees, coaches and unit leaders in two national improvement collaboratives. Despite numerous methods to improve health care, inconsistencies in success have been attributed to factors that include unengaged staff, absence of supportive improvement resources and organisational inertia. Mixed methods sequential exploratory study design, including quantitative and qualitative data from interprofessional improvement teams who received team coaching. The coachees (n = 382), coaches (n = 9) and leaders (n = 30) completed three different data collection tools identifying coaching actions perceived to support improvement activities. Coachees, coaches and unit leaders in both collaboratives reported generally positive perceptions about team coaching. Four categories of coaching actions were perceived to support improvement work: context, relationships, helping and technical support. All participants agreed that regardless of who the coach is, emphasis should include the four categories of team coaching actions. Leaders should reflect on their efforts to support improvement teams and consider the four categories of team coaching actions. A structured team coaching model that offers needed encouragement to keep the team energized, seems to support health care improvement. © 2013 John Wiley & Sons Ltd.

Advances in public health accreditation readiness and quality improvement: evaluation findings from the National Public Health Improvement Initiative.

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McLees, Anita W; Thomas, Craig W; Nawaz, Saira; Young, Andrea C; Rider, Nikki; Davis, Mary

2014-01-01

Continuous quality improvement is a central tenet of the Public Health Accreditation Board's (PHAB) national voluntary public health accreditation program. Similarly, the Centers for Disease Control and Prevention launched the National Public Health Improvement Initiative (NPHII) in 2010 with the goal of advancing accreditation readiness, performance management, and quality improvement (QI). Evaluate the extent to which NPHII awardees have achieved program goals. NPHII awardees responded to an annual assessment and program monitoring data requests. Analysis included simple descriptive statistics. Seventy-four state, tribal, local, and territorial public health agencies receiving NPHII funds. NPHII performance improvement managers or principal investigators. Development of accreditation prerequisites, completion of an organizational self-assessment against the PHAB Standards and Measures, Version 1.0, establishment of a performance management system, and implementation of QI initiatives to increase efficiency and effectiveness. Of the 73 responding NPHII awardees, 42.5% had a current health assessment, 26% had a current health improvement plan, and 48% had a current strategic plan in place at the end of the second program year. Approximately 26% of awardees had completed an organizational PHAB self-assessment, 72% had established at least 1 of the 4 components of a performance management system, and 90% had conducted QI activities focused on increasing efficiencies and/or effectiveness. NPHII appears to be supporting awardees' initial achievement of program outcomes. As NPHII enters its third year, there will be additional opportunities to advance the work of NPHII, compile and disseminate results, and inform a vision of high-quality public health necessary to improve the health of the population.

General Health status of workers among different workplaces in Qom Province, Iran.

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Koohpaei, Alireza; Khandan, Mohammad; Gaeeni, Mahdi; Momenyan, Somayeh

2015-12-01

In a healthy organization, psychological health and physical health are as important as production and productivity; and healthy workers have higher productivity. Regarding lack of information about workers' general health profile in Qom Province, this study aimed to assess and compare the staffs' general health and its components among different workplaces in 2014. In a cross-sectional study, 2,276 employees working at 46 industries and organizations completed a standardized General Health Questionnaire (GHQ 28) and a demographic questionnaire. Data were analyzed using t-test, ANOVA, and Pearson product-moment correlation coefficient by IBM SPSS version 20. The mean age of the participants was 32.22 (±7.55) years. Seventy-nine point four percent of participants were married and the rest were single. Highest and lowest scores belonged to social dysfunction and depression, respectively. Also, total score of staffs' general health was 17.87 ± 10.93. The results showed that, in spite of the non-relationship between general health score difference among married and single personnel (p > 0.05), there was a significant difference between men and women and among organizations and industries with regards to general health score (p creativity in the workplaces are at risk. Altogether, the general health score in the studied population was suitable in its entirety.

Associations of psychosocial working conditions with self-rated general health and mental health among municipal employees.

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Laaksonen, Mikko; Rahkonen, Ossi; Martikainen, Pekka; Lahelma, Eero

2006-03-01

To examine associations of job demands and job control, procedural and relational organizational fairness, and physical work load with self-rated general health and mental health. In addition, the effect of occupational class on these associations is examined. The data were derived from the Helsinki Health Study baseline surveys in 2001-2002. Respondents to cross-sectional postal surveys were middle-aged employees of the City of Helsinki (n=5.829, response rate 67%). Associations of job demands and job control, organizational fairness and physical work load with less than good self-rated health and poor GHQ-12 mental health were examined. Those with the poorest working conditions two to three times more, often reported poor general and mental health than those with the best working conditions. Adjustment for occupational class weakened the associations of low job control and physical work load with general health by one fifth, but even more strengthened that of high job demands. Adjustment for occupational class clearly strengthened the associations of job control and physical work load with mental health in men. Mutual adjustment for all working conditions notably weakened their associations with both health measures, except those of job control in men. All working conditions except relational organizational fairness remained independently associated with general and mental health. All studied working conditions were strongly associated with both general and mental health but the associations weakened after mutual adjustments. Of the two organizational fairness measures, procedural fairness remained independently associated with both health outcomes. Adjustment for occupational class had essentially different effects on the associations of different working conditions and different health outcomes.

Advancing public health obesity policy through state attorneys general.

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Pomeranz, Jennifer L; Brownell, Kelly D

2011-03-01

Obesity in the United States exacts a heavy health and financial toll, requiring new approaches to address this public health crisis. State attorneys general have been underutilized in efforts to formulate and implement food and obesity policy solutions. Their authority lies at the intersection of law and public policy, creating unique opportunities unavailable to other officials and government entities. Attorneys general have a broad range of authority over matters specifically relevant to obesity and nutrition policy, including parens patriae (parent of the country) authority, protecting consumer interests, enacting and supporting rules and regulations, working together across states, engaging in consumer education, and drafting opinions and amicus briefs. Significant room exists for greater attorney general involvement in formulating and championing solutions to public health problems such as obesity.

Health programmes for school employees: improving quality of life, health and productivity.

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Kolbe, Lloyd J; Tirozzi, Gerald N; Marx, Eva; Bobbitt-Cooke, Mary; Riedel, Sara; Jones, Jack; Schmoyer, Michael

2005-01-01

School health programmes in the 21st century could include eight components: 1) health services; 2) health education; 3) healthy physical and psychosocial environments; 4) psychological, counselling, and social services; 5) physical education and other physical activities; 6) healthy food services; and 7) integrated efforts of schools, families, and communities to improve the health of school students and employees. The eighth component of modern school health programmes, health programmes for school employees, is the focus of this article. Health programmes for school employees could be designed to increase the recruitment, retention, and productivity of school employees by partially focusing each of the preceding seven components of the school health programme on improving the health and quality of life of school employees as well as students. Thus, efforts to improve the quality of life, health, and productivity of school employees may be distinct from, but integrated with, efforts to improve the quality of life, health, and education of students. School employee health programmes can improve employee: 1) recruitment; 2) morale; 3) retention; and 4) productivity. They can reduce employee: 5) risk behaviours (e.g., physical inactivity); 6) risk factors (e.g., stress, obesity, high blood pressure); (7) illnesses; 8) work-related injuries; 9) absentee days; 10) worker compensation and disability claims; and 11) health care and health insurance costs. Further, if we hope to improve our schools' performance and raise student achievement levels, developing effective school employee health programmes can increase the likelihood that employees will: 12) serve as healthy role models for students; 13) implement effective school health programmes for students; and 14) present a positive image of the school to the community. If we are to improve the quality of life, health, and productivity of school employees in the 21st century: school administrators, employees, and

Telemental health technology in deaf and general mental-health services: access and use.

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Austen, Sally; McGrath, Melissa

2006-01-01

Long-distance travel to provide mental health services for deaf people has implications for efficiency, safety, and equality of service. However, uptake of Telemental Health (TMH) has been slow in both deaf and general mental health services. A quantitative study was used to investigate access to TMH and whether staff confidence, experience, or demographics affect TMH use. It was concluded that staff in neither deaf mental health services nor general mental health services had adequate knowledge of or access to TMH. Staff expressed concerns over TMH's appropriateness in their work. Previous use of videoconferencing was assosciated significantly with confidence, but previous use of videophones was not. Neither staff in deaf services nor deaf staff were more experienced with or more confident about videoconferencing, whereas, within deaf services, deaf staff were significantly more confident about videophone use. Training implications are discussed.

Improving health care quality and safety: the role of collective learning

Directory of Open Access Journals (Sweden)

Singer SJ

2015-11-01

Full Text Available Sara J Singer,1–4 Justin K Benzer,4–6 Sami U Hamdan4,6 1Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA; 2Department of Medicine, Harvard Medical School, Boston, MA, USA; 3Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA; 4Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA; 5VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA; 6Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, USA Abstract: Despite decades of effort to improve quality and safety in health care, this goal feels increasingly elusive. Successful examples of improvement are infrequently replicated. This scoping review synthesizes 76 empirical or conceptual studies (out of 1208 originally screened addressing learning in quality or safety improvement, that were published in selected health care and management journals between January 2000 and December 2014 to deepen understanding of the role that collective learning plays in quality and safety improvement. We categorize learning activities using a theoretical model that shows how leadership and environmental factors support collective learning processes and practices, and in turn team and organizational improvement outcomes. By focusing on quality and safety improvement, our review elaborates the premise of learning theory that leadership, environment, and processes combine to create conditions that promote learning. Specifically, we found that learning for quality and safety improvement includes experimentation (including deliberate experimentation, improvisation, learning from failures, exploration, and exploitation, internal and external knowledge acquisition, performance monitoring and comparison, and training. Supportive learning environments are characterized by team characteristics like psychological

Aligning health information technologies with effective service delivery models to improve chronic disease care.

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Bauer, Amy M; Thielke, Stephen M; Katon, Wayne; Unützer, Jürgen; Areán, Patricia

2014-09-01

Healthcare reforms in the United States, including the Affordable Care and HITECH Acts, and the NCQA criteria for the Patient Centered Medical Home have promoted health information technology (HIT) and the integration of general medical and mental health services. These developments, which aim to improve chronic disease care, have largely occurred in parallel, with little attention to the need for coordination. In this article, the fundamental connections between HIT and improvements in chronic disease management are explored. We use the evidence-based collaborative care model as an example, with attention to health literacy improvement for supporting patient engagement in care. A review of the literature was conducted to identify how HIT and collaborative care, an evidence-based model of chronic disease care, support each other. Five key principles of effective collaborative care are outlined: care is patient-centered, evidence-based, measurement-based, population-based, and accountable. The potential role of HIT in implementing each principle is discussed. Key features of the mobile health paradigm are described, including how they can extend evidence-based treatment beyond traditional clinical settings. HIT, and particularly mobile health, can enhance collaborative care interventions, and thus improve the health of individuals and populations when deployed in integrated delivery systems. Copyright © 2014 Elsevier Inc. All rights reserved.

Reducing indoor air pollution by air conditioning is associated with improvements in cardiovascular health among the general population.

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Lin, Lian-Yu; Chuang, Hsiao-Chi; Liu, I-Jung; Chen, Hua-Wei; Chuang, Kai-Jen

2013-10-01

Indoor air pollution is associated with cardiovascular effects, however, little is known about the effects of improving indoor air quality on cardiovascular health. The aim of this study was to explore whether improving indoor air quality through air conditioning can improve cardiovascular health in human subjects. We recruited a panel of 300 healthy subjects from Taipei, aged 20 and over, to participate in six home visits each, to measure a variety of cardiovascular endpoints, including high sensitivity-C-reactive protein (hs-CRP), 8-hydroxy-2'-deoxyguanosine (8-OHdG), fibrinogen in plasma and heart rate variability (HRV). Indoor particles and total volatile organic compounds (VOCs) were measured simultaneously at the participant's home during each visit. Three exposure conditions were investigated in this study: participants were requested to keep their windows open during the first two visits, close their windows during the next two visits, and close the windows and turn on their air conditioners during the last two visits. We used linear mixed-effects models to associate the cardiovascular endpoints with individual indoor air pollutants. The results showed that increases in hs-CRP, 8-OHdG and fibrinogen, and decreases in HRV indices were associated with increased levels of indoor particles and total VOCs in single-pollutant and two-pollutant models. The effects of indoor particles and total VOCs on cardiovascular endpoints were greatest during visits with the windows open. During visits with the air conditioners turned on, no significant changes in cardiovascular endpoints were observed. In conclusion, indoor air pollution is associated with inflammation, oxidative stress, blood coagulation and autonomic dysfunction. Reductions in indoor air pollution and subsequent improvements in cardiovascular health can be achieved by closing windows and turning on air conditioners at home. Copyright © 2013 Elsevier B.V. All rights reserved.

[Strategies to improve influenza vaccination coverage in Primary Health Care].

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Antón, F; Richart, M J; Serrano, S; Martínez, A M; Pruteanu, D F

2016-04-01

Vaccination coverage reached in adults is insufficient, and there is a real need for new strategies. To compare strategies for improving influenza vaccination coverage in persons older than 64 years. New strategies were introduced in our health care centre during 2013-2014 influenza vaccination campaign, which included vaccinating patients in homes for the aged as well as in the health care centre. A comparison was made on vaccination coverage over the last 4 years in 3 practices of our health care centre: P1, the general physician vaccinated patients older than 64 that came to the practice; P2, the general physician systematically insisted in vaccination in elderly patients, strongly advising to book appointments, and P3, the general physician did not insist. These practices looked after P1: 278; P2: 320; P3: 294 patients older than 64 years. Overall/P1/P2/P3 coverages in 2010: 51.2/51.4/55/46.9% (P=NS), in 2011: 52.4/52.9/53.8/50.3% (P=NS), in 2012: 51.9/52.5/55.3/47.6% (P=NS), and in 2013: 63.5/79.1/59.7/52.7 (P=.000, P1 versus P2 and P3; P=NS between P2 and P3). Comparing the coverages in 2012-2013 within each practice P1 (P=.000); P2 (P=.045); P3 (P=.018). In P2 and P3 all vaccinations were given by the nurses as previously scheduled. In P3, 55% of the vaccinations were given by the nurses, 24.1% by the GP, 9.7% rejected vaccination, and the remainder did not come to the practice during the vaccination period (October 2013-February 2014). The strategy of vaccinating in the homes for the aged improved the vaccination coverage by 5% in each practice. The strategy of "I've got you here, I jab you here" in P1 improved the vaccination coverage by 22%. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

General physical health advice for people with serious mental illness.

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Tosh, Graeme; Clifton, Andrew V; Xia, Jun; White, Margueritte M

2014-03-28

care visit was significantly higher in the advice group (n = 80, 1 RCT, RR 1.77, CI 1.09 to 2.85). Economic data were equivocal. Attrition was large (> 30%) but similar for both groups (n = 964, 6 RCTs, RR 1.11, CI 0.92 to 1.35). Comparisons of one type of physical healthcare advice with another were grossly underpowered and equivocal. General physical health could lead to people with serious mental illness accessing more health services which, in turn, could mean they see longer-term benefits such as reduced mortality or morbidity. On the other hand, it is possible clinicians are expending much effort, time and financial resources on giving ineffective advice. The main results in this review are based on low or very low quality data. There is some limited and poor quality evidence that the provision of general physical healthcare advice can improve health-related quality of life in the mental component but not the physical component, but this evidence is based on data from one study only. This is an important area for good research reporting outcome of interest to carers and people with serious illnesses as well as researchers and fundholders.

Cell phone-based health education messaging improves health literacy.

Science.gov (United States)

Zhuang, Runsen; Xiang, Yueying; Han, Tieguang; Yang, Guo-An; Zhang, Yuan

2016-03-01

The ubiquity of cell phones, which allow for short message service (SMS), provides new and innovative opportunities for disease prevention and health education. To explore the use of cell phone-based health education SMS to improve the health literacy of community residents in China. A multi-stage random sampling method was used to select representative study communities and participants ≥ 18 years old. Intervention participants were sent health education SMSs once a week for 1 year and controls were sent conventional, basic health education measures. Health literacy levels of the residents before and after the intervention were evaluated between intervention and control groups. Public health literacy scores increased 1.5 points, from 61.8 to 63.3, after SMS intervention for 1 year (P<0.01); the increase was greater for males than females (2.01 vs. 1.03; P<0.01) and for Shenzhen local residents than non-permanent residents (2.56 vs. 1.14; P<0.01). The frequency of high health literacy scores was greater for the intervention than control group (22.03% to 30.93% vs. 22.07% to 20.82%). With health literacy as a cost-effective index, the cost-effectiveness per intervention was 0.54. SMS may be a useful tool for improving health literacy.

Effectiveness of a Tai Chi intervention for improving functional fitness and general health among ethnically diverse older adults with self-reported arthritis living in low-income neighborhoods: a cohort study.

Science.gov (United States)

Dogra, Shilpa; Shah, Suhayb; Patel, Meghavi; Tamim, Hala

2015-01-01

Tai Chi (TC) is a form of low to moderate physical activity that has been shown to significantly impact health and functional fitness among older adults; the impact of TC on the health and functional fitness of older adults with arthritis is not well understood. The purpose of this study was to assess the effectiveness of a 16-week TC intervention for improving functional fitness and self-reported general health among older adults with arthritis who were born outside Canada and were residing in low-income neighborhoods. A 16-week intervention was conducted among older adults residing in 1 of 2 specified low-income neighborhoods in Canada. The analysis was limited to those who self-reported having arthritis (n = 102). Participants were encouraged to attend 2 moderate-intensity TC sessions per week for a total of 120 minutes. Functional fitness and health were assessed at baseline and at 16 weeks. Average attendance was 1.1 sessions per week. Functional fitness assessment results indicated that right-hand grip strength (25.6 ± 8.2 to 26.7 ± 7.8 kg), left-hand grip strength (24.9 ± 7.3 to 26.8 ± 7.1 kg), 30-second arm curl (15.6 ± 5.0 to 18.6 ± 5.7 repetitions/30 s), Timed Up-and-Go (7.4 ± 2.6 to 6.9 ± 2.6 s), and 30-second chair stand (12.0 ± 3.9 to 15.4 ± 5.8 s) improved significantly (P health (61.5 ± 20.9 to 66.0 ± 20.4; P = 0.03), vitality (61.5 ± 18.9 to 67.5 ± 20.2; P = 0.008), and mental health (74.3 ± 16.5 to 78.5 ± 17.7; P = 0.04) also improved significantly over the intervention period. Improvements in physical health and physical function scores were clinically meaningful. Participating in TC for 16 weeks led to significant improvements in functional fitness and components of physical and mental health among older adults with self-reported arthritis. Tai Chi seems to be a valuable mode of physical activity for this population.

Health-Improving Potential of Dancing Exercises in Physical Education of Students of Higher Educational Institutions

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Т. М. Кравчук

2015-06-01

Full Text Available Research objective: to determine the health-improving potential of dancing exercises used in physical education of female students of higher educational institutions.  Research methods: study and analysis of pedagogical, scientific and methodological literature on the subject matter of the research; observations, questionnaires, functional tests; statistical methods of data reduction. Conclusions. As part of the study, the use of dancing exercises in the physical education of female students of higher educational institutions proved contributing to a significant increase in the level of their physical health in general and improvement of some of its indicators, including strength and life indices, heart rate recovery time after 20 squats. Dancing exercises also boost spirits, improve health and activity of the female students, which the study proved statistically.

[Rethinking how health is promoted in the Colombian general health-related social security system (Sistema General de Seguridad Social en Salud)].

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Eslava-Castañeda, Juan C

2006-12-01

This article takes stock of how promoting health (PH) (promoción de la salud - PS) has been understood within an international setting and gives three meanings for promotion: as general policy orientation, as a set of actions and as a special dimension of sanitary work. Interest expressed in giving it a specific basis distinguishing it from prevention, transcending educational work, has emerged from the subtle differences established from such different ways of coming to terms with PH. After recognising the challenge posed by PH in the field of health, the text succinctly describes how discourse regarding PH has been introduced in Colombia and discusses how an attempt has been made to be more precise regarding its place in the general health-related social security system. Efforts currently being made in Colombia regarding making PH become a reality within the Colombian health system are then mentioned.

Improving the use of health data for health system strengthening

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Tara Nutley

2013-02-01

Full Text Available Background: Good quality and timely data from health information systems are the foundation of all health systems. However, too often data sit in reports, on shelves or in databases and are not sufficiently utilised in policy and program development, improvement, strategic planning and advocacy. Without specific interventions aimed at improving the use of data produced by information systems, health systems will never fully be able to meet the needs of the populations they serve. Objective: To employ a logic model to describe a pathway of how specific activities and interventions can strengthen the use of health data in decision making to ultimately strengthen the health system. Design: A logic model was developed to provide a practical strategy for developing, monitoring and evaluating interventions to strengthen the use of data in decision making. The model draws on the collective strengths and similarities of previous work and adds to those previous works by making specific recommendations about interventions and activities that are most proximate to affect the use of data in decision making. The model provides an organizing framework for how interventions and activities work to strengthen the systematic demand, synthesis, review, and use of data. Results: The logic model and guidance are presented to facilitate its widespread use and to enable improved data-informed decision making in program review and planning, advocacy, policy development. Real world examples from the literature support the feasible application of the activities outlined in the model. Conclusions: The logic model provides specific and comprehensive guidance to improve data demand and use. It can be used to design, monitor and evaluate interventions, and to improve demand for, and use of, data in decision making. As more interventions are implemented to improve use of health data, those efforts need to be evaluated.

Improving general flexibility with a mind-body approach: a randomized, controlled trial using neuro emotional Technique®.

Science.gov (United States)

Jensen, Anne M; Ramasamy, Adaikalavan; Hall, Michael W

2012-08-01

General flexibility is a key component of health, well-being, and general physical conditioning. Reduced flexibility has both physical and mental/emotional etiologies and can lead to musculoskeletal injuries and athletic underperformance. Few studies have tested the effectiveness of a mind-body therapy on general flexibility. The aim of this study was to investigate if Neuro Emotional Technique® (NET), a mind-body technique shown to be effective in reducing stress, can also improve general flexibility. The sit-and-reach test (SR) score was used as a measure of general flexibility. Forty-five healthy participants were recruited from the general population and assessed for their initial SR score before being randomly allocated to receive (a) two 20-minute sessions of NET (experimental group); (b) two 20-minute sessions of stretching instruction (active control group); or (c) no intervention or instruction (passive control group). After intervention, the participants were reassessed in a similar manner by the same blind assessor. The participants also answered questions about demographics, usual water and caffeine consumption, and activity level, and they completed an anxiety/mood psychometric preintervention and postintervention. The mean (SD) change in the SR score was +3.1 cm (2.5) in the NET group, +1.2 cm (2.3) in the active control group and +1.0 cm (2.6) in the passive control group. Although all the 3 groups showed some improvement, the improvement in the NET group was statistically significant when compared with that of either the passive controls (p = 0.015) or the active controls (p = 0.021). This study suggests that NET could provide an effective treatment in improving general flexibility. A larger study is required to confirm these findings and also to assess longer term effectiveness of this therapy on general flexibility.

General practice and primary health care in Denmark

DEFF Research Database (Denmark)

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

2012-01-01

General practice is the corner stone of Danish primary health care. General practitioners (GPs) are similar to family physicians in the United States. On average, all Danes have 6.9 contacts per year with their GP (in-person, telephone, or E-mail consultation). General practice is characterized...... education. The contract is (re)negotiated every 2 years. General practice is embedded in a universal tax-funded health care system in which GP and hospital services are free at the point of use. The current system has evolved over the past century and has shown an ability to adapt flexibly to new challenges...... by 5 key components: (1) a list system, with an average of close to 1600 persons on the list of a typical GP; (2) the GP as gatekeeper and first-line provider in the sense that a referral from a GP is required for most office-based specialists and always for in- and outpatient hospital treatment; (3...

Generic project definitions for improvement of health care delivery: a case-based approach.

Science.gov (United States)

Niemeijer, Gerard C; Does, Ronald J M M; de Mast, Jeroen; Trip, Albert; van den Heuvel, Jaap

2011-01-01

The purpose of this article is to create actionable knowledge, making the definition of process improvement projects in health care delivery more effective. This study is a retrospective analysis of process improvement projects in hospitals, facilitating a case-based reasoning approach to project definition. Data sources were project documentation and hospital-performance statistics of 271 Lean Six Sigma health care projects from 2002 to 2009 of general, teaching, and academic hospitals in the Netherlands and Belgium. Objectives and operational definitions of improvement projects in the sample, analyzed and structured in a uniform format and terminology. Extraction of reusable elements of earlier project definitions, presented in the form of 9 templates called generic project definitions. These templates function as exemplars for future process improvement projects, making the selection, definition, and operationalization of similar projects more efficient. Each template includes an explicated rationale, an operationalization in the form of metrics, and a prototypical example. Thus, a process of incremental and sustained learning based on case-based reasoning is facilitated. The quality of project definitions is a crucial success factor in pursuits to improve health care delivery. We offer 9 tried and tested improvement themes related to patient safety, patient satisfaction, and business-economic performance of hospitals.

General practitioners and national health insurance results of a ...

African Journals Online (AJOL)

Objective. To determine the attitudes of South African general practitioners (GPs) to national health insurance (NHI), social health insurance (SHI) and other related health system reforms. Design. A national survey using postal questionnaires and telephonic follow-up of non-responders. Setting. GPs throughout South Africa.

Role of video games in improving health-related outcomes: a systematic review.

Science.gov (United States)

Primack, Brian A; Carroll, Mary V; McNamara, Megan; Klem, Mary Lou; King, Brandy; Rich, Michael; Chan, Chun W; Nayak, Smita

2012-06-01

Video games represent a multibillion-dollar industry in the U.S. Although video gaming has been associated with many negative health consequences, it also may be useful for therapeutic purposes. The goal of this study was to determine whether video games may be useful in improving health outcomes. Literature searches were performed in February 2010 in six databases: the Center on Media and Child Health Database of Research, MEDLINE, CINAHL, PsycINFO, EMBASE, and the Cochrane Central Register of Controlled Trials. Reference lists were hand-searched to identify additional studies. Only RCTs that tested the effect of video games on a positive, clinically relevant health consequence were included. Study selection criteria were strictly defined and applied by two researchers working independently. Study background information (e.g., location, funding source); sample data (e.g., number of study participants, demographics); intervention and control details; outcomes data; and quality measures were abstracted independently by two researchers. Of 1452 articles retrieved using the current search strategy, 38 met all criteria for inclusion. Eligible studies used video games to provide physical therapy, psychological therapy, improved disease self-management, health education, distraction from discomfort, increased physical activity, and skills training for clinicians. Among the 38 studies, a total of 195 health outcomes were examined. Video games improved 69% of psychological therapy outcomes, 59% of physical therapy outcomes, 50% of physical activity outcomes, 46% of clinician skills outcomes, 42% of health education outcomes, 42% of pain distraction outcomes, and 37% of disease self-management outcomes. Study quality was generally poor; for example, two thirds (66%) of studies had follow-up periods of video games to improve health outcomes, particularly in the areas of psychological therapy and physical therapy. RCTs with appropriate rigor will help build evidence in this

Climate Services to Improve Public Health

Science.gov (United States)

Jancloes, Michel; Thomson, Madeleine; Costa, María Máñez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary

2014-01-01

A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4–6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers. PMID:24776719

Relationship between oral health-related quality of life, oral health, socioeconomic, and general health factors in elderly Brazilians.

Science.gov (United States)

de Andrade, Fabíola Bof; Lebrão, Maria Lúcia; Santos, Jair Lício Ferreira; da Cruz Teixeira, Doralice Severo; de Oliveira Duarte, Yeda Aparecida

2012-09-01

To assess the impact of oral health on quality of life in elderly Brazilians and to evaluate its association with clinical oral health measures and socioeconomic and general health factors. Cross-sectional study. Population-based cohort study on health, well-being, and aging. Eight hundred fifty-seven participants representing 588,384 community-dwelling elderly adults from the city of São Paulo, Brazil. Self-perceived impact of oral health on quality of life was measured using the Geriatric Oral Health Assessment Index (GOHAI), with scores categorized as good, moderate, or poor, indicating low, moderate, and high degrees of negative impact on quality of life, respectively. Nearly half of the individuals had good GOHAI scores (44.7% of overall sample, 45.9% of dentate participants, and 43.4% of edentulous participants). In the overall sample, those with poor self-rated general health and a need for dental prostheses were more likely to have poor and moderate GOHAI scores. Individuals with depression were significantly more likely to have poor GOHAI scores. No socioeconomic variables were related to the outcome, except self-perception of sufficient income, which was a protective factor against a poor GOHAI score in dentate participants. Moderate and high degrees of negative impact of oral health on quality of life were associated with general health and clinical oral health measures, independent of socioeconomic factors. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Spa therapy (balneotherapy) relieves mental stress, sleep disorder, and general health problems in sub-healthy people

Science.gov (United States)

Yang, Bei; Qin, Qi-zhong; Han, Ling-li; Lin, Jing; Chen, Yu

2018-02-01

To investigate the relieving effects of hot spring balneotherapy on mental stress, sleep disorder, general health problems, and women's health problems in sub-healthy people, we recruited 500 volunteers in sub-health in Chongqing, and 362 volunteers completed the project, including 223 in the intervention group and 139 in the control group. The intervention group underwent hot spring balneotherapy for 5 months, while the control group did not. The two groups took questionnaire investigation (general data, mental stress, emotional status, sleep quality, general health problems, as well as some women's health problems) and physical examination (height, weight, waist circumference, blood pressure, blood lipid, blood sugar) 5 months before and after the intervention, respectively. After intervention, sleep disorder (difficulty in falling asleep ( P = 0.017); dreaminess, nightmare suffering, and restless sleep ( P = 0.013); easy awakening ( P = 0.003) and difficulty in falling into sleep again after awakening( P = 0.016); and mental stress ( P = 0.031) and problems of general health (head pain ( P = 0.026), joint pain( P = 0.009), leg or foot cramps ( P = 0.001), blurred vision ( P = 0.009)) were relieved significantly in the intervention group, as compared with the control group. While other indicators (fatigue, eye tiredness, limb numbness, constipation, skin allergy) and women's health problems (breast distending pain; dysmenorrhea, irregular menstruation) were relieved significantly in the self-comparison of the intervention group before and after intervention ( P 0.05). All indications (except bad mood, low mood, and worry or irritability) in the intervention group significantly improved, with effect size from 0.096 to 1.302. Multiple logistic regression analysis showed that the frequency, length, and location of balneotherapy in the intervention group were the factors influencing emotion, sleep, and health condition ( P Physical examination found that waist

General scientific guidance for stakeholders on health claim applications

DEFF Research Database (Denmark)

Sjödin, Anders Mikael

2016-01-01

of Article 13.1 claims except for claims put on hold by the European Commission, and has evaluated additional health claim applications submitted pursuant to Articles 13.5, 14 and also 19. In addition, comments received from stakeholders indicate that general issues that are common to all health claims need...... based on the experience gained to date with the evaluation of health claims, and it may be further updated, as appropriate, when additional issues are addressed.......The European Food Safety Authority (EFSA) asked the Panel on Dietetic Products Nutrition and Allergies (NDA) to update the General guidance for stakeholders on the evaluation of Article 13.1, 13.5 and 14 health claims published in March 2011. Since then, the NDA Panel has completed the evaluation...

Can general practitioner commissioning deliver equity and excellence? Evidence from two studies of service improvement in the English NHS.

Science.gov (United States)

Gridley, Kate; Spiers, Gemma; Aspinal, Fiona; Bernard, Sylvia; Atkin, Karl; Parker, Gillian

2012-04-01

To explore some of the key assumptions underpinning the continued development of general practitioner-led commissioning in health services. Qualitative data from two studies of service improvement in the English NHS were considered against England's plans for GP-led commissioning. These data were collected through in-depth interviews with a total of 187 professionals and 99 people affected by services in 10 different primary care trust areas across England between 2008 and 2009. Internationally, GPs are seen to have a central position in health systems. In keeping with this, the English policy places emphasis on the 'pivotal role' of general practitioners, considered to be ideally placed to commission in the best interests of their patients. However, our evidence suggests that general practitioners do not always have a pivotal role for all patients. Moreover, it is planned that the new commissioning groups in England will not be subject to top-down performance management and this raises the question of how agreed quality standards will be met under the proposed new system. This paper questions the assumption that GPs are best placed to commission health services in a way that meets quality standards and leads to equitable outcomes. There is little evidence to suggest that GPs will succeed where others have failed and a risk that, without top-down performance management, service improvement will be patchy, leading to greater, not reduced, inequity.

[Health-related quality-of-life in the smoking general population of Spain: An approach from the National Health Survey].

Science.gov (United States)

de Lossada, A; Rejas, J

2016-10-01

Smoking has been associated with an important health risk. The aim was to analyze the health-related quality of life (HRQoL) status of the adult Spanish general population included in the National Health Survey according to its smoking status. Data were included from National Health Survey for the year 2011-2012 with information of HRQoL status in general population over 15 years of age. Adult male and female, 18 years of age or above, were categorized into 3 exclusive groups according to their current smoking status: smokers (daily smokers of any form of tobacco, at least the previous 12 months), ex-smokers of one or more years since quitting smoking and people who have never smoked (non smokers). HRQoL was assessed with the Spanish version of the EQ-5D-5L questionnaire included into the National Health Survey. A total of 19,604 records were analyzed: 4,723 (24.09%) smokers, 3,797 (19.37%) ex-smokers, and 11,084 (56.54%) non smokers, male and female with 18 years of age or above. Smokers showed significantly adjusted mean scores (95% CI) in utility of 0.903 (0.899-0.908) and 75.36 (74.06-76.69) in the visual analogue scale of current state of health, ex-smokers 0.924 (0.919-0.929) and 76.85 (76.67-78.07), and non smokers 0.902 (0.899-0.905) and 76.25 (75.02-77.51), P<.01 between groups in both variables. In the Spanish general population, subjects who are ex-smokers showed better utility values and state health scores, supporting the hypothesis that quitting smoking could be associated with a discreet improvement of HRQoL. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Primary health eye care knowledge among general practitioners ...

African Journals Online (AJOL)

Primary health eye care knowledge among general practitioners working in the Cape Town metropole. M Van Zyl, N Fernandes, G Rogers, N Du Toit. Abstract. Aim: The main purpose of this study was to determine whether general practitioners (GPs) in the Cape Town metropole have sufficient knowledge to diagnose and ...

Study of General health, resiliency, and defense mechanisms in patients with migraine headache

Directory of Open Access Journals (Sweden)

Alireza Aghayusefi

2013-06-01

Full Text Available Background: Migraine is a neurological disease that the etiology, several factors affect its onset or its exacerbation. One of the factors affecting disease is psychological factors such as defense mechanisms, resiliency, and general health. This study assessed the relationship between general health, resiliency, and general defense mechanisms, and also predicts the general health of people with migraine headaches that have a high resiliency and use mature defense mechanisms. Material and Methods: 50 women with migraine headache in the city of Bushehr using defense mechanisms, resiliency, and general health questionnaires were studied. For statistical analysis, Pearson correlation and multiple regression tests were used by SPSS 17 software. Results: The results showed that most of the defense mechanisms of migraine sufferers are Immature and Neuroticism. There is significant negative correlation between the deterioration of general health and resiliency as well as the mature defense mechanism (p=0/003, and also there is a significant positive correlation between this deterioration with neuroticism (p=0/040 and immature defense mechanisms (p=0/041. On the other hand there is significant negative correlation between resiliencies with immature (p=0/009 and neuroticism defense mechanisms (p=0/04, and also with mature defense mechanism has a significant positive correlation (p=0/003. Also, as more people use the mature defense mechanism, their deterioration of general health will be reduced, but this relationship will be stronger with the presence of resiliency. So migraine people use the mature defense mechanisms with high resiliency will have more favorable general health (less deterioration of general health. Conclusion: This study showed that migraine patients use the mature defense mechanisms with high resiliency will have more favorable general health (less deterioration of general health.

Description of intensity of physical education in a structure educational educate and health-improvement-educate processes.

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Bondar T.S.

2012-12-01

Full Text Available Comparison of intensity of physical education is presented in child's establishments of making healthy and rest and general educational establishments. Questioning of 183 students-practice and analysis of document of the Kharkov regional management is conducted on physical education and sport. It is set that health-improvement-educate process is directed on forming for children and young people of culture of health. It is marked that the result of pedagogical activity in establishments and establishments of education is physical, spiritual and social development of personality of children and young people. Witnessed, that process of physical education in out-of-town child's establishments of making healthy and rest almost in three times more intensive by comparison to general educational establishments and school summer camps. It contingently a presence for the children of plenty of spare time, by the use in practice of camps of non-standard facilities and forms of increase of motive activity of children, by the features of structure health-improvement-educate process.

The Effect of Electromagnetic Waves on the General Health of Zahedan Gas Power Plant Personnel

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Fereydoon Laal

2016-08-01

Full Text Available Abstract Introduction: With ever improving technology and increasing the use of high voltage power in industrial environments, concerns about the destructive effects of electromagnetic waves on human health have increased. Thus the present study aims to evaluate the effects of electromagnetic waves on the general health of Zahedan gas power plant personnel. Materials & Method: The present case-control study investigated the health of people at one point of time and their amount of exposure to electromagnetic waves at the same time. The data collection tool in this study was 28-item general health questionnaire (GHQ-28. After measuring the electromagnetic waves at distances of 1, 1.5 and 3 meters at high voltage power substations and data extraction, the data were entered to SPSS software and analyzed by descriptive statistics, t-test and chi-square. Results: In this study, the age and experience variables were not significantly different in two groups (p> 0.05. The highest magnetic fields in high voltage power substations was at a distance of 1 meter in the substation 607 (28/1 mG and in precision tool work units (7.03 mG. The results showed that the depressive and general health symptoms were significantly different between the exposed and unexposed groups (p = 0.04, however the difference was not significant in terms of physical performance, anxiety and social performance (p> 0.05. Conclusion: although the level of exposure was lower than standard level determined in Iran, the significant difference of the general health and depression between the two groups, explains the necessity of conducting more studies in this regard. Also by reducing the exposure time and increasing people’s awareness it is possible to take important steps to reduce exposure and complications.

General health assessment in refugees claiming to have been tortured

DEFF Research Database (Denmark)

Draminsky Petersen, Hans; Christensen, Maria Elisabeth; Kastrup, Marianne

1994-01-01

General health assessment of refugees claiming to have been previously exposed to torture takes place in a psychological atmosphere affected by the difficult situation of the refugee. Thirty-one refugees, mainly from the Middle East and Africa, were assessed as regards their physical and mental...... (P general) health. Reliability was moderate with respect to clinical observation during interview....

General health checks in adults for reducing morbidity and mortality from disease

DEFF Research Database (Denmark)

Krogsbøll, Lasse T; Jørgensen, Karsten Juhl; Grønhøj Larsen, Christian

2012-01-01

General health checks are common elements of health care in some countries. These aim to detect disease and risk factors for disease with the purpose of reducing morbidity and mortality. Most of the commonly used screening tests offered in general health checks have been incompletely studied. Als......, screening leads to increased use of diagnostic and therapeutic interventions, which can be harmful as well as beneficial. It is, therefore, important to assess whether general health checks do more good than harm....

Four centuries on from Bacon: progress in building health research systems to improve health systems?

Science.gov (United States)

Hanney, Stephen R; González-Block, Miguel A

2014-09-23

In 1627, Francis Bacon's New Atlantis described a utopian society in which an embryonic research system contributed to meeting the needs of the society. In this editorial, we use some of the aspirations described in New Atlantis to provide a context within which to consider recent progress in building health research systems to improve health systems and population health. In particular, we reflect on efforts to build research capacity, link research to policy, identify the wider impacts made by the science, and generally build fully functioning research systems to address the needs identified. In 2014, Health Research Policy and Systems has continued to publish one-off papers and article collections covering a range of these issues in both high income countries and low- and middle-income countries. Analysis of these contributions, in the context of some earlier ones, is brought together to identify achievements, challenges and possible ways forward. We show how 2014 is likely to be a pivotal year in the development of ways to assess the impact of health research on policies, practice, health systems, population health, and economic benefits.We demonstrate how the increasing focus on health research systems will contribute to realising the hopes expressed in the World Health Report, 2013, namely that all nations would take a systematic approach to evaluating the outputs and applications resulting from their research investment.

Work engagement in employees at professional improvement programs in health

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Elizangela Gianini Gonsalez

2017-09-01

Full Text Available Objective: This study evaluated the levels of engagement at work in enhancement programs and professionals training in health. Method: A cross-sectional study with 82 health professionals enhancement programs and improvement of a public institution in the State of São Paulo, using the Utrech Work Engagement Scale (UWES, a self-administered questionnaire composed of seventeen self-assessment items in three dimensions: vigor, dedication and absorption. The scores were calculated according to the statistical model proposed in the Preliminary Manual UWES. Results: Engagement levels were too high on the force, high dedication and dimension in general score, and medium in size to 71.61% absorption, 58.03%, 53.75% and 51.22% of workers, respectively. The professionals present positive relationship with the work; they are responsible, motivated and dedicated to the job and to the patients. Conclusion: Reinforces the importance of studies that evaluate positive aspects of the relationship between professionals and working environment, contributing to strengthen the programs of improvement, advancing the profile of professionals into the labour market.

The influence of workload and health behavior on job satisfaction of general practitioners.

Science.gov (United States)

Goetz, Katja; Musselmann, Berthold; Szecsenyi, Joachim; Joos, Stefanie

2013-02-01

Workload, personal health behavior, and job satisfaction of the physicians are crucial aspects for the quality of care they provide. The aim of our study was to identify influencing factors on job satisfaction with regard to general practitioners' (GPs) characteristics such as age, gender, health behavior, body mass index (BMI), and workload. A cross-sectional survey with a sample of 1,027 German GPs was used. Job satisfaction was measured according to a modified version of the Warr-Cook-Wall job satisfaction scale. Further, we collected data about health behavior and BMI of GPs and demographic data. Group comparison was evaluated using ANOVA with Bonferroni correction for post-hoc tests. A linear regression analysis was performed in which each of the job satisfaction items were handled as a dependent variable. The response rate was 34.0%. GPs were rather satisfied with their job with the exception of "hours of work," "physical working condition," and "income." GPs working in cities had less working hours per week, less number of patients per day, longer consultation times, and a higher proportion of privately insured patients compared to GPs working in rural areas. Being female, a higher age, a good health behavior, a lower BMI, and a high proportion of privately insured patients were positively associated with job satisfaction. Our results suggest that job satisfaction depends on different aspects of working conditions and individual characteristics. Therefore, strategies to improve job satisfaction should target improving working conditions and activating physicians' health resources.

Group discussions with the health care team--a method of improving care of hypertension in general practice.

Science.gov (United States)

Adorian, D; Silverberg, D S; Tomer, D; Wamosher, Z

1990-06-01

A management-by-objective approach was used by the health care administration of the Kupat Holim Sick Fund to improve care of hypertension in 20 family practices in the city of Ashdod in central Israel. The doctor-nurse teams in these clinics met jointly on a regular basis with a physician-instructor, reviewed the results of their care of hypertension and discussed ways of improving it. Over a seven-year period, until 1988, the percentage of the population treated increased from 4.0% to 9.2% and percentage of treated patients who had diastolic pressure of 100 mmHg or more fell from 29.6% to 13.4%. Dropout rate ranged from 2.3% to 3.1% per year over the whole period. In 20 other practices in the Ashdod area in 1988 used for comparison, only 5.9% of the population was treated and the per cent treated was less than Ashdod for all age groups above 30. Dropout rate was higher, averaging 9.8% per year, and the percentage of patients with diastolic pressures of 100 mmHg or more was higher (18.1%). Thus the use of regular discussions with feedback to the health care team was associated with better detection, treatment and follow-up of hypertension.

General health and religious coping strategies in patients suffering from asthma

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Seyyed Hassan Adeli

2014-09-01

Full Text Available Background and Objectives: Asthma is a chronic respiratory disease characterized by reversible contraction of airways. Coping strategies can reduce the negative impact of the disease in individuals or cause incompatible behaviors by negative effect. This study aimed to evaluate the religious coping strategies in asthma patients and the relationship of religious coping and general health. Methods: The study included 102 asthmatic patients referred to the pulmonary clinic of Shahid Beheshti hospital of Qom. Brief religious coping strategy questionnaire and the general health questionnaire were used in this study. Results: The mean positive religious coping strategy was 26.24±9.89 and 60% of the patients had higher than average scores. The mean negative religious coping strategy was 10.56±3.99 and 35% of patients had a mean score higher than average scores. The mean total general health score was 23.91±11.9. Conclusion: The study results showed that asthmatic patients are at greater risk of depression and a negative correlation exists between positive religious coping and general health scores. It can be concluded that in asthmatic patients, depression should be suspected sooner. Also, during the course of treatment and in cases of resistant to treatment, this issue should be considered. It can be concluded that the patients who use more positive coping strategies and have a strong spiritual beliefs may have higher mental health that leads to higher physical health and a better response to treatment. Religious coping strategies; general health; depression.

Fortification of staple foods with zinc for improving zinc status and other health outcomes in the general population.

Science.gov (United States)

Shah, Dheeraj; Sachdev, Harshpal S; Gera, Tarun; De-Regil, Luz Maria; Peña-Rosas, Juan Pablo

2016-06-09

Zinc deficiency is a global nutritional problem, particularly in children and women residing in settings where diets are cereal based and monotonous. It has several negative health consequences. Fortification of staple foods with zinc may be an effective strategy for preventing zinc deficiency and improving zinc-related health outcomes. To evaluate the beneficial and adverse effects of fortification of staple foods with zinc on health-related outcomes and biomarkers of zinc status in the general population. We searched the following databases in April 2015: Cochrane Central Register of Controlled Trials (CENTRAL, Issue 3 of 12, 2015, the Cochrane Library), MEDLINE & MEDLINE In Process (OVID) (1950 to 8 April 2015), EMBASE (OVID) (1974 to 8 April 2015), CINAHL (1982 to April 2015), Web of Science (1900 to 9 April 2015), BIOSIS (1969 to 9 April 2015), POPLINE (1970 to April 2015), AGRICOLA, OpenGrey, BiblioMap, and Trials Register of Promoting Health Interventions (TRoPHI), besides regional databases (April 2015) and theses. We also searched clinical trial registries (17 March 2015) and contacted relevant organisations (May 2014) in order to identify ongoing and unpublished studies. We included randomised controlled trials, randomised either at the level of the individual or cluster. We also included non-randomised trials at the level of the individual if there was a concurrent comparison group. We included non-randomised cluster trials and controlled before-after studies only if there were at least two intervention sites and two control sites. Interventions included fortification (central/industrial) of staple foods (cereal flours, edible fats, sugar, condiments, seasonings, milk and beverages) with zinc for a minimum period of two weeks. Participants were members of the general population who were over two years of age (including pregnant and lactating women) from any country. Two review authors independently assessed the eligibility of studies for inclusion

Improving adolescent maternal health

African Journals Online (AJOL)

2 Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Nelson R ... of information concerning their bodies and ..... improve quality of healthcare services for adolescents[15] – services that .... equipment, medicines, supplies and technology needed to ensure effective service provision to adolescents.

The Effects of Coping Therapy on General Health of Pregnant Women with High Risk of Genetics Abnormalities in their Fetus

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F Nazmiye

2016-11-01

Full Text Available Introduction: The physiological changes in pregnancy lead to the psychological pressures. Therefore, there is a need for applying cognitive behavioral and emotional confronting to encounter these problems. The present research investigated the effect of coping therapy on general health of pregnant women with high risk of genetic abnormalities in their fetus. Methods: The present study was a semi experimental research. Pre and post tests were used to investigate coping therapy between 30 pregnant women who were referred to Khatomolanbia Genetic Clinic, Yazd, Iran. All the women had pregnancy screening test with high risk of genetics abnormalities in their fetus. They were divided randomly into two groups of case and controls. The test of GHQ was performed in both groups, then the case groups went under 8 sessions of teaching coping therapy each lasting 120 min. After finishing the sessions, post test was performed and analyzing the data using descriptive statistical index and covariance analysis test. Results: Teaching coping therapy to case group caused improvement in their GHQ mark, and this change was significantly different from the change in the GHQ mark of control group. In addition, there was a significant decrease in anxiety, depression and physical signs and an improvement of social function in case group compare to the control group. Discussion: Teaching coping therapy can improve the general health of pregnant women with high risk of genetic abnormalities in their fetus. Therefore, presenting educational courses to the women can improve their general health indices in addition to preventing the probable effects of stress on fetus.

Mobile task management tool that improves workflow of an acute general surgical service.

Science.gov (United States)

Foo, Elizabeth; McDonald, Rod; Savage, Earle; Floyd, Richard; Butler, Anthony; Rumball-Smith, Alistair; Connor, Saxon

2015-10-01

Understanding and being able to measure constraints within a health system is crucial if outcomes are to be improved. Current systems lack the ability to capture decision making with regard to tasks performed within a patient journey. The aim of this study was to assess the impact of a mobile task management tool on clinical workflow within an acute general surgical service by analysing data capture and usability of the application tool. The Cortex iOS application was developed to digitize patient flow and provide real-time visibility over clinical decision making and task performance. Study outcomes measured were workflow data capture for patient and staff events. Usability was assessed using an electronic survey. There were 449 unique patient journeys tracked with a total of 3072 patient events recorded. The results repository was accessed 7792 times. The participants reported that the application sped up decision making, reduced redundancy of work and improved team communication. The mode of the estimated time the application saved participants was 5-9 min/h of work. Of the 14 respondents, nine discarded their analogue methods of tracking tasks by the end of the study period. The introduction of a mobile task management system improved the working efficiency of junior clinical staff. The application allowed capture of data not previously available to hospital systems. In the future, such data will contribute to the accurate mapping of patient journeys through the health system. © 2015 Royal Australasian College of Surgeons.

A small business worksite wellness model for improving health behaviors.

Science.gov (United States)

Merrill, Ray M

2013-08-01

To evaluate the effectiveness of a wellness program delivered by WellSteps, LLC, aimed at improving employee health behaviors in small companies that lack the resources to independently develop and manage a wellness program. Analyses are based on 618 employees from five diverse companies that completed an initial personal health assessment. Exercise and dietary behaviors significantly improved across the five companies. Significant improvements in health perception and life satisfaction also resulted and were associated with improvements in health behaviors. Three of the five companies, each with fewer than 50 employees, were most effective in influencing positive health behaviors, health perceptions, and life satisfaction. The worksite wellness program effectively improved health behaviors, health perceptions, and life satisfaction.

Health Benefits of Urban Allotment Gardening: Improved Physical and Psychological Well-Being and Social Integration

Directory of Open Access Journals (Sweden)

Masashi Soga

2017-01-01

Full Text Available With an ever-increasing urban population, promoting public health and well-being in towns and cities is a major challenge. Previous research has suggested that participating in allotment gardening delivers a wide range of health benefits. However, evidence from quantitative analyses is still scarce. Here, we quantify the effects, if any, of participating in allotment gardening on physical, psychological and social health. A questionnaire survey of 332 people was performed in Tokyo, Japan. We compared five self-reported health outcomes between allotment gardeners and non-gardener controls: perceived general health, subjective health complaints, body mass index (BMI, mental health and social cohesion. Accounting for socio-demographic and lifestyle variables, regression models revealed that allotment gardeners, compared to non-gardeners, reported better perceived general health, subjective health complaints, mental health and social cohesion. BMI did not differ between gardeners and non-gardeners. Neither frequency nor duration of gardening significantly influenced reported health outcomes. Our results highlight that regular gardening on allotment sites is associated with improved physical, psychological and social health. With the recent escalation in the prevalence of chronic diseases, and associated healthcare costs, this study has a major implication for policy, as it suggests that urban allotments have great potential for preventative healthcare.

Health Benefits of Urban Allotment Gardening: Improved Physical and Psychological Well-Being and Social Integration.

Science.gov (United States)

Soga, Masashi; Cox, Daniel T C; Yamaura, Yuichi; Gaston, Kevin J; Kurisu, Kiyo; Hanaki, Keisuke

2017-01-12

With an ever-increasing urban population, promoting public health and well-being in towns and cities is a major challenge. Previous research has suggested that participating in allotment gardening delivers a wide range of health benefits. However, evidence from quantitative analyses is still scarce. Here, we quantify the effects, if any, of participating in allotment gardening on physical, psychological and social health. A questionnaire survey of 332 people was performed in Tokyo, Japan. We compared five self-reported health outcomes between allotment gardeners and non-gardener controls: perceived general health, subjective health complaints, body mass index (BMI), mental health and social cohesion. Accounting for socio-demographic and lifestyle variables, regression models revealed that allotment gardeners, compared to non-gardeners, reported better perceived general health, subjective health complaints, mental health and social cohesion. BMI did not differ between gardeners and non-gardeners. Neither frequency nor duration of gardening significantly influenced reported health outcomes. Our results highlight that regular gardening on allotment sites is associated with improved physical, psychological and social health. With the recent escalation in the prevalence of chronic diseases, and associated healthcare costs, this study has a major implication for policy, as it suggests that urban allotments have great potential for preventative healthcare.

Paucity of qualitative research in general medical and health services and policy research journals: analysis of publication rates.

Science.gov (United States)

Gagliardi, Anna R; Dobrow, Mark J

2011-10-12

Qualitative research has the potential to inform and improve health care decisions but a study based on one year of publications suggests that it is not published in prominent health care journals. A more detailed, longitudinal analysis of its availability is needed. The purpose of this study was to identify, count and compare the number of qualitative and non-qualitative research studies published in high impact health care journals, and explore trends in these data over the last decade. A bibliometric approach was used to identify and quantify qualitative articles published in 20 top general medical and health services and policy research journals from 1999 to 2008. Eligible journals were selected based on performance in four different ranking systems reported in the 2008 ISI Journal Citation Reports. Qualitative and non-qualitative research published in these journals were identified by searching MEDLINE, and validated by hand-searching tables of contents for four journals. The total number of qualitative research articles published during 1999 to 2008 in ten general medical journals ranged from 0 to 41, and in ten health services and policy research journals from 0 to 39. Over this period the percentage of empirical research articles that were qualitative ranged from 0% to 0.6% for the general medical journals, and 0% to 6.4% for the health services and policy research journals. This analysis suggests that qualitative research it is rarely published in high impact general medical and health services and policy research journals. The factors that contribute to this persistent marginalization need to be better understood.

Quality Improvement in Athletic Health Care.

Science.gov (United States)

Lopes Sauers, Andrea D; Sauers, Eric L; Valier, Alison R Snyder

2017-11-01

  Quality improvement (QI) is a health care concept that ensures patients receive high-quality (safe, timely, effective, efficient, equitable, patient-centered) and affordable care. Despite its importance, the application of QI in athletic health care has been limited.   To describe the need for and define QI in health care, to describe how to measure quality in health care, and to present a QI case in athletic training.   As the athletic training profession continues to grow, a widespread engagement in QI efforts is necessary to establish the value of athletic training services for the patients that we serve. A review of the importance of QI in health care, historical perspectives of QI, tools to drive QI efforts, and examples of common QI initiatives is presented to assist clinicians in better understanding the value of QI for advancing athletic health care and the profession. Clinical and Research Advantages:  By engaging clinicians in strategies to measure outcomes and improve their patient care services, QI practice can help athletic trainers provide high-quality and affordable care to patients.

Collaboration between local health and local government agencies for health improvement.

Science.gov (United States)

Hayes, Sara L; Mann, Mala K; Morgan, Fiona M; Kelly, Mark J; Weightman, Alison L

2012-10-17

In many countries, national, regional and local inter- and intra-agency collaborations have been introduced to improve health outcomes. Evidence is needed on the effectiveness of locally developed partnerships which target changes in health outcomes and behaviours. To evaluate the effects of interagency collaboration between local health and local government agencies on health outcomes in any population or age group. We searched the Cochrane Public Health Group Specialised Register, AMED, ASSIA, CENTRAL, CINAHL, DoPHER, EMBASE, ERIC, HMIC, IBSS, MEDLINE, MEDLINE In-Process, OpenGrey, PsycINFO, Rehabdata, Social Care Online, Social Services Abstracts, Sociological Abstracts, TRoPHI and Web of Science from 1966 through to January 2012. 'Snowballing' methods were used, including expert contact, citation tracking, website searching and reference list follow-up. Randomized controlled trials (RCTs), controlled clinical trials (CCTs), controlled before-and-after studies (CBAs) and interrupted time series (ITS) where the study reported individual health outcomes arising from interagency collaboration between health and local government agencies compared to standard care. Studies were selected independently in duplicate, with no restriction on population subgroup or disease. Two authors independently conducted data extraction and assessed risk of bias for each study. Sixteen studies were identified (28,212 participants). Only two were considered to be at low risk of bias. Eleven studies contributed data to the meta-analyses but a narrative synthesis was undertaken for all 16 studies. Six studies examined mental health initiatives, of which one showed health benefit, four showed modest improvement in one or more of the outcomes measured but no clear overall health gain, and one showed no evidence of health gain. Four studies considered lifestyle improvements, of which one showed some limited short-term improvements, two failed to show health gains for the intervention

Experiences of General Practitioners and Practice Support Staff Using a Health and Lifestyle Screening App in Primary Health Care: Implementation Case Study.

Science.gov (United States)

Webb, Marianne Julie; Wadley, Greg; Sanci, Lena Amanda

2018-04-24

Technology-based screening of young people for mental health disorders and health compromising behaviors in general practice increases the disclosure of sensitive health issues and improves patient-centered care. However, few studies investigate how general practitioners (GPs) and practice support staff (receptionists and practice managers) integrate screening technology into their routine work, including the problems that arise and how the staff surmount them. The aim of this study was to investigate the implementation of a health and lifestyle screening app, Check Up GP, for young people aged 14 to 25 years attending an Australian general practice. We conducted an in-depth implementation case study of Check Up GP in one general practice clinic, with methodology informed by action research. Semistructured interviews and focus groups were conducted with GPs and support staff at the end of the implementation period. Data were thematically analyzed and mapped to normalization process theory constructs. We also analyzed the number of times we supported staff, the location where young people completed Check Up GP, and whether they felt they had sufficient privacy and received a text messaging (short message service, SMS) link at the time of taking their appointment. A total of 4 GPs and 10 support staff at the clinic participated in the study, with all except 3 receptionists participating in the final interviews and focus groups. During the 2-month implementation period, the technology and administration of Check Up GP was iterated through 4 major quality improvement cycles in response to the needs of the staff. This resulted in a reduction in the average time taken to complete Check Up GP from 14 min to 10 min, improved SMS text messaging for young people, and a more consistent description of the app by receptionists to young people. In the first weeks of implementation, researchers needed to regularly support staff with the app's administration; however, this support

77 FR 1051 - General Conference Committee of the National Poultry Improvement Plan; Meeting

Science.gov (United States)

2012-01-09

...] General Conference Committee of the National Poultry Improvement Plan; Meeting AGENCY: Animal and Plant... the General Conference Committee of the National Poultry Improvement Plan. DATES: The meeting will be... INFORMATION CONTACT: Dr. C. Stephen Roney, Senior Coordinator, National Poultry Improvement Plan, VS, APHIS...

How could health information be improved? Recommended actions from the Victorian Consultation on Health Literacy.

Science.gov (United States)

Hill, Sophie J; Sofra, Tanya A

2017-03-07

Objective Health literacy is on the policy agenda. Accessible, high-quality health information is a major component of health literacy. Health information materials include print, electronic or other media-based information enabling people to understand health and make health-related decisions. The aim of the present study was to present the findings and recommended actions as they relate to health information of the Victorian Consultation on Health Literacy. Methods Notes and submissions from the 2014 Victorian Consultation workshops and submissions were analysed thematically and a report prepared with input from an advisory committee. Results Health information needs to improve and recommendations are grouped into two overarching themes. First, the quality of information needs to be increased and this can be done by developing a principle-based framework to inform updating guidance for information production, formulating standards to raise quality and improving the systems for delivering information to people. Second, there needs to be a focus on users of health information. Recommendation actions were for information that promoted active participation in health encounters, resources to encourage critical users of health information and increased availability of information tailored to population diversity. Conclusion A framework to improve health information would underpin the efforts to meet literacy needs in a more consistent way, improving standards and ultimately increasing the participation by consumers and carers in health decision making and self-management. What is known about the topic? Health information is a critical component of the concept of health literacy. Poorer health literacy is associated with poorer health outcomes across a range of measures. Improving access to and the use of quality sources of health information is an important strategy for meeting the health literacy needs of the population. In recent years, health services and

[General aspects of planning and care in mental health].

Science.gov (United States)

Saforcada, E

1976-09-01

This paper reviews some general concepts on Planning, especially in public and welfare sectors, stressing those concerning the major flaws in the argentine system of mental health. The author considers the definition of planning levels, and sets forth three: general plan, program and project. The correlative implementation is also considered. The importance of feed-back from adequate evaluation is stressed, emphasizing three aspects: a) evaluation of dynamics, rate and extent of decrease, increase or stagnation; b) assessment of efficacity of factors involved; c) control and stabilization of goals already attained. The necessity to develop a human ecology, encompassing socio-cultural and psycho-social factors is stressed, together with fostering theoretical research and the use of its results by implementation agents. Several differences among prevailing mental health actions are pointed out which allow a distinction between two typical models: clinical and sanitarist. The main differences between them lye on: standard location of working sites, nature of basic actions, field of action, hypothesis for working, including ethiological and ecological assumptions, theoretical and methodological framework. A series of criteria for evaluating sanitary techniques and strategies are set forth, among which: operative procedures, length of treatments, degree of therapeutic concentration, and general pragmatic criteria. The indicators reviewed are: degree of efficacity, covering, degree of perseverance in treatments, cultural barriers between patient and therapist, delegation of functions into special, first-rate sanitary agents, needs for the training of mental health workers. An attempt is made at developping general evaluation criteria for mental health planning, and several indicators are proposed, among which: a) cost/efficacity ratio, including in costs the use of economical, human and physical resources; b) preventive capacities of the community; c) capacities for the

Improving high quality, equitable maternal health services in Malawi ...

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

Improving high quality, equitable maternal health services in Malawi (IMCHA) ... In response, the Ministry of Health implemented a Standards-Based Management and Recognition for Reproductive Health initiative to improve ... Total funding.

Improving generalized inverted index lock wait times

Science.gov (United States)

Borodin, A.; Mirvoda, S.; Porshnev, S.; Ponomareva, O.

2018-01-01

Concurrent operations on tree like data structures is a cornerstone of any database system. Concurrent operations intended for improving read\\write performance and usually implemented via some way of locking. Deadlock-free methods of concurrency control are known as tree locking protocols. These protocols provide basic operations(verbs) and algorithm (ways of operation invocations) for applying it to any tree-like data structure. These algorithms operate on data, managed by storage engine which are very different among RDBMS implementations. In this paper, we discuss tree locking protocol implementation for General inverted index (Gin) applied to multiversion concurrency control (MVCC) storage engine inside PostgreSQL RDBMS. After that we introduce improvements to locking protocol and provide usage statistics about evaluation of our improvement in very high load environment in one of the world’s largest IT company.

The effectiveness of M-health technologies for improving health and health services: a systematic review protocol

Directory of Open Access Journals (Sweden)

Patel Vikram

2010-10-01

Full Text Available Abstract Background The application of mobile computing and communication technology is rapidly expanding in the fields of health care and public health. This systematic review will summarise the evidence for the effectiveness of mobile technology interventions for improving health and health service outcomes (M-health around the world. Findings To be included in the review interventions must aim to improve or promote health or health service use and quality, employing any mobile computing and communication technology. This includes: (1 interventions designed to improve diagnosis, investigation, treatment, monitoring and management of disease; (2 interventions to deliver treatment or disease management programmes to patients, health promotion interventions, and interventions designed to improve treatment compliance; and (3 interventions to improve health care processes e.g. appointment attendance, result notification, vaccination reminders. A comprehensive, electronic search strategy will be used to identify controlled studies, published since 1990, and indexed in MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, the Cochrane Library, or the UK NHS Health Technology Assessment database. The search strategy will include terms (and synonyms for the following mobile electronic devices (MEDs and a range of compatible media: mobile phone; personal digital assistant (PDA; handheld computer (e.g. tablet PC; PDA phone (e.g. BlackBerry, Palm Pilot; Smartphone; enterprise digital assistant; portable media player (i.e. MP3 or MP4 player; handheld video game console. No terms for health or health service outcomes will be included, to ensure that all applications of mobile technology in public health and health services are identified. Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies. Data on objective and self-reported outcomes and study quality will

The effectiveness of M-health technologies for improving health and health services: a systematic review protocol.

Science.gov (United States)

Free, Caroline; Phillips, Gemma; Felix, Lambert; Galli, Leandro; Patel, Vikram; Edwards, Philip

2010-10-06

The application of mobile computing and communication technology is rapidly expanding in the fields of health care and public health. This systematic review will summarise the evidence for the effectiveness of mobile technology interventions for improving health and health service outcomes (M-health) around the world. To be included in the review interventions must aim to improve or promote health or health service use and quality, employing any mobile computing and communication technology. This includes: (1) interventions designed to improve diagnosis, investigation, treatment, monitoring and management of disease; (2) interventions to deliver treatment or disease management programmes to patients, health promotion interventions, and interventions designed to improve treatment compliance; and (3) interventions to improve health care processes e.g. appointment attendance, result notification, vaccination reminders.A comprehensive, electronic search strategy will be used to identify controlled studies, published since 1990, and indexed in MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, the Cochrane Library, or the UK NHS Health Technology Assessment database. The search strategy will include terms (and synonyms) for the following mobile electronic devices (MEDs) and a range of compatible media: mobile phone; personal digital assistant (PDA); handheld computer (e.g. tablet PC); PDA phone (e.g. BlackBerry, Palm Pilot); Smartphone; enterprise digital assistant; portable media player (i.e. MP3 or MP4 player); handheld video game console. No terms for health or health service outcomes will be included, to ensure that all applications of mobile technology in public health and health services are identified. Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies. Data on objective and self-reported outcomes and study quality will be independently extracted by two review

Interventions to improve social determinants of health among elderly ethnic minority groups: a review.

Science.gov (United States)

Pool, Michelle S; Agyemang, Charles O; Smalbrugge, Martin

2017-12-01

Like the European general population, ethnic minorities are aging. In this group, important social determinants of health (social participation, social isolation and loneliness) that lead to negative health outcomes frequently occur. Interventions targeting these determinants may decrease negative health outcomes. The goal of this article was to identify effective interventions that improve social participation, and minimise social isolation and loneliness in community dwelling elderly ethnic minorities. An electronic database (PubMed) was systematically searched using an extensive search strategy, for intervention studies in English, French, Dutch of German, without time limit. Additional articles were found using references. Articles were included if they studied an intervention aimed to improve social participation or minimise social isolation or loneliness and were focusing on community dwelling elderly ethnic minorities. Data regarding studies characteristics and results were extracted. Six studies (three randomized controlled trials, three non-controlled intervention studies) were included in the review. All studies were group-based interventions and had a theoretical basis. Five out of six studies showed improvement on a social participation, -isolation or loneliness outcome. Type of intervention included volunteering-, educational- and physical activities. In three studies active participation of the participant was required, these interventions were not more effective than other interventions. Some interventions improved the included social determinants of health in community dwelling elderly ethnic minorities. Investment in further development and implementation of these interventions may help to improve social determinants of health in these populations. It is necessary to evaluate these interventions in the European setting. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Can life coaching improve health outcomes?

DEFF Research Database (Denmark)

Ammentorp, Jette

26. Ammentorp J, Uhrenfeldt L, Angel F, Ehrensvärd, Carlsen E, Kofoed P-E. Can life coaching improve health outcomes? – A systematic review of intervention studies. Poster presented at the International Conference on Communication in Healthcare, Montreal Canada, 30 Sept 2013.......26. Ammentorp J, Uhrenfeldt L, Angel F, Ehrensvärd, Carlsen E, Kofoed P-E. Can life coaching improve health outcomes? – A systematic review of intervention studies. Poster presented at the International Conference on Communication in Healthcare, Montreal Canada, 30 Sept 2013....

Health activism: the way forward to improve health in difficult times.

Science.gov (United States)

Laverack, Glenn

2013-09-01

Health activism is an action on behalf of a cause, action that goes beyond what is conventional or routine in society. It involves a challenge to the existing order whenever it is perceived to lead to a social injustice or inequality. Today social injustice is killing people on a grand scale and it is timely for health activism to be used as a way forward to improve health during difficult economic and political times. Health activism is essential because it can create the necessary conditions for people to take control over their own lives when others cannot or will not act on their behalf. Health promotion agencies and the practitioners that they employ, professional organisations and researchers can also play an important role. What is clear is that if greedy corporations and complacent governments are not challenged, we will continue to have limited success in improving health.

Lifestyle Course as an Investment in Perceived Improved Health among Newly Arrived Women from Countries outside Europe

Directory of Open Access Journals (Sweden)

Solvig Ekblad

2014-10-01

Full Text Available Family reunification was the most common reason (34% for resettlement in Sweden in 2013. About one-fifth of the population is foreign-born. This study used mixed methods to evaluate a culturally tailored clinical health-promotion intervention. The intervention was conducted by licensed clinicians and a local coordinator. Sessions were five-weeks long, two hours a week. The quantitative data cover results from 54 participants, mainly Arabic and Somali-speaking, who participated in 10 groups. The participants’ perceived health improved significantly over the three measures. They also shared that their health significantly improved according to moderate effect size. The qualitative data, analyzed using revised content analysis, reflected one general theme: “the intervention is an investment in perceived improved health”, and four categories: “perceived increased health literacy”, “strength, empowerment and security”, “finding a new lifestyle”, and “the key to entry into Swedish society is language”. An intervention focusing on the prevention of ill-health, on health as a human right, and on empowerment, and aimed at female newcomers, has practical implications.

Oral and General Health Promotion for Children: A Holistic Approach

DEFF Research Database (Denmark)

Cinar, Ayse Basak

Inequalities in oral and general health have been rising globally; WHO calls for adoption of an integrated approach to their promotion as both share common risk factors. However, research about this issue among children is scarce. Based on the associations of such a research found in common for a...... to adopt healthy lifestyles, both in economically developing and developed countries. This book should be especially useful to researchers, professionals in dentistry and medicine, policy makers, and anyone else involved in provision of better health to community....... Turkish and Finnish children, this book underlies that oral health is turning out to be part of the global health culture, regardless of cultural differences and different oral health care systems. The book, further, by most recent literature, provides a review of 'Significance of Oral Health, Concept......Inequalities in oral and general health have been rising globally; WHO calls for adoption of an integrated approach to their promotion as both share common risk factors. However, research about this issue among children is scarce. Based on the associations of such a research found in common for all...

Stable or improved health status in the population 65 years and older in Stockholm, Sweden - an 8-year follow-up of self-reported health items.

Science.gov (United States)

Modig, Karin; Virtanen, Suvi; Ahlbom, Anders; Agahi, Neda

2016-07-01

Previous studies have reached different conclusions about whether health is improving in the ageing population. More studies with narrow age groups analyzed separately for men and women will contribute to the literature. To describe trends in self-reported indicators of health and health-related quality of life between 2002 and 2010, focusing on differences between gender and age groups. A population-based survey of individuals 65+ in the Stockholm County was used. Prevalence of health problems increased with age both among men and women. Men generally reported having no health problems to a larger extent than women, but the proportions reporting severe problems were similar. The larger picture is one of stability in health-related quality of life, even if several items developed for the better, especially among women. While the proportions reporting no health/functional problems increased for many items, the proportions reporting severe problems remained unchanged among men and improved only for two items among women. CONCLUSIONS OVERALL, IMPROVEMENTS WERE SEEN IN MANY OF THE HEALTH-RELATED QUALITY OF LIFE ITEMS AS WELL AS FOR SELF-RATED HEALTH AMONG WOMEN THE PROPORTIONS REPORTING LONG-TERM ILLNESS OR PERSISTENT HEALTH PROBLEMS INCREASED, BUT FEWER SEEM TO BE LIMITED IN THEIR DAILY ACTIVITIES BY THESE PROBLEMS THE STABLE PROPORTIONS OF POOR SELF-RATED HEALTH INDICATES THAT WHILE HEALTH AND FUNCTIONING SEEM TO BE IMPROVING FOR THE MAJORITY OF THE OLDER POPULATION, SOME GROUPS MAY BE LAGGING BEHIND FUTURE STUDIES SHOULD PAY ATTENTION TO CHANGES BOTH IN THE UPPER AND LOWER ENDS OF THE HEALTH SPECTRUM. © 2016 the Nordic Societies of Public Health.

Relationship between Abuse Experience and General Health among Older Adults in Yazd City- Iran

Directory of Open Access Journals (Sweden)

Hassan Rezaeipandari

2016-06-01

Full Text Available Introduction: Elder abuse may increase the vulnerability of ageing people to disease and decrease their general health status, so addressing the issue is essential for promoting elderly quality of life. The study aimed to examine the relation between abuse experience and general health among elderly people in Yazd city- Iran. Methods: The cross-sectional study carried out on 250 community-dwelling seniors in the city of Yazd who were selected with cluster random sampling. Data collection tools included, Iranian Domestic Elder Abuse Questionnaire and Persian version of the General Health Questionnaire 28. Data were analyzed using Spearman correlation coefficient and linear regression tests. Results: Mean scores of abuse experience and general health among the elders were 11.84±12.70 (range 0-100 and 21.82±10.84 (range 0-84 respectively. General health status was more undesirable among elders who had experienced abuse than those who had not. Elder abuse subscales accounted for 17.2 % changes in general health, which had only care neglect and physical abuse subscales with significant prediction effect. Conclusion: Abuse experience has negative effects on older adults' general health. care neglect and physical abuse play a more important role.

Do Web-based Mental Health Literacy Interventions Improve the Mental Health Literacy of Adult Consumers? Results From a Systematic Review.

Science.gov (United States)

Brijnath, Bianca; Protheroe, Joanne; Mahtani, Kamal Ram; Antoniades, Josefine

2016-06-20

Low levels of mental health literacy (MHL) have been identified as an important contributor to the mental health treatment gap. Interventions to improve MHL have used traditional media (eg, community talks, print media) and new platforms (eg, the Internet). Evaluations of interventions using conventional media show improvements in MHL improve community recognition of mental illness as well as knowledge, attitude, and intended behaviors toward people having mental illness. However, the potential of new media, such as the Internet, to enhance MHL has yet to be systematically evaluated. Study aims were twofold: (1) To systematically appraise the efficacy of Web-based interventions in improving MHL. (2) To establish if increases in MHL translated into improvement in individual health seeking and health outcomes as well as reductions in stigma toward people with mental illness. We conducted a systematic search and appraisal of all original research published between 2000 and 2015 that evaluated Web-based interventions to improve MHL. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to report findings. Fourteen studies were included: 10 randomized controlled trials and 4 quasi-experimental studies. Seven studies were conducted in Australia. A variety of Web-based interventions were identified ranging from linear, static websites to highly interactive interventions such as social media games. Some Web-based interventions were specifically designed for people living with mental illness whereas others were applicable to the general population. Interventions were more likely to be successful if they included "active ingredients" such as a structured program, were tailored to specific populations, delivered evidenced-based content, and promoted interactivity and experiential learning. Web-based interventions targeting MHL are more likely to be successful if they include active ingredients. Improvements in MHL see concomitant

Memory and Comprehension for Health Information among Older Adults: Distinguishing the Effects of Domain-General and Domain-Specific Knowledge

Science.gov (United States)

Chin, Jessie; Payne, Brennan; Gao, Xuefei; Conner-Garcia, Thembi; Graumlich, James F.; Murray, Michael D.; Morrow, Daniel G.; Stine-Morrow, Elizabeth A.L.

2014-01-01

While there is evidence that knowledge influences understanding of health information, less is known about the processing mechanisms underlying this effect and its impact on memory. We used the moving window paradigm to examine how older adults varying in domain-general crystallized ability (verbal ability) and health knowledge allocate attention to understand health and domain-general texts. Participants (n=107, aged 60 to 88 yrs) read and recalled single sentences about hypertension and about non-health topics. Mixed-effects modeling of word-by-word reading times suggested that domain-general crystallized ability increased conceptual integration regardless of text domain, while health knowledge selectively increased resource allocation to conceptual integration at clause boundaries in health texts. These patterns of attentional allocation were related to subsequent recall performance. Although older adults with lower levels of crystallized ability were less likely to engage in integrative processing, when they did, this strategy had a compensatory effect in improving recall. These findings suggest that semantic integration during reading is an important comprehension process that supports the construction of the memory representation and is engendered by knowledge. Implications of the findings for theories of text processing and memory as well as for designing patient education materials are discussed. PMID:24787361

Memory and comprehension for health information among older adults: distinguishing the effects of domain-general and domain-specific knowledge.

Science.gov (United States)

Chin, Jessie; Payne, Brennan; Gao, Xuefei; Conner-Garcia, Thembi; Graumlich, James F; Murray, Michael D; Morrow, Daniel G; Stine-Morrow, Elizabeth A L

2015-01-01

While there is evidence that knowledge influences understanding of health information, less is known about the processing mechanisms underlying this effect and its impact on memory. We used the moving window paradigm to examine how older adults varying in domain-general crystallised ability (verbal ability) and health knowledge allocate attention to understand health and domain-general texts. Participants (n = 107, age: 60-88 years) read and recalled single sentences about hypertension and about non-health topics. Mixed-effects modelling of word-by-word reading times suggested that domain-general crystallised ability increased conceptual integration regardless of text domain, while health knowledge selectively increased resource allocation to conceptual integration at clause boundaries in health texts. These patterns of attentional allocation were related to subsequent recall performance. Although older adults with lower levels of crystallised ability were less likely to engage in integrative processing, when they did, this strategy had a compensatory effect in improving recall. These findings suggest that semantic integration during reading is an important comprehension process that supports the construction of the memory representation and is engendered by knowledge. Implications of the findings for theories of text processing and memory as well as for designing patient education materials are discussed.

Effects of health education for migrant females with psychosomatic complaints treated by general practitioners. A randomised controlled evaluation study

NARCIS (Netherlands)

Kocken, P.L.; Zwanenburg, E.J.-v.; Hoop, T.de

2008-01-01

Objective: : The effectiveness of use of migrant health educators in the general practitioners' care for female migrants with psychosomatic problems was evaluated to contribute to the improvement of the care for these patients. Methods: : A randomised controlled trial (RCT) design was used. A total

Quality improvement, implementation, and dissemination strategies to improve mental health care for children and adolescents: a systematic review.

Science.gov (United States)

Forman-Hoffman, Valerie L; Middleton, Jennifer Cook; McKeeman, Joni L; Stambaugh, Leyla F; Christian, Robert B; Gaynes, Bradley N; Kane, Heather Lynne; Kahwati, Leila C; Lohr, Kathleen N; Viswanathan, Meera

2017-07-24

included only educational materials or meetings (or both), or only educational materials and outreach components. Evidence was insufficient to draw conclusions on harms and moderators of interventions. Several strategies can improve both intermediate and final health outcomes and resource use. This complex and heterogeneous body of evidence does not permit us to have a high degree of confidence about the efficacy of any one strategy because we generally found only a single study testing each strategy. PROSPERO, CRD42015024759 .

Patient information materials in general practices and promotion of health literacy: an observational study of their effectiveness.

Science.gov (United States)

Protheroe, Joanne; Estacio, Emee Vida; Saidy-Khan, Sirandou

2015-03-01

Government policy in the UK emphasises providing patients with good health information to encourage participation in their health care. Patient information leaflets (PILs) form part of this policy and have been shown to affect patient health outcomes; however, many are poorly written. To describe the PILs in general practice surgeries in Stoke-on-Trent in terms of readability and variety of content. An observational study of randomly selected GP practices (n = 17) across Stoke-on-Trent. PILs were assessed for readability (Flesch Reading Ease and Flesch-Kincaid Grade Level) and compared with national skills level data and with the recommended level for medical information. The PILs were also categorised for content using the Rudd (2007) health material classification framework. A total of 345 PILs were collected and assessed. Only 24.3% meet recommended reading-level criteria. Compared with national skills levels, over 75% of the PILs collected were too complex for at least 15% of the English population. Of the PILs, 47.8% were classified as 'systems navigation' (information regarding services); 22.9% were disease prevention (screening and immunisations); 14.2% personal and public safety; and less than 10% were for managing illness or health promotion. Current PILs in general practices do not all promote health literacy. Information only accessible to a proportion of higher skilled patients may increase inequalities in health. Less than 10% of PILs promote managing illness or healthy lifestyles. Processes must be put in place to improve the readability and variety of content of PILs in GP practices. © British Journal of General Practice 2015.

The Oklahoma Attorney General's Task Force report on the State of End-of-Life Health Care, 2005.

Science.gov (United States)

Edmondson, W A Drew

2005-05-01

This article includes the recommendations submitted by the 15 members of the Oklahoma Attorney General's Task Force in their Report on the State of End-of-Life Health Care. The task force was created on April 21, 2004, and their report was accepted by Attorney General W.A. Drew Edmondson at a press conference April 11, 2005. It has been forwarded to members of the Oklahoma Legislature, relevant state agencies and organizations with an invitation to join with members of the task force to continue efforts to improve end-of-life care for Oklahomans. Copies of the report are available upon request to the Office of Attorney General.

Common and Critical Components Among Community Health Assessment and Community Health Improvement Planning Models.

Science.gov (United States)

Pennel, Cara L; Burdine, James N; Prochaska, John D; McLeroy, Kenneth R

Community health assessment and community health improvement planning are continuous, systematic processes for assessing and addressing health needs in a community. Since there are different models to guide assessment and planning, as well as a variety of organizations and agencies that carry out these activities, there may be confusion in choosing among approaches. By examining the various components of the different assessment and planning models, we are able to identify areas for coordination, ways to maximize collaboration, and strategies to further improve community health. We identified 11 common assessment and planning components across 18 models and requirements, with a particular focus on health department, health system, and hospital models and requirements. These common components included preplanning; developing partnerships; developing vision and scope; collecting, analyzing, and interpreting data; identifying community assets; identifying priorities; developing and implementing an intervention plan; developing and implementing an evaluation plan; communicating and receiving feedback on the assessment findings and/or the plan; planning for sustainability; and celebrating success. Within several of these components, we discuss characteristics that are critical to improving community health. Practice implications include better understanding of different models and requirements by health departments, hospitals, and others involved in assessment and planning to improve cross-sector collaboration, collective impact, and community health. In addition, federal and state policy and accreditation requirements may be revised or implemented to better facilitate assessment and planning collaboration between health departments, hospitals, and others for the purpose of improving community health.

Transgender health care: improving medical students' and residents' training and awareness

Directory of Open Access Journals (Sweden)

Dubin SN

2018-05-01

Full Text Available Samuel N Dubin,1,* Ian T Nolan,1,* Carl G Streed Jr,2 Richard E Greene,3 Asa E Radix,4 Shane D Morrison5 1NYU School of Medicine, New York, NY, 2Department of Medicine, Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA, 3Department of Internal Medicine, NYU School of Medicine, 4Callen-Lorde Community Health Center, New York, NY, 5Department of Surgery, Division of Plastic Surgery, University of Washington School of Medicine, Seattle, WA, USA *These authors contributed equally to this work Background: A growing body of research continues to elucidate health inequities experienced by transgender individuals and further underscores the need for medical providers to be appropriately trained to deliver care to this population. Medical education in transgender health can empower physicians to identify and change the systemic barriers to care that cause transgender health inequities as well as improve knowledge about transgender-specific care. Methods: We conducted structured searches of five databases to identify literature related to medical education and transgender health. Of the 1272 papers reviewed, 119 papers were deemed relevant to predefined criteria, medical education, and transgender health topics. Citation tracking was conducted on the 119 papers using Scopus to identify an additional 12 relevant citations (a total of 131 papers. Searches were completed on October 15, 2017 and updated on December 11, 2017. Results: Transgender health has yet to gain widespread curricular exposure, but efforts toward incorporating transgender health into both undergraduate and graduate medical educations are nascent. There is no consensus on the exact educational interventions that should be used to address transgender health. Barriers to increased transgender health exposure include limited curricular time, lack of topic-specific competency among faculty, and underwhelming institutional support. All published

Paucity of qualitative research in general medical and health services and policy research journals: analysis of publication rates

Science.gov (United States)

2011-01-01

Background Qualitative research has the potential to inform and improve health care decisions but a study based on one year of publications suggests that it is not published in prominent health care journals. A more detailed, longitudinal analysis of its availability is needed. The purpose of this study was to identify, count and compare the number of qualitative and non-qualitative research studies published in high impact health care journals, and explore trends in these data over the last decade. Methods A bibliometric approach was used to identify and quantify qualitative articles published in 20 top general medical and health services and policy research journals from 1999 to 2008. Eligible journals were selected based on performance in four different ranking systems reported in the 2008 ISI Journal Citation Reports. Qualitative and non-qualitative research published in these journals were identified by searching MEDLINE, and validated by hand-searching tables of contents for four journals. Results The total number of qualitative research articles published during 1999 to 2008 in ten general medical journals ranged from 0 to 41, and in ten health services and policy research journals from 0 to 39. Over this period the percentage of empirical research articles that were qualitative ranged from 0% to 0.6% for the general medical journals, and 0% to 6.4% for the health services and policy research journals. Conclusions This analysis suggests that qualitative research it is rarely published in high impact general medical and health services and policy research journals. The factors that contribute to this persistent marginalization need to be better understood. PMID:21992238

A strategic approach to quality improvement and patient safety education and resident integration in a general surgery residency.

Science.gov (United States)

O'Heron, Colette T; Jarman, Benjamin T

2014-01-01

To outline a structured approach for general surgery resident integration into institutional quality improvement and patient safety education and development. A strategic plan to address Accreditation Council for Graduate Medical Education (ACGME) Clinical Learning Environment Review assessments for resident integration into Quality Improvement and Patient Safety initiatives is described. Gundersen Lutheran Medical Foundation is an independent academic medical center graduating three categorical residents per year within an integrated multi-specialty health system serving 19 counties over 3 states. The quality improvement and patient safety education program includes a formal lecture series, online didactic sessions, mandatory quality improvement or patient safety projects, institutional committee membership, an opportunity to serve as a designated American College of Surgeons National Surgical Quality Improvement Project and Quality in Training representative, mandatory morbidity and mortality conference attendance and clinical electives in rural surgery and international settings. Structured education regarding and participation in quality improvement and patient safety programs are able to be accomplished during general surgery residency. The long-term outcomes and benefits of these strategies are unknown at this time and will be difficult to measure with objective data. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

Effectiveness of Motivational Interviewing in improving lipid level in patients with dyslipidemia assisted by general practitioners: Dislip-EM study protocol.

Science.gov (United States)

Pérula, Luis A; Bosch, Josep M; Bóveda, Julia; Campiñez, Manuel; Barragán, Nieves; Arboniés, Juan C; Prados, Jose A; Martín, Enrique; Martín, Remedios; Massons, Josep; Criado, Margarita; Ruiz, Roger; Fernández, José A; Buitrago, Francisco; Olaya, Inmaculada; Pérez, Modesto; Ruiz, Joaquin

2011-11-05

The non-pharmacological approach to cholesterol control in patients with hyperlipidemia is based on the promotion of a healthy diet and physical activity. Thus, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns, and that include brief advice and counseling services. Within this context, Motivational Interviewing has proven to be effective in changing health behaviors in specific cases. However, more robust evidence is needed on the effectiveness of Motivational Interviewing in treating chronic pathologies -such as dyslipidemia- in patients assisted by general practitioners. This article describes a protocol to assess the effectiveness of MI as compared with general practice (brief advice), with the aim of improving lipid level control in patients with dyslipidemia assisted by a general practitioner. An open, two-arm parallel, multicentre, cluster, controlled, randomized, clinical trial will be performed. A total of 48-50 general practitioners from 35 public primary care centers in Spain will be randomized and will recruit 436 patients with dyslipidemia. They will perform an intervention based either on Motivational Interviewing or on the usual brief advice. After an initial assessment, follow-ups will be performed at 2, 4, 8 and 12 months. Primary outcomes are lipid levels (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and cardiovascular risk. The study will assess the degree of dietary and physical activity improvement, weight loss in overweight patients, and adherence to treatment guidelines. Motivational interview skills constitute the primary strategies GPs use to treat their patients. Having economical, simple, effective and applicable techniques is essential for primary care professionals to help

Creating Quality Improvement Culture in Public Health Agencies

Science.gov (United States)

Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon

2014-01-01

Objectives. We conducted case studies of 10 agencies that participated in early quality improvement efforts. Methods. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007–2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Results. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Conclusions. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies’ ability to create and sustain a quality improvement culture. PMID:24228680

Creating quality improvement culture in public health agencies.

Science.gov (United States)

Davis, Mary V; Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon

2014-01-01

We conducted case studies of 10 agencies that participated in early quality improvement efforts. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007-2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies' ability to create and sustain a quality improvement culture.

Work-Family Conflict and Oral and General Health-Related Quality of Life.

Science.gov (United States)

Singh, Kiran A; Spencer, A John; Roberts-Thomson, Kaye F; Brennan, David S

2015-08-01

The characteristics of the work environment and relationships with family roles may impact on health and be of public health significance. The aims were to investigate the cross-sectional association of work-family conflict with oral- and general health-related quality of life, and well-being. A random sample of 45-54-year olds from Adelaide, South Australia, was surveyed by self-complete questionnaire in 2004-2005 (n = 879, response rate = 43.8%). Health-related quality of life was measured with the OHIP-14 and EQ-VAS instruments, and well-being by the Satisfaction With Life Scale. In adjusted analyses controlling for sex, income, education, tooth brushing frequency and social support, the higher Family Interferes with Work (FIW) tertile and the middle tertile of Work Interferes with Family (WIF) were associated with more oral health-related impacts as measured by OHIP-14 in relation to problems with teeth, mouth or dentures (Beta = 1.64, P Work-family conflict was associated with more oral health impacts and lower general health and well-being among employed middle-aged adults. This supports the view of work-family conflict as a psychosocial risk factor for health outcomes spanning function, health perceptions and well-being, and encompassing both oral health and general health.

Investigation of General Health in Female Care givers of Elderly People With Alzheimer

Directory of Open Access Journals (Sweden)

Farideh Bastani

2010-10-01

Full Text Available Objectives: The purpose of this study was to explore the general health status in women as care givers of the elderly people with Alzheimer who attending to the Iranian Association of Alzheimer’s Disease. Methods & Materials: In this descriptive –cross sectional study as a introductory stage of a randomized controlled field trial, 150 women were recruited with a consecutive sampling method. The study population of this study included the women as family care givers attending to the Iranian Association of Alzheimer Disease. In this study, the inclusion criteria was consisted of women who had 18-60 years old, be a close relative to elderly patients with Alzheimer disease, as well as they have had direct caring with the duration of at least six months. Data collection regarding assessment of general health of the women was a questionnaire including 28 items of Persian version of the General Health Questionnaire (GHQ. For data analysis, descriptive statistics and chi square were used in the study. Results: The study findings showed that only 24% of the subjects had a good level of general health, but 58.7% and 17.3% of them had a moderate and weak general health respectively. There were significant relations between general health of the women as care givers and the variables such as age (P=0.016, occupation (P=0.008, type of relative (P=0.013, and economic status (P=0.049. However, there were not any significant relation between general health and the other variables of marriage situation (P=0.5, education (P=0.07, and duration of caring the elderly patients with Alzheimer (P=0.205. Conclusion: According to the findings, the considerable percentage of the female care givers of elders with Alzheimer disease did not pose optimum level of general health. As Care givers’ gender centered studies have seldom conducted in Iran, future researches should focus on different dimensions of health promotion among both male and female care givers.

Corporate Philanthropy Toward Community Health Improvement in Manufacturing Communities.

Science.gov (United States)

McHugh, Megan; Farley, Diane; Maechling, Claude R; Dunlop, Dorothy D; French, Dustin D; Holl, Jane L

2018-06-01

Virtually all large employers engage in corporate philanthropy, but little is known about the extent to which it is directed toward improving community health. We conducted in-depth interviews with leaders of corporate philanthropy from 13 of the largest manufacturing companies in the US to understand how giving decisions were made, the extent to which funding was directed towards improving community health, and whether companies coordinate with local public health agencies. We found that corporate giving was sizable and directed towards communities in which the manufacturers have a large presence. Giving was aligned with the social determinants of health (i.e., aimed at improving economic stability, the neighborhood and physical environment, education, food security and nutrition, the community and social context, and the health care system). However, improving public health was not often cited as a goal of corporate giving, and coordination with public health agencies was limited. Our results suggest that there may be opportunities for public health agencies to help guide corporate philanthropy, particularly by sharing community-level data and offering their measurement and evaluation expertise.

Primary care and public health: exploring integration to improve population health

National Research Council Canada - National Science Library

Committee on Integrating Primary Care and Public Health; Board on Population Health and Public Health Practice; Institute of Medicine

...; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal...

Iraqi health system in kurdistan region: medical professionals' perspectives on challenges and priorities for improvement.

Science.gov (United States)

Shabila, Nazar P; Al-Tawil, Namir G; Tahir, Rebaz; Shwani, Falah H; Saleh, Abubakir M; Al-Hadithi, Tariq S

2010-11-30

evaluation of physicians and other health staff (69.8%). Medical professionals were generally unsatisfied with the different aspects of the health system in Iraqi Kurdistan region. A number of problems and different priority needs for health system improvement have been recognized that require to be studied in more details.

Improving Scotland's health: time for a fresh approach?

Science.gov (United States)

Stone, D H

2012-05-01

Scotland's health remains the worst in the UK. There are several probable reasons for this. Of those that are amenable to change, health improvement policy has been excessively preoccupied with targeting individuals perceived to be 'at risk' rather than adopting a whole population perspective. Environmental as opposed to behavioural approaches to health improvement have been relatively neglected. To meet the challenge of Scotland's poor health more effectively in the future, new strategic thinking is necessary. Three initial steps are required: recognize that current approaches are inadequate and that fresh ideas are needed; identify the principles that should underlie future strategy development; translate these principles into achievable operational objectives. Five principles of a revitalized strategy to improve the health of Scotland in the future are proposed. These are start early and sustain effort; create a healthy and safe environment; reduce geographical as well as social inequalities in health; adopt an evidence-based approach to public health interventions; use epidemiology to assess need, plan interventions and monitor progress. These principles may then be translated into achievable operational policy and practice objectives.

Measuring and improving productivity in general radiology.

Science.gov (United States)

Wilt, Michelle A; Miranda, Rafael; Johnson, C Daniel; Love, Peggy Sue

2010-10-01

The aim of this study was to determine a method of measuring productivity among general radiographers in a moderate-sized hospital and to improve and sustain productivity within that work area. The average times needed to perform the 13 most common examinations were measured. Performance of the various examinations was tracked and multiplied by the time allocated per procedure; this measure was divided by the length of the work shift to determine productivity. Productivity measures were shared among the work group, and decisions to improve productivity (eg, whether to fill open positions) were made by group members. Average time spent per examination type was calculated (range, 10 minutes to 1 hour 16 minutes). At baseline (February 2008), group productivity was 50%. Productivity increased during the first year of monitoring and was sustained through November 2009 (productivity range, 57%-63%). Yearly savings from not filling open positions were estimated to be $174,000. Productivity in a general radiology work area can be measured. Consensus among the work group helped increase productivity and assess progress. This methodology, if widely adopted, could be standardized and used to compare productivity across departments and institutions. Copyright © 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The role of mHealth for improving medication adherence in patients with cardiovascular disease: a systematic review.

Science.gov (United States)

Gandapur, Yousuf; Kianoush, Sina; Kelli, Heval M; Misra, Satish; Urrea, Bruno; Blaha, Michael J; Graham, Garth; Marvel, Francoise A; Martin, Seth S

2016-10-01

Cardiovascular disease is a leading cause of morbidity and mortality worldwide, and a key barrier to improved outcomes is medication non-adherence. The aim of this study is to review the role of mobile health (mHealth) tools for improving medication adherence in patients with cardiovascular disease. We performed a systematic search for randomized controlled trials that primarily investigated mHealth tools for improving adherence to cardiovascular disease medications in patients with hypertension, coronary artery disease, heart failure, peripheral arterial disease, and stroke. We extracted and reviewed data on the types of mHealth tools used, preferences of patients and healthcare providers, the effect of the mHealth interventions on medication adherence, and the limitations of trials. We identified 10 completed trials matching our selection criteria, mostly with mHealth tools included text messages, Bluetooth-enabled electronic pill boxes, online messaging platforms, and interactive voice calls. Patients and healthcare providers generally preferred mHealth to other interventions. All 10 studies reported that mHealth interventions improved medication adherence, though the magnitude of benefit was not consistently large and in one study was not greater than a telehealth comparator. Limitations of trials included small sample sizes, short duration of follow-up, self-reported outcomes, and insufficient assessment of unintended harms and financial implications. Current evidence suggests that mHealth tools can improve medication adherence in patients with cardiovascular diseases. However, high-quality clinical trials of sufficient size and duration are needed to move the field forward and justify use in routine care.

Comparison of general health status in mothers of hearing and hearing-impaired children

Directory of Open Access Journals (Sweden)

Movallali

2013-05-01

Full Text Available Background and Aim: The birth of a hearing-impaired child and raising him/her often brings special psychological feelings for parents, especially mothers who spend more time with the child. This study aimed to compare the general health status in mothers of hearing-impaired and hearing children. Methods: This was a descriptive-analytic study. General Health Questionnaire was used to identify general health status; and data were analyzed with independent-t test. Results: The general health level of mothers of hearing-impaired children was lower than mothers of normal hearing children (p=0.01 . The average scores of anxiety (p=0.01, depression (p= 0.01 and physical (p=0.02 symptoms and social function (p=0.01 of mothers of hearing-impaired children was higher than mothers of normal hearing ones (p=0.01. Conclusion: Having a child with hearing impairment affects mothers’ general health status. Our findings show that it’s necessary to provide psychological and social support for mothers of hearing-impaired children.

Sleep of professional athletes: Underexploited potential to improve health and performance.

Science.gov (United States)

Tuomilehto, Henri; Vuorinen, Ville-Pekka; Penttilä, Elina; Kivimäki, Marko; Vuorenmaa, Markus; Venojärvi, Mika; Airaksinen, Olavi; Pihlajamäki, Jussi

2017-04-01

Sleep disorders have become increasingly prevalent affecting health and working ability. Restorative sleep may be considered important for athletes' successful recovery and performance. However, some athletes seem to experience major problems in sleeping. Thus far, there is limited scientific information about their sleep. This study aimed to evaluate the quality of sleep and the prevalence of sleep disorders as well as the impact of a structured sleep counselling protocol in professional athletes. A total of 107 professional ice hockey players participated in the study. The exploratory observational 1-year follow-up study consisted of questionnaire-based sleep assessment followed by general sleep counselling and, when needed, polysomnography and an individual treatment plan. One in every four players was found to have a significant problem in sleeping. All athletes considered sleep essential for their health and three in every four players considered that counselling would improve their performance. Counselling and individual treatment were found to improve significantly the quality of sleep with the mean alteration of 0.6 (95% CI 0.2-1.0, P = 0.004) in a scale from 0 to 10. Our results support that sleep problems are common in professional athletes. However, systematic examination, counselling and individual treatment planning can improve the quality of their sleep.

General Practitioners' Perspective on eHealth and Lifestyle Change

DEFF Research Database (Denmark)

Brandt, Carl Joakim; Søgaard, Gabrielle Isidora; Clemensen, Jane

2018-01-01

BACKGROUND: Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how...... they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. OBJECTIVE: This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior...... or in partnership with 1 to 4 colleagues and all use electronic patient health records for prescription, referral, and asynchronous electronic consultations. We performed qualitative, semistructured, individual in-depth interviews with the GPs in their own office about how they used eHealth and mHealth devices...

Animal-Assisted Therapy for Improving Human Health

Directory of Open Access Journals (Sweden)

Sibel Cevizci

2009-06-01

Full Text Available ABSTRACT Animal Assisted Therapy (AAT or Pet Therapy is an adjunctive therapy by taking advantage of human and animal interaction, activate the physiological and psychological mechanisms, initiate positive changes improving health in metabolism. In recent years, this interaction are in use to treat psychological and psychiatric disorders such as stress, depression, loneliness, pervasive developmental disorders affect negatively to human health. Furthermore, AAT has been increasingly used to improve quality of life, hypertension, cardiovascular diseases, chronic illnesses such as cancer and AIDS. The aim of this paper is to identify AAT by reviewing human and animal interaction, evaluate how AAT has a scientific background from past to now. Also, we aim to give some information about the risks, institutional applications, some factors referring AAT’s mechanism of action and chronic diseases, psychological and physical improvements provided with animal assisted therapies. The therapy results will be evaluated more advisable providing AAT is being applied with public health specialist, veterinarian, physician, psychologist, psychiatrist and veterinary public health experts who are monitor applications. Especially, the psychosomatic effects result from physical, emotional and play mechanism of action of HDT can be used for improving quality of life in individuals with chronic diseases. In Turkey, there is no any investigation which have been performed in this scientific field. It is quitely important to evaluate the benefits of this therapy accurately and to select various methods proper to diseases. Consequently, it is obvious that AAT will be considered by the healthcare services as a supportive therapy process for improving human health in Turkey and needs further studies. [TAF Prev Med Bull 2009; 8(3.000: 263-272

Do longer consultations improve the management of psychological problems in general practice? A systematic literature review

Directory of Open Access Journals (Sweden)

Hutton Catherine

2007-05-01

Full Text Available Abstract Background Psychological problems present a huge burden of illness in our community and GPs are the main providers of care. There is evidence that longer consultations in general practice are associated with improved quality of care; but this needs to be balanced against the fact that doctor time is a limited resource and longer consultations may lead to reduced access to health care. The aim of this research was to conduct a systematic literature review to determine whether management of psychological problems in general practice is associated with an increased consultation length and to explore whether longer consultations are associated with better health outcomes for patients with psychological problems. Methods A search was conducted on Medline (Ovid databases up to7 June 2006. The following search terms, were used: general practice or primary health care (free text or family practice (MeSH AND consultation length or duration (free text or time factors (MeSH AND depression or psychological problems or depressed (free text. A similar search was done in Web of Science, Pubmed, Google Scholar, and Cochrane Library and no other papers were found. Studies were included if they contained data comparing consultation length and management or detection of psychological problems in a general practice or primary health care setting. The studies were read and categories developed to enable systematic data extraction and synthesis. Results 29 papers met the inclusion criteria. Consultations with a recorded diagnosis of a psychological problem were reported to be longer than those with no recorded psychological diagnosis. It is not clear if this is related to the extra time or the consultation style. GPs reported that time pressure is a major barrier to treating depression. There was some evidence that increased consultation length is associated with more accurate diagnosis of psychological problems. Conclusion Further research is needed to

Pathways leading to self-perceived general health and overall quality of life in burned adults.

Science.gov (United States)

Moi, Asgjerd L; Nilsen, Roy M

2012-12-01

The aim of the study was to explore pathways leading to self-perceived general health and overall quality of life in burn patients. Data on burn-specific health, generic health, overall quality of life, injury characteristics and socio-demographics were obtained from 95 adult burn patients 47.0 (23.8) [mean (SD)] months after injury. A theoretical path model was established based on the concepts of Wilson and Cleary's model on health-related quality of life [1], and the proposed model was examined by structural equation modelling. Two main paths were identified, one leading to general health perception and the other leading to overall quality of life. Together, direct and indirect paths explained 63% of the variance of perceived general health and 43% of the variance in overall quality of life. The total effects of the SF-36 domain Vitality on perceived general health and overall quality of life were 0.62 and 0.66, respectively. No statistically significant path could be revealed between general health perception and overall quality of life. The results indicate that self-perceived general health and overall quality of life are related but distinct constructs. Moreover, vitality seems to be an important factor for the perception of both general health and overall quality of life in burned adults. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Changes in chronic disease management among community health centers (CHCs) in China: Has health reform improved CHC ability?

Science.gov (United States)

Wang, Zhaoxin; Shi, Jianwei; Wu, Zhigui; Xie, Huiling; Yu, Yifan; Li, Ping; Liu, Rui; Jing, Limei

2017-07-01

Since the 1980s, China has been criticized for its mode of chronic disease management (CDM) that passively provides treatment in secondary and tertiary hospitals but lacks active prevention in community health centers (CHCs). Since there are few systematic evaluations of the CHCs' methods for CDM, this study aimed to analyze their abilities. On the macroperspective, we searched the literature in China's largest and most authoritative databases and the official websites of health departments. Literature was used to analyze the government's efforts in improving CHCs' abilities to perform CDM. At the microlevel, we examined the CHCs' longitudinal data after the New Health Reform in 2009, including financial investment, facilities, professional capacities, and the conducted CDM activities. A policy analysis showed that there was an increasing tendency towards government efforts in developing CDM, and the peak appeared in 2009. By evaluating the reform at CHCs, we found that there was an obvious increase in fiscal and public health subsidies, large-scale equipment, general practitioners, and public health physicians. The benefited vulnerable population in this area also rose significantly. However, rural centers were inferior in their CDM abilities compared with urban ones, and the referral system is still not effective in China. This study showed that CHCs are increasingly valued in managing chronic diseases, especially after the New Health Reform in 2009. However, we still need to improve collaborative management for chronic diseases in the community and strengthen the abilities of CHCs, especially in rural areas. Copyright © 2017 John Wiley & Sons, Ltd.

Health-promoting schools: evidence for a holistic approach to promoting health and improving health literacy.

Science.gov (United States)

Lee, Albert

2009-01-01

Chronic diseases are now the major causes of death and disability worldwide, and non-communicable diseases (NCD) account for the majority of the global health burden. About half of premature deaths are related to health-risking behaviours that are often established during youth and extend to adulthood. While these diseases might not be curable, they are preventable. Prevention is possible when sustained actions are directed at individuals and families, as well as at the broader social, economic and cultural determinants of NCD. A 'life-course' approach to promoting healthy behaviour should begin early in life. The aim of this article is to discuss the impact of the 'health-promoting school' (HPS) on improvements in youth health. HPS can be described as a holistic, whole-school approach in which a broad health education curriculum is supported by the environment and ethos of the school. HPS moves beyond individual behavioural change to consider organizational and policy change such as improving the physical and social environment of the school, as well as its curricula and teaching and learning methods. A positive culture for health would facilitate higher levels of health literacy by helping individuals tackle the determinants of health better as they build the personal, cognitive and social skills for maintaining good health. There is reasonable evidence to demonstrate that the whole-school approach using the HPS framework is effective in improving health, ranging from physical activities and healthy eating to emotional health. Schools adopting the HPS framework have demonstrated changes in culture and organizational practice to become more conducive to health improvement. These schools were reported to have better school health policies, higher degrees of community participation, and a more hygienic environment than non-HPS schools, and students in these schools had a more positive health behaviour profile. Health promotion and disease prevention is essential to

Towards a Unified Taxonomy of Health Indicators: Academic Health Centers and Communities Working Together to Improve Population Health

Science.gov (United States)

Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J.; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton “Mickey”; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B.; Strelnick, A. Hal; Wallerstein, Nina

2014-01-01

The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public’s health and reducing health disparities, the CTSA Consortium’s Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators. The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy’s application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health. PMID:24556775

General practice vocational training and public health medicine: a novel collaboration.

Science.gov (United States)

Brenner, H; Money, P; Quinn, R

1994-06-01

The incorporation of a module of public health teaching into a general practice vocational training programme is described. This programme is itself innovative in that in addition to the 2 years of hospital-based training, it provides 2 years of community-based training. While the curriculum of the public health module is evolving with time, the objectives have remained the same, and are being met. The module has been appraised by external observers, and has been evaluated by participating trainees. The public health module is now an established feature of the Sligo general practice training programme.

Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

Directory of Open Access Journals (Sweden)

Aveledi Blandine

2009-12-01

Full Text Available Abstract Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC. Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC and family planning (FP. Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive. Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1 providing necessary equipment and renovations to health facilities; 2 improving supply management systems; 3 providing comprehensive competency

Stochastic abstract policies: generalizing knowledge to improve reinforcement learning.

Science.gov (United States)

Koga, Marcelo L; Freire, Valdinei; Costa, Anna H R

2015-01-01

Reinforcement learning (RL) enables an agent to learn behavior by acquiring experience through trial-and-error interactions with a dynamic environment. However, knowledge is usually built from scratch and learning to behave may take a long time. Here, we improve the learning performance by leveraging prior knowledge; that is, the learner shows proper behavior from the beginning of a target task, using the knowledge from a set of known, previously solved, source tasks. In this paper, we argue that building stochastic abstract policies that generalize over past experiences is an effective way to provide such improvement and this generalization outperforms the current practice of using a library of policies. We achieve that contributing with a new algorithm, AbsProb-PI-multiple and a framework for transferring knowledge represented as a stochastic abstract policy in new RL tasks. Stochastic abstract policies offer an effective way to encode knowledge because the abstraction they provide not only generalizes solutions but also facilitates extracting the similarities among tasks. We perform experiments in a robotic navigation environment and analyze the agent's behavior throughout the learning process and also assess the transfer ratio for different amounts of source tasks. We compare our method with the transfer of a library of policies, and experiments show that the use of a generalized policy produces better results by more effectively guiding the agent when learning a target task.

Access to general health care services by a New Zealand population with serious mental illness.

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Wheeler A

2014-03-01

Full Text Available INTRODUCTION: Literature suggests that good quality health care access can have a positive impact on the health of people with serious mental illness (SMI, but literature relating to patterns of access by this group is equivocal. AIM: This study was designed to explore health care access patterns in a group of people with SMI and to compare them with a general New Zealand population group, in order for health providers to understand how they might contribute to positive health outcomes for this group. METHODS: The study surveyed 404 mental health consumers aged 18-65 years receiving care from one district health board in Auckland about their patterns of health care access. Results were compared with those from the New Zealand Health Survey of the general population. RESULTS: Findings suggest that the SMI consumer respondents had poorer physical health than the general population respondents, accessed health care services in more complex ways and were more particular about who they accessed for their care than the general population respondents. There was some concern from SMI consumers around discrimination from health care providers. The study also suggested that some proactive management with SMI consumers for conditions such as metabolic syndrome was occurring within the health care community. DISCUSSION: The first point of access for SMI consumers with general health problems is not always the family general practitioner and so other health professionals may sometimes need to consider the mental and physical health of such consumers in a wider context than their own specialism.

Purchasing to improve health systems performance

National Research Council Canada - National Science Library

Robinson, Ray; Jakubowski, Elke; Figueras, Josep

2005-01-01

... as they formulate purchasing strategies so that they can increase effectiveness and improve performance in their own national context An assessment of the intersecting roles of citizens, the government and the providers * * * Written by leading health policy analysts, this book is essential reading for health policy makers, planners and managers as well as resear...

The roles of government in improving health care quality and safety.

Science.gov (United States)

Tang, Ning; Eisenberg, John M; Meyer, Gregg S

2004-01-01

Discussions surrounding the role of government have been and continue to be a favorite American pastime. A framework is provided for understanding the 10 roles that government plays in improving health care quality and safety in the United States. Examples of proposed federal actions to reduce medical errors and enhance patient safety are provided to illustrate the 10 roles: (1) purchase health care, (2) provide health care, (3) ensure access to quality care for vulnerable populations, (4) regulate health care markets, (5) support acquisition of new knowledge, (6) develop and evaluate health technologies and practices, (7) monitor health care quality, (8) inform health care decision makers, (9) develop the health care workforce, and (10) convene stakeholders from across the health care system. Government's responsibility to protect and advance the interests of society includes the delivery of high-quality health care. Because the market alone cannot ensure all Americans access to quality health care, the government must preserve the interests of its citizens by supplementing the market where there are gaps and regulating the market where there is inefficiency or unfairness. The ultimate goal of achieving high quality of care will require strong partnerships among federal, state, and local governments and the private sector. Translating general principles regarding the appropriate role of government into specific actions within a rapidly changing, decentralized delivery system will require the combined efforts of the public and private sectors.

The role of physician counseling in improving adherence to physical activity among the general population

Directory of Open Access Journals (Sweden)

Marcos Ausenka Ribeiro

2007-03-01

Full Text Available The regular practice of physical activity at appropriate levels ensures various benefits for the individual over the short, medium and long terms. It is therefore important in health promotion. On the other hand, sedentary behavior has reached alarming levels among the general population, which qualifies it as a serious health problem of endemic proportions. The present review describes public health problems consequent to sedentary behavior and the importance of physician counseling for change their patients’ beha-vior and making them more physically active on a regular basis. Models and behavioral theories are presented to facilitate physicians’ understan-ding of how to approach patients during clinical practice. We also describe programs conducted in many countries based on physician counseling for reducing sedentary behavior, and we present many tools used to quantify and qualify patients’ attitudes towards becoming more physically active. Through understanding the barriers faced by patients, we suggest methodologies that will enable physicians to use physical activity promotion appropriately. We hope that this will provide support for physicians in conducting physical activity counseling, as a means for improving the health of the population.

Lake Naivasha Sustainability : Ecosystem Improvement for Health ...

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

Lake Naivasha Sustainability : Ecosystem Improvement for Health and ... The overall goal is to make recommendations for the sustainable management of natural ... to improve livestock vaccine development and production to benefit farmers ...

Work Related Stress, Burnout, Job Satisfaction and General Health of Nurses

OpenAIRE

Khamisa, Natasha; Oldenburg, Brian; Peltzer, Karl; Ilic, Dragan

2015-01-01

Gaps in research focusing on work related stress, burnout, job satisfaction and general health of nurses is evident within developing contexts like South Africa. This study identified the relationship between work related stress, burnout, job satisfaction and general health of nurses. A total of 1200 nurses from four hospitals were invited to participate in this cross-sectional study (75% response rate). Participants completed five questionnaires and multiple linear regression analysis was us...

General practitioners' and district nurses' conceptions of the encounter with obese patients in primary health care

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Rasmussen Finn

2011-02-01

Full Text Available Abstract Background Primary health care specialists have a key role in the management of obesity. Through understanding how they conceive the encounter with patients with obesity, treatment may be improved. The aim of this study was thus to explore general practitioners' and district nurses' conceptions of encountering patients with obesity in primary health care. Method Data were collected through semi-structured interviews, and analysed using a phenomenographic approach. The participants were 10 general practitioners (6 women, 4 men and 10 district nurses (7 women, 3 men from 19 primary health care centres within a well-defined area of Sweden. Results Five descriptive categories were identified: Adequate primary health care, Promoting lifestyle change, Need for competency, Adherence to new habits and Understanding patient attitudes. All participants, independent of gender and profession, were represented in the descriptive categories. Some profession and gender differences were, however, found in the underlying conceptions. The general staff view was that obesity had to be prioritised. However, there was also the contradictory view that obesity is not a disease and therefore not the responsibility of primary health care. Despite this, staff conceived it as important that patients were met with respect and that individual solutions were provided which could be adhered to step-by-step by the patient. Patient attitudes, such as motivation to change, evasive behaviour, too much trust in care and lack of self-confidence, were, however, conceived as major barriers to a fruitful encounter. Conclusions Findings from this study indicate that there is a need for development and organisation of weight management in primary health care. Raising awareness of staff's negative views of patient attitudes is important since it is likely that it affects the patient-staff relationship and staff's treatment efforts. More research is also needed on gender and

Is Education Associated with Improvements in General Cognitive Ability, or in Specific Skills?

Science.gov (United States)

Ritchie, Stuart J.; Bates, Timothy C.; Deary, Ian J.

2015-01-01

Previous research has indicated that education influences cognitive development, but it is unclear what, precisely, is being improved. Here, we tested whether education is associated with cognitive test score improvements via domain-general effects on general cognitive ability ("g"), or via domain-specific effects on particular cognitive…

Promoting employee health by integrating health protection, health promotion, and continuous improvement: a longitudinal quasi-experimental intervention study.

Science.gov (United States)

von Thiele Schwarz, Ulrica; Augustsson, Hanna; Hasson, Henna; Stenfors-Hayes, Terese

2015-02-01

To test the effects of integrating health protection and health promotion with a continuous improvement system (Kaizen) on proximal employee outcomes (health promotion, integration, and Kaizen) and distal outcomes (workability, productivity, self-rated health and self-rated sickness absence). Twelve units in a county hospital in Sweden were randomized to control or intervention groups using a quasiexperimental study design. All staff (approximately 500) provided self-ratings in questionnaires at baseline, and a 12- and 24-month follow-up (response rate, 79% to 87.5%). There was a significant increase in the proximal outcomes over time in the intervention group compared with the control group, and a trend toward improvement in the distal outcomes workability and productivity. Integration seems to promote staff engagement in health protection and promotion, as well as to improve their understanding of the link between work and health.

Older adults rate their mental health better than their general health

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Elena M. Magwene

2017-09-01

Full Text Available Background. Self-rated health (SRH shows strong associations with measures of health and well-being. Increasingly, studies have used self-rated mental health (SRMH as a predictor of various outcomes, independently or together with SRH. Research has not firmly established if and how these two constructs differ. We sought to characterize the relationship between SRH and SRMH, and to determine how this relationship differed across subgroups defined by sociodemographic and health-related characteristics.Design and methods. We analyzed data from the 2012 CAHPS Medicare Advantage Survey. SRH and SRMH ratings were crosstabulated to determine the distribution of responses across response categories. The expected joint probability distribution was computed and compared to the observed distribution. A constructed variable indicated whether SRMH was better, the same, or worse than SRH. We analyzed the distribution of this variable across various subgroups defined by sociodemographic and health-related factors. Results. A total of 114,905 Medicare Advantage beneficiaries responded to both the SRH and SRMH questions. Both in general and within all subgroups, SRMH was usually rated as better than SRH, and rarely as worse. Conclusions. Within a large group of Medicare recipients, the overwhelming trend was for recipients to rate their mental health as at least as good as their overall health, regardless of any sociodemographic and health-related factors. This finding of a shifted distribution encourages caution in the analytic use of selfrated mental health, particularly the use of both SRH and SRMH for adjustment. Additional research is needed to help clarify the complex relationship between these variables.

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

DEFF Research Database (Denmark)

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

1991-01-01

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

Demystifying and improving organizational culture in health-care.

Science.gov (United States)

Pellegrin, Karen L; Currey, Hal S

2011-01-01

Organizational culture is defined as the shared values and beliefs that guide behavior within each organization, and it matters because it is related to performance. While culture is generally considered important, it is mysterious and intangible to most leaders. The first step toward understanding organizational culture is to measure it properly. This chapter describes methods for measuring culture in health-care organizations and how these methods were implemented in a large academic medical center. Because of the consistent empirical link between the dimension of communication, other culture dimensions, and employee satisfaction, special attention is focused in this area. Specifically, a case study of successful communication behaviors during a major "change management" initiative at a large academic medical center is described. In summary, the purpose of this chapter is to demystify the concept of culture and demonstrate how to improve it.

Child and adolescent mental health care in Dutch general practice: time trend analyses.

NARCIS (Netherlands)

Zwaanswijk, M.; Dijk, C.E. van; Verheij, R.A.

2011-01-01

Background: Because most children and adolescents visit their general practitioner (GP) regularly, general practice is a useful setting in which child and adolescent mental health problems can be identified, treated or referred to specialised care. Measures to strengthen Dutch primary mental health

Improving health and energy efficiency through community-based housing interventions.

Science.gov (United States)

Howden-Chapman, Philippa; Crane, Julian; Chapman, Ralph; Fougere, Geoff

2011-12-01

Houses designed for one climate and cultural group may not be appropriate for other places and people. Our aim is to find cost-effective ways to improve the characteristics of older homes, ill-fitted for New Zealand's climate, in order to improve the occupants' health. We have carried out two community randomised trials, in partnership with local communities, which have focused on retrofitted insulation and more effective heating and have two other studies under way, one which focuses on electricity vouchers and the other on housing hazard remediation. The Housing, Insulation and Health Study showed that insulating 1,350 houses, built before insulation was required, improved the occupants' health and well being as well as household energy efficiency. In the Housing, Heating and Health Study we investigated the impact of installing more effective heating in insulated houses for 409 households, where there was a child with doctor-diagnosed asthma. Again, the study showed significant results in the intervention group; indoor temperatures increased and levels of NO(2) were halved. Children reported less poor health, lower levels of asthma symptoms and sleep disturbances by wheeze and dry cough. Children also had fewer days off school. Improving the energy efficiency of older housing leads to health improvements and energy efficiency improvements. Multidisciplinary studies of housing interventions can create compelling evidence to support policies for sustainable housing developments which improve health.

Improving children's oral health: an interdisciplinary research framework.

Science.gov (United States)

Casamassimo, P S; Lee, J Y; Marazita, M L; Milgrom, P; Chi, D L; Divaris, K

2014-10-01

Despite the concerted efforts of research and professional and advocacy stakeholders, recent evidence suggests that improvements in the oral health of young children in the United States has not followed the prevailing trend of oral health improvement in other age groups. In fact, oral health disparities in the youngest children may be widening, yet efforts to translate advances in science and technology into meaningful improvements in populations' health have had limited success. Nevertheless, the great strides in genomics, biological, behavioral, social, and health services research in the past decade have strengthened the evidence base available to support initiatives and translational efforts. Concerted actions to accelerate this translation and implementation process are warranted; at the same time, policies that can help tackle the upstream determinants of oral health disparities are imperative. This article summarizes the proceedings from the symposium on the interdisciplinary continuum of pediatric oral health that was held during the 43rd annual meeting of the American Association for Dental Research, Charlotte, North Carolina, USA. This report showcases the latest contributions across the interdisciplinary continuum of pediatric oral health research and provides insights into future research priorities and necessary intersectoral synergies. Issues are discussed as related to the overwhelming dominance of social determinants on oral disease and the difficulty of translating science into action. © International & American Associations for Dental Research.

Health promotion via SMS improves hypertension knowledge for deaf South Africans

Directory of Open Access Journals (Sweden)

Hanne Jensen Haricharan

2017-08-01

Full Text Available Abstract Background Signing Deaf South Africans have limited access to health information. As a result, their knowledge about health is limited. Cell phone usage in South Africa is high. This study aimed to assess whether a short message service (SMS-based health promotion campaign could improve Deaf people’s knowledge of hypertension and healthy living. Additionally, the study aimed to assess the acceptability of using SMSs for health promotion targeting Deaf people. Methods A baseline questionnaire assessed participants’ knowledge about hypertension before an SMS-based information campaign was conducted. After the campaign, an exit questionnaire was conducted, containing the same questions as the baseline questionnaire with additional questions about general acceptability and communication preferences. Results were compared between baseline and exit, using McNemar’s test, paired t-test and Wilcoxon signed-rank test. Focus groups aimed to get further information on the impact and acceptability of SMSs. The focus groups were analysed using inductive thematic analysis. Results The campaign recruited 82 participants for the baseline survey, but due to significant loss-to-follow-up and exclusions only 41 participants were included in the analysis of the survey. The majority (60% were men. Eighty percent were employed, while 98% had not finished high school. The campaign showed a statistically significant improvement in overall knowledge about hypertension and healthy living amongst participants. Six individual questions out of 19 also showed a statistically significant improvement. Despite this, participants in focus groups found the medical terminology difficult to understand. Several ways of improving SMS campaigns for the Deaf were identified. These included using using pictures, using ‘signed’ SMSs, combining SMSs with signed drama and linking SMS-campaigns to an interactive communication service that would enable the Deaf to pose

Health promotion via SMS improves hypertension knowledge for deaf South Africans.

Science.gov (United States)

Haricharan, Hanne Jensen; Heap, Marion; Hacking, Damian; Lau, Yan Kwan

2017-08-18

Signing Deaf South Africans have limited access to health information. As a result, their knowledge about health is limited. Cell phone usage in South Africa is high. This study aimed to assess whether a short message service (SMS)-based health promotion campaign could improve Deaf people's knowledge of hypertension and healthy living. Additionally, the study aimed to assess the acceptability of using SMSs for health promotion targeting Deaf people. A baseline questionnaire assessed participants' knowledge about hypertension before an SMS-based information campaign was conducted. After the campaign, an exit questionnaire was conducted, containing the same questions as the baseline questionnaire with additional questions about general acceptability and communication preferences. Results were compared between baseline and exit, using McNemar's test, paired t-test and Wilcoxon signed-rank test. Focus groups aimed to get further information on the impact and acceptability of SMSs. The focus groups were analysed using inductive thematic analysis. The campaign recruited 82 participants for the baseline survey, but due to significant loss-to-follow-up and exclusions only 41 participants were included in the analysis of the survey. The majority (60%) were men. Eighty percent were employed, while 98% had not finished high school. The campaign showed a statistically significant improvement in overall knowledge about hypertension and healthy living amongst participants. Six individual questions out of 19 also showed a statistically significant improvement. Despite this, participants in focus groups found the medical terminology difficult to understand. Several ways of improving SMS campaigns for the Deaf were identified. These included using using pictures, using 'signed' SMSs, combining SMSs with signed drama and linking SMS-campaigns to an interactive communication service that would enable the Deaf to pose questions for clarification. Focus groups suggested that

Physical Activity: A Tool for Improving Health (Part 1--Biological Health Benefits)

Science.gov (United States)

Gallaway, Patrick J.; Hongu, Nobuko

2015-01-01

Extension educators have been promoting and incorporating physical activities into their community-based programs and improving the health of individuals, particularly those with limited resources. This article is the first of a three-part series describing the benefits of physical activity for human health: 1) biological health benefits of…

Physical Activity: A Tool for Improving Health (Part 2-Mental Health Benefits)

Science.gov (United States)

Gallaway, Patrick J.; Hongu, Nobuko

2016-01-01

By promoting physical activities and incorporating them into their community-based programs, Extension professionals are improving the health of individuals, particularly those with limited resources. This article is the second in a three-part series describing the benefits of physical activity for human health: (1) biological health benefits of…

The role of general dental practitioner in oral health | Nwoku ...

African Journals Online (AJOL)

Other diseases that affect the oral cavity include, but not limited to caries, infections of the gum and jaws, malformations, benign and malignant tumours, as well as diabetes. The general dental practitioner therefore has very important duties. These include early recognition and diagnosis of oral health problems, oral health ...

Volunteering and health benefits in general adults: cumulative effects and forms.

Science.gov (United States)

Yeung, Jerf W K; Zhang, Zhuoni; Kim, Tae Yeun

2017-07-11

Although the health benefits of volunteering have been well documented, no research has examined its cumulative effects according to other-oriented and self-oriented volunteering on multiple health outcomes in the general adult public. This study examined other-oriented and self-oriented volunteering in cumulative contribution to health outcomes (mental and physical health, life satisfaction, social well-being and depression). Data were drawn from the Survey of Texas Adults 2004, which contains a statewide population-based sample of adults (n = 1504). Multivariate linear regression and Wald test of parameters equivalence constraint were used to test the relationships. Both forms of volunteering were significantly related to better health outcomes (odds ratios = 3.66% to 11.11%), except the effect of self-oriented volunteering on depression. Other-oriented volunteering was found to have better health benefits than did self-volunteering. Volunteering should be promoted by public health, education and policy practitioners as a kind of healthy lifestyle, especially for the social subgroups of elders, ethnic minorities, those with little education, single people, and unemployed people, who generally have poorer health and less participation in volunteering.

Health Literacy Amongst Tuberculosis Patient in a General Hospital ...

African Journals Online (AJOL)

Background: Healthy literacy has been shown to improve health care access and adherence to Tuberculosis (TB) treatment. Still it remains largely unstudied in many high risks, underserved and low literacy African populations. This study aims to bridge the existing knowledge gap by assessing health literacy among ...

Effectiveness of Motivational Interviewing in improving lipid level in patients with dyslipidemia assisted by general practitioners: Dislip-EM study protocol

Directory of Open Access Journals (Sweden)

Pérula Luis A

2011-11-01

Full Text Available Abstract Background The non-pharmacological approach to cholesterol control in patients with hyperlipidemia is based on the promotion of a healthy diet and physical activity. Thus, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns, and that include brief advice and counseling services. Within this context, Motivational Interviewing has proven to be effective in changing health behaviors in specific cases. However, more robust evidence is needed on the effectiveness of Motivational Interviewing in treating chronic pathologies -such as dyslipidemia- in patients assisted by general practitioners. This article describes a protocol to assess the effectiveness of MI as compared with general practice (brief advice, with the aim of improving lipid level control in patients with dyslipidemia assisted by a general practitioner. Methods/Design An open, two-arm parallel, multicentre, cluster, controlled, randomized, clinical trial will be performed. A total of 48-50 general practitioners from 35 public primary care centers in Spain will be randomized and will recruit 436 patients with dyslipidemia. They will perform an intervention based either on Motivational Interviewing or on the usual brief advice. After an initial assessment, follow-ups will be performed at 2, 4, 8 and 12 months. Primary outcomes are lipid levels (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides and cardiovascular risk. The study will assess the degree of dietary and physical activity improvement, weight loss in overweight patients, and adherence to treatment guidelines. Discussion Motivational interview skills constitute the primary strategies GPs use to treat their patients. Having economical, simple, effective and

Nutrigenomics of essential oils and their potential domestic use for improving health.

Science.gov (United States)

Cayuela Sánchez, José Antonio; Elamrani, Abdelaziz

2014-11-01

The use of essential oils as industrial food additives is notorious, like their medicinal properties. However, their use in household food spicing is for now limited. In this work, we have made a review to reveal the nutrigenomic actions exerted by their bioactive components, to promote awareness of their modulating gene expression ability and the potential that this implies. Also considered is how essential oils can be used as flavoring and seasoning after cooking and before consumption, such as diet components which can improve human health. Genetic mechanisms involved in the medicinal properties of essential oils for food use are identified from literature. These genetic mechanisms reveal nutrigenomic actions. Reviews on the medicinal properties of essential oils have been particularly considered. A wide diversity of nutrigenomic effects from essential oils useful potentially for food spicing is reviewed. General ideas are discussed about essential oils and their properties, such as anti-inflammatory, analgesic, immunomodulatory, anticancer, hepatoprotective, hypolipidemic, anti-diabetic, antioxidant, bone-reparation, anti-depressant and mitigatory for Alzheimer's disease. The essential oils for food use are potentially promoting health agents, and, therefore, worth using as flavoring and condiments. Becoming aware of the modulating gene expression actions from essential oils is important for understanding their potential for use in household dishes as spices to improve health.

General Health Status Among Students of Islamic Azad University: A Cross-Sectional Study from Iran

Directory of Open Access Journals (Sweden)

Mohammad Taghi Savadpour

2015-06-01

Full Text Available Background & Aims of the Study: Health is one of the basic needs of human. There is a close relationship between physical and mental health. Human psyche is directly affected by his physical condition, and mutually his body and actions of human systems are influenced by psychological and mental space. Students because of their particular circumstances are vulnerable to mental health problems. The purpose of this study is to determine the general health status of students of Islamic Azad University. Materials & Methods: This descriptive analytical research was conducted on 478 students of Khalkhal Islamic Azad University. Simple random sampling method was used. General health questionnaire (GHQ-28 was used as research tool. Following data collection, data were analyzed using SPSS Software 13. Results: The results show that mean score of general health of the subjects is higher than cutoff. In this study, 21.3 percent of students were suspected of impaired health. Also, status of general health of female students was worse than male students and significant statistical relationship was observed between general health status and all its sub-scales except depression and gender (P < 0.5. Conclusions: G eneral health of students especially female students is impaired which may considerably affect their learning and performance and academic achievement.

A qualitative study of collaboration in general practice: understanding the general practice nurse's role.

Science.gov (United States)

McInnes, Susan; Peters, Kath; Bonney, Andrew; Halcomb, Elizabeth

2017-07-01

To explore the nature of collaboration between registered nurses and general practitioners in Australian general practice. There is international recognition that collaboration between health professionals can improve care coordination, enhance health outcomes, optimise the work environment and reduce healthcare costs. However, effective collaboration requires a clear understanding of each team member's role. A qualitative approach guided by Naturalistic Inquiry was used to elicit and interpret participant narratives. Eight general practitioners and fourteen registered nurses working in general practice were purposefully recruited. Data were collected via individual, semi-structured face-to-face interviews during February to May 2015. Interviews were audio recorded and transcribed verbatim. Data were analysed using thematic analysis. Data revealed three overarching themes. This study presents the data for the overarching theme 'Understanding the general practice registered nurse's role'. Many general practitioner participants lacked clarity around the role and scope of practice of the registered nurse. At the same time, nursing participants often articulated their role as an assistant rather than as an independent health professional. This limited collaboration and the nurses' role within the team. Collaboration was enhanced when general practitioners actively sought an understanding of the registered nurses scope of practice. Clarifying the nurses' role promotes collaboration and supports nurses to work to the full extent of their practice. This is important in terms of optimising the nurses' role within the team and reinforcing their professional identity. Identification of key issues around understanding the nurses' role may help inform strategies that improve collaboration and workplace relations. © 2016 John Wiley & Sons Ltd.

Consultations for mental problems in general practices with and without mental health nurses.

NARCIS (Netherlands)

Magnée, T.; Beurs, D. de; Verhaak, P.

2016-01-01

Background & Aim: It seems cost-effective to provide mental health care to patient with mild mental problems in general practices instead of in specialized care, but general practitioners (GPs) often lack time or expertise. Since 2008, Dutch GPs have been collaborating with nurses with mental health

Sectoral job training as an intervention to improve health equity.

Science.gov (United States)

Tsui, Emma K

2010-04-01

A growing literature on the social determinants of health strongly suggests the value of examining social policy interventions for their potential links to health equity. I investigate how sectoral job training, an intervention favored by the Obama administration, might be conceptualized as an intervention to improve health equity. Sectoral job training programs ideally train workers, who are typically low income, for upwardly mobile job opportunities within specific industries. I first explore the relationships between resource redistribution and health equity. Next, I discuss how sectoral job training theoretically redistributes resources and the ways in which these resources might translate into improved health. Finally, I make recommendations for strengthening the link between sectoral job training and improved health equity.

General practice ethnicity data: evaluation of a tool

Directory of Open Access Journals (Sweden)

Neuwelt P

2014-03-01

Full Text Available INTRODUCTION: There is evidence that the collection of ethnicity data in New Zealand primary care is variable and that data recording in practices does not always align with the procedures outlined in the Ethnicity Data Protocols for the Health and Disability Sector. In 2010, The Ministry of Health funded the development of a tool to audit the collection of ethnicity data in primary care. The aim of this study was to pilot the Ethnicity Data Audit Tool (EAT in general practice. The goal was to evaluate the tool and identify recommendations for its improvement. METHODS: Eight general practices in the Waitemata District Health Board region participated in the EAT pilot. Feedback about the pilot process was gathered by questionnaires and interviews, to gain an understanding of practices’ experiences in using the tool. Questionnaire and interview data were analysed using a simple analytical framework and a general inductive method. FINDINGS: General practice receptionists, practice managers and general practitioners participated in the pilot. Participants found the pilot process challenging but enlightening. The majority felt that the EAT was a useful quality improvement tool for handling patient ethnicity data. Larger practices were the most positive about the tool. CONCLUSION: The findings suggest that, with minor improvements to the toolkit, the EAT has the potential to lead to significant improvements in the quality of ethnicity data collection and recording in New Zealand general practices. Other system-level factors also need to be addressed.

Empathy Variation in General Practice: A Survey among General Practitioners in Denmark

DEFF Research Database (Denmark)

Charles, Justin; Ahnfeldt-Mollerup, Peder; Søndergaard, Jens

2018-01-01

Background: Previous studies have demonstrated that high levels of physician empathy may be correlated with improved patient health outcomes and high physician job satisfaction. Knowledge about variation in empathy and related general practitioner (GP) characteristics may allow for a more informe...

77 FR 42257 - General Conference Committee of the National Poultry Improvement Plan; Solicitation for Membership

Science.gov (United States)

2012-07-18

...] General Conference Committee of the National Poultry Improvement Plan; Solicitation for Membership AGENCY... regional membership for the General Conference Committee of the National Poultry Improvement Plan. DATES... INFORMATION CONTACT: Dr. C. Stephen Roney, Senior Coordinator, National Poultry Improvement Plan, VS, APHIS...

Mental health care in general practice in the context of a system reform.

NARCIS (Netherlands)

Magnée, T.

2017-01-01

The aim of this thesis was to monitor mental health care in Dutch general practices in recent years. In 2014, a reform of the Dutch mental health care system was introduced. Since this reform, general practitioners (GPs) are expected to only refer patients with a (suspected) psychiatric disorder or

Piracetam improves children's memory after general anaesthesia.

Science.gov (United States)

Fesenko, Ułbołgan A

2009-01-01

Surgery and anaesthesia may account for postoperative complications including cognitive impairment. The purpose of the study was to assess the influence of general anaesthetics on children's memory and effectiveness of piracetam for prevention of postoperative cognitive dysfunction. The study included patients receiving different kinds of anaesthesia for various surgical procedures, randomly allocated to two groups. According to immediate postoperative treatment, the study group received intravenous piracetam 30 mg kg(-1) and the control group--placebo. The cognitive functions were examined preoperatively and within 10 consecutive postoperative days using the ten-word memory test. The study group consisted of 123 children, the control one--of 127. Declines in memory indexes were observed in all anaesthetized patients. The most injured function was long-term memory. The intravenous administration of piracetam improved this cognitive function. The study results confirm that general anaesthesia affects the memory function in children. Piracetam is effective for prevention of postoperative cognitive dysfunction after anaesthesia.

Improving awareness, accountability, and access through health coaching

Science.gov (United States)

Liddy, Clare; Johnston, Sharon; Irving, Hannah; Nash, Kate; Ward, Natalie

2015-01-01

Abstract Objective To assess patients’ experiences with and perceptions of health coaching as part of their ongoing care. Design A qualitative research design using semistructured interviews that were recorded and transcribed verbatim. Setting Ottawa, Ont. Participants Eleven patients (> 18 years of age) enrolled in a health coaching pilot program who were at risk of or diagnosed with type 2 diabetes. Methods Patients’ perspectives were assessed with semistructured interviews. Interviews were conducted with 11 patients at the end of the pilot program, using a stratified sampling approach to ensure maximum variation. Main findings All patients found the overall experience with the health coaching program to be positive. Patients believed the health coaching program was effective in increasing awareness of how diabetes affected their bodies and health, in building accountability for their health-related actions, and in improving access to care and other health resources. Conclusion Patients perceive one-on-one health coaching as an acceptable intervention in their ongoing care. Patients enrolled in the health coaching pilot program believed that there was an improvement in access to care, health literacy, and accountability, all factors considered to be precursors to behavioural change. PMID:25932483

Improving health-related quality of life through an evidence-based obesity reduction program: the Healthy Weights Initiative

Directory of Open Access Journals (Sweden)

Lemstra ME

2016-03-01

Full Text Available Mark E Lemstra,1 Marla R Rogers,21Alliance Health, Moose Jaw, 2Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada Abstract: When evaluating any health intervention, it is critical to include the impact of the intervention on health-related quality of life (HRQL. Among those who are obese, HRQL is often lower than the general population and even more when considering obesity-related comorbidities and bodily pain. The objectives of this paper were to determine the impact of a multidisciplinary, community-based obesity reduction program on HRQL and to determine the independent risk factors for lack of improvement from baseline to follow-up. HRQL was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36 at baseline and follow-up (24 weeks. To date, 84.5% of those who completed the program had improvements in their overall SF-36 score. Significant increases in the mean scores on eight dimensions of health were also observed. Lack of improvement was independently affected by smoking status (odds ratio 3.75; 95% confidence interval 1.44–9.78; P=0.007 and not having a buddy to attend the program (odds ratio 3.70; 95% confidence interval 1.28–10.68; P=0.015. Obesity reduction programs that target increasing exercise, improving diet, and cognitive behavioral therapy can positively impact HRQL in obese adults. Social support has a strong role to play in improving outcomes. Keywords: obesity, health-related quality of life, social- support, SF-36, Canada

Simple and Multivariate Relationships Between Spiritual Intelligence with General Health and Happiness.

Science.gov (United States)

Amirian, Mohammad-Elyas; Fazilat-Pour, Masoud

2016-08-01

The present study examined simple and multivariate relationships of spiritual intelligence with general health and happiness. The employed method was descriptive and correlational. King's Spiritual Quotient scales, GHQ-28 and Oxford Happiness Inventory, are filled out by a sample consisted of 384 students, which were selected using stratified random sampling from the students of Shahid Bahonar University of Kerman. Data are subjected to descriptive and inferential statistics including correlations and multivariate regressions. Bivariate correlations support positive and significant predictive value of spiritual intelligence toward general health and happiness. Further analysis showed that among the Spiritual Intelligence' subscales, Existential Critical Thinking Predicted General Health and Happiness, reversely. In addition, happiness was positively predicted by generation of personal meaning and transcendental awareness. The findings are discussed in line with the previous studies and the relevant theoretical background.

General health and well-being in outpatients with depressive and bipolar disorders

DEFF Research Database (Denmark)

Kessing, Lars Vedel; Hansen, Hanne Vibe; Bech, Per

2006-01-01

-VAS) and well-being (WHO (Five) well-being index) and more depressive and anxiety symptoms compared with bipolar disorder. Similarly, more psychiatric admissions were associated with poorer general health and well-being and more depressive and anxiety symptoms. However, when adjusting for the effect...... of depressive symptoms, the associations between number of admissions and general health, and between numbers of admissions and well-being, lost significance. Thus, depressive symptoms seem to be the strongest predictor of general health and well-being in both disorders. As the response rate......Prior studies have found contradictory results regarding the association between course of illness and quality of life among patients with depressive disorder or bipolar disorder. Questionnaires about quality of life and affective symptoms (the EQ-5D, EQ-5D-VAS, WHO (Five) well-being index...

Optimising value and quality in general practice within the primary health care sector through relationship marketing: a conceptual framework.

Science.gov (United States)

Bansal, Manjit K

2004-01-01

Discusses the rationale of applying relationship marketing and service quality concepts within the primary health care sector. The use of relational strategies in general practice, by modelling the relationships between practitioners and patients from a marketing perspective, could potentially lead to sustained high quality service being provided, and to more efficient use of resources. This essentially conceptually focused paper addresses an area that has not yet been researched in detail, and furthers understanding of the relationships that facilitate exchange within general practice and service delivery in non-profit, resource-constrained conditions. Deeper understanding of the needs and expectations of patients and the way these can be delivered by general practice can only lead to improvements for all parties involved. The relationship marketing paradigm presents itself as a potentially exciting way of addressing issues associated with ensuring that the highest level of quality is delivered in this area of the UK National Health Service.

A new approach to child mental health care within general practice.

NARCIS (Netherlands)

Verhaak, P.F.M.; Dijk, M. van; Walstock, D.; Zwaanswijk, M.

2015-01-01

Background: Child and adolescent mental health problems are frequently not identified and properly treated within general practice. Politicians in the Netherlands are promoting more primary healthcare treatment for mental health problems. The current study aims to evaluate an integrated primary

General Satisfaction Among Healthcare Workers: Differences Between Employees in Medical and Mental Health Sector

Science.gov (United States)

Papathanasiou, Ioanna V.; Kleisiaris, Christos F.; Tsaras, Konstantinos; Fradelos, Evangelos C.; Kourkouta, Lambrini

2015-01-01

Background: General satisfaction is a personal experience and sources of satisfaction or dissatisfaction vary between professional groups. General satisfaction is usually related with work settings, work performance and mental health status. Aim: The purpose of this research study was to investigate the level of general satisfaction of health care workers and to examine whether there were any differences among employees of medical and mental health sector. Methods: The sample consisted of employees from the medical and mental health sector, who were all randomly selected. A two-part questionnaire was used to collect data. The first section involved demographic information and the second part was a General Satisfaction Questionnaire (GSQ). The statistical analysis of data was performed using the software package 19.0 for Windows. Descriptive statistics were initially generated for sample characteristics. All data exhibited normal distributions and thus the parametric t-test was used to compare mean scores between the two health sectors. P values satisfaction for the employees in medical sector was 4.5 (5=very satisfied) and for the employees in mental health sector is 4.8. T-test showed that these results are statistical different (t=4.55, psatisfaction. Conclusions: Mental health employees appear to experience higher levels of general satisfaction and mainly they experience higher satisfaction from family roles, life and sexual life, emotional state and relations with patients. PMID:26543410

General Satisfaction Among Healthcare Workers: Differences Between Employees in Medical and Mental Health Sector.

Science.gov (United States)

Papathanasiou, Ioanna V; Kleisiaris, Christos F; Tsaras, Konstantinos; Fradelos, Evangelos C; Kourkouta, Lambrini

2015-08-01

General satisfaction is a personal experience and sources of satisfaction or dissatisfaction vary between professional groups. General satisfaction is usually related with work settings, work performance and mental health status. The purpose of this research study was to investigate the level of general satisfaction of health care workers and to examine whether there were any differences among employees of medical and mental health sector. The sample consisted of employees from the medical and mental health sector, who were all randomly selected. A two-part questionnaire was used to collect data. The first section involved demographic information and the second part was a General Satisfaction Questionnaire (GSQ). The statistical analysis of data was performed using the software package 19.0 for Windows. Descriptive statistics were initially generated for sample characteristics. All data exhibited normal distributions and thus the parametric t-test was used to compare mean scores between the two health sectors. P values satisfaction for the employees in medical sector was 4.5 (5=very satisfied) and for the employees in mental health sector is 4.8. T-test showed that these results are statistical different (t=4.55, psatisfaction. Mental health employees appear to experience higher levels of general satisfaction and mainly they experience higher satisfaction from family roles, life and sexual life, emotional state and relations with patients.

Providing health information to the general public: a survey of current practices in academic health sciences libraries.

Science.gov (United States)

Hollander, S M

2000-01-01

A questionnaire was mailed to 148 publicly and privately supported academic health sciences libraries affiliated with Association of American Medical Colleges (AAMC-accredited medical schools in the United States and Canada to determine level of access and services provided to the general public. For purposes of this study, "general public" was defined as nonaffiliated students or health care professionals, attorneys and other nonhealth-related professionals, patients from affiliated or other hospitals or clinics, and general consumers. One hundred five (71%) libraries responded. Results showed 98% of publicly supported libraries and 88% of privately supported libraries provided access to some or all of the general public. Publicly supported libraries saw greater numbers of public patrons, often provided more services, and were more likely to circulate materials from their collections than were privately supported libraries. A significant number of academic health sciences libraries housed a collection of consumer-oriented materials and many provided some level of document delivery service, usually for a fee. Most allowed the public to use some or all library computers. Results of this study indicated that academic health sciences libraries played a significant role in serving the information-seeking public and suggested a need to develop written policies or guidelines covering the services that will be provided to minimize the impact of this service on primary clientele.

Providing health information to the general public: a survey of current practices in academic health sciences libraries*

Science.gov (United States)

Hollander, Sue M.

2000-01-01

A questionnaire was mailed to 148 publicly and privately supported academic health sciences libraries affiliated with Association of American Medical Colleges (AAMC)–accredited medical schools in the United States and Canada to determine level of access and services provided to the general public. For purposes of this study, “general public” was defined as nonaffiliated students or health care professionals, attorneys and other nonhealth-related professionals, patients from affiliated or other hospitals or clinics, and general consumers. One hundred five (71%) libraries responded. Results showed 98% of publicly supported libraries and 88% of privately supported libraries provided access to some or all of the general public. Publicly supported libraries saw greater numbers of public patrons, often provided more services, and were more likely to circulate materials from their collections than were privately supported libraries. A significant number of academic health sciences libraries housed a collection of consumer-oriented materials and many provided some level of document delivery service, usually for a fee. Most allowed the public to use some or all library computers. Results of this study indicated that academic health sciences libraries played a significant role in serving the information-seeking public and suggested a need to develop written policies or guidelines covering the services that will be provided to minimize the impact of this service on primary clientele. PMID:10658965

GPs' views of health policy changes: a qualitative 'netnography' study of UK general practice online magazine commentary.

Science.gov (United States)

Elvey, Rebecca; Voorhees, Jennifer; Bailey, Simon; Burns, Taylor; Hodgson, Damian

2018-06-01

Shifts in health policy since 2010 have brought major structural changes to the English NHS, with government stating intentions to increase GPs' autonomy and improve access to care. Meanwhile, GPs' levels of job satisfaction are low, while stress levels are high. PulseToday is a popular UK general practice online magazine that provides a key discussion forum on news relevant to general practice. To analyse readers' reactions to news stories about health policy changes published in an online general practice magazine. A qualitative 'netnography' was undertaken of readers' comments to PulseToday. METHOD: A sample of readers' comments on articles published in PulseToday was collated and subjected to thematic analysis. Around 300 comments on articles published between January 2012 and March 2016 were included in the analysis, using 'access to care' as a tracer theme. Concern about the demand and strain on general practice was perhaps to be expected. However, analysis revealed various dimensions to this concern: GPs' underlying feelings about their work and place in the NHS; constraints to GPs' control of their own working practices; a perceived loss of respect for the role of GP; and disappointment with representative bodies and GP leadership. This study shows a complex mix of resistance and resignation in general practice about the changing character of GPs' roles. This ambivalence deserves further attention because it could potentially shape responses to further change in primary care in ways that are as yet unknown. © British Journal of General Practice 2018.

Quality Improvement for Maternal and Newborn Health in Mtwara ...

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

Maternal and newborn health outcomes in southern Tanzania's Mtwara region are poor ... rates were similar when comparing home births with health facility births. ... and newborn health care services, better care-seeking, and improved health ...

Chronic care model in primary care: can it improve health-related quality of life?

Directory of Open Access Journals (Sweden)

Aryani FMY

2016-01-01

Full Text Available Faridah Md Yusof Aryani,1 Shaun Wen Huey Lee,2 Siew Siang Chua,3 Li Ching Kok,4 Benny Efendie,2 Thomas Paraidathathu5 1Pharmaceutical Services Division, Ministry of Health Malaysia, Petaling Jaya, 2School of Pharmacy, Monash University Malaysia, Bandar Sunway, 3Department of Pharmacy, Faculty of Medicine, University of Malaya, 4Clinical Research Centre, Kuala Lumpur Hospital, Kuala Lumpur, 5School of Pharmacy, Taylor’s University, Subang Jaya, Selangor, Malaysia Purpose: Chronic diseases such as hypertension, diabetes mellitus, and hyperlipidemia are public health concerns. However, little is known about how these affect patient-level health measures. The aim of the study was to examine the impact of a chronic care model (CCM on the participant’s health-related quality of life (QoL. Patients and methods: Participants received either usual care or CCM by a team of health care professionals including pharmacists, nurses, dietitians, and general practitioners. The participants in the intervention group received medication counseling, adherence, and dietary advice from the health care team. The QoL was measured using the EQ-5D (EuroQoL-five dimension, health-related quality of life questionnaire and comparison was made between usual care and intervention groups at the beginning and end of the study at 6 months. Results: Mean (standard deviation EQ-5D index scores improved significantly in the intervention group (0.92±0.10 vs 0.95±0.08; P≤0.01, but not in the usual care group (0.94±0.09 vs 0.95±0.09; P=0.084. Similarly, more participants in the intervention group reported improvements in their QoL compared with the usual care group, especially in the pain/discomfort and anxiety/depression dimensions. Conclusion: The implementation of the CCM resulted in significant improvement in QoL. An interdisciplinary team CCM approach should be encouraged, to ultimately result in behavior changes and improve the QoL of the patients. Keywords: diabetes

The association between job satisfaction and general health among employees of Golestan Hospital in Ahvaz, Iran.

Science.gov (United States)

Khiavi, Farzad Faraji; Dashti, Rezvan; Zergani, Nadia

2016-04-01

Job satisfaction is one of the most challenging organizational concepts, and it is the basis of management policies to increase productivity and efficiency of the organization. The general health rate may affect job satisfaction in several ways. This study aimed to determine the association between job satisfaction and general health among employees of Golestan Hospital in Ahvaz, Iran. The study population of this cross-sectional research included 100 employees of Golestan Hospital in Ahvaz, Iran. The data collection instruments were the General Health Questionnaire (28-GHQ) and the Job Descriptive Index (JDI) questionnaire. The data were analyzed using Pearson's product-moment correlation coefficient, independent samples t-test, and ANOVA statistical tests in SPSS software. The mean general health was calculated as 26.19 ± 11.04, which indicated a positive psychiatric condition. Job satisfaction with a mean score of 89.67 ± 23.3 was deemed to be relatively dissatisfied. A medium negative and significant association was observed between job satisfaction and general health and its subscales (physical health, anxiety, social, and depression). General health subscales and job satisfaction are associated. Some actions must be planned to cope with the negative factors in general health in order to increase employees' satisfaction in university educational hospitals.

Measuring and improving patient safety through health information technology: The Health IT Safety Framework.

Science.gov (United States)

Singh, Hardeep; Sittig, Dean F

2016-04-01

Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety

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."

[Is health really the most important value? - Results of a representative survey of the German general population concerning the subjective meaning of health].

Science.gov (United States)

Hinz, A; Hübscher, U; Brähler, E; Berth, H

2010-12-01

The aim of this study was to investigate which meaning is attributed to health by the general population. Furthermore, the relationship between health satisfaction and health importance was also analysed. A sample of 4,808 representatively selected subjects from the general German population judged the importance and the satisfaction with several life domains, including health, using the questions on life satisfaction FLZ (M). Moreover, sociodemographic variables (sex, age, socioeconomic status) and psychological variables (self-esteem, resilience, anxiety and depression) were collected. Health is the most important life domain. The importance of health increases with increasing age. However, there are no sex differences and SES (socio-economic status) differences concerning the importance of health. Subjective satisfaction with health and health importance are only marginally correlated (r=0.08). High degrees of self-esteem and resilience are associated with a high importance of health. Anxiety and depression show only weak relationships to the importance of health. In the German general population health has a very high subjective significance. This is not only true for handicapped or ill people, but for all subsamples of the society. Therefore, a general plea for an understanding of the importance of health is not necessary, not even for subgroups. Preventive activity can be based on the general understanding of the meaning of health, but it should pursue specific health- related goals for target groups. © Georg Thieme Verlag KG Stuttgart · New York.

General budget support: has it benefited the health sector?

Science.gov (United States)

Fernandes Antunes, Adelio; Xu, Ke; James, Chris D; Saksena, Priyanka; Van de Maele, Nathalie; Carrin, Guy; Evans, David B

2013-12-01

There has been recent controversy about whether aid directed specifically to health has caused recipient governments to reallocate their own funds to non-health areas. At the same time, general budget support (GBS) has been increasing. GBS allows governments to set their own priorities, but little is known about how these additional resources are subsequently used. This paper uses cross-country panel data to assess the impact of GBS programmes on health spending in low-income and middle-income countries, using dynamic panel techniques to estimate unbiased coefficients in the presence of serial correlation. We found no clear evidence that GBS had any impact, positive or negative, on government health spending derived from domestic sources. GBS also had no observed impact on total government health spending from all sources (external as well as domestic). In contrast, health-specific aid was associated with a decline in health expenditures from domestic sources, but there was not a full substitution effect. That is, despite this observed fungibility, health-specific aid still increases total government health spending from all sources. Finally, increases in total government expenditure led to substantial increases in domestic government health expenditures. Copyright © 2012 John Wiley & Sons, Ltd.

Heart Failure Care in General Practice

NARCIS (Netherlands)

Valk, M.J.M.

2017-01-01

Heart failure (HF) is an increasing health care problem worldwide, and a multidisciplinary approach with a general practitioner (GP) in the health care team is considered optimal. HF management has improved substantially over the last two decades, mainly for patients with HF with a reduced ejection

Animal health and welfare planning improves udder health and cleanliness but not leg health in Austrian dairy herds.

Science.gov (United States)

Tremetsberger, Lukas; Leeb, Christine; Winckler, Christoph

2015-10-01

Animal health and welfare planning is considered an important tool for herd management; however, its effectiveness is less well known. The aim of this study was to conduct animal health and welfare planning on 34 Austrian dairy farms and to evaluate changes in health and welfare after 1 yr. After an initial assessment using the Welfare Quality protocol (Welfare Quality Consortium, Lelystad, the Netherlands), results were reported back to the farmers. Health and welfare area(s) in which both the farmer and the researcher regarded improvement as important were discussed. Management practices and husbandry measures were chosen according to the respective farm situation. One year after interventions had been initiated, farms were reassessed, and the degree of implementation of improvement measures was recorded. The average implementation rate was 57% and thus relatively high when compared with other studies. High degrees of implementation were achieved related to cleanliness and udder health, at 77 and 63%, respectively. Intervention measures addressing udder health were mostly easy to incorporate in the daily routine and led to a reduced somatic cell score, whereas this score increased in herds without implementation of measures. The decrease in cows with dirty teats was more pronounced when measures were implemented compared with control farms. The implementation rate regarding leg health (46%) was comparably low in the present study, and leg health did not improve even when measures were implemented. Lying comfort, social behavior, and human-animal relationship did not require interventions and were therefore seldom chosen by farmers as part of health and welfare plans. In conclusion, the structured, participatory process of animal health and welfare planning appears to be a promising way to improve at least some animal health and welfare issues. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Joint Community Health Needs Assessments as a Path for Coordinating Community-Wide Health Improvement Efforts Between Hospitals and Local Health Departments.

Science.gov (United States)

Carlton, Erik L; Singh, Simone Rauscher

2018-05-01

To examine the association between hospital-local health department (LHD) collaboration around community health needs assessments (CHNAs) and hospital investment in community health. We combined 2015 National Association of County and City Health Officials (NACCHO) Forces of Change, 2013 NACCHO Profile, and 2014-2015 Area Health Resource File data to identify a sample of LHDs (n = 439) across the United States. We included data on hospitals' community benefit from their 2014 tax filings (Internal Revenue Service Form 990, Schedule H). We used bivariate and multivariate regression analyses to examine LHDs' involvement in hospitals' CHNAs and implementation strategies and the relationship with hospital investment in community health. The LHDs that collaborated with hospitals around CHNAs were significantly more likely to be involved in joint implementation planning activities than were those that did not. Importantly, LHD involvement in hospitals' implementation strategies was associated with greater hospital investment in community health improvement initiatives. Joint CHNAs may improve coordination of community-wide health improvement efforts between hospitals and LHDs and encourage hospital investment in community health improvement activities. Public Health Implications. Policies that strengthen LHD-hospital collaboration around the CHNA may enhance hospital investments in community health.

Indigenous health: effective and sustainable health services through continuous quality improvement.

Science.gov (United States)

Bailie, Ross S; Si, Damin; O'Donoghue, Lyn; Dowden, Michelle

2007-05-21

The Australian government's Healthy for Life program is supporting capacity development in Indigenous primary care using continuous quality improvement (CQI) techniques. An important influence on the Healthy for Life program has been the ABCD research project. The key features contributing to the success of the project are described. The ABCD research project: uses a CQI approach, with an ongoing cycle of gathering data on how well organisational systems are functioning, and developing and then implementing improvements; is guided by widely accepted principles of community-based research, which emphasise participation; and adheres to the principles and values of Indigenous health research and service delivery. The potential for improving health outcomes in Aboriginal and Torres Strait Islander communities using a CQI approach should be strengthened by clear clinical and managerial leadership, supporting service organisations at the community level, and applying participatory-action principles.

[Interventions to improve access to health services by indigenous peoples in the Americas].

Science.gov (United States)

Araujo, Miguel; Moraga, Cecilia; Chapman, Evelina; Barreto, Jorge; Illanes, Eduardo

2016-11-01

Synthesize evidence on effectiveness of interventions designed to improve access to health services by indigenous populations. Review of systematic reviews published as of July 2015, selecting and analyzing only studies in the Region of the Americas. The bibliographic search encompassed MEDLINE, Lilacs, SciELO, EMBASE, DARE, HTA, The Cochrane Library, and organization websites. Two independent reviewers selected studies and analyzed their methodological quality. A narrative summary of the results was produced. Twenty-two reviews met the inclusion criteria. All selected studies were conducted in Canada and the United States of America. The majority of the interventions were preventive, to surmount geographical barriers, increase use of effective measures, develop human resources, and improve people's skills or willingness to seek care. Topics included pregnancy, cardiovascular risk factors, diabetes, substance abuse, child development, cancer, mental health, oral health, and injuries. Some interventions showed effectiveness with moderate or high quality studies: educational strategies to prevent depression, interventions to prevent childhood caries, and multicomponent programs to promote use of child safety seats. In general, results for chronic non-communicable diseases were negative or inconsistent. Interventions do exist that have potential for producing positive effects on access to health services by indigenous populations in the Americas, but available studies are limited to Canada and the U.S. There is a significant research gap on the topic in Latin America and the Caribbean.

Healthy, wealthy, and wise: retirement planning predicts employee health improvements.

Science.gov (United States)

Gubler, Timothy; Pierce, Lamar

2014-09-01

Are poor physical and financial health driven by the same underlying psychological factors? We found that the decision to contribute to a 401(k) retirement plan predicted whether an individual acted to correct poor physical-health indicators revealed during an employer-sponsored health examination. Using this examination as a quasi-exogenous shock to employees' personal-health knowledge, we examined which employees were more likely to improve their health, controlling for differences in initial health, demographics, job type, and income. We found that existing retirement-contribution patterns and future health improvements were highly correlated. Employees who saved for the future by contributing to a 401(k) showed improvements in their abnormal blood-test results and health behaviors approximately 27% more often than noncontributors did. These findings are consistent with an underlying individual time-discounting trait that is both difficult to change and domain interdependent, and that predicts long-term individual behaviors in multiple dimensions. © The Author(s) 2014.

Weight Loss and Lowering Androgens Predict Improvements in Health-Related Quality of Life in Women With PCOS.

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Dokras, Anuja; Sarwer, David B; Allison, Kelly C; Milman, Lauren; Kris-Etherton, Penny M; Kunselman, Allen R; Stetter, Christy M; Williams, Nancy I; Gnatuk, Carol L; Estes, Stephanie J; Fleming, Jennifer; Coutifaris, Christos; Legro, Richard S

2016-08-01

Polycystic ovary syndrome (PCOS) is associated with reduced health-related quality of life (HRQOL) and increased prevalence of depressive and anxiety disorders. The impact of PCOS-specific treatments on these co-morbidities is unclear. To assess the impact of weight loss and decreasing hyperandrogenism on HRQOL and mood and anxiety disorders in women with PCOS. A secondary analysis of a randomized controlled trial (OWL-PCOS) of preconception treatment conducted at two academic centers in women (age, 18-40 years; body mass index, 27-42 kg/m(2)) with PCOS defined by Rotterdam criteria. Continuous oral contraceptive pill (OCP) or intensive lifestyle intervention or the combination (Combined) for 16 weeks. Changes in HRQOL assessed by PCOSQ and SF-36 and prevalence of depression and anxiety disorder assessed by PRIME-MD PHQ. The lowest scores were noted on the general health domain of the SF-36 and the weight and infertility domains on the PCOSQ. All three interventions resulted in significant improvement in the general health score on the SF-36. Both the OCP and Combined groups showed improvements in all domains of the PCOSQ (P symptoms, and anxiety disorders, and combined therapies offer further benefits in overweight/obese women with PCOS.

Working with community health workers to improve maternal and newborn health outcomes: implementation and scale-up lessons from eastern Uganda.

Science.gov (United States)

Namazzi, Gertrude; Okuga, Monica; Tetui, Moses; Muhumuza Kananura, Rornald; Kakaire, Ayub; Namutamba, Sarah; Mutebi, Aloysius; Namusoke Kiwanuka, Suzanne; Ekirapa-Kiracho, Elizabeth; Waiswa, Peter

2017-08-01

Preventable maternal and newborn deaths can be averted through simple evidence-based interventions, such as the use of community health workers (CHWs), also known in Uganda as village health teams. However, the CHW strategy faces implementation challenges regarding training packages, supervision, and motivation. This paper explores knowledge levels of CHWs, describes the coverage of home visits, and shares lessons learnt from setting up and implementing the CHW strategy. The CHWs were trained to conduct four home visits: two during pregnancy and two after delivery. The aim of the visits was to promote birth preparedness and utilization of maternal and newborn health (MNH) services. Mixed methods of data collection were employed. Quantitative data were analyzed using Stata version 13.0 to determine the level and predictors of CHW knowledge of MNH. Qualitative data from 10 key informants and 15 CHW interviews were thematically analyzed to assess the implementation experiences. CHWs' knowledge of MNH improved from 41.3% to 77.4% after training, and to 79.9% 1 year post-training. However, knowledge of newborn danger signs declined from 85.5% after training to 58.9% 1 year later. The main predictors of CHW knowledge were age (≥ 35 years) and post-primary level of education. The level of coverage of at least one CHW visit to pregnant and newly delivered mothers was 57.3%. Notably, CHW reports complemented the facility-based health information. CHWs formed associations, which improved teamwork, reporting, and general performance, and thus maintained low dropout rates at 3.6%. Challenges included dissatisfaction with the quarterly transport refund of 6 USD and lack of means of transportation such as bicycles. CHWs are an important resource in community-based health information and improving demand for MNH services. However, the CHW training and supervision models require strengthening for improved performance. Local solutions regarding CHW motivation are necessary

Defining and Assessing Quality Improvement Outcomes: A Framework for Public Health

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Nawaz, Saira; Thomas, Craig; Young, Andrea

2015-01-01

We describe an evidence-based framework to define and assess the impact of quality improvement (QI) in public health. Developed to address programmatic and research-identified needs for articulating the value of public health QI in aggregate, this framework proposes a standardized set of measures to monitor and improve the efficiency and effectiveness of public health programs and operations. We reviewed the scientific literature and analyzed QI initiatives implemented through the Centers for Disease Control and Prevention’s National Public Health Improvement Initiative to inform the selection of 5 efficiency and 8 effectiveness measures. This framework provides a model for identifying the types of improvement outcomes targeted by public health QI efforts and a means to understand QI’s impact on the practice of public health. PMID:25689185

A modified Continuous Quality Improvement approach to improve culturally and socially inclusive care within rural health services.

Science.gov (United States)

Mitchell, Olivia; Malatzky, Christina; Bourke, Lisa; Farmer, Jane

2018-03-23

The sickest Australians are often those belonging to non-privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically diverse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature. The aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations. This approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness. The approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care. The approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on-the-ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated. © 2018 National Rural Health Alliance Ltd.

Mental health, job satisfaction, and job stress among general practitioners.

OpenAIRE

Cooper, C. L.; Rout, U.; Faragher, B.

1989-01-01

OBJECTIVE--To identify sources of job stress associated with high levels of job dissatisfaction and negative mental wellbeing among general practitioners in England. DESIGN--Multivariate analysis of large database of general practitioners compiled from results of confidential questionnaire survey. Data obtained on independent variables of job stress, demographic factors, and personality. Dependent variables were mental health, job satisfaction, alcohol consumption, and smoking. SETTING--Natio...

General Public Views on Uses and Users of Administrative Health Data

Directory of Open Access Journals (Sweden)

P. Alison Paprica

2017-04-01

Members of general public were generally supportive of research based on linked administrative health data but with conditions, particularly when the possibility of private sector research was discussed. Notably, and citing security concerns, focus group participants preferred models that had a limited number of individuals or organizations accessing data.

Health profiles of overweight and obese youth attending general practice.

Science.gov (United States)

Paulis, Winifred D; Palmer, Millicent; Chondros, Patty; Kauer, Sylvia; van Middelkoop, Marienke; Sanci, Lena A

2017-05-01

Literature suggests that overweight and obese young people use healthcare services more often, but this awaits confirmation in primary care. To identify health profiles of underweight, overweight and obese young people attending general practice and compare them to normal-weight youth and also to explore the weight-related health risks of eating and exercise behaviour in the four different weight categories. This study used a cross-sectional design with baseline data from a trial including 683 young people (14-24 years of age) presenting to general practice. Through computer-assisted telephone interviews data were obtained on number and type of health complaints and consultations, emotional distress, health-related quality of life (HRQoL) and eating and exercise behaviour. General practitioners (GPs) were consulted more often by overweight (incidence rate ratio (IRR): 1.28, 95% CI (1.04 to 1.57)) and obese youth (IRR: 1.54, 95% CI (1.21 to 1.97), but not for different health problems compared with normal-weight youth. The reason for presentation was seldom a weight issue. Obese youth reported lower physical HRQoL. Obese and underweight youth were less likely to be satisfied with their eating behaviour than their normal-weight peers. Exercise levels were low in the entire cohort. Our study highlights the need for effective weight management given that overweight and obese youth consult their GP more often. Since young people do not present with weight issues, it becomes important for GPs to find ways to initiate the discussion about weight, healthy eating and exercise with youth. ISRCTN16059206. 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/.

Engaging with complexity to improve the health of indigenous people: a call for the use of systems thinking to tackle health inequity.

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Hernández, Alison; Ruano, Ana Lorena; Marchal, Bruno; San Sebastián, Miguel; Flores, Walter

2017-02-21

The 400 million indigenous people worldwide represent a wealth of linguistic and cultural diversity, as well as traditional knowledge and sustainable practices that are invaluable resources for human development. However, indigenous people remain on the margins of society in high, middle and low-income countries, and they bear a disproportionate burden of poverty, disease, and mortality compared to the general population. These inequalities have persisted, and in some countries have even worsened, despite the overall improvements in health indicators in relation to the 15-year push to meet the Millennium Development Goals. As we enter the Sustainable Development Goals (SDGs) era, there is growing consensus that efforts to achieve Universal Health Coverage (UHC) and promote sustainable development should be guided by the moral imperative to improve equity. To achieve this, we need to move beyond the reductionist tendency to frame indigenous health as a problem of poor health indicators to be solved through targeted service delivery tactics and move towards holistic, integrated approaches that address the causes of inequalities both inside and outside the health sector. To meet the challenge of engaging with the conditions underlying inequalities and promoting transformational change, equity-oriented research and practice in the field of indigenous health requires: engaging power, context-adapted strategies to improve service delivery, and mobilizing networks of collective action. The application of systems thinking approaches offers a pathway for the evolution of equity-oriented research and practice in collaborative, politically informed and mutually enhancing efforts to understand and transform the systems that generate and reproduce inequities in indigenous health. These approaches hold the potential to strengthen practice through the development of more nuanced, context-sensitive strategies for redressing power imbalances, reshaping the service delivery

Individualized feedback-based virtual reality exercise improves older women's self-perceived health: a randomized controlled trial.

Science.gov (United States)

Lee, Minyoung; Son, Jaebum; Kim, Jungjin; Yoon, BumChul

2015-01-01

Individualized feedback-based virtual reality (IFVR) exercise is gaining attention as a cost-effective self-management strategy, however little is known about whether older adults themselves perceive IFVR exercise effective in improving their health. Therefore, we studied the effect of IFVR exercise on health-related quality of life (HRQoL) in older women. Fifty-four older women aged ≥65 years were randomized to either IFVR exercise group (IFVRG, n=26) or group-based exercise group (GG, n=28). Both groups received a 60-min intervention three times a week for eight weeks. The Short-Form Health Survey (SF-36) was administered. To identify the possible placebo effect, 30-Second Chair Stand Test (30SCST), 8-Foot Up-and-Go Test (8FUGT), and 2-Minute Step Test (2MST) were also administered. intention-to-treat analysis with adjustment for baseline levels revealed that IFVRG showed greater improvement in mental health (p=0.029) and lower body strength (p=0.042), compared to GG. Within-group analysis for HRQoL revealed that IFVRG showed an increase in role-physical (p=0.015), bodily pain (p=0.017), general health (p=0.004), vitality (p=0.010), role-emotional (p=0.007), and mental health (phealth (p=0.023), and social functioning (p = 0.023). Both groups showed an increase in 30SCST, 2MST and 8FUGT (all pexercise improved HRQoL in older women, in addition to improving physical fitness. Therefore, it might be recommended to older women as an effective self-management strategy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Fatigue, General Health, and Ischemic Heart Disease in Older Adults

DEFF Research Database (Denmark)

Ekmann, Anette; Petersen, Inge; Mänty, Minna Regina

2013-01-01

Backgrounds.Fatigue has been shown to predict ischemic heart disease (IHD) and mortality in nonsmoking middle-aged men free of cardiovascular disease. The aim of this study was to investigate the predictive value of fatigue for IHD and general health in nondisabled individuals free...... of cardiovascular disease and older than 70 years. METHODS: The study population was drawn from The Longitudinal Study of Aging Danish Twins. In total, 1,696 participants were followed up for 2-10 years by questionnaires and 10-16 years through registries. Kaplan Meier, Cox Proportional Hazard and logistic.......08-2.00) compared with participants without fatigue. CONCLUSION: We concluded that fatigue in nondisabled older adults free of cardiovascular disease is an early predictor for development of subsequent poor general health and IHD....

Useful tool for general practitioners, home health care nurses and social workers in assessing determinants of the health status and treatment of patients visited in their homes

Directory of Open Access Journals (Sweden)

Andrzej Brodziak

2012-09-01

Full Text Available The necessity is emphasized to distinguish between the traditional model of data acquisition reported by a patient in doctor’s office and the more valuable and desired model to become acquainted with the core of the problem by going to a patient’s domicile. In the desired model it is possible to come across various determinants of health during home visits. Family members can be approached and there is a possibility to evaluate the relationships between the patient and his loved ones. One can visually assess one’s living conditions and predictable environmental hazard. For several years, the desired model has been put into practice by general practitioners and home health care nurses. Recently this model is also promoted by “health care therapists” who are members of “teams of home health care”. The authors, being convinced of the merits of “home and environmental model” of practical medicine, have developed a method of recording and illustrating data collected during visits in patient’s home. The elaborated tool helps to communicate and exchange information among general practitioners, home health care nurses, social workers of primary health care centers and specialists. The method improves the formulation of the plan of further therapeutic steps and remedial interventions in psycho-social relations and living conditions of patients.

Protocol for the development of a CONSORT-equity guideline to improve reporting of health equity in randomized trials.

Science.gov (United States)

Welch, Vivian; Jull, J; Petkovic, J; Armstrong, R; Boyer, Y; Cuervo, L G; Edwards, Sjl; Lydiatt, A; Gough, D; Grimshaw, J; Kristjansson, E; Mbuagbaw, L; McGowan, J; Moher, D; Pantoja, T; Petticrew, M; Pottie, K; Rader, T; Shea, B; Taljaard, M; Waters, E; Weijer, C; Wells, G A; White, H; Whitehead, M; Tugwell, P

2015-10-21

Health equity concerns the absence of avoidable and unfair differences in health. Randomized controlled trials (RCTs) can provide evidence about the impact of an intervention on health equity for specific disadvantaged populations or in general populations; this is important for equity-focused decision-making. Previous work has identified a lack of adequate reporting guidelines for assessing health equity in RCTs. The objective of this study is to develop guidelines to improve the reporting of health equity considerations in RCTs, as an extension of the Consolidated Standards of Reporting Trials (CONSORT). A six-phase study using integrated knowledge translation governed by a study executive and advisory board will assemble empirical evidence to inform the CONSORT-equity extension. To create the guideline, the following steps are proposed: (1) develop a conceptual framework for identifying "equity-relevant trials," (2) assess empirical evidence regarding reporting of equity-relevant trials, (3) consult with global methods and content experts on how to improve reporting of health equity in RCTs, (4) collect broad feedback and prioritize items needed to improve reporting of health equity in RCTs, (5) establish consensus on the CONSORT-equity extension: the guideline for equity-relevant trials, and (6) broadly disseminate and implement the CONSORT-equity extension. This work will be relevant to a broad range of RCTs addressing questions of effectiveness for strategies to improve practice and policy in the areas of social determinants of health, clinical care, health systems, public health, and international development, where health and/or access to health care is a primary outcome. The outcomes include a reporting guideline (CONSORT-equity extension) for equity-relevant RCTs and a knowledge translation strategy to broadly encourage its uptake and use by journal editors, authors, and funding agencies.

Assessing Protective Factors for Violence Risk in U.K. General Mental Health Services Using the Structured Assessment of Protective Factors.

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Haines, Alina; Brown, Andrew; Javaid, Syed Fahad; Khan, Fayyaz; Noblett, Steve; Omodunbi, Oladipupo; Sadiq, Khurram; Zaman, Wahid; Whittington, Richard

2017-12-01

Violence risk assessment and management are key tasks in mental health services and should be guided by validated instruments covering both risk and protective factors. This article is part of an international effort to validate the Structured Assessment of Protective Factors (SAPROF) for violence. The SAPROF, Historical, Clinical, Risk Management-20 (HCR-20) and the Psychopathy Checklist-Screening Version (PCL-SV) were administered in a sample of 261 patients in U.K. forensic, general inpatient, and community mental health settings. There was significant variation between these groups on SAPROF scores with fewer protective factors in the forensic group. The prospective validity of the SAPROF for nonviolence in the general inpatient and community samples was moderate (area under the curve [AUC] = .60). Adoption of the SAPROF or similar instruments as a supplement to risk-focused assessments has the potential to improve awareness of protective factors and enhance therapeutic engagement in a range of mental health services.

Improving the oral health of older people

DEFF Research Database (Denmark)

Petersen, Poul Erik; Yamamoto, Tatsuo

2005-01-01

changing burden of chronic diseases in old age. Chronic disease and most oral diseases share common risk factors. Globally, poor oral health amongst older people has been particularly evident in high levels of tooth loss, dental caries experience, and the prevalence rates of periodontal disease, xerostomia...... and oral precancer/cancer. The negative impact of poor oral conditions on the quality of life of older adults is an important public health issue, which must be addressed by policy-makers. The means for strengthening oral health programme implementation are available; the major challenge is therefore...... to translate knowledge into action programmes for the oral health of older people. The World Health Organization recommends that countries adopt certain strategies for improving the oral health of the elderly. National health authorities should develop policies and measurable goals and targets for oral health...

75 FR 70712 - General Conference Committee of the National Poultry Improvement Plan; Reestablishment

Science.gov (United States)

2010-11-18

...] General Conference Committee of the National Poultry Improvement Plan; Reestablishment AGENCY: Animal and... Poultry Improvement Plan (Committee) for a 2-year period. The Secretary of Agriculture has determined that.... Rhorer, Senior Coordinator, National Poultry Improvement Plan, VS, APHIS, USDA, Suite 101, 1498 Klondike...

Improving health visitor emollient prescribing using a CQUIN-based approach.

Science.gov (United States)

Brooks, Christina; Khatau, Tejas

2015-12-01

Prescribing is an essential element of health visiting practice. This initiative used the payment framework of Commissioning for Quality and Innovation (CQUIN) to develop health visiting practice across a large health visiting workforce in the East Midlands. A focus on emollient prescribing practice was agreed and a guidance booklet regarding preferred emollient products was produced, based on the local formulary Each health visitor benefitted from receiving additional training and was given a guidance booklet to inform their practice. Targets were set for each quarter to demonstrate an improved prescribing adherence to the preferred product list.The targets were achieved for each quarter. Prescribing rates and confidence improved across the service. Therefore, it was demonstrated that specific guidance and ongoing support can improve prescribing practice within the health visiting service.

Can We Improve Training for Health Professionals to Sustain Local Health Development?

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King, Stephen

2016-01-01

Can we improve training for health professionals? We explore specific variables that need to be accounted for to achieve sustainable local health development through training. A problem-based approach with appreciation of the need for making changes is suggested as the only authentic basis for training. PMID:28090174

Theoretical investigation of the upper and lower bounds of a generalized dimensionless bearing health indicator

Science.gov (United States)

Wang, Dong; Tsui, Kwok-Leung

2018-01-01

Bearing-supported shafts are widely used in various machines. Due to harsh working environments, bearing performance degrades over time. To prevent unexpected bearing failures and accidents, bearing performance degradation assessment becomes an emerging topic in recent years. Bearing performance degradation assessment aims to evaluate the current health condition of a bearing through a bearing health indicator. In the past years, many signal processing and data mining based methods were proposed to construct bearing health indicators. However, the upper and lower bounds of these bearing health indicators were not theoretically calculated and they strongly depended on historical bearing data including normal and failure data. Besides, most health indicators are dimensional, which connotes that these health indicators are prone to be affected by varying operating conditions, such as varying speeds and loads. In this paper, based on the principle of squared envelope analysis, we focus on theoretical investigation of bearing performance degradation assessment in the case of additive Gaussian noises, including distribution establishment of squared envelope, construction of a generalized dimensionless bearing health indicator, and mathematical calculation of the upper and lower bounds of the generalized dimensionless bearing health indicator. Then, analyses of simulated and real bearing run to failure data are used as two case studies to illustrate how the generalized dimensionless health indicator works and demonstrate its effectiveness in bearing performance degradation assessment. Results show that squared envelope follows a noncentral chi-square distribution and the upper and lower bounds of the generalized dimensionless health indicator can be mathematically established. Moreover, the generalized dimensionless health indicator is sensitive to an incipient bearing defect in the process of bearing performance degradation.

The Journey to Become a Health Literate Organization: A Snapshot of Health System Improvement

Science.gov (United States)

BRACH, Cindy

2017-01-01

A health literate health care organization is one that makes it easy for people to navigate, understand, and use information and services to take care of their health. This chapter explores the journey that a growing number of organizations are taking to become health literate. Health literacy improvement has increasingly been viewed as a systems issue, one that moves beyond siloed efforts by recognizing that action is required on multiple levels. To help operationalize the shift to a systems perspective, members of the National Academies Roundtable on Health Literacy defined ten attributes of health literate health care organizations. External factors, such as payment reform in the U.S., have buoyed health literacy as an organizational priority. Health care organizations often begin their journey to become health literate by conducting health literacy organizational assessments, focusing on written and spoken communication, and addressing difficulties in navigating facilities and complex systems. As organizations’ efforts mature, health literacy quality improvement efforts give way to transformational activities. These include: the highest levels of the organization embracing health literacy, making strategic plans for initiating and spreading health literate practices, establishing a health literacy workforce and supporting structures, raising health literacy awareness and training staff system-wide, expanding patient and family input, establishing policies, leveraging information technology, monitoring policy compliance, addressing population health, and shifting the culture of the organization. The penultimate section of this chapter highlights the experiences of three organizations that have explicitly set a goal to become health literate: Carolinas Healthcare System (CHS), Intermountain Healthcare, and Northwell Health. These organizations are pioneers that approached health literacy in a systematic fashion, each exemplifying different routes an

The Journey to Become a Health Literate Organization: A Snapshot of Health System Improvement.

Science.gov (United States)

Brach, Cindy

2017-01-01

A health literate health care organization is one that makes it easy for people to navigate, understand, and use information and services to take care of their health. This chapter explores the journey that a growing number of organizations are taking to become health literate. Health literacy improvement has increasingly been viewed as a systems issue, one that moves beyond siloed efforts by recognizing that action is required on multiple levels. To help operationalize the shift to a systems perspective, members of the U.S. National Academies of Sciences, Engineering, Medicine Roundtable on Health Literacy defined ten attributes of health literate health care organizations. External factors, such as payment reform in the U.S., have buoyed health literacy as an organizational priority. Health care organizations often begin their journey to become health literate by conducting health literacy organizational assessments, focusing on written and spoken communication, and addressing difficulties in navigating facilities and complex systems. As organizations' efforts mature, health literacy quality improvement efforts give way to transformational activities. These include: the highest levels of the organization embracing health literacy, making strategic plans for initiating and spreading health literate practices, establishing a health literacy workforce and supporting structures, raising health literacy awareness and training staff system-wide, expanding patient and family input, establishing policies, leveraging information technology, monitoring policy compliance, addressing population health, and shifting the culture of the organization. The penultimate section of this chapter highlights the experiences of three organizations that have explicitly set a goal to become health literate: Carolinas Healthcare System (CHS), Intermountain Healthcare, and Northwell Health. These organizations are pioneers that approached health literacy in a systematic fashion, each

Improving Work Functioning and Mental Health of Health Care Employees Using an E-Mental Health Approach to Workers' Health Surveillance: Pretest–Posttest Study

Directory of Open Access Journals (Sweden)

Sarah M. Ketelaar

2014-12-01

Conclusion: The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, because we found small effects and participation in the offered EMH interventions was low, there is ample room for improvement.

Effect of autogenic training on general improvement in patients with irritable bowel syndrome: a randomized controlled trial.

Science.gov (United States)

Shinozaki, Masae; Kanazawa, Motoyori; Kano, Michiko; Endo, Yuka; Nakaya, Naoki; Hongo, Michio; Fukudo, Shin

2010-09-01

Autogenic training (AT) is a useful and comprehensive relaxation technique. However, no studies have investigated the effects of AT on irritable bowel syndrome (IBS). In this study we tested the hypothesis that AT improves symptoms of IBS. Twenty-one patients with IBS were randomly assigned to AT (n = 11, 5 male, 6 female) or control therapy (n = 10, 5 male, 5 female). AT patients were trained intensively, while the control therapy consisted of discussions about patients' meal habits and life styles. All patients answered a question related to adequate relief (AR) of IBS symptoms and four questionnaires: Self-induced IBS Questionnaire (SIBSQ), Self-reported Depression Scale (SDS), State-Trait Anxiety Inventory (STAI), and Medical Outcome Short Form 36 Health Survey (SF-36). The proportion of AR in the last AT session in the AT group (9/11, 81.8%) was significantly higher than that in the controls (3/10, 30.0%, Chi-square test, p = 0.048). Two subscales of the SF-36, i.e., social functioning and bodily pain, were significantly improved in the AT group (p < 0.05) as compared to the control group. Role emotional (p = 0.051) and general health (p = 0.068) showed a tendency for improvement in the AT group. AT may be useful in the treatment of IBS by enhancing self-control.

Segmenting a general practitioner market to improve recruitment outcomes.

Science.gov (United States)

Hemphill, Elizabeth; Kulik, Carol T

2011-05-01

Recruitment is an ongoing challenge in the health industry with general practitioner (GP) shortages in many areas beyond rural and Indigenous communities. This paper suggests a marketing solution that identifies different segments of the GP market for recruitment strategy development. In February 2008, 96 GPs in Australia responded to a mail questionnaire (of which 85 questionnaires were useable). A total of 350 GPs were sent the questionnaire. Respondents considered small sets of attributes in the decision to accept a new job at a general practice and selected the most and least important attribute from each set. We identified latent class clusters (cohorts) of GPs from the most-least important data. Three cohorts were found in the GP market, distinguishing practitioners who emphasised job, family or practice attributes in their decision to join a practice. Few significant demographic differences exist between the cohorts. A segmented GP market suggests two alternative recruitment strategies. One option is for general practices to target members of a single cohort (family-, job-, or practice-focussed GPs). The other option is for general practices to diversify their recruitment strategies to target all three cohorts (family-, job- and practice-focussed GPs). A single brand (practice) can have multiple advertising strategies with each strategy involving advertising activities targeting a particular consumer segment.

Population health improvement: a community health business model that engages partners in all sectors.

Science.gov (United States)

Kindig, David A; Isham, George

2014-01-01

Because population health improvement requires action on multiple determinants--including medical care, health behaviors, and the social and physical environments--no single entity can be held accountable for achieving improved outcomes. Medical organizations, government, schools, businesses, and community organizations all need to make substantial changes in how they approach health and how they allocate resources. To this end, we suggest the development of multisectoral community health business partnership models. Such collaborative efforts are needed by sectors and actors not accustomed to working together. Healthcare executives can play important leadership roles in fostering or supporting such partnerships in local and national arenas where they have influence. In this article, we develop the following components of this argument: defining a community health business model; defining population health and the Triple Aim concept; reaching beyond core mission to help create the model; discussing the shift for care delivery beyond healthcare organizations to other community sectors; examining who should lead in developing the community business model; discussing where the resources for a community business model might come from; identifying that better evidence is needed to inform where to make cost-effective investments; and proposing some next steps. The approach we have outlined is a departure from much current policy and management practice. But new models are needed as a road map to drive action--not just thinking--to address the enormous challenge of improving population health. While we applaud continuing calls to improve health and reduce disparities, progress will require more robust incentives, strategies, and action than have been in practice to date. Our hope is that ideas presented here will help to catalyze a collective, multisectoral response to this critical social and economic challenge.

Valuation of scleroderma and psoriatic arthritis health states by the general public

Directory of Open Access Journals (Sweden)

Hays Ron D

2010-10-01

Full Text Available Abstract Objective Psoriatic arthritis (PsA and scleroderma (SSc are chronic rheumatic disorders with detrimental effects on health-related quality of life. Our objective was to assess health values (utilities from the general public for health states common to people with PsA and SSc for economic evaluations. Methods Adult subjects from the general population in a Midwestern city (N = 218 completed the SF-12 Health Survey and computer-assisted 0-100 rating scale (RS, time trade-off (TTO, range: 0.0-1.0 and standard gamble (SG, range: 0.0-1.0 utility assessments for several hypothetical PsA and SSc health states. Results Subjects included 135 (62% females, 143 (66% Caucasians, and 62 (28% African-Americans. The mean (SD scores for the SF-12 Physical Component Summary scale were 52.9 (8.3 and for the SF-12 Mental Component Summary scale were 49.0 (9.1, close to population norms. The mean RS, TTO, and SG scores for PsA health states varied with severity, ranging from 20.2 to 63.7 (14.4-20.3 for the RS 0.29 to 0.78 (0.24-0.31 for the TTO, and 0.48 to 0.82 (0.24-0.34 for the SG. The mean RS, TTO, and SG scores for SSc health states were 25.3-69.7 (15.2-16.3 for the RS, 0.36-0.80 (0.25-0.31 for the TTO, and 0.50-0.81 (0.26-0.32 for the SG, depending on disease severity. Conclusion Health utilities for PsA and SSc health states as assessed from the general public reflect the severity of the diseases. These descriptive findings could have implications regarding comparative effectiveness research for tests and treatments for PsA and SSc.

Health benefits from improved outdoor air quality and intervention in China

International Nuclear Information System (INIS)

Li, Shanshan; Williams, Gail; Guo, Yuming

2016-01-01

China is at its most critical stage of outdoor air quality management. In order to prevent further deterioration of air quality and to protect human health, the Chinese government has made a series of attempts to reduce ambient air pollution. Unlike previous literature reviews on the widespread hazards of air pollution on health, this review article firstly summarized the existing evidence of human health benefits from intermittently improved outdoor air quality and intervention in China. Contents of this paper provide concrete and direct clue that improvement in outdoor air quality generates various health benefits in China, and confirm from a new perspective that it is worthwhile for China to shift its development strategy from economic growth to environmental economic sustainability. Greater emphasis on sustainable environment design, consistently strict regulatory enforcement, and specific monitoring actions should be regarded in China to decrease the health risks and to avoid long-term environmental threats. - Highlights: • Firstly reviews the health benefits of improvement in outdoor air quality in China. • Reduction in air pollution generates various health benefits in China. • Chinese government should consider environmental economic sustainability. • Future research on health benefits of air quality improvement is proposed. - Improvement in outdoor air quality generates various health benefits in China. It is worthwhile for China to consider environmental economic sustainability.

'Just a lovely luxury?' What can public health attachments add to postgraduate general practice training?

Science.gov (United States)

Wills, Jane; Reynolds, Joanna; Swanwick, Tim

2009-07-01

Changing trends in the role of general practice and general practitioners (GPs), including a focus on commissioning and practice population health needs, were reflected in the specialty training curriculum published by the Royal College of General Practitioners (RCGP) in 2007. In response to these developments the London Deanery established training attachments to the public health departments of ten primary care trusts (PCTs) across London, incorporated into three-year GP specialty training programmes. These attachments were evaluated in 2008 by London South Bank University. The aims of the evaluation were to assess the attachment's suitability for addressing areas of the RCGP curriculum; and to explore perceptions of its value for GP training and for future practice. Semi-structured interviews were carried out with two cohorts of trainees towards the end of their public health attachment, and with public health trainers and GP training programme directors from participating schemes. The training attachments were generally considered to offer good opportunities for trainees to fulfil both public health competences and to address relevant areas of the RCGP curriculum, through a variety of types of work. However, this did not necessarily influence either the level of importance attributed to public health in comparison with other clinical training posts or the perceived impact of the attachment on the trainees' future practice as GPs. The reported learning outcomes and value of the attachment for the public health trainers and programme directors reflected the changing and perceived future demands on GPs, but these views were not generally shared by trainees. Public health attachments may offer general practice training programme opportunities for the development of skills and knowledge that are relevant to the changing nature of general practice. Yet, there still appears to be a barrier for trainee GPs in acknowledging their role in non-clinical, population

Improving the health of mental health staff through exercise interventions: a systematic review.

Science.gov (United States)

Fibbins, Hamish; Ward, Philip B; Watkins, Andrew; Curtis, Jackie; Rosenbaum, Simon

2018-04-01

Exercise interventions are efficacious in reducing cardiometabolic risk and improving symptoms in people with severe mental illness, yet evidence guiding the implementation and scalability of such efforts is lacking. Given increasing efforts to address the disparity in physical health outcomes facing people with a mental illness, novel approaches to increasing adoption of effective interventions are required. Exercise interventions targeting mental health staff may improve staff health while also creating more positive attitudes towards the role of lifestyle interventions for people experiencing mental illness. We aimed to determine the feasibility, acceptability and effectiveness of exercise interventions delivered to staff working in mental health services. A systematic review was conducted from database inception, until November 2017. Studies recruiting staff participants to receive an exercise intervention were eligible for inclusion. Five studies met the inclusion criteria. Physical health interventions for mental health staff were feasible and acceptable with low dropout rates. Reductions in anthropometric measures and work-related stress were reported. Limited evidence suggests that exercise interventions targeting mental health staff are feasible and acceptable. Further research is required to determine the efficacy of such interventions and the impact such strategies may have on staff culture and patient outcomes.

Health Effects of Job Insecurity among Employees in Swiss General Population

OpenAIRE

Gianfranco DOMENIGHETTI; Barbara D'AVANZO; Brigitte BISIG

1999-01-01

Objectives. To investigate at national level the association between health and the social distress in which the whole employed population is plunged as a consequence of job insecurity. Design. Cross-sectional study. Setting. Switzerland. Subjects. Individuals working full or part time as employees drawn from a random sample (N=2024) of the Swiss general population interviewed by phone. Main outcome measures. Prevalence rates of ten self reported health and health related behaviour indicators...

Commentary - Advancing health equity to improve health: the time is now

Directory of Open Access Journals (Sweden)

B. Jackson

2016-02-01

Full Text Available Health inequities, or avoidable inequalities in health between groups of people, are increasingly recognized and tackled to improve public health. Canada’s interest in health inequities goes back over 40 years, with the landmark 1974 Lalonde report, and continues with the 2011 Rio Political Declaration on Social Determinants of Health, which affirmed a global political commitment to implementing a social determinants of health approach to reducing health inequities. Research in this area includes documenting and tracking health inequalities, exploring their multidimensional causes, and developing and evaluating ways to address them. Inequalities can be observed in who is vulnerable to infectious and chronic diseases, the impact of health promotion and disease prevention efforts, how disease progresses, and the outcomes of treatment. Many programs, policies and projects with potential impacts on health equity and determinants of health have been implemented across Canada. Recent theoretical and methodological advances in the areas of implementation science and population health intervention research have strengthened our capacity to develop effective interventions. With the launch of a new health equity series this month, the journals Canada Communicable Disease Report and Health Promotion and Chronic Disease Prevention in Canada will continue to reflect and foster analysis of social determinants of health and focus on intervention studies that advance health equity.

Are Health State Valuations from the General Public Biased? A Test of Health State Reference Dependency Using Self-assessed Health and an Efficient Discrete Choice Experiment.

Science.gov (United States)

Jonker, Marcel F; Attema, Arthur E; Donkers, Bas; Stolk, Elly A; Versteegh, Matthijs M

2017-12-01

Health state valuations of patients and non-patients are not the same, whereas health state values obtained from general population samples are a weighted average of both. The latter constitutes an often-overlooked source of bias. This study investigates the resulting bias and tests for the impact of reference dependency on health state valuations using an efficient discrete choice experiment administered to a Dutch nationally representative sample of 788 respondents. A Bayesian discrete choice experiment design consisting of eight sets of 24 (matched pairwise) choice tasks was developed, with each set providing full identification of the included parameters. Mixed logit models were used to estimate health state preferences with respondents' own health included as an additional predictor. Our results indicate that respondents with impaired health worse than or equal to the health state levels under evaluation have approximately 30% smaller health state decrements. This confirms that reference dependency can be observed in general population samples and affirms the relevance of prospect theory in health state valuations. At the same time, the limited number of respondents with severe health impairments does not appear to bias social tariffs as obtained from general population samples. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Groups 4 Health: Evidence that a social-identity intervention that builds and strengthens social group membership improves mental health.

Science.gov (United States)

Haslam, Catherine; Cruwys, Tegan; Haslam, S Alexander; Dingle, Genevieve; Chang, Melissa Xue-Ling

2016-04-01

Social isolation and disconnection have profound negative effects on mental health, but there are few, if any, theoretically-derived interventions that directly target this problem. We evaluate a new intervention, Groups 4 Health (G4H), a manualized 5-module psychological intervention that targets the development and maintenance of social group relationships to treat psychological distress arising from social isolation. G4H was tested using a non-randomized control design. The program was delivered to young adults presenting with social isolation and affective disturbance. Primary outcome measures assessed mental health (depression, general anxiety, social anxiety, and stress), well-being (life satisfaction, self-esteem) and social connectedness (loneliness, social functioning). Our secondary goal was to assess whether mechanisms of social identification were responsible for changes in outcomes. G4H was found to significantly improve mental health, well-being, and social connectedness on all measures, both on program completion and 6-month follow-up. In line with social identity theorizing, analysis also showed that improvements in depression, anxiety, stress, loneliness, and life satisfaction were underpinned by participants' increased identification both with their G4H group and with multiple groups. This study provides preliminary evidence of the potential value of G4H and its underlying mechanisms, but further examination is required in other populations to address issues of generalizability, and in randomized controlled trials to address its wider efficacy. Results of this pilot study confirm that G4H has the potential to reduce the negative health-related consequences of social disconnection. Future research will determine its utility in wider community contexts. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Developing a taxonomy for the science of improvement in public health.

Science.gov (United States)

Riley, William; Lownik, Beth; Halverson, Paul; Parrotta, Carmen; Godsall, Jonathan R; Gyllstrom, Elizabeth; Gearin, Kimberly J; Mays, Glen

2012-11-01

Quality improvement (QI) methods have been used for almost a decade in public health departments to increase effectiveness and efficiency. Although results are rapidly accumulating, the evidence for the science of improvement is shallow and limited. To advance the use and effectiveness of QI in public health, it is important to develop a science of improvement using practice-based research to build an evidence base for QI projects. This purpose of this study is to advance the science of improvement in public health departments with 3 objectives: (1) establish a taxonomy of QI projects in public health, (2) categorize QI projects undertaken in health departments using the taxonomy, and (3) create an opportunity modes and effects analysis. This study is a qualitative analysis of archival data from 2 separate large databases consisting of 51 QI projects undertaken in public health departments over the last 5 years. The study involves 2 separate QI collaboratives. One includes Minnesota health departments; the other is a national collaborative. We propose a standardized case definition, common metrics, and a taxonomy of QI projects to begin building the evidence base for QI in public health and to advance the science of continuous quality improvement. All projects created an aim statement and used metrics while 53% used a specific QI model with an average of 3.25 QI techniques per project. Approximately 40% of the projects incorporated a process control methodology, and 60% of the projects identified the process from beginning to end, while 11 of 12 PHAB (Public Health Accreditation Board) domains were included. The findings provide a baseline for QI taxonomy to operationalize a science of improvement for public health departments.

Evaluation of two communication strategies to improve udder health management

NARCIS (Netherlands)

Jansen, J.; Renes, R.J.; Lam, T.J.G.M.

2010-01-01

Worldwide, programs to improve udder health are implemented using communication tools and methods that inform and persuade dairy farmers. This study evaluated 2 communication strategies used in a mastitis control program in the Netherlands. To improve farmers’ udder health management, tools such as

75 FR 23222 - National Poultry Improvement Plan; General Conference Committee Meeting and 40th Biennial Conference

Science.gov (United States)

2010-05-03

...] National Poultry Improvement Plan; General Conference Committee Meeting and 40th Biennial Conference AGENCY... notice of a meeting of the General Conference Committee of the National Poultry Improvement Plan (NPIP... Coordinator, National Poultry Improvement Plan, VS, APHIS, 1498 Klondike Road, Suite 101, Conyers, GA 30094...

77 FR 46374 - National Poultry Improvement Plan; General Conference Committee Meeting and 41st Biennial Conference

Science.gov (United States)

2012-08-03

...] National Poultry Improvement Plan; General Conference Committee Meeting and 41st Biennial Conference AGENCY... notice of a meeting of the General Conference Committee of the National Poultry Improvement Plan (NPIP... CONTACT: Dr. C. Stephen Roney, Senior Coordinator, National Poultry Improvement Plan, VS, APHIS, 1506...

Improving somatic health of outpatients with severe mental illness

NARCIS (Netherlands)

Van Hasselt, Fenneke M.; Oud, Marian J. T.; Krabbe, Paul F. M.; Postma, Maarten J.; Loonen, A.J.M.

2014-01-01

Background: Patients with severe mental illness (SMI) experience a 13-to 30-year reduction in life expectancy compared with the general population. The majority of these deaths can be attributed to somatic health problems. The risk on somatic health problems is partly increased due to a reduced

Can action research strengthen district health management and improve health workforce performance? A research protocol.

Science.gov (United States)

Mshelia, C; Huss, R; Mirzoev, T; Elsey, H; Baine, S O; Aikins, M; Kamuzora, P; Bosch-Capblanch, X; Raven, J; Wyss, K; Green, A; Martineau, T

2013-08-30

The single biggest barrier for countries in sub-Saharan Africa (SSA) to scale up the necessary health services for addressing the three health-related Millennium Development Goals and achieving Universal Health Coverage is the lack of an adequate and well-performing health workforce. This deficit needs to be addressed both by training more new health personnel and by improving the performance of the existing and future health workforce. However, efforts have mostly been focused on training new staff and less on improving the performance of the existing health workforce. The purpose of this paper is to disseminate the protocol for the PERFORM project and reflect on the key challenges encountered during the development of this methodology and how they are being overcome. The overall aim of the PERFORM project is to identify ways of strengthening district management in order to address health workforce inadequacies by improving health workforce performance in SSA. The study will take place in three districts each in Ghana, Tanzania and Uganda using an action research approach. With the support of the country research teams, the district health management teams (DHMTs) will lead on planning, implementation, observation, reflection and redefinition of the activities in the study. Taking into account the national and local human resource (HR) and health systems (HS) policies and practices already in place, 'bundles' of HR/HS strategies that are feasible within the context and affordable within the districts' budget will be developed by the DHMTs to strengthen priority areas of health workforce performance. A comparative analysis of the findings from the three districts in each country will add new knowledge on the effects of these HR/HS bundles on DHMT management and workforce performance and the impact of an action research approach on improving the effectiveness of the DHMTs in implementing these interventions. Different challenges were faced during the development of

Deciphering the imperative: translating public health quality improvement into organizational performance management gains.

Science.gov (United States)

Beitsch, Leslie M; Yeager, Valerie A; Moran, John

2015-03-18

With the launching of the national public health accreditation program under the auspices of the Public Health Accreditation Board (PHAB), health department momentum around quality improvement adoption has accelerated. Domain 9 of the PHAB standards (one of 12 domains) focuses on evaluation and improvement of performance and is acting as a strong driver for quality improvement and performance management implementation within health departments. Widespread adoption of quality improvement activities in public health trails that in other US sectors. Several performance management models have received broad acceptance, including models among government and nonprofits. A model specifically for public health has been developed and is presented herein. All models in current use reinforce customer focus; streamlined, value-added processes; and strategic alignment. All are structured to steer quality improvement efforts toward organizational priorities, ensuring that quality improvement complements performance management. High-performing health departments harness the synergy of quality improvement and performance management, providing powerful tools to achieve public health strategic imperatives.

Systematic review of physical activity and exercise interventions to improve health, fitness and well-being of children and young people who use wheelchairs.

Science.gov (United States)

O'Brien, Thomas D; Noyes, Jane; Spencer, Llinos Haf; Kubis, Hans-Peter; Hastings, Richard P; Whitaker, Rhiannon

2016-01-01

To perform a systematic review establishing the current evidence base for physical activity and exercise interventions that promote health, fitness and well-being, rather than specific functional improvements, for children who use wheelchairs. A systematic review using a mixed methods design. A wide range of databases, including Web of Science, PubMed, BMJ Best Practice, NHS EED, CINAHL, AMED, NICAN, PsychINFO, were searched for quantitative, qualitative and health economics evidence. participants: children/young people aged >25 years who use a wheelchair, or parents and therapists/carers. Intervention: home-based or community-based physical activity to improve health, fitness and well-being. Thirty quantitative studies that measured indicators of health, fitness and well-being and one qualitative study were included. Studies were very heterogeneous preventing a meta-analysis, and the risk of bias was generally high. Most studies focused on children with cerebral palsy and used an outcome measure of walking or standing, indicating that they were generally designed for children with already good motor function and mobility. Improvements in health, fitness and well-being were found across the range of outcome types. There were no reports of negative changes. No economics evidence was found. It was found that children who use wheelchairs can participate in physical activity interventions safely. The paucity of robust studies evaluating interventions to improve health and fitness is concerning. This hinders adequate policymaking and guidance for practitioners, and requires urgent attention. However, the evidence that does exist suggests that children who use wheelchairs are able to experience the positive benefits associated with appropriately designed exercise. CRD42013003939.

Social marketing meets health literacy: Innovative improvement of health care providers’ comfort with patient interaction

Science.gov (United States)

Primack, Brian A.; Bui, Thuy; Fertman, Carl I.

2010-01-01

Objective It is essential to train health care providers to deliver care sensitive to the needs of diverse individuals with varying degrees of health literacy. We aimed to evaluate an innovative, theory-based, educational intervention involving social marketing and health literacy. Methods In 2006 at a large medical school, all first-year students were exposed to the intervention. They completed pre- and post-test anonymous surveys including demographic data, covariates, and key outcome variables. Paired t-tests and multiple linear regression were used to evaluate the intervention and to determine independent associations among the key outcome variables. Results Post-intervention scores were significantly higher than pre-intervention scores for social marketing (3.31 versus 1.90, p marketing and health literacy can improve skills that improve medical students’ comfort with patients of diverse backgrounds. Practice implications Health care providers can be taught educational principles and skills involved in developing effective patient education materials. These skills may improve providers’ comfort with direct patient interaction. PMID:17418522

Holistic self-management education and support: a proposed public health model for improving women's health in Zimbabwe.

Science.gov (United States)

Kanchense, Jane Handina Murigwa

2006-08-01

The primary health care model of public health has been implemented in many countries around the globe since the Declaration of Alma Ata in 1978, without pilot testing the primary health care model. Therefore, many public health researchers have sought methods of improving primary health care by creating evidence-based models. Many of these researchers recognize the role of behavioral models in public health. These offshoots of primary health care include the ecological, care, central human capabilities, and the SPECIES models. Holistic self-management education and support is a capacity-building philosophy that ensures active involvement of consumers of health care in the planning and implementation and evaluation of health care services. It helps consumers of health care to achieve the desired improved quality of health and life in managing and sustaining their health at the grassroots level. The care model addresses disease management ideals of the in the original primary health care model. The SPECIES model addresses those aspects of the primary health care model that include the cultural and social factors, as well as individual health education and support in the original primary health care model. The ecological model offers an improvement of the socioeconomic ideal in the original primary health care model. Improving the health of individuals will prevent illness, thereby reducing health care costs and lessening the current strain on an overburdened health care system in Zimbabwe. Holistic self-management education and support links health care delivery systems with social processes. It is a best practices model that could better serve Zimbabwean girls and women by contributing positively to the national challenges in health care, thereby meeting the Zimbabwean primary health care and safe motherhood goals. It is here recommended that holistic self-management education and support must be pilot tested before being adopted as the most appropriate model for

The relationship between lifestyle, occupational health, and work-related factors with presenteeism amongst general practitioners.

Science.gov (United States)

Pit, Sabrina Winona; Hansen, Vibeke

2016-01-01

There is evidence that general practitioners (GPs) are more likely to exhibit sickness presenteeism than other health professional groups or other high-income earners and less likely to take sick leave. This study aims to examine the relationship between lifestyle, occupational health, and work-related factors with presenteeism amongst GPs. A cross-sectional study was conducted amongst GPs in 2011. Logistic regression was used to determine crude and adjusted odds ratios between lifestyle, occupational health, and work-related factors with presenteeism. Whilst adjusting for age and gender, exercising 1 to 3 times a week (odds ratio [OR] = 4.88), not having a good work-life balance (OR = 4.2), work-related sleep problems (OR = 2.55), moderate psychological distress (OR = 3.94), and poor or fair health (OR = 6.22) were associated with presenteeism. Increased burnout and reduced job satisfaction and workability due to the physical demands of the job were also associated with presenteeism. In conclusion, presenteeism amongst GPs can be addressed by implementing interventions in relation to physical activity, stress reduction, and sleep hygiene and improving work-life balance and the physical demands of the job.

Generalization in the XCSF classifier system: analysis, improvement, and extension.

Science.gov (United States)

Lanzi, Pier Luca; Loiacono, Daniele; Wilson, Stewart W; Goldberg, David E

2007-01-01

We analyze generalization in XCSF and introduce three improvements. We begin by showing that the types of generalizations evolved by XCSF can be influenced by the input range. To explain these results we present a theoretical analysis of the convergence of classifier weights in XCSF which highlights a broader issue. In XCSF, because of the mathematical properties of the Widrow-Hoff update, the convergence of classifier weights in a given subspace can be slow when the spread of the eigenvalues of the autocorrelation matrix associated with each classifier is large. As a major consequence, the system's accuracy pressure may act before classifier weights are adequately updated, so that XCSF may evolve piecewise constant approximations, instead of the intended, and more efficient, piecewise linear ones. We propose three different ways to update classifier weights in XCSF so as to increase the generalization capabilities of XCSF: one based on a condition-based normalization of the inputs, one based on linear least squares, and one based on the recursive version of linear least squares. Through a series of experiments we show that while all three approaches significantly improve XCSF, least squares approaches appear to be best performing and most robust. Finally we show how XCSF can be extended to include polynomial approximations.

Indicators for continuous quality improvement for otitis media in primary health care for Aboriginal and Torres Strait Islander children.

Science.gov (United States)

Sibthorpe, Beverly; Agostino, Jason; Coates, Harvey; Weeks, Sharon; Lehmann, Deborah; Wood, Marianne; Lannigan, Francis; McAullay, Daniel

2017-04-01

Otitis media is a common, generally self-limiting childhood illness that can progress to severe disease and have lifelong sequelae, including hearing loss and developmental delays. Severe disease is disproportionately prevalent among Aboriginal and Torres Strait Islander children. Primary health care is at the frontline of appropriate prevention and treatment. Continuous quality improvement in the prevention and management of important causes of morbidity in client populations is accepted best practice in primary health care and now a requirement of Australian Government funding to services providing care for Aboriginal and Torres Strait Islander children. To date, there have been no indicators for continuous quality improvement in the prevention and management of otitis media and its sequelae in primary health care. Through an expert group consensus process, seven evidence-based indicators, potentially extractable from electronic health records, have been developed. The development process and indicators are described.

Benefits and harms of general health checks- lifelong learning in general practice: how to read and use scientific literature

DEFF Research Database (Denmark)

Arreskov, Anne Beiter; Graungaard, Anette Hauskov; Nielsen, Kirsten Lykke

the paper using the method of critical appraisal. Session content The didactic method used in the workshop is mostly small group activities with eight participants and two tutors in each group. The participants will receive two scientific papers: the BMJ-version of the Cochrane review about general health......Abstract title: Benefits and harms of general health checks - lifelong learning in general practice: how to read and use scientific literature Objectives After this workshop the participants will know the basics of how to read a systematic literature review and interpret a meta-analysis and be able......, assesses, and implements methods of diagnosis and treatment on the basis of the best available current research, clinical expertise, and combines this with the needs and preferences of the patient, is termed evidence-based medicine. By learning and practising the principles of evidence-based medicine, GPs...

Debt Collection: More Aggressive Action Needed To Collect Debts Owed by Health Professionals. United States General Accounting Office Report to the Honorable John R. Kasich, House of Representatives.

Science.gov (United States)

General Accounting Office, Washington, DC.

The General Accounting Office (GAO) reviewed and evaluated debt collection activities of five programs of the Health Resources and Services Administration (HRSA) that provide financial assistance to health professions students and medical facilities. The principal findings include: (1) HRSA changes have improved delinquency rates; however, large…

Asking about Sex in General Health Surveys: Comparing the Methods and Findings of the 2010 Health Survey for England with Those of the Third National Survey of Sexual Attitudes and Lifestyles.

Directory of Open Access Journals (Sweden)

Philip Prah

Full Text Available Including questions about sexual health in the annual Health Survey for England (HSE provides opportunities for regular measurement of key public health indicators, augmenting Britain's decennial National Survey of Sexual Attitudes and Lifestyles (Natsal. However, contextual and methodological differences may limit comparability of the findings. We examine the extent of these differences between HSE 2010 and Natsal-3 and investigate their impact on parameter estimates.Complex survey analyses of data from men and women in the 2010 HSE (n = 2,782 men and 3,588 women and Natsal-3 undertaken 2010-2012 (n = 4,882 men and 6,869 women aged 16-69y and resident in England, both using probability sampling, compared their characteristics, the amount of non-response to, and estimates from, sexual health questions. Both surveys used self-completion for the sexual behaviour questions but this was via computer-assisted self-interview (CASI in Natsal-3 and a pen-and-paper questionnaire in HSE 2010.The surveys achieved similar response rates, both around 60%, and demographic profiles largely consistent with the census, although HSE participants tended to be less educated, and reported worse general health, than Natsal-3 participants. Item non-response to the sexual health questions was typically higher in HSE 2010 (range: 9-18% relative to Natsal-3 (all <5%. Prevalence estimates for sexual risk behaviours and STI-related indicators were generally slightly lower in HSE 2010 than Natsal-3.While a relatively high response to sexual health questions in HSE 2010 demonstrates the feasibility of asking such questions in a general health survey, differences with Natsal-3 do exist. These are likely due to the HSE's context as a general health survey and methodological limitations such as its current use of pen-and-paper questionnaires. Methodological developments to the HSE should be considered so that its data can be interpreted in combination with those from dedicated

Improving work functioning and mental health of health care employees using an e-mental health approach to workers' health surveillance: pretest-posttest study.

Science.gov (United States)

Ketelaar, Sarah M; Nieuwenhuijsen, Karen; Bolier, Linda; Smeets, Odile; Sluiter, Judith K

2014-12-01

Mental health complaints are quite common in health care employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers' health surveillance (WHS) for nurses and allied health professionals. Using the waiting-list group of a previous randomized controlled trial with high dropout and low compliance to the intervention, we studied the pre- and posteffects of the EMH approach in a larger group of participants. We applied a pretest-posttest study design. The WHS consisted of online screening on impaired work functioning and mental health followed by online automatically generated personalized feedback, online tailored advice, and access to self-help EMH interventions. The effects on work functioning, stress, and work-related fatigue after 3 months were analyzed using paired t tests and effect sizes. One hundred and twenty-eight nurses and allied health professionals participated at pretest as well as posttest. Significant improvements were found on work functioning (p = 0.01) and work-related fatigue (p Work functioning had relevantly improved in 30% of participants. A small meaningful effect on stress was found (Cohen d = .23) in the participants who had logged onto an EMH intervention (20%, n = 26). The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, because we found small effects and participation in the offered EMH interventions was low, there is ample room for improvement.

Workplace Safety and Health Improvements Through a Labor/Management Training and Collaboration

Science.gov (United States)

Mahan, Bruce; Morawetz, John; Ruttenberg, Ruth; Workman, Rick

2014-01-01

Seven hundred thirty-nine workers at Merck's Stonewall plant in Elkton, Virginia, have a safer and healthier workplace because four of them were enthusiastic about health and safety training they received from the union's training center in Cincinnati, Ohio. What emerged was not only that all 739 plant employees received OSHA 10-hour General Industry training, but that it was delivered by “OSHA-authorized” members of the International Chemical Workers Union Council who worked at the plant. Merck created a new fulltime position in its Learning and Development Department and hired one of the four workers who had received the initial training. Strong plant leadership promoted discussions both during the training, in evaluation, and in newly energized joint labor-management meetings following the training. These discussions identified safety and health issues needing attention. Then, in a new spirit of trust and collaboration, major improvements occurred. PMID:24704812

Workplace safety and health improvements through a labor/management training and collaboration.

Science.gov (United States)

Mahan, Bruce; Morawetz, John; Ruttenberg, Ruth; Workman, Rick

2013-01-01

Seven hundred thirty-nine workers at Merck's Stonewall plant in Elkton, Virginia, have a safer and healthier workplace because four of them were enthusiastic about health and safety training they received from the union's training center in Cincinnati, Ohio. What emerged was not only that all 739 plant employees received OSHA 10-hour General Industry training, but that it was delivered by "OSHA-authorized" members of the International Chemical Workers Union Council who worked at the plant. Merck created a new full-time position in its Learning and Development Department and filled it with one of the four workers who had received the initial training. Strong plant leadership promoted discussions both during the training, in evaluation, and in newly energized joint labor-management meetings following the training. These discussions identified safety and health issues needing attention. Then, in a new spirit of trust and collaboration, major improvements occurred.

Prioritizing health disparities in medical education to improve care

Science.gov (United States)

Awosogba, Temitope; Betancourt, Joseph R.; Conyers, F. Garrett; Estapé, Estela S.; Francois, Fritz; Gard, Sabrina J.; Kaufman, Arthur; Lunn, Mitchell R.; Nivet, Marc A.; Oppenheim, Joel D.; Pomeroy, Claire; Yeung, Howa

2015-01-01

Despite yearly advances in life-saving and preventive medicine, as well as strategic approaches by governmental and social agencies and groups, significant disparities remain in health, health quality, and access to health care within the United States. The determinants of these disparities include baseline health status, race and ethnicity, culture, gender identity and expression, socioeconomic status, region or geography, sexual orientation, and age. In order to renew the commitment of the medical community to address health disparities, particularly at the medical school level, we must remind ourselves of the roles of doctors and medical schools as the gatekeepers and the value setters for medicine. Within those roles are responsibilities toward the social mission of working to eliminate health disparities. This effort will require partnerships with communities as well as with academic centers to actively develop and to implement diversity and inclusion strategies. Besides improving the diversity of trainees in the pipeline, access to health care can be improved, and awareness can be raised regarding population-based health inequalities. PMID:23659676

Prioritizing health disparities in medical education to improve care.